Science.gov

Sample records for advanced plume treatment

  1. Radiation from advanced solid rocket motor plumes

    NASA Astrophysics Data System (ADS)

    Farmer, Richard C.; Smith, Sheldon D.; Myruski, Brian L.

    1994-12-01

    The overall objective of this study was to develop an understanding of solid rocket motor (SRM) plumes in sufficient detail to accurately explain the majority of plume radiation test data. Improved flowfield and radiation analysis codes were developed to accurately and efficiently account for all the factors which effect radiation heating from rocket plumes. These codes were verified by comparing predicted plume behavior with measured NASA/MSFC ASRM test data. Upon conducting a thorough review of the current state-of-the-art of SRM plume flowfield and radiation prediction methodology and the pertinent data base, the following analyses were developed for future design use. The NOZZRAD code was developed for preliminary base heating design and Al2O3 particle optical property data evaluation using a generalized two-flux solution to the radiative transfer equation. The IDARAD code was developed for rapid evaluation of plume radiation effects using the spherical harmonics method of differential approximation to the radiative transfer equation. The FDNS CFD code with fully coupled Euler-Lagrange particle tracking was validated by comparison to predictions made with the industry standard RAMP code for SRM nozzle flowfield analysis. The FDNS code provides the ability to analyze not only rocket nozzle flow, but also axisymmetric and three-dimensional plume flowfields with state-of-the-art CFD methodology. Procedures for conducting meaningful thermo-vision camera studies were developed.

  2. Radiation from advanced solid rocket motor plumes

    NASA Technical Reports Server (NTRS)

    Farmer, Richard C.; Smith, Sheldon D.; Myruski, Brian L.

    1994-01-01

    The overall objective of this study was to develop an understanding of solid rocket motor (SRM) plumes in sufficient detail to accurately explain the majority of plume radiation test data. Improved flowfield and radiation analysis codes were developed to accurately and efficiently account for all the factors which effect radiation heating from rocket plumes. These codes were verified by comparing predicted plume behavior with measured NASA/MSFC ASRM test data. Upon conducting a thorough review of the current state-of-the-art of SRM plume flowfield and radiation prediction methodology and the pertinent data base, the following analyses were developed for future design use. The NOZZRAD code was developed for preliminary base heating design and Al2O3 particle optical property data evaluation using a generalized two-flux solution to the radiative transfer equation. The IDARAD code was developed for rapid evaluation of plume radiation effects using the spherical harmonics method of differential approximation to the radiative transfer equation. The FDNS CFD code with fully coupled Euler-Lagrange particle tracking was validated by comparison to predictions made with the industry standard RAMP code for SRM nozzle flowfield analysis. The FDNS code provides the ability to analyze not only rocket nozzle flow, but also axisymmetric and three-dimensional plume flowfields with state-of-the-art CFD methodology. Procedures for conducting meaningful thermo-vision camera studies were developed.

  3. ASRM radiation and flowfield prediction status. [Advanced Solid Rocket Motor plume radiation prediction

    NASA Technical Reports Server (NTRS)

    Reardon, J. E.; Everson, J.; Smith, S. D.; Sulyma, P. R.

    1991-01-01

    Existing and proposed methods for the prediction of plume radiation are discussed in terms of their application to the NASA Advanced Solid Rocket Motor (ASRM) and Space Shuttle Main Engine (SSME) projects. Extrapolations of the Solid Rocket Motor (SRM) are discussed with respect to preliminary predictions of the primary and secondary radiation environments. The methodology for radiation and initial plume property predictions are set forth, including a new code for scattering media and independent secondary source models based on flight data. The Monte Carlo code employs a reverse-evaluation approach which traces rays back to their point of absorption in the plume. The SRM sea-level plume model is modified to account for the increased radiation in the ASRM plume due to the ASRM's propellant chemistry. The ASRM cycle-1 environment predictions are shown to identify a potential reason for the shutdown spike identified with pre-SRM staging.

  4. Advances in Optical Characterization of Methane Seeps and Bubble Plumes

    NASA Astrophysics Data System (ADS)

    Pizarro, O.; Farr, N.; Camilli, R.; Whelan, J.; Martens, C.; Goudreau, J.; Mendlovitz, H.; Camilli, L.

    2005-12-01

    Methane seeps are potentially a key contributor to the atmospheric methane reservoir and to the global greenhouse gas budget. Improved estimates of methane flux from ocean floor seeps are required to understand the magnitude and characteristics of this potential source. At less active, deep water seeps a large portion of the migrating gas is dissolved and oxidized before reaching the surface. However, in high-intensity, shallow water methane seeps the bubble density, speed and size are such that a significant fraction of the gas may reach the atmosphere. New types of in-situ chemical sensors are now available to quickly and reliably quantify dissolved methane throughout the water column. However, quantifying methane within the water column in the free gas phase (i.e., in bubbles) remains a challenging problem. Current approaches rely either on indirect acoustic methods or direct collection of bubbles. Acoustic methods have the disadvantage of requiring extensive calibration, and can fail to distinguish the bubble signal from other sources of acoustic noise. Gas-capture techniques are mechanically complex, have a surface expression that introduces some noise, and can potentially alias episodic events. In both cases the fine scale structure such as heterogeneity of the rising bubbling plume is lost. We describe a vision-based system to characterize bubble plumes and the seep features from which they emanate. Video-rate optical imagery from 3 cameras is used to generate precise measurements of the motion of bubbles. Lighting is provided by a distributed array of LED modules synchronized to the cameras. In order to conserve power and extend deployment times the system can be configured to be dormant until triggered by chemical sensors indicating high concentrations of methane. Plume characterization is based on the identification of the individual bubbles (and rejection of other particles). Additional image processing steps are then used to estimate each bubble

  5. Advances in Alcoholism Treatment

    PubMed Central

    Huebner, Robert B.; Kantor, Lori Wolfgang

    2011-01-01

    Researchers are working on numerous and varied approaches to improving the accessibility, quality, effectiveness, and cost-effectiveness of treatment for alcohol use disorders (AUDs). This overview article summarizes the approaches reviewed in this issue, including potential future developments for alcoholism treatment, such as medications development, behavioral therapy, advances in technology that are being used to improve treatment, integrated care of patients with AUDs and co-occurring disorders, the role of 12-step programs in the broader realm of treatment, treating patients with recurring and chronic alcohol dependence, strategies to close the gap between treatment need and treatment utilization, and how changes in the health care system may affect the delivery of treatment. This research will not only reveal new medications and behavioral therapies but also will contribute to new ways of approaching current treatment problems. PMID:23580014

  6. Achalasia: advances in treatment.

    PubMed

    Schoenberg, Markus Bo; Vassiliou, Melina Catherine; von Renteln, Daniel

    2014-09-01

    Achalasia is a primary esophageal motility disorder, which shows distinct clinical, manometric, radiologic, and pathologic features. Available treatment strategies are pharmacological, endoscopic or surgical. In the past decades preferred treatment has alternated between surgical myotomy (presently Laparoscopic Heller Myotomy [LHM]) and endoscopic balloon dilation (EBD). While surgical myotomy promises superior long-term results and significantly less retreatment, endoscopic balloon dilation is initially far less invasive and yields comparable results after redilation. Peroral Endoscopic Myotomy (POEM) aims to combine the minimal invasive approach through the mouth with the better long-term results after LHM. Initial findings in the literature point to comparable success-rates after POEM and LHM. In the literature complication rates are similar to those obtained after surgery. This new interventional technique should be subject to randomized controlled trials and compared to EBD and LHM.

  7. Behavior of a chlorinated ethene plume following source-area treatment with Fenton's reagent

    USGS Publications Warehouse

    Chapelle, F.H.; Bradley, P.M.; Casey, C.C.

    2005-01-01

    Monitoring data collected over a 6-year period show that a plume of chlorinated ethene-contaminated ground water has contracted significantly following treatment of the contaminant source area using in situ oxidation. Prior to treatment (1998), concentrations of perchloroethene (PCE) exceeded 4500 ??g/L in a contaminant source area associated with a municipal landfill in Kings Bay, Georgia. The plume emanating from this source area was characterized by vinyl chloride (VC) concentrations exceeding 800 ??g/L. In situ oxidation using Fenton's reagent lowered PCE concentrations in the source area below 100 ??g/L, and PCE concentrations have not rebounded above this level since treatment. In the 6 years following treatment, VC concentrations in the plume have decreased significantly. These concentration declines can be attributed to the movement of Fenton's reagent-treated water downgradient through the system, the cessation of a previously installed pump-and-treat system, and the significant natural attenuation capacity of this anoxic aquifer. While in situ oxidation briefly decreased the abundance and activity of microorganisms in the source area, this activity rebounded in <6 months. Nevertheless, the shift from sulfate-reducing to Fe(III)-reducing conditions induced by Fenton's treatment may have decreased the efficiency of reductive dechlorination in the injection zone. The results of this study indicate that source-area removal actions, particularly when applied to ground water systems that have significant natural attenuation capacity, can be effective in decreasing the areal extent and contaminant concentrations of chlorinated ethene plumes. Copyright ?? 2005 National Ground Water Association.

  8. Advances in the Validation of Satellite-Based Maps of Volcanic Sulfur Dioxide Plumes

    NASA Astrophysics Data System (ADS)

    Realmuto, V. J.; Berk, A.; Acharya, P. K.; Kennett, R.

    2013-12-01

    The monitoring of volcanic gas emissions with gas cameras, spectrometer arrays, tethersondes, and UAVs presents new opportunities for the validation of satellite-based retrievals of gas concentrations. Gas cameras and spectrometer arrays provide instantaneous observations of the gas burden, or concentration along an optical path, over broad sections of a plume, similar to the observations acquired by nadir-viewing satellites. Tethersondes and UAVs provide us with direct measurements of the vertical profiles of gas concentrations within plumes. This presentation will focus on our current efforts to validate ASTER-based maps of sulfur dioxide plumes at Turrialba and Kilauea Volcanoes (located in Costa Rica and Hawaii, respectively). These volcanoes, which are the subjects of comprehensive monitoring programs, are challenging targets for thermal infrared (TIR) remote sensing due the warm and humid atmospheric conditions. The high spatial resolution of ASTER in the TIR (90 meters) allows us to map the plumes back to their source vents, but also requires us to pay close attention to the temperature and emissivity of the surfaces beneath the plumes. Our knowledge of the surface and atmospheric conditions is never perfect, and we employ interactive mapping techniques that allow us to evaluate the impact of these uncertainties on our estimates of plume composition. To accomplish this interactive mapping we have developed the Plume Tracker tool kit, which integrates retrieval procedures, visualization tools, and a customized version of the MODTRAN radiative transfer (RT) model under a single graphics user interface (GUI). We are in the process of porting the RT calculations to graphics processing units (GPUs) with the goal of achieving a 100-fold increase in the speed of computation relative to conventional CPU-based processing. We will report on our progress with this evolution of Plume Tracker. Portions of this research were conducted at the Jet Propulsion Laboratory

  9. 40 CFR 35.2101 - Advanced treatment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Advanced treatment. 35.2101 Section 35... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2101 Advanced treatment. Projects proposing advanced treatment shall be awarded grant assistance only after the project has...

  10. Audits for advanced treatment dosimetry

    NASA Astrophysics Data System (ADS)

    Ibbott, G. S.; Thwaites, D. I.

    2015-01-01

    Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

  11. Treatment of advanced esophageal cancer

    SciTech Connect

    Kelsen, D.

    1982-12-01

    When radiation therapy is used for palliation of obstruction in patients with advanced esophageal carcinoma, an improvement in dysphagia can be expected in approximately 50% of patients. Major objective responses have rarely been quantitied but, in one study, were seen in 33% patients. Recurrence of dysphagia is usually seen within 2-6 months of treatment. Radiation toxicities and complications, even when used with palliative intent, can be substantial and include esophagitis, tracheoesophageal or esophageal-aortic fistula, mediastinitis, hemorrhage, pneumonitis, and myelosuppression. (JMT)

  12. Comparison of plasma plume expansion simulations using fully kinetic electron treatment and electron fluid models

    NASA Astrophysics Data System (ADS)

    Pfeiffer, M.; Copplestone, S.; Binder, T.; Fasoulas, S.; Munz, C.-D.

    2016-11-01

    The expansion of a plasma plume resulting from laser ablation plays an important role in a large number of applications, e.g., material processing, medical laser applications or novel space propulsion concepts. Here, a high-order three-dimensional Particle-In-Cell code is used to simulate such a plasma plume expansion. A major challenge in this kind of simulation is the handling of the electrons due to their low inertia and resultant high acceleration. Therefore, two separate treatments of electron modeling are compared. Firstly, the electrons are simulated as a normal particle species in a kinetic manner, which strongly decreases the time step size and thereby increases the computational effort. Secondly, the electrons are simulated using an electron fluid model that reduces the computational cost but is less accurate [1]. Additionally, the results from the fully kinetic model are compared regarding chemical reactions, in this case ionization and ion recombination. The electron potential is solved using a high-order highly parallel Hybrid Discontinuous Galerkin (HDG) method [2]. This method also allows simulating computationally expensive three-dimensional setups.

  13. Advances in paediatric cancer treatment.

    PubMed

    Saletta, Federica; Seng, Michaela S; Lau, Loretta M S

    2014-04-01

    Four out of five children diagnosed with cancer can be cured with contemporary cancer therapy. This represents a dramatic improvement since 50 years ago when the cure rate of childhood cancer was <25% in the pre-chemotherapy era. Over the past ten years, while improvement in overall survival (OS) has been marginal, progress in pediatric oncology lies with adopting risk-adapted therapeutic approach. This has been made possible through identifying clinical and biologic prognostic factors with rigorous research and stratifying patients using these risk factors, and subsequently modifying therapy according to risk group assignment. This review provides a perspective for eight distinct pediatric malignancies, in which significant advances in treatment were made in the last decade and are leading to changes in standard of care. This includes four hematologic malignancies [acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL)] and four solid tumors [medulloblastoma (MB), low grade glioma (LGG), neuroblastoma (NB) and Ewing sarcoma (ES)]. Together, they comprise 60% of childhood cancer. Improved patient outcome is not limited to better survival, but encompasses reducing both short and long-term treatment-related complications which is as important as cure, given the majority of childhood cancer patients will become long-term survivors. Risk-adapted approach allows treatment intensification in the high-risk cohort while therapy can be de-escalated in the low-risk to minimize toxicity and late sequelae without compromising survival. Advances in medical research technology have also led to a rapid increase in the understanding of the genetics of childhood cancer in the last decade, facilitating identification of molecular targets that can potentially be exploited for therapeutic benefits. As we move into the era of targeted therapeutics, searching for novel agents that target specific genetic lesions becomes a

  14. Hybrid Model for Plasma Thruster Plume Simulation Including PIC-MCC Electrons Treatment

    SciTech Connect

    Alexandrov, A. L.; Bondar, Ye. A.; Schweigert, I. V.

    2008-12-31

    The simulation of stationary plasma thruster plume is important for spacecraft design due to possible interaction plume with spacecraft surface. Such simulations are successfully performed using the particle-in-cell technique for describing the motion of charged particles, namely the propellant ions. In conventional plume models the electrons are treated using various fluid approaches. In this work, we suggest an alternative approach, where the electron kinetics is considered 'ab initio', using the particle-in-cell--Monte Carlo collision method. To avoid the large computational expenses due to small time steps, the relaxation of simulated plume plasma is split into the fast relaxation of the electrons distribution function and the slow one of the ions. The model is self-consistent but hybrid, since the simultaneous electron and ion motion is not really modeled. The obtained electron temperature profile is in good agreement with experiment.

  15. NASA Bioreactors Advance Disease Treatments

    NASA Technical Reports Server (NTRS)

    2009-01-01

    the body. Experiments conducted by Johnson scientist Dr. Thomas Goodwin proved that the NASA bioreactor could successfully cultivate cells using simulated microgravity, resulting in three-dimensional tissues that more closely approximate those in the body. Further experiments conducted on space shuttle missions and by Wolf as an astronaut on the Mir space station demonstrated that the bioreactor s effects were even further expanded in space, resulting in remarkable levels of tissue formation. While the bioreactor may one day culture red blood cells for injured astronauts or single-celled organisms like algae as food or oxygen producers for a Mars colony, the technology s cell growth capability offers significant opportunities for terrestrial medical research right now. A small Texas company is taking advantage of the NASA technology to advance promising treatment applications for diseases both common and obscure.

  16. CHLORINATED SOLVENT PLUME CONTROL

    EPA Science Inventory

    This lecture will cover recent success in controlling and assessing the treatment of shallow ground water plumes of chlorinated solvents, other halogenated organic compounds, and methyl tert-butyl ether (MTBE).

  17. Recent advances in leishmaniasis treatment.

    PubMed

    Tiuman, Tatiana S; Santos, Adriana O; Ueda-Nakamura, Tânia; Filho, Benedito P Dias; Nakamura, Celso V

    2011-08-01

    About 1.5 million new cases of cutaneous leishmaniasis and 500,000 new cases of visceral leishmaniasis occur each year around the world. For over half a century, the clinical forms of the disease have been treated almost exclusively with pentavalent antimonial compounds. In this review, we describe the arsenal available for treating Leishmania infections, as well as recent advances from research on plants and synthetic compounds as source drugs for treating the disease. We also review some new drug-delivery systems for the development of novel chemotherapeutics. We observe that the pharmaceutical industry should employ its modern technologies, which could lead to better use of plants and their extracts, as well as to the development of synthetic and semi-synthetic compounds. New studies have highlighted some biopharmaceutical technologies in the design of the delivery strategy, such as nanoparticles, liposomes, cochleates, and non-specific lipid transfer proteins. These observations serve as a basis to indicate novel routes for the development and design of effective anti-Leishmania drugs.

  18. Fuel Plume Image Mixing Analysis Formulation With Proper Treatment of Non-Constant Velocity Flowfields

    NASA Technical Reports Server (NTRS)

    Mekkes, Gregory L.

    2000-01-01

    A previously developed technique allows an estimate of integral mixing to be obtained from an image of laser scattered light from particle seeded fuel in the hypervelocity flow through a scramjet combustor. This previous mixing analysis formulation contains an assumption of a constant velocity flowfield across the plane of the fuel plume image. For high-speed scramjet combustors, the velocity flowfield is quite uniform and an assumption of constant velocity works well. Applying this same mixing analysis technique to fuel plume images obtained from a mid-speed scramjet combustor makes it desirable to remove the constant velocity assumption. This is due to the non-uniform velocity flowfields present in mid-speed scramjet combustors. A new formulation of the mixing analysis methodology is developed and presented so that the technique can be applied to a mid-speed scramjet combustor without the need to assume a constant velocity flowfield.

  19. New Treatment in Advanced Thyroid Cancer

    PubMed Central

    Giuffrida, Dario; Prestifilippo, Angela; Scarfia, Alessia; Martino, Daniela; Marchisotta, Stefania

    2012-01-01

    Thyroid cancer is the most common endocrine tumor. Thyroidectomy, radioactive iodine, and TSH suppression represent the standard treatment for differentiated thyroid cancer. Since chemotherapy has been shown to be unsuccessful in case of advanced thyroid carcinomas, the research for new therapies is fundamental. In this paper, we reviewed the recent literature reports (pubmed, medline, EMBASE database, and abstracts published in meeting proceedings) on new treatments in advanced nonmedullary and medullary thyroid carcinomas. Studies of many tyrosine kinase inhibitors as well as antiangiogenic inhibitors suggest that patients with thyroid cancer could have an advantage with new target therapy. We summarized both the results obtained and the toxic effects associated with these treatments reported in clinical trials. Reported data in this paper are encouraging, but further trials are necessary to obtain a more effective result in thyroid carcinoma treatment. PMID:23133451

  20. Advanced Plume Studies

    DTIC Science & Technology

    2005-04-01

    mixtures of hydrocarbons and infrared laser sensitizers to be pyrolyzed and analyzed (gas chromatographically) after a single carbon dioxide laser ...Kinet., 33, 354 (2001). ADA409315 Vaghjiani, Ghanshyam L., “ UV Absorption Cross Sections, Laser Photodissociation Product Quantum Yields of...Kinet., 27, 777 (1995). Vaghjiani, Ghanshyam L., “Vacuum- UV CW-Resonance Fluorescence Studies on Laser Photodissociation of Hydrazine Fuels,” Non

  1. Plume Development and Mass Flux Following Surfactant-Based Treatment of Heterogeneous PCE-DNAPL Source Zones

    NASA Astrophysics Data System (ADS)

    Suchomel, E. J.; Pennell, K. D.

    2004-12-01

    The zones of contamination at typical chlorinated solvent-contaminated sites can be divided into two regions: a source zone in which free-phase contaminants (dense nonaqueous phase liquids, or DNAPLs) are present, and a solute plume containing only dissolved-phase contaminants. Currently, pump-and-treat is the most common method for achieving dissolved-phase plume containment; however, it is widely recognized that this approach is generally ineffective for source zone mass removal. As a result, a number of innovative technologies for in situ DNAPL source zone treatment have been developed, but mass removal using these methods is often incomplete. In addition, the effects of partial source zone mass removal on subsequent dissolved-phase plume development and contaminant flux remain poorly understood. To address these issues laboratory-scale experiments were conducted in a two dimensional (2-D) aquifer cell having overall dimensions of 150 cm (length) by 48 cm (height) by 1.4 cm (internal thickness) and containing both source zone and down-gradient "plume" regions. The aquifer cells were packed under water-saturated conditions with Accusand (either 20/30 sieve size or a mixture of 50% 20/30 and 50% 40/50 sieve sizes). Within the source zone, three layers of F-70 Ottawa sand lenses were emplaced to mimic heterogeneous regions of lower permeability media. Following tetrachloroethene (PCE) release and redistribution in the source zone, a solubilizing surfactant solution containing 4% Tween 80 was used to achieve sequential PCE mass removals ranging from 30% to 80%. At the conclusion of each surfactant flood, down-gradient contaminant concentrations and mass fluxes were monitored at a hydraulic gradient of 1x10-3. The PCE-DNAPL distributions in the source zone were quantified using light transmission prior to and following each surfactant flood. PCE-DNAPL distribution was expressed in terms of a ganglia to pool ratio (G:P), for which the volume of PCE above residual

  2. Europa's Atmosphere and Aurora: Recent Advances from HST-STIS and Plans for Plume Searches with JUICE-UVS

    NASA Astrophysics Data System (ADS)

    Retherford, K. D.; Gladstone, R.; Roth, L.; McGrath, M. A.; Saur, J.; Feldman, P. D.; Steffl, A. J.; Strobel, D. F.; Greathouse, T. K.; Spencer, J. R.; Bagenal, F.; Fletcher, L. N.; Eterno, J. S.

    2013-12-01

    Space Telescope Imaging System (STIS) images of Europa's neutral oxygen 130.4 nm and 135.6 nm emissions contain a wealth of information about the molecular oxygen atmosphere, discovered using previous Hubble far-UV observations. Europa's magnetospheric plasma interaction generates auroral emissions, which exhibit a morphology that has been difficult to interpret. Recent observations in Nov. & Dec. 2012 allow a new understanding of how Jupiter's magnetic field orientation and relation to the plasma sheet control the emission variability, yet explanations for this general behavior, including the likely role of ocean-induced magnetic fields and possible local atmospheric density enhancements, remain incomplete (cf. Roth et al. this meeting). NASA's Ultraviolet Spectrograph (UVS) instrument contribution to the ESA-led Jupiter Icy Moons Explorer (JUICE) mission will obtain excellent imaging of these atmospheric and auroral emissions from Europa during two flybys currently planned, with the objective of investigating these and other unanswered questions. UVS's stellar occultation technique will be used to characterize Europa's atmosphere structure and composition and to also search for local enhancements created by plumes. This stellar occultation technique, demonstrated by Cassini-UVIS at Enceladus, has the benefit of being useful at relatively large distances (several 10's of Jupiter radii) as well as during the Europa flyby sequences (several 10's of Europa radii). A robust search for plumes is planned in JUICE's first year at Jupiter to provide a roughly 30-degree grid of global coverage, followed by focused targeting of likely plumes/active-regions during early and late stages of the flyby sequences. High spatial resolution limb imaging is also planned near closest approaches, which could directly image plume gases in a manner analogous with plume aurora imaging of Io. A UV spectrograph on the planned Europa Clipper mission could perform an even more robust search

  3. Splash Plumes

    NASA Astrophysics Data System (ADS)

    Davies, J. H.

    2006-12-01

    I have discovered a new class of thermal upwellings in mantle convection simulations which are not rooted in a thermal boundary layer (ref 1). Since they look a bit like water droplet splashes, I have abbreviated these `plumes not rooted in thermal boundary layers' as `splash plumes'. These mantle convection simulations are high resolution ( ~ 22km spacing) 3D spherical simulations at Earth-like vigour. They have a chondritic rate of internal heating and bottom heating that straddles expected Earth values. There is a realistic depth variation in viscosity, with a lithosphere and lower mantle more viscous than upper mantle. The mantle is compressible with the coefficient of thermal expansion decreasing with depth. Some models have phase transitions. The surface of the models is driven by 119Myr of recent plate motion history. At the end of most simulations (present day) we discover many examples of hot mid-mantle thermal anomalies in the shape of bowls which have hot cylindrical plumes rising from the rim. They originate at a range of depths and are not rooted in thermal boundary layers. These splash plumes are formed from hot mantle collecting beneath the surface, and then a cold instability from the surface descending onto the sheet of hot underlying material pushing it down into the mantle and forming a bowl. The plumes are formed by instabilities coming from the bowl rim edge. In fact the downwellings can push the sheets all the way to the core mantle boundary in certain cases where it is then difficult to tell splash plumes apart from `traditional plumes'. Splash plumes might provide explanations for weak, short-lived plumes that do not seem to have deep roots (e.g. Eifel). If the surface boundary condition is made free-slip (ref 2), rather than be driven by recent plate motion history, we do not discover splash plumes but rather large steady strong thermal boundary layer plumes. Therefore while the discovery of splash plumes is interesting, potentially a more

  4. The porphyrias: advances in diagnosis and treatment.

    PubMed

    Balwani, Manisha; Desnick, Robert J

    2012-11-29

    The inborn errors of heme biosynthesis, the porphyrias, are 8 genetically distinct metabolic disorders that can be classified as "acute hepatic," "hepatic cutaneous," and "erythropoietic cutaneous" diseases. Recent advances in understanding their pathogenesis and molecular genetic heterogeneity have led to improved diagnosis and treatment. These advances include DNA-based diagnoses for all the porphyrias, new understanding of the pathogenesis of the acute hepatic porphyrias, identification of the iron overload-induced inhibitor of hepatic uroporphyrin decarboxylase activity that causes the most common porphyria, porphyria cutanea tarda, the identification of an X-linked form of erythropoietic protoporphyria due to gain-of-function mutations in erythroid-specific 5-aminolevulinate synthase (ALAS2), and new and experimental treatments for the erythropoietic porphyrias. Knowledge of these advances is relevant for hematologists because they administer the hematin infusions to treat the acute attacks in patients with the acute hepatic porphyrias, perform the chronic phlebotomies to reduce the iron overload and clear the dermatologic lesions in porphyria cutanea tarda, and diagnose and treat the erythropoietic porphyrias, including chronic erythrocyte transfusions, bone marrow or hematopoietic stem cell transplants, and experimental pharmacologic chaperone and stem cell gene therapies for congenital erythropoietic protoporphyria. These developments are reviewed to update hematologists on the latest advances in these diverse disorders.

  5. The porphyrias: advances in diagnosis and treatment.

    PubMed

    Balwani, Manisha; Desnick, Robert J

    2012-01-01

    The inborn errors of heme biosynthesis, the porphyrias, are 8 genetically distinct metabolic disorders that can be classified as "acute hepatic," "hepatic cutaneous," and "erythropoietic cutaneous" diseases. Recent advances in understanding their pathogenesis and molecular genetic heterogeneity have led to improved diagnosis and treatment. These advances include DNA-based diagnoses for all the porphyrias, new understanding of the pathogenesis of the acute hepatic porphyrias, identification of the iron overload-induced inhibitor of hepatic uroporphyrin decarboxylase activity that causes the most common porphyria, porphyria cutanea tarda, the identification of an X-linked form of erythropoietic protoporphyria due to gain-of-function mutations in erythroid-specific 5-aminolevulinate synthase (ALAS2), and new and experimental treatments for the erythropoietic prophyrias. Knowledge of these advances is relevant for hematologists because they administer the hematin infusions to treat the acute attacks in patients with the acute hepatic porphyrias, perform the chronic phlebotomies to reduce the iron overload and clear the dermatologic lesions in porphyria cutanea tarda, and diagnose and treat the erythropoietic porphyrias, including chronic erythrocyte transfusions, bone marrow or hematopoietic stem cell transplants, and experimental pharmacologic chaperone and stem cell gene therapies for congenital erythropoietic protoporphyria. These developments are reviewed to update hematologists on the latest advances in these diverse disorders.

  6. Vismodegib in the treatment of advanced BCC.

    PubMed

    O'Kane, G M; Lyons, T; McDonald, I; Mulligan, N; Moloney, F J; Murray, D; Kelly, C M

    2014-01-01

    Basal-cell carcinoma (BCC) is the most commonly diagnosed malignancy, comprising over 80 per thousand of non-melanoma skin cancers. Surgical excision is adequate treatment for most BCC's. Options are however limited for the minority of patients presenting with locally advanced inoperable or metastatic BCC. The Hedgehog signalling pathway is a critical driver in the pathogenesis of both sporadic and hereditary BCC. On 31st January 2012, based on a phase II clinical trial the US Food and Drug Administration approved Vismodegib (Erivedge, Roche) a first-in-class, small-molecule oral Hedgehog-inhibitor for the treatment of locally advanced inoperable and metastatic BCC. We present our experience treating the first Irish patient with this agent.

  7. Advanced treatment for basal cell carcinomas.

    PubMed

    Atwood, Scott X; Whitson, Ramon J; Oro, Anthony E

    2014-07-01

    Basal cell carcinomas (BCCs) are very common epithelial cancers that depend on the Hedgehog pathway for tumor growth. Traditional therapies such as surgical excision are effective for most patients with sporadic BCC; however, better treatment options are needed for cosmetically sensitive or advanced and metastatic BCC. The first approved Hedgehog antagonist targeting the membrane receptor Smoothened, vismodegib, shows remarkable effectiveness on both syndromic and nonsyndromic BCCs. However, drug-resistant tumors frequently develop, illustrating the need for the development of next-generation Hedgehog antagonists targeting pathway components downstream from Smoothened. In this article, we will summarize available BCC treatment options and discuss the development of next-generation antagonists.

  8. Advanced Treatment for Basal Cell Carcinomas

    PubMed Central

    Atwood, Scott X.; Whitson, Ramon J.; Oro, Anthony E.

    2014-01-01

    Basal cell carcinomas (BCCs) are very common epithelial cancers that depend on the Hedgehog pathway for tumor growth. Traditional therapies such as surgical excision are effective for most patients with sporadic BCC; however, better treatment options are needed for cosmetically sensitive or advanced and metastatic BCC. The first approved Hedgehog antagonist targeting the membrane receptor Smoothened, vismodegib, shows remarkable effectiveness on both syndromic and nonsyndromic BCCs. However, drug-resistant tumors frequently develop, illustrating the need for the development of next-generation Hedgehog antagonists targeting pathway components downstream from Smoothened. In this article, we will summarize available BCC treatment options and discuss the development of next-generation antagonists. PMID:24985127

  9. New advances in targeted gastric cancer treatment

    PubMed Central

    Lazăr, Daniela Cornelia; Tăban, Sorina; Cornianu, Marioara; Faur, Alexandra; Goldiş, Adrian

    2016-01-01

    Despite a decrease in incidence over past decades, gastric cancer remains a major global health problem. In the more recent period, survival has shown only minor improvement, despite significant advances in diagnostic techniques, surgical and chemotherapeutic approaches, the development of novel therapeutic agents and treatment by multidisciplinary teams. Because multiple genetic mutations, epigenetic alterations, and aberrant molecular signalling pathways are involved in the development of gastric cancers, recent research has attempted to determine the molecular heterogeneity responsible for the processes of carcinogenesis, spread and metastasis. Currently, some novel agents targeting a part of these dysfunctional molecular signalling pathways have already been integrated into the standard treatment of gastric cancer, whereas others remain in phases of investigation within clinical trials. It is essential to identify the unique molecular patterns of tumours and specific biomarkers to develop treatments targeted to the individual tumour behaviour. This review analyses the global impact of gastric cancer, as well as the role of Helicobacter pylori infection and the efficacy of bacterial eradication in preventing gastric cancer development. Furthermore, the paper discusses the currently available targeted treatments and future directions of research using promising novel classes of molecular agents for advanced tumours. PMID:27570417

  10. Therapeutic advances in the treatment of vasculitis.

    PubMed

    Eleftheriou, Despina; Brogan, Paul A

    2016-04-26

    Considerable therapeutic advances for the treatment of vasculitis of the young have been made in the past 10 years, including the development of outcome measures that facilitate clinical trial design. Notably, these include: a recognition that some patients with Kawasaki Disease require corticosteroids as primary treatment combined with IVIG; implementation of rare disease trial design for polyarteritis nodosa to deliver the first randomised controlled trial for children; first clinical trials involving children for anti-neutrophil cytoplasmic antibody (ANCA) vasculitis; and identification of monogenic forms of vasculitis that provide an understanding of pathogenesis, thus facilitating more targeted treatment. Robust randomised controlled trials for Henoch Schönlein Purpura nephritis and Takayasu arteritis are needed; there is also an over-arching need for trials examining new agents that facilitate corticosteroid sparing, of particular importance in the paediatric population since glucocorticoid toxicity is a major concern.

  11. Genetic Discoveries and Treatment Advances in Neuroblastoma

    PubMed Central

    Bagatell, Rochelle; Cohn, Susan L.

    2016-01-01

    Purpose of review Major advances in our understanding of the genetic basis of neuroblastoma and the role somatic alterations play in driving tumor growth have led to improvements in risk-stratified therapy and have provided the rationale for targeted therapies. In this review, we highlight current risk-based treatment approaches and discuss the opportunities and challenges of translating recent genomic discoveries into the clinic. Recent Findings Significant progress in the treatment of neuroblastoma has been realized using risk-based treatment strategies. Outcome has improved for all patients, including those classified as high-risk, although survival remains poor for this cohort. Integration of whole-genome DNA copy number and comprehensive molecular profiles into neuroblastoma classification systems will allow more precise prognostication and refined treatment assignment. Promising treatments that include targeted systemic radiotherapy, pathway-targeted small molecules, and therapy targeted at cell surface molecules are being evaluated in clinical trials, and recent genomic discoveries in relapsed tumor samples have led to the identification of new actionable mutations. Summary The integration of refined treatment stratification based on whole-genome profiles with therapeutics that target the molecular drivers of malignant behavior in neuroblastoma has the potential to dramatically improve survival with decreased toxicity. PMID:26576010

  12. Myeloma Today: Disease Definitions and Treatment Advances

    PubMed Central

    Rajkumar, S. Vincent

    2015-01-01

    There have been major advances in the diagnosis, staging, risk-stratification, and management of multiple myeloma (MM). In addition to established CRAB (hypercalcemia, renal failure, anemia, and lytic bone lesions) features, new diagnostic criteria include 3 new biomarkers to diagnose the disease: bone marrow clonal plasmacytosis ≥60%, serum involved/uninvolved free light chain ratio ≥100, and >1 focal lesion on magnetic resonance imaging. MM can be classified into several subtypes based on baseline cytogenetics, and prognosis varies according to underlying cytogenetic abnormalities. A Revised International Staging System has been developed which combines markers of tumor burden (albumin, beta-2 microglobulin) with markers of aggressive disease biology (high risk cytogenetics and elevated serum lactate dehydrogenase). Although the approach to therapy remains largely the same, the treatment options at every stage of the disease have changed. Carfilzomib, pomalidomide, and panobinostat have been approved for the treatment of the disease. Elotuzumab, daratumumab, and ixazomib are expected to be approved shortly. These drugs combined with older agents such as cyclophosphamide, dexamethasone, thalidomide, bortezomib, and lenalidomide dramatically increase the repertoire of regimens available for the treatment of MM. This review provides a concise overview of recent advances in MM, including updates to diagnostic criteria, staging, risk-stratification, and management. PMID:26565896

  13. Advances in HTGR spent fuel treatment technology

    SciTech Connect

    Holder, N.D.; Lessig, W.S.

    1984-08-01

    GA Technologies, Inc. has been investigating the burning of spent reactor graphite under Department of Energy sponsorship since 1969. Several deep fluidized bed burners have been used at the GA pilot plant to develop graphite burning techniques for both spent fuel recovery and volume reduction for waste disposal. Since 1982 this technology has been extended to include more efficient circulating bed burners. This paper includes updates on high-temperature gas-cooled reactor fuel cycle options and current results of spent fuel treatment testing for fluidized and advanced circulating bed burners.

  14. [Advances in the treatment of hypertension].

    PubMed

    Román, O

    1999-04-01

    This review describes the most recent advances in the treatment of essential hypertension, from non pharmacological measures and changes in lifestyles to new blood pressure lowering drugs. A blood pressure lower tha 130/80 mmHg, has been established as the new goal for optimal treatment. In the last two consensus a new range of blood pressure, denominated "high normal" (130-139/85-89 mm Hg) has been incorporated. People with other cardiovascular risk factors and a blood pressure within this range, should be treated. The HOT study recently demonstrated that a reduction to less than 90 mmHg of diastolic pressure is associated with a reduction on cardiovascular morbidity and mortality. The importance of the peak/valley relationship in the election of anti hypertensive medication is also reviewed.

  15. Tvashtar's Plume

    NASA Technical Reports Server (NTRS)

    2007-01-01

    This dramatic image of Io was taken by the Long Range Reconnaissance Imager (LORRI) on New Horizons at 11:04 Universal Time on February 28, 2007, just about 5 hours after the spacecraft's closest approach to Jupiter. The distance to Io was 2.5 million kilometers (1.5 million miles) and the image is centered at 85 degrees west longitude. At this distance, one LORRI pixel subtends 12 kilometers (7.4 miles) on Io.

    This processed image provides the best view yet of the enormous 290-kilometer (180-mile) high plume from the volcano Tvashtar, in the 11 o'clock direction near Io's north pole. The plume was first seen by the Hubble Space Telescope two weeks ago and then by New Horizons on February 26; this image is clearer than the February 26 image because Io was closer to the spacecraft, the plume was more backlit by the Sun, and a longer exposure time (75 milliseconds versus 20 milliseconds) was used. Io's dayside was deliberately overexposed in this picture to image the faint plumes, and the long exposure also provided an excellent view of Io's night side, illuminated by Jupiter. The remarkable filamentary structure in the Tvashtar plume is similar to details glimpsed faintly in 1979 Voyager images of a similar plume produced by Io's volcano Pele. However, no previous image by any spacecraft has shown these mysterious structures so clearly.

    The image also shows the much smaller symmetrical fountain of the plume, about 60 kilometers (or 40 miles) high, from the Prometheus volcano in the 9 o'clock direction. The top of a third volcanic plume, from the volcano Masubi, erupts high enough to catch the setting Sun on the night side near the bottom of the image, appearing as an irregular bright patch against Io's Jupiter-lit surface. Several Everest-sized mountains are highlighted by the setting Sun along the terminator, the line between day and night.

    This is the last of a handful of LORRI images that New Horizons is sending 'home' during its busy close

  16. Advances in sarcoma diagnostics and treatment

    PubMed Central

    Dancsok, Amanda R; Asleh-Aburaya, Karama; Nielsen, Torsten O

    2017-01-01

    The heterogeneity of sarcomas with regard to molecular genesis, histology, clinical characteristics, and response to treatment makes management of these rare yet diverse neoplasms particularly challenging. This review encompasses recent developments in sarcoma diagnostics and treatment, including cytotoxic, targeted, epigenetic, and immune therapy agents. In the past year, groups internationally explored the impact of adding mandatory molecular testing to histological diagnosis, reporting some changes in diagnosis and/or management; however, the impact on outcomes could not be adequately assessed. Transcriptome sequencing techniques have brought forward new diagnostic tools for identifying fusions and/or characterizing unclassified entities. Next-generation sequencing and advanced molecular techniques were also applied to identify potential targets for directed and epigenetic therapy, where preclinical studies reported results for agents active within the receptor tyrosine kinase, mTOR, Notch, Wnt, Hedgehog, Hsp90, and MDM2 signaling networks. At the level of clinical practice, modest developments were seen for some sarcoma subtypes in conventional chemotherapy and in therapies targeting the pathways activated by various receptor tyrosine kinases. In the burgeoning field of immune therapy, sarcoma work is in its infancy; however, elaborate protocols for immune stimulation are being explored, and checkpoint blockade agents advance from preclinical models to clinical studies. PMID:27732970

  17. Recent advances in treatment of aplastic anemia.

    PubMed

    Shin, Seung Hwan; Lee, Sung Eun; Lee, Jong Wook

    2014-11-01

    Recent advances in the treatment of aplastic anemia (AA) made most of patients to expect to achieve a long-term survival. Allogeneic stem cell transplantation (SCT) from HLA-matched sibling donor (MSD-SCT) is a preferred first-line treatment option for younger patients with severe or very severe AA, whereas immunosuppressive treatment (IST) is an alternative option for others. Horse anti-thymocyte globuline (ATG) with cyclosporin A (CsA) had been a standard IST regimen with acceptable response rate. Recently, horse ATG had been not available and replaced with rabbit ATG in most countries. Subsequently, recent comparative studies showed that the outcomes of patients who received rabbit ATG/CsA were similar or inferior compared to those who received horse ATG/CsA. Therefore, further studies to improve the outcomes of IST, including additional eltrombopag, are necessary. On the other hand, the upper age limit of patients who are able to receive MSD-SCT as first-line treatment is a current issue because of favorable outcomes of MSD-SCT of older patients using fludarabine-based conditioning. In addition, further studies to improve the outcomes of patients who receive allogeneic SCT from alternative donors are needed. In this review, current issues and the newly emerging trends that may improve their outcomes in near futures will be discussed focusing the management of patients with AA.

  18. Biogenic metals in advanced water treatment.

    PubMed

    Hennebel, Tom; De Gusseme, Bart; Boon, Nico; Verstraete, Willy

    2009-02-01

    Microorganisms can change the oxidation state of metals and concomitantly deposit metal oxides and zerovalent metals on or into their cells. The microbial mechanisms involved in these processes have been extensively studied in natural environments, and researchers have recently gained interest in the applications of microbe-metal interactions in biotechnology. Because of their specific characteristics, such as high specific surface areas and high catalytic reactivity, biogenic metals offer promising perspectives for the sorption and (bio)degradation of contaminants. In this review, the precipitation of biogenic manganese and iron species and the microbial reduction of precious metals, such as palladium, platinum, silver and gold, are discussed with specific attention to the application of these biogenic metals in innovative remediation technologies in advanced water treatment.

  19. Cutaneous melanoma: new advances in treatment*

    PubMed Central

    Foletto, Michele Ceolin; Haas, Sandra Elisa

    2014-01-01

    Cutaneous melanoma is a challenge to treat. Over the last 30 years, no drug or combination of drugs demonstrated significant impact to improve patient survival. From 1995 to 2000, the use of cytokines such as interferon and interleukin become treatment options. In 2011, new drugs were approved by the U.S. Food and Drug Administration, including peginterferon alfa-2b for patients with stage III disease, vemurafenib for patients with metastatic melanoma with the BRAF V600E mutation, and ipilimumab, a monoclonal antibody directed to the CTLA-4 T lymphocyte receptor, to combat metastatic melanoma in patients who do not have the BRAF V600E mutation. Both ipilimumab and vemurafenib showed results in terms of overall survival. Other trials with inhibitors of other genes, such as the KIT gene and MEK, are underway in the search for new discoveries. The discovery of new treatments for advanced or metastatic disease aims to relieve symptoms and improve patient quality of life. PMID:24770508

  20. Permeable sorptive walls for treatment of hydrophobic organic contaminant plumes in groundwater

    SciTech Connect

    Grathwohl, P.; Peschik, G.

    1997-12-31

    Highly hydrophobic contaminants are easily adsorbed from aqueous solutions. Since for many of these compounds sorption increases with increasing organic carbon content natural materials such as bituminous shales and coals may be used in permeable sorptive walls. This, however, only applies if sorption is at equilibrium, which may not always be the case in groundwater treatment using a funnel-and-gate system. In contrast to the natural solids, granular activated carbons (GACs) have very high sorption capacities and reasonably fast sorption kinetics. The laboratory results show that application of GACs (e.g. F100) is economically feasible for in situ removal of polycyclic aromatic hydrocarbons (PAH) from groundwater at a former manufactured gas plant site (MGP). For less sorbing compounds (such as benzene, toluene, xylenes) a combination of adsorption and biodegradation is necessary (i.e. sorptive + reactive treatment).

  1. HIV Diagnosis and Treatment through Advanced Technologies

    PubMed Central

    Zulfiqar, Hafiza Fizzah; Javed, Aneeqa; Sumbal; Afroze, Bakht; Ali, Qurban; Akbar, Khadija; Nadeem, Tariq; Rana, Muhammad Adeel; Nazar, Zaheer Ahmad; Nasir, Idrees Ahmad; Husnain, Tayyab

    2017-01-01

    Human immunodeficiency virus (HIV) is the chief contributor to global burden of disease. In 2010, HIV was the fifth leading cause of disability-adjusted life years in people of all ages and leading cause for people aged 30–44 years. It is classified as a member of the family Retroviridae and genus Lentivirus based on the biological, morphological, and genetic properties. It infects different cells of the immune system, such as CD4+ T cells (T-helper cells), dendritic cells, and macrophages. HIV has two subtypes: HIV-1 and HIV-2. Among these strains, HIV-1 is the most virulent and pathogenic. Advanced diagnostic methods are exploring new ways of treatment and contributing in the reduction of HIV cases. The diagnostic techniques like PCR, rapid test, EIA, p24 antigen, and western blot have markedly upgraded the diagnosis of HIV. Antiretroviral therapy and vaccines are promising candidates in providing therapeutic and preventive regimes, respectively. Invention of CRISPR/Cas9 is a breakthrough in the field of HIV disease management. PMID:28326304

  2. Nivolumab-Based Treatments for Advanced Melanoma

    Cancer.gov

    A summary of results from an international, double-blind, randomized phase III trial testing the combination of nivolumab (Opdivo®) and ipilimumab (Yervoy®) against nivolumab alone and ipilimumab alone in patients with advanced melanoma.

  3. Advances in Monitoring, Modelling and Forecasting Volcanic Ash Plumes over the Past 5 Years and the Impact on Preparedness from the London VAAC Perspective

    NASA Astrophysics Data System (ADS)

    Lee, D. S.; Lisk, I.

    2015-12-01

    Hosted and run by the Met Office, the London VAAC (Volcanic Ash Advisory Centre) is responsible for issuing advisories on the location and likely dispersion of ash clouds originating from volcanoes in the North East Atlantic, primarily from Iceland. These advisories and additional guidance products are used by the civil aviation community to make decisions on airspace flight management. London VAAC has specialist forecasters who use a combination of volcano source data, satellite-based, ground-based and aircraft observations, weather forecast models and dispersion models. Since the eruption of the Icelandic volcano Eyjafjallajökull in 2010, which resulted in the decision by many northern European countries to impose significant restrictions on the use of their airspace, London VAAC has been active in further developing its volcanic ash monitoring, modelling and forecasting capabilities, collaborating with research organisations, industry, other VAACs, Meteorological Services and the Volcano Observatory in Iceland. It has been necessary to advance operational capabilities to address evolving requirements, including for more quantitative assessments of volcanic ash in the atmosphere. Here we summarise advances in monitoring, modelling and forecasting of volcanic ash plumes over the past 5 years from the London VAAC perspective, and the realization of science into operations. We also highlight the importance of collaborative activities, such as the 'VAAC Best Practice' Workshop, where information is exchanged between all nine VAACs worldwide on the operational practices in monitoring and forecasting volcanic ash, with the aim of working toward a more harmonized service for decision makers in the aviation community. We conclude on an evaluation of how better we are prepared for the next significant ash-rich Icelandic eruption, and the challenges still remaining.

  4. Combination treatment including targeted therapy for advanced hepatocellular carcinoma

    PubMed Central

    Xie, Yuan; Wang, Anqiang; Zhang, Haohai; Yang, Xiaobo; Wan, Xueshuai; Lu, Xin; Sang, Xinting; Zhao, Haitao

    2016-01-01

    Management of advanced hepatocellular carcinoma (HCC), one of the most lethal cancers worldwide, has presented a therapeutic challenge over past decades. Most patients with advanced HCC and a low possibility of surgical resection have limited treatment options and no alternative but to accept local or palliative treatment. In the new era of cancer therapy, increasing numbers of molecular targeted agents (MTAs) have been applied in the treatment of advanced HCC. However, mono-targeted therapy has shown disappointing outcomes in disease control, primarily because of tumor heterogeneity and complex cell signal transduction. Because incapacitation of a single target is insufficient for cancer suppression, combination treatment for targeted therapy has been proposed and experimentally tested in several clinical trials. In this article, we review research studies aimed to enhance the efficacy of targeted therapy for HCC through combination strategies. Combination treatments involving targeted therapy for advanced HCC are compared and discussed. PMID:27626176

  5. ASSESSMENT OF PLUME DIVING

    EPA Science Inventory

    This presentation presents an assessment of plume diving. Observations included: vertical plume delineation at East Patchogue, NY showed BTEX and MTBE plumes sinking on either side of a gravel pit; Lake Druid TCE plume sank beneath unlined drainage ditch; and aquifer recharge/dis...

  6. Advances in the treatment of testicular cancer

    PubMed Central

    Margel, David; Lubin, Marc Alan; Baniel, Jack

    2015-01-01

    Germ cell tumors (GCT) are relatively uncommon, accounting for only 1% of male malignancies in the United States. It has become an important oncological disease for several reasons. It is the most common malignancy in young men 15-35 years old. GCTs are among a unique numbers of neoplasms where biochemical markers play a critical role. Finally, it is a model of curable cancer. In this review we discuss cancer epidemiology, genetics, and therapeutic principles. Recent advances in the management of stage I GCT and controversies in the management of post chemotherapy residual mass are presented. PMID:26816836

  7. Plume base flow simulation technology

    NASA Technical Reports Server (NTRS)

    Roberts, B. B.; Wallace, R. O.; Sims, J. L.

    1983-01-01

    A combined analytical/empirical approach was studied in an effort to define the plume simulation parameters for base flow. For design purposes, rocket exhaust simulation (i.e., plume simulation) is determined by wind tunnel testing. Cold gas testing was concluded to be a cost and schedule effective data base of substantial scope. The results fell short of the target, although work conducted was conclusive and advanced the state of the art. Comparisons of wind tunnel predictions with Space Transportation System (STS) flight data showed considerable differences. However, a review of the technology program data base has yielded an additional parameter that may correlate flight and cold gas test data. Data from the plume technology program and the NASA test flights are presented to substantiate the proposed simulation parameters.

  8. Treatment advances in liver-limited metastatic colorectal cancer.

    PubMed

    Alberts, Steven R; Poston, Graeme J

    2011-12-01

    Over the last several decades advances in the management and treatment of patients with liver metastases from colorectal cancer (CRC) has changed a disease with a dismal prognosis to one with a potential for cure in some patients. Advances have been made through coordinated management of patients by surgeons, medical oncologists, radiologists, and other health care professionals coupled with advances in treatment options. Although these advances have clearly impacted patient outcomes, it is clear that the benefit of traditional surgical approaches and the use of cytoxic chemotherapy are reaching a plateau. Continued research to develop new and more active therapies, including targeted or biologic agents, is needed. This review discusses the advances made in management of patients with liver-limited metastatic disease.

  9. Advances in the Treatment of Neutropenia

    PubMed Central

    Dale, David C.

    2012-01-01

    Purpose of review This review updates treatment of neutropenia from articles published from January 2008 through April 2009. Recent findings Chemotherapy-induced neutropenia occurs most commonly in the first cycle of treatment. Older patients, patients with multiple co-morbidities, and those receiving more myelotoxic drugs are prone to develop neutropenia and its complications. Current guidelines recommend use of the myeloid growth factors for the first cycle of chemotherapy for patients with more that a 20 % risk of febrile neutropenia. Meta-analysis from randomized trials shows that granulocyte colony-stimulating factor (G-CSF) prophylaxis is associated with patients receiving more intensive chemotherapy, having better survival, but also having a higher risk of secondary AML. Antibiotic remain the mainstay of treatment of febrile neutropenia and are increasingly used for prophylaxis in “low risk” patients. Diagnosis and treatment of other type of neutropenia is also steadily improving. Summary The myeloid growth factor G-CSF has radically changed our approach to the management of neutropenia. Antibiotics remain the mainstay of treatment of febrile neutropenia. PMID:19550332

  10. Advances in the treatment of acne.

    PubMed

    Kimball, Alexa B

    2008-09-01

    Acne vulgaris affects most people at some time in their life. This common condition can have devastating effects on a person's quality of life and may leave permanent scars. Treatment options, which are designed to disrupt one or more of the pathogenic features that characterize acne, include topical therapies (e.g., antibiotics, retinoids, benzoyl peroxide and combination products), systemic treatments (e.g., oral antibiotics, hormonal therapies and oral retinoids, which are indicated for severe recalcitrant nodulocystic acne), and, to a lesser extent, light-based and physical treatments. Combination oral contraceptives (COCs) represent one type of hormonal treatment. Their mode of action is to reduce the availability of free testosterone, which stimulates the sebaceous glands to produce sebum. Most COCs used in the United States contain progestins derived from 19-nortestosterone, giving them at least some degree of androgenic activity. Of the 3 COCs with an FDA indication for the treatment of moderate acne, only YAZ contains drospirenone, a progestin that combines no androgenic activity with antiandrogenic activity. This drospirenone-containing COC has been shown to be effective in reducing both inflammatory and noninflammatory acne lesions.

  11. Novel Advances in the Treatment of Osteoporosis

    PubMed Central

    Chan, Christopher KY; Mason, Alice; Cooper, Cyrus; Dennison, Elaine

    2016-01-01

    Introduction Osteoporosis is a significant public health issue affecting over half of women aged over 50. With an aging population its importance is set to increase further over time. Prevention of fragility fractures avoids significant mortality and morbidity as well as saving significant direct and indirect costs to the economy. In this review, we discuss existing treatments to contextualise the treatment landscape, and demonstrate how our understanding of bone pathophysiology has led to novel therapies – in the form of combinations and altered durations of existing treatments, as well as newer drug therapies. Sources of data Pubmed and Embase were searched for randomised controlled trials of new therapies for osteoporosis. These searches were supplemented with material presented in abstract form at international meetings Areas of agreement New drugs that appear promising in the treatment of osteoporosis include the cathepsin K inhibitor, monoclonal antibodies against sclerostin, and parathyroid hormone related peptide. Areas of controversy Separate to the development of novel drug therapies is the issue of how best to use agents that are currently available to us; specifically which agent to choose, alone or in combination; duration of therapy; how best to identify patients at highest risk of fracture, and to ensure the highest possible adherence to medication. Many of these issues have been addressed in other excellent review papers, and will not be considered in detail here. Growing points As with all new treatments, we await results of long term use, and experience in ‘real life’ patient populations Areas timely for developing research As alluded to above, data are urgently required regarding the optimal duration of therapy; use of combination therapy; ordering of therapies for best therapeutic effect. As stratified medicine becomes more strongly considered in all areas of therapy, its merits in osteoporosis as in other musculoskeletal conditions, is

  12. Case history advanced coatings for water treatment plant components

    SciTech Connect

    Stephenson, L.D.; Kumar, A.

    2008-12-15

    Components of water treatment plants (WTPs) are susceptible to corrosion from constant immersion in water. A case history of corrosion and proximity to chlorine problems and their treatment at an Army WTP is presented. Solutions included using high micro-silica restoration mortar and advanced coal tar epoxy coatings.

  13. [Advances on endoscopic treatment of intestinal fistulas].

    PubMed

    Wu, X W; Ren, J A; Li, J S

    2016-03-01

    Intestinal fistulas are severe complications after abdominal surgical procedures. The endoscopic therapy makes it possible to close fistulas without surgical interventions. When patients achieved stabilization and had no signs of systemic sepsis or inflammation, these therapies could be conducted, which included endoscopic vacuum therapy, fibrin glue sealing, stents, fistula plug, suture, and Over The Scope Clip (OTSC). Various techniques may be combined. Endoscopy vacuum therapy could be applied to control systemic inflammation and prevent continuing septic contamination by active drainage. Endoscopic stent is placed over fistulas and gastrointestinal continuity is recovered. The glue sealing is applied for enterocutaneous fistulas, and endoscopy suture has the best results seen in fistulas <1 cm in diameter. Insertion of the fistula plug is used to facilitate fistula healing. The OTSC is effective to treat leaks with large defects. Endoscopic treatment could avoid reoperation and could be regarded as the first-line treatment for specific patients.

  14. Recent Advances in Hydrocortisone Replacement Treatment.

    PubMed

    Mallappa, Ashwini; Debono, Miguel

    2016-01-01

    Since the first use of cortisone in patients around 65 years ago, the use of synthetic glucocorticoids has made a crucial impact on the treatment of several diseases in medicine. Although significant reductions in morbidity and mortality have occurred in patients suffering from cortisol deficiency, conventional hydrocortisone replacement treatment is still inadequate. A major limitation is that it fails to replace cortisol in a physiological manner. Cortisol has a distinct circadian rhythm and acts as a secondary messenger synchronizing the central to peripheral clocks, hence playing a key role in biological processes and the circadian timing system. Circadian misalignment has been associated with ill-health and so nonphysiological glucocorticoid treatment could explain the increased mortality rate, poor quality of life and metabolic complications in patients suffering from adrenal insufficiency. Attempts at replacing cortisol in a physiological manner have shown significant progress in the past decade with the development of modified-release formulations of hydrocortisone (Chronocort® and Plenadren®) and continuous subcutaneous hydrocortisone infusions. Initial studies investigating the use of these replacement regimens are promising, demonstrating both clinical and biochemical improvement. Larger studies are needed to determine whether this novel approach enhances long-term outcomes in both children and adults with cortisol deficiency. This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply. Published by S. Karger AG, Basel.

  15. Advances in Tourette syndrome: diagnoses and treatment.

    PubMed

    Serajee, Fatema J; Mahbubul Huq, A H M

    2015-06-01

    Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder characterized by multiple motor tics and at least one vocal or phonic tic, and often one or more comorbid psychiatric disorders. Premonitory sensory urges before tic execution and desire for "just-right" perception are central features. The pathophysiology involves cortico-striato-thalamo-cortical circuits and possibly dopaminergic system. TS is considered a genetic disorder but the genetics is complex and likely involves rare mutations, common variants, and environmental and epigenetic factors. Treatment is multimodal and includes education and reassurance, behavioral interventions, pharmacologic, and rarely, surgical interventions.

  16. Follow the plume: the habitability of Enceladus.

    PubMed

    McKay, Christopher P; Anbar, Ariel D; Porco, Carolyn; Tsou, Peter

    2014-04-01

    The astrobiological exploration of other worlds in our Solar System is moving from initial exploration to more focused astrobiology missions. In this context, we present the case that the plume of Enceladus currently represents the best astrobiology target in the Solar System. Analysis of the plume by the Cassini mission indicates that the steady plume derives from a subsurface liquid water reservoir that contains organic carbon, biologically available nitrogen, redox energy sources, and inorganic salts. Furthermore, samples from the plume jetting out into space are accessible to a low-cost flyby mission. No other world has such well-studied indications of habitable conditions. Thus, the science goals that would motivate an Enceladus mission are more advanced than for any other Solar System body. The goals of such a mission must go beyond further geophysical characterization, extending to the search for biomolecular evidence of life in the organic-rich plume. This will require improved in situ investigations and a sample return.

  17. Advances in treatment of achondroplasia and osteoarthritis.

    PubMed

    Klag, Kendra A; Horton, William A

    2016-04-15

    Achondroplasia (ACH) is the prototype and most common of the human chondrodysplasias. It results from gain-of-function mutations that exaggerate the signal output of the fibroblast growth factor receptor 3 (FGFR3), a receptor tyrosine kinase that negatively regulates growth plate activity and linear bone growth. Several approaches to reduce FGFR3 signaling by blocking receptor activation or inhibiting downstream signals have been proposed. Five show promise in preclinical mouse studies. Two candidate therapies target the extracellular domain of FGFR3. The first is a decoy receptor that competes for activating ligands. The second is a synthetic blocking peptide that prevents ligands from binding and activating FGFR3. Two established drugs, statins and meclozine, improve growth of ACH mice. The strongest candidate therapy employs an analog of C-type natriuretic peptide (CNP), which antagonizes the mitogen-activated-protein (MAP) kinase pathway downstream of the FGFR3 receptor and may also act independently in the growth plate. Only the CNP analog has reached clinical trials. Preliminary results of Phase 2 studies show a substantial increase in growth rate of ACH children after six months of therapy with no serious adverse effects. A challenge for drug therapy in ACH is targeting agents to the avascular growth plate. The application of gene therapy in osteoarthritis offers insights because it faces similar technical obstacles. Major advances in gene therapy include the emergence of recombinant adeno-associated virus as the vector of choice, capsid engineering to target vectors to specific tissues, and development of methods to direct vectors to articular chondrocytes.

  18. Actinomycetoma and advances in its treatment.

    PubMed

    Welsh, Oliverio; Vera-Cabrera, Lucio; Welsh, Esperanza; Salinas, Mario Cesar

    2012-01-01

    Actinomycetoma is a chronic subcutaneous infection caused by aerobic branching actinomycetes. Its clinical features are firm tumefaction of the affected site and the presence of abscesses, nodules, and sinuses that drain a seropurulent exudate containing filamenting granules. The disease is caused by inoculation of the infectious agent through minor trauma in susceptible individuals. Nocardia brasiliensis, Actinomadura madurae, and Streptomyces somaliensis are among the most frequent agents in the Americas. Cellular and humoral immunity have been studied in animal models. Standard therapy for uncomplicated cases is sulfamethoxazole-trimethoprim given for many months. Bone involvement, disseminated cases, and special locations require combined treatment with amikacin and sulfamethoxazole-trimethoprim. Isolated reports include the addition of other antibiotics such as rifampicin, imipenem, or meropenem. When needed, other aminoglycosides can be used. Amoxicillin-clavulanic acid is indicated in specific cases as alternative treatment. Oxazolidinone antibiotics, such as linezolid and other similar compounds (DA-7218 and DA-7157), have been studied in experimental infections in animal models as well as in vitro and ex vivo, with encouraging results.

  19. Recent advancements in drug treatment of obesity.

    PubMed

    Carter, Rebeca; Mouralidarane, Angelina; Ray, Shuvra; Soeda, Junpei; Oben, Jude

    2012-10-01

    The prevalence of obesity is rising worldwide, with the U.K. having the highest prevalence in Europe. Obesity is associated with significant morbidity and has substantial healthcare implications, with current projections estimating that by 2030 obesity will cost the NHS approximately pounds 2 billion each year. Lifestyle modification remains the cornerstone of anti-obesity treatment, but drugs can be introduced as adjuncts to assist and maintain weight loss. Some 1.45 million obesity-related prescriptions were dispensed in 2009, highlighting the high demand for obesity pharmacotherapy. At present, the lipase inhibitor orlistat (Xenical) is the only UK-approved long-term medical therapy for obesity. Double-blind clinical trials have shown that orlistat significantly increases weight loss compared to placebo, but the array of adverse side effects associated with orlistat limits its tolerability. The need for more effective and better-tolerated anti-obesity medications is clear and six therapies have reached phase-III trials.

  20. Advances in nanomedicines for malaria treatment.

    PubMed

    Aditya, N P; Vathsala, P G; Vieira, V; Murthy, R S R; Souto, E B

    2013-12-01

    Malaria is an infectious disease that mainly affects children and pregnant women from tropical countries. The mortality rate of people infected with malaria per year is enormous and became a public health concern. The main factor that has contributed to the success of malaria proliferation is the increased number of drug resistant parasites. To counteract this trend, research has been done in nanotechnology and nanomedicine, for the development of new biocompatible systems capable of incorporating drugs, lowering the resistance progress, contributing for diagnosis, control and treatment of malaria by target delivery. In this review, we discussed the main problems associated with the spread of malaria and the most recent developments in nanomedicine for anti-malarial drug delivery.

  1. Advances in stroke treatment are within reach.

    PubMed

    Taylor, Allan; Le Feuvre, David; Mngomezulu, Victor; Royston, Duncan; Harrichandparsard, Rohen; De Vries, Coert; Winter, Arthur; Potgieter, Francois

    2016-03-30

    Five recent trials have shown that mechanical removal of clot from cerebral arteries after a stroke can achieve a functional independent outcome in up to 60% of patients. This was an absolute benefit of between 13.5% and 31% for patients who had clot removal initiated within 6 hours of symptoms over those who had best medical treatment. Coupled with this, there is a strong drive to develop stroke units internationally and in South Africa. As a starting point, more primary stroke care centres that can administer intravenous thrombolysis are needed. Comprehensive stroke centres that can offer mechanical thrombectomy are available, but more will be required as referral of patients increases. Collaboration of all roleplayers will ensure that we can deliver training and care at the best level for stroke patients.

  2. Lipodystrophy: Pathophysiology and Advances in Treatment

    PubMed Central

    Fiorenza, Christina G.; Chou, Sharon H.; Mantzoros, Christos S.

    2011-01-01

    Lipodystrophy is a medical condition characterized by complete or partial loss of adipose tissue. Not infrequently, lipodystrophy occurs in combination with pathological accumulation of adipose tissue at distinct anatomical sites. Patients with lipodystrophy suffer from numerous metabolic complications, indicating the importance of adipose tissue as an active endocrine organ. Not only does the total amount but also the appropriate distribution of fat deposits contribute to the metabolic state. Recent genetic and molecular research has improved our understanding of the mechanisms underlying lipodystrophy. Circulating levels of hormones secreted by adipose tissue, such as leptin and adiponectin, are greatly reduced in distinct subsets of patients with lipodystrophy, rationalizing the use of such hormones or agents that increase their circulating levels, such as peroxisome proliferator-activated receptor gamma (PPARγ) agonists, in a subset of patients with lipodystrophy. Other novel therapeutic approaches, including the use of growth hormone (GH) and GH-releasing factors, are also being studied as potential additions to the therapeutic armamentarium. Insights from recent research efforts and clinical trials could potentially revolutionize the treatment of this difficult-to-treat condition. PMID:21079616

  3. Prostate cancer: 9. Treatment of advanced disease

    PubMed Central

    Gleave, M E; Bruchovsky, N; Moore, M J; Venner, P

    1999-01-01

    A 70-year-old man is referred to a urologist for recommendations on the management of metastatic prostate cancer. His cancer was diagnosed 5 years ago, and he underwent radical prostatectomy at that time. The tumour was confined to the prostate gland (Gleason score 7), and during surgery the lymph nodes were assessed as being clear of cancer. Before the surgery, the patient's prostate-specific antigen (PSA) level had been 8 ng/mL. After the prostatectomy, PSA was at first undetectable, but recently the PSA level rose to 2 ng/mL and then, at the most recent test, to 16 ng/mL. A bone scan was ordered to investigate back discomfort, which has been persistent but easily controlled with acetaminophen. Unfortunately, the bone scan shows several sites of metastatic disease. The man's medical history includes type 2 diabetes, which has developed during the past 3 years and which is controlled by diet, as well as asymptomatic hypertension, which is managed by means of a thiazide diuretic. The patient asks what treatments are available, what impact they are likely to have on his disease and what risks are associated with the therapies. PMID:9951446

  4. Advances in medical treatment of hypertrophic cardiomyopathy.

    PubMed

    Hamada, Mareomi; Ikeda, Shuntaro; Shigematsu, Yuji

    2014-07-01

    We reviewed the natural history of patients with hypertrophic cardiomyopathy (HCM). The effect of medical treatments on natural history, left ventricular (LV) functions and LV remodeling was also evaluated. Sudden cardiac death and end-stage heart failure are the most serious complications of HCM. Age <30 years and a family history of sudden premature death are risk factors for sudden cardiac death in HCM patients. End-stage heart failure is not a specific additional phenomenon observed in patients with HCM, but is the natural course of the disease in most of those patients. After the occurrence of heart failure, the progression to cardiac death is very rapid. Young age at diagnosis, a family history of HCM, and greater wall thickness are associated with a greater likelihood of developing end-stage heart failure. Neither beta-blockers nor calcium antagonists can prevent this transition. The class Ia antiarrhythmic drugs, disopyramide and cibenzoline are useful for the reduction of LV pressure gradient. Unlike disopyramide, cibenzoline has little anticholinergic activity; therefore, this drug can be easily adapted to long-term use. In addition to the reduction in LV pressure gradient, cibenzoline can improve LV diastolic dysfunction, and induce regression of LV hypertrophy in patients with HCM. A decrease in intracellular Ca(2+) concentration through the activation of the Na(+)/Ca(2+) exchanger associated with cibenzoline therapy is likely to be closely related with the improvement in HCM-related disorders. It is possible that cibenzoline can prevent the progression from typical HCM to end-stage heart failure.

  5. Recent advances in the medical treatment of breast cancer.

    PubMed

    Vorobiof, Daniel A

    2016-01-01

    Over the past few decades, the systemic therapy of breast cancer (early and advanced) has changed considerably. For the past 40-50 years, and since the discovery and further therapeutic use of tamoxifen, a selective estrogen receptor modulator, breast cancer treatment has become the model for the development and success of tailored medical treatment. Much still needs to be done in improving outcomes for all patients with breast cancer, and especially for those who have advanced breast cancer, a challenging area for medical oncologists. Ongoing international clinical trials are currently evaluating new therapeutic approaches and identifying specific biological subsets that could determine a patient's ability to respond to particular chemotherapeutic drugs.

  6. New Insight into the Treatment of Advanced Differentiated Thyroid Cancer

    PubMed Central

    Safavi, Arash; Vijayasekaran, Aparna; Guerrero, Marlon A.

    2012-01-01

    The vast majority of patients with differentiated thyroid cancer (DTC) are treated successfully with surgery and radioactive iodine ablation, yet the treatment of advanced cases is frustrating and largely ineffective. Systemic treatment with conventional cytotoxic chemotherapy is basically ineffective in most patients with advanced DTC. However, a better understanding of the genetics and biologic basis of thyroid cancers has generated opportunities for innovative therapeutic modalities, resulting in several clinical trials. We aim to delineate the latest knowledge regarding the biologic characteristics of DTC and to describe the available data related to novel targeted therapies that have demonstrated clinical effectiveness. PMID:23326755

  7. Protein Innovations Advance Drug Treatments, Skin Care

    NASA Technical Reports Server (NTRS)

    2012-01-01

    Dan Carter carefully layered the sheets of tracing paper on the light box. On each sheet were renderings of the atomic components of an essential human protein, one whose structure had long been a mystery. With each layer Carter laid down, a never-before-seen image became clearer. Carter joined NASA s Marshall Space Flight Center in 1985 and began exploring processes of protein crystal growth in space. By bouncing intense X-rays off the crystals, researchers can determine the electron densities around the thousands of atoms forming the protein molecules, unveiling their atomic structures. Cultivating crystals of sufficient quality on Earth was problematic; the microgravity conditions of space were far more accommodating. At the time, only a few hundred protein structures had been mapped, and the methods were time consuming and tedious. Carter hoped his work would help reveal the structure of human serum albumin, a major protein in the human circulatory system responsible for ferrying numerous small molecules in the blood. More was at stake than scientific curiosity. Albumin has a high affinity for most of the world s pharmaceuticals, Carter explains, and its interaction with drugs can change their safety and efficacy. When a medication enters the bloodstream a cancer chemotherapy drug, for example a majority of it can bind with albumin, leaving only a small percentage active for treatment. How a drug interacts with albumin can influence considerations like the necessary effective dosage, playing a significant role in the design and application of therapeutic measures. In spite of numerous difficulties, including having no access to microgravity following the 1986 Space Shuttle Challenger disaster, the image Carter had hoped to see was finally clarifying. In 1988, his lab had acquired specialized X-ray and detection equipment a tipping point. Carter and his colleagues began to piece together albumin s portrait, the formation of its electron densities coalescing on

  8. Volcanic Plume Chemistry: Models, Observations and Impacts

    NASA Astrophysics Data System (ADS)

    Roberts, Tjarda; Martin, Robert; Oppenheimer, Clive; Griffiths, Paul; Braban, Christine; Cox, Tony; Jones, Rod; Durant, Adam; Kelly, Peter

    2010-05-01

    Volcanic plumes are highly chemically reactive; both in the hot, near-vent plume, and also at ambient temperatures in the downwind plume, as the volcanic gases and aerosol disperse into the background atmosphere. In particular, DOAS (Differential Optical Absortpion Spectroscopy) observations have identified BrO (Bromine Monoxide) in several volcanic plumes degassing into the troposphere. These observations are explained by rapid in-plume autocatalytic BrO-chemistry that occurs whilst the plume disperses, enabling oxidants such as ozone from background air to mix with the acid gases and aerosol. Computer modelling tools have recently been developed to interpret the observed BrO and predict that substantial ozone depletion occurs downwind. Alongside these modelling developments, advances in in-situ and remote sensing techniques have also improved our observational understanding of volcanic plumes. We present simulations using the model, PlumeChem, that predict the spatial distribution of gases in volcanic plumes, including formation of reactive halogens BrO, ClO and OClO that are enhanced nearer the plume edges, and depletion of ozone within the plume core. The simulations also show that in-plume chemistry rapidly converts NOx into nitric acid, providing a mechanism to explain observed elevated in-plume HNO3. This highlights the importance of coupled BrO-NOx chemistry, both for BrO-formation and as a production mechanism for HNO3 in BrO-influenced regions of the atmosphere. Studies of coupled halogen-H2S-chemistry are consistent with in-situ Alphasense electrochemical sensor observations of H2S at a range of volcanoes, and only predict H2S-depletion if Cl is additionally elevated. Initial studies regarding the transformations of mercury within volcanic plumes suggest that significant in-plume conversion of Hg0 to Hg2+ can occur in the downwind plume. Such Hg2+ may impact downwind ecology through enhanced Hg-deposition, and causing enhanced biological uptake of

  9. Recent Advances in Egypt for Treatment of Talar Osteochondral Lesions.

    PubMed

    Haleem, Amgad M; AbouSayed, Mostafa M; Gomaa, Mohammed

    2016-06-01

    Treatment of osteochondral defects (OCLs) of the talus is a challenging orthopedic surgery. Treatment of talar OCLs has evolved through the 3 "R" paradigm: reconstruction, repair, and replacement. This article highlights current state-of-the-art techniques and reviews recent advances in the literature about articular cartilage repair using various novel tissue engineering approaches, including various scaffolds, growth factors, and cell niches; which include chondrocytes and culture-expanded bone marrow-derived mesenchymal stem cells.

  10. Modeling Europa's dust plumes

    NASA Astrophysics Data System (ADS)

    Southworth, B. S.; Kempf, S.; Schmidt, J.

    2015-12-01

    The discovery of Jupiter's moon Europa maintaining a probably sporadic water vapor plume constitutes a huge scientific opportunity for NASA's upcoming mission to this Galilean moon. Measuring properties of material emerging from interior sources offers a unique chance to understand conditions at Europa's subsurface ocean. Exploiting results obtained for the Enceladus plume, we simulate possible Europa plume configurations, analyze particle number density and surface deposition results, and estimate the expected flux of ice grains on a spacecraft. Due to Europa's high escape speed, observing an active plume will require low-altitude flybys, preferably at altitudes of 5-100 km. At higher altitudes a plume may escape detection. Our simulations provide an extensive library documenting the possible structure of Europa dust plumes, which can be quickly refined as more data on Europa dust plumes are collected.

  11. Dust Plume off Mauritania

    NASA Technical Reports Server (NTRS)

    2007-01-01

    A thick plume of dust blew off the coast of Mauritania in western Africa on October 2, 2007. The Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA's Aqua satellite observed the dust plume as it headed toward the southwest over the Atlantic Ocean. In this image, the dust varies in color from nearly white to medium tan. The dust plume is easier to see over the dark background of the ocean, but the plume stretches across the land surface to the east, as well. The dust plume's structure is clearest along the coastline, where relatively clear air pockets separate distinct puffs of dust. West of that, individual pillows of dust push together to form a more homogeneous plume. Near its southwest tip, the plume takes on yet another shape, with stripes of pale dust fanning out toward the northwest. Occasional tiny white clouds dot the sky overhead, but skies are otherwise clear.

  12. Advanced gastric cancer: Current treatment landscape and future perspectives

    PubMed Central

    Digklia, Antonia; Wagner, Anna Dorothea

    2016-01-01

    Gastric cancer currently ranks fourth in cancer-related mortality worldwide. In the western world, it is most often diagnosed at an advanced stage, after becoming metastatic at distant sites. Patients with advanced disease (locally advanced or metastatic) have a somber prognosis, with a median overall survival of 10-12 mo, and palliative chemotherapy is the mainstay of treatment. In recent years, novel approaches using inhibition of human epidermal growth factor receptor 2 (HER2) have demonstrated significant improvements in progression-free and overall survival, compared with chemotherapy alone, in first-line treatment of patients with overexpression of HER2. In addition, both second-line chemotherapy and treatment with the vascular endothelial growth factor receptor-inhibitor ramucirumab demonstrated significant benefits in terms of overall survival, compared with best supportive care, in randomized studies. Moreover, ramucirumab in combination with chemotherapy demonstrated further significant benefits in terms of progression-free and overall survival, compared with chemotherapy alone, in second-line treatment for patients with metastatic gastric cancer. A recently published molecular classification of gastric cancer is expected to improve patient stratification and selection for clinical trials and provide a roadmap for future drug development. Nevertheless, despite these developments the prognosis of patients with advanced gastric cancer remains poor. In this review we discuss current standards of care and outline major topics of drug development in gastric cancer. PMID:26937129

  13. Advanced oxidation processes with coke plant wastewater treatment.

    PubMed

    Krzywicka, A; Kwarciak-Kozłowska, A

    2014-01-01

    The aim of this study was to determine the most efficient method of coke wastewater treatment. This research examined two processes - advanced oxidation with Fenton and photo-Fenton reaction. It was observed that the use of ultraviolet radiation with Fenton process had a better result in removal of impurities.

  14. Advanced Waste Treatment. A Field Study Training Program.

    ERIC Educational Resources Information Center

    California State Univ., Sacramento. Dept. of Civil Engineering.

    This operations manual represents a continuation of operator training manuals developed for the United States Environmental Protection Agency (USEPA) in response to the technological advancements of wastewater treatment and the changing needs of the operations profession. It is intended to be used as a home-study course manual (using the concepts…

  15. Targeted Approach to Overcoming Treatment Resistance in Advanced Prostate Cancer

    DTIC Science & Technology

    2013-07-01

    therapy -­‐resistant   prostate   cancer  cells  and  in  combination   therapy  (SOW...treatment resistance in advanced prostate cancer PRINCIPAL INVESTIGATOR: Dr. Karin Scarpinato CONTRACTING ORGANIZATION: Georgia Southern...SUPPLEMENTARY NOTES 14. ABSTRACT The purpose of this project is to determine if rescinnamine is effective against prostate cancer and

  16. Recent Advances in the Treatment of Isosexual Precocious Puberty

    PubMed Central

    Leung, Alexander K.C.; McArthur, Robert G.

    1991-01-01

    In isosexual precocious puberty, the changes that characterize puberty occur in roughly the same order, but at a much earlier age. The causes and clinical features of isosexual precocity and their evaluation and treatment are discussed in this article, the purpose of which is to provide a general review of the disorder, taking into account recent advances in its management. PMID:20469522

  17. Advances in developing alternative treatments for postharvest pest control

    Technology Transfer Automated Retrieval System (TEKTRAN)

    USDA-ARS made two significant advances in the last 10 years in the development of alternative treatments for postharvest pest control: oxygenated phosphine fumigation and nitric oxide fumigation. Oxygenated phosphine is phosphine fumigation in an oxygen enriched atmosphere. It is significantly more...

  18. Advances in the treatment of visual hallucinations in neurodegenerative diseases

    PubMed Central

    Collerton, Daniel; Taylor, John-Paul

    2013-01-01

    Treatment of visual hallucinations in neurodegenerative disorders is not well advanced. The complexity of underlying mechanisms presents a number of potential avenues for developing treatments, but also suggests that any single one may be of limited efficacy. Reducing medication, with the careful introduction of antidementia medication if needed, is the mainstay of current management. Antipsychotic medication leads to excessive morbidity and mortality and should only be used in cases of high distress that do not otherwise respond. Education, reduction of risk factors and psychological treatments have limited evidence of efficacy, but are unlikely to cause harm. PMID:23882162

  19. Advances in the treatment of inherited coagulation disorders.

    PubMed

    Escobar, M A

    2013-09-01

    Inherited coagulation disorders constitute a broad spectrum of coagulation factor deficiencies that include X-linked factor (F)VIII or FIX deficiency that causes haemophilia, and autosomal recessive disorders producing heterogeneous deficiencies in fibrinogen (FI), prothrombin (FII), FV, FVII, FX, FXI, FXIII and combined FV+FVIII. Significant advances in treatments for patients with congenital haemophilia A (FVIII deficiency) and B (FIX deficiency) over the last two decades have resulted from improvements in the production, availability and patient access to factor replacement products. Translation of advances in biotechnology, namely recombinant protein technology, targeted protein modifications to improve function and potentially reduce immunogenicity, and advanced formulations to optimize bioavailability and sustain activity offer promisingly new treatments for haemophilia as well as recessively inherited bleeding disorders in patients who otherwise have few therapeutic options. Though a theoretical risk remains for blood-borne viral infections with pooled plasma-derived products, this concern has diminished with breakthroughs in purification and viral inactivation methods. Development of inhibitory antibodies is still the most daunting problem for patients with inherited bleeding disorders, complicating treatment approaches to control and prevent bleeding, and posing risks for allergic and anaphylactic reactions in susceptible patients. The objectives of this review are to (i) highlight emerging advances in hemostatic therapies that are bioengineered to improve pharmacokinetic properties and bioavailability, sustain functional activity, and possibly eliminate immunogenicity of recombinant factor proteins; and (ii) present an overview of key clinical trials of novel factor products currently in the development pipeline.

  20. [Recent advances in medical and surgical treatment of ulcerative colitis].

    PubMed

    Sugita, Akira; Koganei, Kazutaka; Tatsumi, Kenji; Futatsuki, Ryo; Kuroki, Hirosuke; Yamada, Kyoko; Arai, Katsuhiko; Fukushima, Tsuneo

    2015-03-01

    Recent advances in both medical and surgical treatment of ulcerative colitis have been remarkable. Changes in medical treatment are mainly good results of therapy with the anti-TNF-α antibody, tacrolimus, and those in surgical treatment are an expansion of the surgical indications to include patients with intractable disease, such as treatment refractoriness and chronic corticosteroid dependence, by a better postoperative clinical course after pouch surgery, improred selection of surgical procedures and the timing of surgery in elderly patients. To offer the optimal treatment for patients with ulcerative colitis, new medical therapies should be analyzed from the standpoint of the efficacy and limitations of effect. Long postoperative clinical course of surgical patients including colitic cancer, prevention of postoperative complications should be also analyzed.

  1. Recent advances in the medical treatment of breast cancer

    PubMed Central

    Vorobiof, Daniel A.

    2016-01-01

    Over the past few decades, the systemic therapy of breast cancer (early and advanced) has changed considerably. For the past 40–50 years, and since the discovery and further therapeutic use of tamoxifen, a selective estrogen receptor modulator, breast cancer treatment has become the model for the development and success of tailored medical treatment. Much still needs to be done in improving outcomes for all patients with breast cancer, and especially for those who have advanced breast cancer, a challenging area for medical oncologists. Ongoing international clinical trials are currently evaluating new therapeutic approaches and identifying specific biological subsets that could determine a patient’s ability to respond to particular chemotherapeutic drugs. PMID:27990275

  2. Surgical adjuvant treatment of locally advanced breast cancer.

    PubMed Central

    Townsend, C M; Abston, S; Fish, J C

    1985-01-01

    The reported incidence of local recurrence after mastectomy for locally advanced breast cancer (TNM Stage III and IV) is between 30% and 50%. The purpose of this study was to evaluate the effect of radiation therapy (XRT) followed by total mastectomy on the incidence of local recurrence in patients with locally advanced breast cancer. Fifty-three patients who presented with locally advanced breast cancer, without distant metastases, were treated with XRT (4500-5000 R) to the breast, chest wall, and regional lymph nodes. Five weeks after completion of XRT, total mastectomy was performed. There were no operative deaths. The complications that occurred in 22 patients after surgery were flap necrosis, wound infection, and seroma. Patients have been followed from 3 to 134 months. Twenty-five patients are alive (3-134 months), 12 free of disease; 28 patients have died with distant metastases (6-67 months). Isolated local recurrence occurred in only two patients. Four patients had local and distant recurrence (total local recurrence is 6/53). The remaining patients all developed distant metastases. We have devised a treatment strategy which significantly decreases the incidence of local recurrence in patients with locally advanced breast cancer. However, the rapid appearance of distant metastases emphasizes the need for systemically active therapy in patients with locally advanced breast cancer. PMID:3994434

  3. Modeling Europa's Dust Plumes

    NASA Astrophysics Data System (ADS)

    Southworth, B.; Kempf, S.; Schmidt, J.

    2015-12-01

    The discovery of Europa maintaining a probably sporadic water vapor plume constitutes a huge scientific opportunity for NASA's upcoming mission to this Galilean moon. Measuring the properties of material emerging from interior sources offers a unique chance to understand conditions at Europa's subsurface ocean. Exploiting results obtained for the Enceladus plume, we adjust the ejection model by Schmidt et al. [2008] to the conditions at Europa. In this way, we estimate properties of a possible, yet unobserved dust component of the Europa plume. For a size-dependent speed distribution of emerging ice particles we use the model from Kempf et al. [2010] for grain dynamics, modified to run simulations of plumes on Europa. Specifically, we model emission from the two plume locations determined from observations by Roth et al. [2014] and also from other locations chosen at the closest approach of low-altitude flybys investigated in the Europa Clipper study. This allows us to estimate expected fluxes of ice grains on the spacecraft. We then explore the parameter space of Europa dust plumes with regard to particle speed distribution parameters, plume location, and spacecraft flyby elevation. Each parameter set results in a 3-dimensional particle density structure through which we simulate flybys, and a map of particle fallback ('snowfall') on the surface of Europa. Due to the moon's high escape speed, a Europa plume will eject few to no particles that can escape its gravity, which has several further consequences: (i) For given ejection velocity a Europa plume will have a smaller scale height, with a higher particle number densities than the plume on Enceladus, (ii) plume particles will not feed the diffuse Galilean dust ring, (iii) the snowfall pattern on the surface will be more localized about the plume location, and will not induce a global m = 2 pattern as seen on Enceladus, and (iv) safely observing an active plume will require low altitude flybys, preferably at 50

  4. Life Prediction of Fretting Fatigue with Advanced Surface Treatments (Preprint)

    DTIC Science & Technology

    2006-05-01

    surfaces and not the fretting pads. The chosen coatings included DLC, Ni-B, Molybdenum, and Nitride. These 4 coatings, their application to the titanium ...Article Preprint 5a. CONTRACT NUMBER In-house 5b. GRANT NUMBER 4 . TITLE AND SUBTITLE LIFE PREDICTION OF FRETTING FATIGUE WITH ADVANCED SURFACE...TREATMENTS (PREPRINT) 5c. PROGRAM ELEMENT NUMBER N/A 5d. PROJECT NUMBER M02R 5e. TASK NUMBER 30 6 . AUTHOR(S) Patrick J. Golden and Michael

  5. Sipuleucel-T for the treatment of advanced prostate cancer.

    PubMed

    Frohlich, Mark W

    2012-06-01

    Sipuleucel-T is an autologous cellular immunotherapy designed to stimulate an immune response to prostate cancer that prolongs the overall survival of men with asymptomatic or minimally symptomatic metastatic castrate-resistant prostate cancer (CRPC). The clinical development program and key efficacy, safety, and immune response findings from the phase III studies are presented. The integration of sipuleucel-T into the treatment paradigm of advanced prostate cancer and future directions for research are discussed.

  6. Advances in temporary mechanical support for treatment of cardiogenic shock.

    PubMed

    Koprivanac, Marijan; Kelava, Marta; Soltesz, Edward; Smedira, Nicholas; Kapadia, Samir; Brzezinski, Anna; Alansari, Shehab; Moazami, Nader

    2015-01-01

    Mechanical circulatory support devices are the mainstay of treatment for severe cardiogenic shock refractory to pharmacologic therapy. Their evolution over the past few decades has been remarkable with a common theme of developing reliable, less bulky and more easily percutaneously implantable devices. The goal of this article is to review existing devices and advances in technology and provide insight into direction of further research and evolution of mechanical circulatory support devices for temporary support.

  7. Advancement in treatment and diagnosis of pancreatic cancer with radiopharmaceuticals

    PubMed Central

    Xu, Yu-Ping; Yang, Min

    2016-01-01

    Pancreatic cancer (PC) is a major health problem. Conventional imaging modalities show limited accuracy for reliable assessment of the tumor. Recent researches suggest that molecular imaging techniques with tracers provide more biologically relevant information and are benefit for the diagnosis of the cancer. In addition, radiopharmaceuticals also play more important roles in treatment of the disease. This review summaries the advancement of the radiolabeled compounds in the theranostics of PC. PMID:26909131

  8. Evaluation of advanced oxidation process for the treatment of groundwater

    SciTech Connect

    Garland, S.B. II ); Peyton, G.R. ); Rice, L.E. . Kansas City Div.)

    1990-01-01

    An advanced oxidation process utilizing ozone, ultraviolet radiation, and hydrogen peroxide was selected for the removal of chlorinated hydrocarbons, particularly trichlorethene and 1,2-dichlorethene, from groundwater underlying the US Department of Energy Kansas City Plant. Since the performance of this process for the removal of organics from groundwater is not well-documented, an evaluation was initiated to determine the performance of the treatment plant, document the operation and maintenance costs experience, and evaluate contaminant removal mechanisms. 11 refs., 3 figs.

  9. Advances in diagnosis and treatment of nonmelanoma skin cancer.

    PubMed

    Ibrahim, Omer; Gastman, Brian; Zhang, Alexandra

    2014-11-01

    The incidence of nonmelanoma skin cancer (NMSC) is rising. Research in the field of these tumors is aimed toward developing earlier and less invasive diagnostic methods and more effective, more accessible therapeutic options. Although there is much advancement in the diagnosis and treatment of NMSC, there are few literatures cataloging these developments. The aim of this review was to present the sensitivity and specificity of new imaging modalities, the dosing regimen and clearance rates of topical treatments, newer systemic treatment modalities, and discuss developments in the use of radiation as a mode of therapy. Recent developments in the diagnosis of NMSC include imaging modalities such as reflectance confocal microscopy, elastic scattering spectroscopy, and spectrophotometric intracutaneous analysis. Recent advances in the treatment of these tumors include systemic therapies such as epidermal growth factor receptor inhibitors, and topical immunomodulating drugs such as imiquimod. The progress in the diagnosis and treatment of these tumors is a gradual but fruitful growth. Scientists and clinicians alike must continue their exploration and study to address these tumors and, hopefully in the future, prevent their occurrence.

  10. NRL Satellite Volcanic Ash Plume Monitoring

    NASA Astrophysics Data System (ADS)

    Hawkins, J.; Kuciauskas, A. P.; Richardson, K.; Solbrig, J.; Miller, S. D.; Pavolonis, M. J.; Bankert, R.; Lee, T.; Kent, J.; Tsui, T.

    2009-12-01

    The Naval Research Laboratory’s (NRL) Marine Meteorology Division (NRL-MRY) is assembling a unique suite of near real-time digital satellite products geared towards monitoring volcanic ash plumes which can create hazardous aviation conditions. Ash plume detection, areal extent, plume top height and mass loading will be extracted via automated algorithms from a combination of geostationary (GEO) and low earth orbiting (LEO) data sets that take advantage of their complimentary strengths since no one sensor has the required spectral, spatial and temporal attributes needed. This product suite would then be available to the Volcanic Ash Advisory Centers (VAAC) and other interested users via web distribution. Initially, GOES-West and the Japanese MTSAT data will be incorporated to view volcanic plumes within the north Pacific region. Although GEO sensor spectral channels are not optimized for ash detection, temporal changes over limited timeframes can assist in plume extraction, but not for those at the highest latitudes. Examples with multi-channel techniques will be highlighted via animations. LEO sensors provide a suite of spectral channels unmatched on GEO platforms and permit enhanced ash plume monitoring. NRL has exploited the Moderate Resolution Imaging Spectroradiometer (MODIS) and SeaWiFS via a “dust enhancement technique” that has demonstrated positive plume monitoring results. Multi-channel methods using the Advanced Very High Resolution Radiometer (AVHRR) will be highlighted to take advantage of the numerous NOAA LEO satellites carrying this wide swath sensor with frequent volcano overpasses at the higher latitudes. The DMSP Operational Linescan System (OLS) provides daytime visible/infrared, as well as night time visible data which has shown value in spotting ash plumes when sufficient lunar illumination is present. The following suite of products is potentially available for over twenty (20) volcano sites world-wide via our NexSat web site: http

  11. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances.

    PubMed

    Ito, Tetsuhide; Igarashi, Hisato; Jensen, Robert T

    2012-12-01

    Pancreatic neuroendocrine tumors (pNETs) comprise with gastrointestinal carcinoids, the main groups of gastrointestinal neuroendocrine tumors (GI-NETs). Although these two groups of GI-NETs share many features including histological aspects; over-/ectopic expression of somatostatin receptors; the ability to ectopically secrete hormones/peptides/amines which can result in distinct functional syndromes; similar approaches used for tumor localization and some aspects of treatment, it is now generally agreed they should be considered separate. They differ in their pathogenesis, hormonal syndromes produced, many aspects of biological behaviour and most important, in their response to certain anti-tumour treatment (chemotherapy, molecular targeted therapies). In this chapter the clinical features of the different types of pNETs will be considered as well as aspects of their diagnosis and medical treatment of the hormone-excess state. Emphasis will be on controversial areas or recent advances. The other aspects of the management of these tumors (surgery, treatment of advanced disease, tumor localization) are not dealt with here, because they are covered in other chapters in this volume.

  12. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances

    PubMed Central

    Ito, Tetsuhide; Igarashi, Hisato; Jensen, Robert T.

    2013-01-01

    Pancreatic neuroendocrine tumors (pNETs) comprise with gastrointestinal carcinoids, the main groups of gastrointestinal neuroendocrine tumors (GI-NETs). Although these two groups of GI-NETs share many features including histological aspects; over-/ectopic expression of somatostatin receptors; the ability to ectopically secrete hormones/peptides/amines which can result in distinct functional syndromes; similar approaches used for tumor localization and some aspects of treatment, it is now generally agreed they should be considered separate. They differ in their pathogenesis, hormonal syndromes produced, many aspects of biological behavior and most important, in their response to certain anti-tumor treatment (chemotherapy, molecular targeted therapies). In this chapter the clinical features of the different types of pNETs will be considered as well as aspects of their diagnosis and medical treatment of the hormone-excess state. Emphasis will be on controversial areas or recent advances. The other aspects of the management of these tumors (surgery, treatment of advanced disease, tumor localization) are not dealt with here, because they are covered in other chapters in this volume. PMID:23582916

  13. [Advance notice of contents of treatment influences patients' stress during dental treatment].

    PubMed

    Ozaki, Takashi

    2010-03-01

    The purpose of this study is to clarify the effect of advance notice of contents of treatment on the patients' physiological stress during dental treatment The subjects of our study comprised 34 non-dental professionals (22 female and 12 male). In simulated dental treatment, the subjects were exposed to predetermined stimulations comprised of blowing air on the molars, percussion on the premolar and usage of an air turbine next to the molar in randomized order, with/without advance notice. The skin potential level (SPL) of the subjects was measured as a physiological stress index during such simulated dental treatment As a psychological profile, the stress-coping style of each subject was examined using Lazarus Type Stress Coping Inventory (SCI). The number of decayed, missing, filled teeth (DMF). and the experience of teeth extraction in the past of each subject was also recorded. The correlation among advance notice, order and kind of stimulation, factors of SCI, DMF, gender of the subject, the experience of teeth extraction, and the subjects' stress (SPL change) was statistically analyzed using the generalized estimating equation. As a result, the effect of advance notice on the subjects' stress was opposite when the stress-coping style differed; therefore, dentists must pay attention to the patients' psychological characteristics when using advance notice for the purpose of relieving the patients' stress during dental treatment.

  14. High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer

    PubMed Central

    Zhou, Yufeng

    2014-01-01

    Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU) is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS) score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered. PMID:25053938

  15. CAP--advancing the evaluation of preclinical Alzheimer disease treatments.

    PubMed

    Reiman, Eric M; Langbaum, Jessica B; Tariot, Pierre N; Lopera, Francisco; Bateman, Randall J; Morris, John C; Sperling, Reisa A; Aisen, Paul S; Roses, Allen D; Welsh-Bohmer, Kathleen A; Carrillo, Maria C; Weninger, Stacie

    2016-01-01

    If we are to find treatments to postpone, reduce the risk of, or completely prevent the clinical onset of Alzheimer disease (AD), we need faster methods to evaluate promising preclinical AD treatments, new ways to work together in support of common goals, and a determination to expedite the initiation and performance of preclinical AD trials. In this article, we note some of the current challenges, opportunities and emerging strategies in preclinical AD treatment. We describe the Collaboration for Alzheimer's Prevention (CAP)-a convening, harmonizing and consensus-building initiative to help stakeholders advance AD prevention research with rigour, care and maximal impact-and we demonstrate the impact of CAP on the goals and design of new preclinical AD trials.

  16. Advances in mechanisms, diagnosis, and treatment of pernicious anemia.

    PubMed

    Rojas Hernandez, Cristhiam M; Oo, Thein Hlaing

    2015-03-01

    Pernicious anemia (PA) is an entity initially described in 1849 as a condition that consisted of pallor, weakness, and progressive health decline. Since then several advances led to the conclusion that PA is an autoimmune disease characterized by the deficient absorption of dietary cobalamin. It is currently recognized as the most common cause of cobalamin deficiency worldwide. We hereby review the current understanding of the disease and its neurological, hematological, and biochemical manifestations with emphasis on the diagnostic approach, treatment, and monitoring strategies. We propose an algorithm for the diagnostic approach considering the current performance and limitations of the available diagnostic tools for evaluation of cobalamin status and the presence of autoimmune chronic atrophic gastritis (CAG). Patients with PA require lifelong treatment with cobalamin replacement therapy. The current widely available treatment can be provided through enteral or parenteral cobalamin supplements, with comparable efficacy and tolerability.

  17. CAP—advancing the evaluation of preclinical Alzheimer disease treatments

    PubMed Central

    Reiman, Eric M.; Langbaum, Jessica B.; Tariot, Pierre N.; Lopera, Francisco; Bateman, Randall J.; Morris, John C.; Sperling, Reisa A.; Aisen, Paul S.; Roses, Allen D.; Welsh-Bohmer, Kathleen A.; Carrillo, Maria C.; Weninger, Stacie

    2016-01-01

    If we are to find treatments to postpone, reduce the risk of, or completely prevent the clinical onset of Alzheimer disease (AD), we need faster methods to evaluate promising preclinical AD treatments, new ways to work together in support of common goals, and a determination to expedite the initiation and performance of preclinical AD trials. In this article, we note some of the current challenges, opportunities and emerging strategies in preclinical AD treatment. We describe the Collaboration for Alzheimer’s Prevention (CAP)—a convening, harmonizing and consensus-building initiative to help stakeholders advance AD prevention research with rigour, care and maximal impact—and we demonstrate the impact of CAP on the goals and design of new preclinical AD trials. PMID:26416539

  18. Microbial populations in contaminant plumes

    USGS Publications Warehouse

    Haack, S.K.; Bekins, B.A.

    2000-01-01

    Efficient biodegradation of subsurface contaminants requires two elements: (1) microbial populations with the necessary degradative capabilities, and (2) favorable subsurface geochemical and hydrological conditions. Practical constraints on experimental design and interpretation in both the hydrogeological and microbiological sciences have resulted in limited knowledge of the interaction between hydrogeological and microbiological features of subsurface environments. These practical constraints include: (1) inconsistencies between the scales of investigation in the hydrogeological and microbiological sciences, and (2) practical limitations on the ability to accurately define microbial populations in environmental samples. However, advances in application of small-scale sampling methods and interdisciplinary approaches to site investigations are beginning to significantly improve understanding of hydrogeological and microbiological interactions. Likewise, culture-based and molecular analyses of microbial populations in subsurface contaminant plumes have revealed significant adaptation of microbial populations to plume environmental conditions. Results of recent studies suggest that variability in subsurface geochemical and hydrological conditions significantly influences subsurface microbial-community structure. Combined investigations of site conditions and microbial-community structure provide the knowledge needed to understand interactions between subsurface microbial populations, plume geochemistry, and contaminant biodegradation.

  19. Treatment of advanced renal cell carcinoma: recent advances and current role of immunotherapy, surgery, and cryotherapy.

    PubMed

    Mennitto, Alessia; Verzoni, Elena; Calareso, Giuseppina; Spreafico, Carlo; Procopio, Giuseppe

    2017-01-21

    Renal cell carcinoma (RCC) is the 10th most common cancer in Western countries. The prognosis of metastatic disease is unfavorable but may be different according to several risk factors, such as histology and clinical features (Karnofsky performance status, time from nephrectomy, hemoglobin level, neutrophils and thrombocytes count, lactate dehydrogenase and calcium serum value, sites and extension of the disease). In this review, we focused on some recent developments in the use of immunotherapy, surgery and cryotherapy in the treatment of advanced disease. While RCC is unresponsive to chemotherapy, recent advances have emerged with the development of targeted agents and innovative immunotherapy-based treatments. Surgical resection remains the standard of care for patients with small renal lesions but in patients with significant comorbidities ablative therapies such as cryoablation and radiofrequency ablation may lead to local cancer control and avoid surgical complications and morbidity. In the setting of metastatic RCC, radical nephrectomy, or cytoreductive nephrectomy, is considered a palliative surgery, usually part of a multimodality treatment approach that requires systemic treatments.

  20. Recent and Future Advances in the Treatment of Status Epilepticus

    PubMed Central

    Knake, Susanne

    2008-01-01

    Status epilepticus (SE) is one of the most frequent neurological emergencies with an incidence of 20/100,000 per year and a mortality between 3% and 40% depending on etiology, age, SE type and duration. Generalized convulsive forms of SE (GTCSE), in particular, require aggressive treatment. Presently, only 55–80% of cases of GTCSE are controlled by initial therapy. Therefore, there is a need for new options for the treatment of SE. Here we review the current standard treatment including recent advances and provide a summary of preclinical and clinical data regarding treatment options which may become available in the near future. The initial treatment of SE usually consists of a benzodiazepine (preferably lorazepam 0.1 mg/kg) followed by phenytoin or fosphenytoin or valproic acid (where approved for SE therapy). With intravenous formulations of levetiracetam, available since 2006, and lacosamide, which is expected for autumn of 2008, new treatment options have become available, that should be evaluated in prospective controlled trials. If SE remains refractory, the induction of general anaesthesia using propofol, midazolam, thiopental, or pentobarbital is warranted in GTCSE. PMID:21180563

  1. Advancing Land-Sea Conservation Planning: Integrating Modelling of Catchments, Land-Use Change, and River Plumes to Prioritise Catchment Management and Protection.

    PubMed

    Álvarez-Romero, Jorge G; Pressey, Robert L; Ban, Natalie C; Brodie, Jon

    2015-01-01

    Human-induced changes to river loads of nutrients and sediments pose a significant threat to marine ecosystems. Ongoing land-use change can further increase these loads, and amplify the impacts of land-based threats on vulnerable marine ecosystems. Consequently, there is a need to assess these threats and prioritise actions to mitigate their impacts. A key question regarding prioritisation is whether actions in catchments to maintain coastal-marine water quality can be spatially congruent with actions for other management objectives, such as conserving terrestrial biodiversity. In selected catchments draining into the Gulf of California, Mexico, we employed Land Change Modeller to assess the vulnerability of areas with native vegetation to conversion into crops, pasture, and urban areas. We then used SedNet, a catchment modelling tool, to map the sources and estimate pollutant loads delivered to the Gulf by these catchments. Following these analyses, we used modelled river plumes to identify marine areas likely influenced by land-based pollutants. Finally, we prioritised areas for catchment management based on objectives for conservation of terrestrial biodiversity and objectives for water quality that recognised links between pollutant sources and affected marine areas. Our objectives for coastal-marine water quality were to reduce sediment and nutrient discharges from anthropic areas, and minimise future increases in coastal sedimentation and eutrophication. Our objectives for protection of terrestrial biodiversity covered species of vertebrates. We used Marxan, a conservation planning tool, to prioritise interventions and explore spatial differences in priorities for both objectives. Notable differences in the distributions of land values for terrestrial biodiversity and coastal-marine water quality indicated the likely need for trade-offs between catchment management objectives. However, there were priority areas that contributed to both sets of objectives. Our

  2. Advancing Land-Sea Conservation Planning: Integrating Modelling of Catchments, Land-Use Change, and River Plumes to Prioritise Catchment Management and Protection

    PubMed Central

    Álvarez-Romero, Jorge G.; Pressey, Robert L.; Ban, Natalie C.; Brodie, Jon

    2015-01-01

    Human-induced changes to river loads of nutrients and sediments pose a significant threat to marine ecosystems. Ongoing land-use change can further increase these loads, and amplify the impacts of land-based threats on vulnerable marine ecosystems. Consequently, there is a need to assess these threats and prioritise actions to mitigate their impacts. A key question regarding prioritisation is whether actions in catchments to maintain coastal-marine water quality can be spatially congruent with actions for other management objectives, such as conserving terrestrial biodiversity. In selected catchments draining into the Gulf of California, Mexico, we employed Land Change Modeller to assess the vulnerability of areas with native vegetation to conversion into crops, pasture, and urban areas. We then used SedNet, a catchment modelling tool, to map the sources and estimate pollutant loads delivered to the Gulf by these catchments. Following these analyses, we used modelled river plumes to identify marine areas likely influenced by land-based pollutants. Finally, we prioritised areas for catchment management based on objectives for conservation of terrestrial biodiversity and objectives for water quality that recognised links between pollutant sources and affected marine areas. Our objectives for coastal-marine water quality were to reduce sediment and nutrient discharges from anthropic areas, and minimise future increases in coastal sedimentation and eutrophication. Our objectives for protection of terrestrial biodiversity covered species of vertebrates. We used Marxan, a conservation planning tool, to prioritise interventions and explore spatial differences in priorities for both objectives. Notable differences in the distributions of land values for terrestrial biodiversity and coastal-marine water quality indicated the likely need for trade-offs between catchment management objectives. However, there were priority areas that contributed to both sets of objectives. Our

  3. The Oak Ridge Field Research Center : Advancing Scientific Understanding of the Transportation, Fate, and Remediation of Subsurface Contamination Sources and Plumes

    SciTech Connect

    David Watson

    2005-04-18

    Historical research, development, and testing of nuclear materials across this country resulted in subsurface contamination that has been identified at over 7,000 discrete sites across the U.S. Department of Energy (DOE) complex. With the end of the Cold War threat, DOE has shifted its emphasis to remediation, decommissioning, and decontamination of the immense volumes of contaminated groundwater, sediments, and structures at its sites. DOE currently is responsible for remediating 1.7 trillion gallons of contaminated groundwater, an amount equal to approximately four times the daily U.S. water consumption, and 40 million cubic meters of contaminated soil, enough to fill approximately 17 professional sports stadiums.* DOE also sponsors research intended to improve or develop remediation technologies, especially for difficult, currently intractable contaminants or conditions. The Oak Ridge FRC is representative of some difficult sites, contaminants, and conditions. Buried wastes in contact with a shallow water table have created huge reservoirs of contamination. Rainfall patterns affect the water table level seasonally and over time. Further, the hydrogeology of the area, with its fractures and karst geology, affects the movement of contaminant plumes. Plumes have migrated long distances and to surface discharge points through ill-defined preferred flowpaths created by the fractures and karst conditions. From the standpoint of technical effectiveness, remediation options are limited, especially for contaminated groundwater. Moreover, current remediation practices for the source areas, such as capping, can affect coupled processes that, in turn, may affect the movement of subsurface contaminants in unknown ways. Research conducted at the FRC or with FRC samples therefore promotes understanding of the processes that influence the transport and fate of subsurface contaminants, the effectiveness and long-term consequences of extant remediation options, and the

  4. [Locally advanced prostate cancer: definition, prognosis and treatment].

    PubMed

    Plantade, Anne; Massard, Christophe; de Crevoisier, Renaud; Fizazi, Karim

    2007-07-01

    According to d'Amico's criteria, high-risk localized prostate cancer are defined either by an extracapsular extension (T3 or T4), either by a high Gleason score (> 7) or a PSA rate higher than 20 ng/ml. Pelvic lymph node involvement also corresponds to locally advanced prostate cancer. Statistical models called nomograms have been developed to predict the probability of prostate cancer recurrence and are also used to define locally advanced patients. Prostate MRI may help to detect an extracapsular extension or a seminal vesicles involvement but remains still discussed. A bone scan, an abdominal and pelvic CT scan have to be performed in order to detect metastases. A pelvic lymph node dissection is recommended in order to adapt the treatment of these patients. Standard treatment for high-risk localized prostate cancer without lymph node involvement is now well defined. The association of both local radiation and a long androgen deprivation (GnHR agonist) showed an overall survival benefit (more than 10%). The radiation dose of 74 Gy is recommended. Other questions are still debating : the optimal duration of the hormonotherapy , the use of the bicalutamide 150 mg instead of GnRH agonists, the optimal radiation dose. Radical prostatectomy is no more considered as a standard treatment for these patients. Since the use of chemotherapy for metastatic patients showed a benefit in overall survival, the place of chemotherapy as adjuvant or neo-adjuvant treatment is questionned in several randomized phase III studies. Sometimes high-risk disease is diagnosed after performance of a radical prostatectomy. A postoperative radiation may be performed in order to decrease clinical and biochemical progression. The use of bicalutamide 150 mg in this situation may have a positive impact too on progression free survival. In case of lymph node involvement, androgen deprivation is the standard treatment with an overall survival benefit. The place of local radiation therapy is still

  5. Emplacement of zero-valent metal for remediation of deep contaminant plumes

    SciTech Connect

    Hubble, D.W.; Gillham, R.W.; Cherry, J.A.

    1997-12-31

    Some groundwater plumes containing chlorinated solvent contaminants are found to be so deep that current in situ remediation technologies cannot be economically applied. Also, source zones are often found to be too deep for removal or inaccessible due to surface features. Plumes emanating from these sources require containment or treatment. Containment technologies are available for shallow sites (< 15 m) and are being developed for greater depths. However, it is important to advance the science of reactive treatment - both for cut off of plumes and to contain and treat source zones. Zero-valent metal technology has been used for remediation of solvent plumes at sites in Canada, the UK and at several industrial and military sites in the USA. To date, all of the plumes treated with zero-valent metal (granular iron) have been at depths less than 15 m. This paper gives preliminary results of research into methods to emplace granular iron at depths in the range of 15 to 60 m. The study included review of available and emerging methods of installing barrier or reactive material and the selection, preliminary design and costing of several methods. The design of a treatment system for a 122 m wide PCE plume that, immediately down gradient from its source, extends from a depth of 24 to 37 m below the ground surface is used as a demonstration site. Both Permeable Reactive Wall and Funnel-and-Gate{trademark} systems were considered. The emplacement methods selected for preliminary design and costing were slurry wall, driven/vibrated beam, deep soil mixing and hydrofracturing injection. For each of these methods, the iron must be slurried for ease of pumping and placement using biodegradable polymer viscosifiers that leave the iron reactive.

  6. Entrainment by Lazy Plumes

    NASA Astrophysics Data System (ADS)

    Kaye, Nigel; Hunt, Gary

    2004-11-01

    We consider plumes with source conditions that have a net momentum flux deficit compared to a pure plume - so called lazy plumes. We examine both the case of constant buoyancy flux and buoyancy flux linearly increasing with height. By re-casting the plume conservation equations (Morton, Taylor & Turner 1956) for a constant entrainment coefficient ((α)) in terms of the plume radius (β) and the dimensionless parameter (Γ=frac5Q^2 B4α M^5/2) we show that the far-field flow in a plume with a linear internal buoyancy flux gain is a constant velocity lazy plume with reduced entrainment and radial growth rate. For highly lazy source conditions we derive first-order approximate solutions which indicate a region of zero entrainment near the source. These phenomena have previously been observed, however, it has often been assumed that reduced entrainment implies a reduced (α). We demonstrate that a constant (α) formulation is able to capture the behaviour of these reduced entrainment flows. Morton, B. R., Taylor, G. I. & Turner, J. S. (1956), Turbulent gravitational convection from maintained and instantaneous sources.', Proc. Roy. Soc. 234, 1-23.

  7. Treatment of diabetic retinopathy: Recent advances and unresolved challenges.

    PubMed

    Stewart, Michael W

    2016-08-25

    Diabetic retinopathy (DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor (VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement. Anti-VEGF injections improve visual acuity in patients with diabetic macular edema (DME) from 8-12 letters and improvements with corticosteroids are only slightly less. Unfortunately, a third of patients have an incomplete response to anti-VEGF therapy, but the best second-line therapy remains unknown. Current first-line therapy requires monthly visits and injections; longer acting therapies are needed to free up healthcare resources and improve patient compliance. VEGF suppression may be as effective as panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, but more studies are needed before PRP is abandoned. For over 30 years laser was the mainstay for the treatment of DME, but recent studies question its role in the pharmacologic era. Aggressive treatment improves vision in most patients, but many still do not achieve reading and driving vision. New drugs are needed to add to gains achieved with available therapies.

  8. Recent advances and novel treatment paradigms in acute lymphocytic leukemia

    PubMed Central

    Papadantonakis, Nikolaos; Advani, Anjali S.

    2016-01-01

    This is an exciting time in the treatment of acute lymphoblastic leukemia (ALL) given the advances in the relapsed/refractory setting. The development of antibody treatments (including antibody drug conjugates with toxins) offers a different treatment approach compared with conventional chemotherapy regimens. Moreover, the use of bispecific T-cell-engager antibodies (BiTEs) such as blinatumomab harness the cytotoxic activity of T cells against CD19-positive lymphoblasts. Another strategy involves the use of chimeric antigen receptor (CAR) T cells. CAR T cells have demonstrated promising results in the relapsed/refractory setting. However, the use of BiTEs and CAR T cells is also associated with a distinct set of adverse reactions that must be taken into account by the treating physician. Apart from the above strategies, the use of other targeted therapies has attracted interest. Namely, the discovery of the Philadelphia (Ph)-like signature in children and young adults with ALL has led to the use of tyrosine kinase inhibitors (TKI) in these patients. The different drugs and strategies that are being tested in the relapsed/refractory ALL setting pose a unique challenge in identifying the optimum sequence of treatment and determining which approaches should be considered for frontline treatment. PMID:27695616

  9. Treatment of diabetic retinopathy: Recent advances and unresolved challenges

    PubMed Central

    Stewart, Michael W

    2016-01-01

    Diabetic retinopathy (DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor (VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement. Anti-VEGF injections improve visual acuity in patients with diabetic macular edema (DME) from 8-12 letters and improvements with corticosteroids are only slightly less. Unfortunately, a third of patients have an incomplete response to anti-VEGF therapy, but the best second-line therapy remains unknown. Current first-line therapy requires monthly visits and injections; longer acting therapies are needed to free up healthcare resources and improve patient compliance. VEGF suppression may be as effective as panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, but more studies are needed before PRP is abandoned. For over 30 years laser was the mainstay for the treatment of DME, but recent studies question its role in the pharmacologic era. Aggressive treatment improves vision in most patients, but many still do not achieve reading and driving vision. New drugs are needed to add to gains achieved with available therapies. PMID:27625747

  10. Export of reactive nitrogen from coal-fired power plants in the U.S.: Estimates from a plume-in-grid modeling study

    NASA Astrophysics Data System (ADS)

    Vijayaraghavan, Krish; Zhang, Yang; Seigneur, Christian; Karamchandani, Prakash; Snell, Hilary E.

    2009-02-01

    The export of reactive nitrogen (nitrogen oxides and their oxidation products, collectively referred to as NOy) from coal-fired power plants in the U.S. to the rest of the world could have a significant global contribution to ozone. Traditional Eulerian gridded air quality models cannot characterize accurately the chemistry and transport of plumes from elevated point sources such as power plant stacks. A state-of-the-science plume-in-grid (PinG) air quality model, a reactive plume model embedded in an Eulerian gridded model, is used to estimate the export of NOy from 25 large coal-fired power plants in the U.S. (in terms of NOx and SO2 emissions) in July 2001 to the global atmosphere. The PinG model used is the Community Multiscale Air Quality Model with Advanced Plume Treatment (CMAQ-APT). A benchmark simulation with only the gridded model, CMAQ, is also conducted for comparison purposes. The simulations with and without advanced plume treatment show differences in the calculated export of NOy from the 25 plants considered reflecting the effect of using a detailed and explicit treatment of plume transport and chemistry. The advanced plume treatment results in 31% greater simulated export of NOy compared to the purely grid-based modeling approach. The export efficiency of NOy (the fraction of NOy emitted that is exported) is predicted to be 21% without APT and 27% with APT. When considering only export through the eastern boundary across the Atlantic, CMAQ-APT predicts that the export efficiency is 24% and that 2% of NOy is exported as NOx, 49% as inorganic nitrate, and 25% as PAN. These results are in reasonably good agreement with an analysis reported in the literature of aircraft measurements over the North Atlantic.

  11. Construction of the Largest Radionuclide Commingled Plume Groundwater Treatment Facility for the Department of Energy at the Hanford Site - 12411

    SciTech Connect

    Pargmann, Delise

    2012-07-01

    CH2M Hill Plateau Remediation Company (CHPRC) has constructed the largest groundwater treatment systems of its kind throughout the DOE Complex at the Hanford Site in an accelerated manner with American Recovery and Reinvestment Act (ARRA) funds. This complex, one of a kind groundwater treatment facility in Washington State has also attained Leadership in Energy and Environmental Design (LEED) Gold certification. The original concept for the 200 West Area groundwater treatment facility was a 6100 liter per minute (1,600 gallon per minute) facility. With additional ARRA funding, the plant design was improved to construct a 9500 liter per minute (2,500 gallon per minute) facility with expansion areas up to 14,000 liter per minute (3,750 gallon per minute). The current design will remove 53 percent more mass per year for faster clean-up. It is also expected to treat extracted groundwater to 25 percent or less than the Record of Decision-specified limit which improves Monitored Natural Attenuation (MNA) effectiveness. (author)

  12. Midfacial advancement by bone distraction for treatment of craniofacial deformities.

    PubMed

    Alonso, N; Munhoz, A M; Fogaça, W; Ferreira, M C

    1998-03-01

    Craniofaciostenosis is often associated with midfacial hypoplasia and has been treated traditionally using Le Fort advancement osteotomies and bone grafts. The surgical procedure requires a prolonged operating time, several osteotomies with a significant blood loss, and wide surgical exposure. According to the principles of bone lengthening, we performed midfacial advancement by bone distraction in 4 patients with midfacial hypoplasia to reduce the operative time and complication rate. In 2 patients with Crouzon's syndrome we performed a Le Fort III osteotomy and placed the distraction device behind the malar eminence and screwed it on the temporal bone bilaterally. In the other 2 children, with Apert's syndrome, we performed frontal advancement and remodeling before placing the device during the same surgery behind the malar bone without any midfacial osteotomy. It appears to us that patients with more severe deformities will need surgical procedures to offer more satisfactory results. In these patients, distraction is an initial therapy to reduce the severity of the deformity, making it possible to effect a better treatment afterward.

  13. Advances in non-dopaminergic treatments for Parkinson's disease

    PubMed Central

    Stayte, Sandy; Vissel, Bryce

    2014-01-01

    Since the 1960's treatments for Parkinson's disease (PD) have traditionally been directed to restore or replace dopamine, with L-Dopa being the gold standard. However, chronic L-Dopa use is associated with debilitating dyskinesias, limiting its effectiveness. This has resulted in extensive efforts to develop new therapies that work in ways other than restoring or replacing dopamine. Here we describe newly emerging non-dopaminergic therapeutic strategies for PD, including drugs targeting adenosine, glutamate, adrenergic, and serotonin receptors, as well as GLP-1 agonists, calcium channel blockers, iron chelators, anti-inflammatories, neurotrophic factors, and gene therapies. We provide a detailed account of their success in animal models and their translation to human clinical trials. We then consider how advances in understanding the mechanisms of PD, genetics, the possibility that PD may consist of multiple disease states, understanding of the etiology of PD in non-dopaminergic regions as well as advances in clinical trial design will be essential for ongoing advances. We conclude that despite the challenges ahead, patients have much cause for optimism that novel therapeutics that offer better disease management and/or which slow disease progression are inevitable. PMID:24904259

  14. Prometheus: Io's wandering plume.

    PubMed

    Kieffer, S W; Lopes-Gautier, R; McEwen, A; Smythe, W; Keszthelyi, L; Carlson, R

    2000-05-19

    Unlike any volcanic behavior ever observed on Earth, the plume from Prometheus on Io has wandered 75 to 95 kilometers west over the last 20 years since it was first discovered by Voyager and more recently observed by Galileo. Despite the source motion, the geometric and optical properties of the plume have remained constant. We propose that this can be explained by vaporization of a sulfur dioxide and/or sulfur "snowfield" over which a lava flow is moving. Eruption of a boundary-layer slurry through a rootless conduit with sonic conditions at the intake of the melted snow can account for the constancy of plume properties.

  15. Teaching the Mantle Plumes Debate

    NASA Astrophysics Data System (ADS)

    Foulger, G. R.

    2010-12-01

    There is an ongoing debate regarding whether or not mantle plumes exist. This debate has highlighted a number of issues regarding how Earth science is currently practised, and how this feeds into approaches toward teaching students. The plume model is an hypothesis, not a proven fact. And yet many researchers assume a priori that plumes exist. This assumption feeds into teaching. That the plume model is unproven, and that many practising researchers are skeptical, may be at best only mentioned in passing to students, with most teachers assuming that plumes are proven to exist. There is typically little emphasis, in particular in undergraduate teaching, that the origin of melting anomalies is currently uncertain and that scientists do not know all the answers. Little encouragement is given to students to become involved in the debate and to consider the pros and cons for themselves. Typically teachers take the approach that “an answer” (or even “the answer”) must be taught to students. Such a pedagogic approach misses an excellent opportunity to allow students to participate in an important ongoing debate in Earth sciences. It also misses the opportunity to illustrate to students several critical aspects regarding correct application of the scientific method. The scientific method involves attempting to disprove hypotheses, not to prove them. A priori assumptions should be kept uppermost in mind and reconsidered at all stages. Multiple working hypotheses should be entertained. The predictions of a hypothesis should be tested, and unpredicted observations taken as weakening the original hypothesis. Hypotheses should not be endlessly adapted to fit unexpected observations. The difficulty with pedagogic treatment of the mantle plumes debate highlights a general uncertainty about how to teach issues in Earth science that are not yet resolved with certainty. It also represents a missed opportunity to let students experience how scientific theories evolve, warts

  16. Treatment outcomes of micropulse transscleral cyclophotocoagulation in advanced glaucoma.

    PubMed

    Kuchar, Sarah; Moster, Marlene R; Reamer, Courtney B; Waisbourd, Michael

    2016-02-01

    Glaucoma is the leading cause of irreversible blindness worldwide. The goal of this study was to describe our experience with the novel micropulse transscleral cyclophotocoagulation (MP-TSCPC; IRIDEX IQ810 Laser Systems, CA) in patients with advanced glaucoma. Patients with advanced glaucoma who underwent MP-TSCPC were included in our study. Laser settings were 2000 mW of 810 nm infrared diode laser set on micropulse delivery mode. The laser was delivered over 360° for 100-240 s. The duty cycle was 31.3 %, which translated to 0.5 ms of "on time" and 1.1 ms of "off time." Surgical success was defined as an intraocular pressure (IOP) of 6-21 mmHg or a reduction of IOP by 20 % at the last follow-up visit. Failure was defined as an inability to meet the criteria for success or a need for incisional glaucoma surgery. Nineteen patients underwent MP-TSCPC with mean follow-up of 60.3 days. Mean IOP dropped from 37.9 mmHg preoperatively to 22.7 mmHg at last follow-up, representing a 40.1 % decrease. The success rate for initial treatment was 73.7 % (n = 14). Three patients underwent a second treatment, increasing the overall success rate to 89.5 % (n = 17). Four patients gained one line of vision, and four patients lost one line of vision. The novel MP-TSCPC laser had a high rate of surgical success after a short follow-up period in patients with advanced glaucoma. Further long-term evaluation and comparison to the traditional transscleral cyclophotocoagulation are warranted.

  17. Examining single-source secondary impacts estimated from brute-force, decoupled direct method, and advanced plume treatment approaches

    EPA Science Inventory

    In regulatory assessments, there is a need for reliable estimates of the impacts of precursor emissions from individual sources on secondary PM2.5 (particulate matter with aerodynamic diameter less than 2.5 microns) and ozone. Three potential methods for estimating th...

  18. Advances in the treatment of advanced oestrogen-receptor-positive breast cancer.

    PubMed

    Turner, Nicholas C; Neven, Patrick; Loibl, Sibylle; Andre, Fabrice

    2016-12-06

    Oestrogen-receptor-positive breast cancer is the most common subtype of breast cancer. Endocrine therapies that target the dependence of this subtype on the oestrogen receptor have substantial activity, yet the development of resistance to therapy is inevitable in advanced cancer. Major progress has been made in identifying the drivers of oestrogen-receptor-positive breast cancer and the mechanisms of resistance to endocrine therapy. This progress has translated into major advances in the treatment of advanced breast cancer, with several targeted therapies that enhance the efficacy of endocrine therapy; inhibitors of mTOR and inhibitors of the cyclin-dependent kinases CDK4 and CDK6 substantially improve progression-free survival. A new wave of targeted therapies is being developed, including inhibitors of PI3K, AKT, and HER2, and a new generation of oestrogen-receptor degraders. Considerable challenges remain in patient selection, deciding on the most appropriate order in which to administer therapies, and establishing whether cross-resistance occurs between therapies.

  19. Advances in Risk Classification and Treatment Strategies for Neuroblastoma

    PubMed Central

    Pinto, Navin R.; Applebaum, Mark A.; Volchenboum, Samuel L.; Matthay, Katherine K.; London, Wendy B.; Ambros, Peter F.; Nakagawara, Akira; Berthold, Frank; Schleiermacher, Gudrun; Park, Julie R.; Valteau-Couanet, Dominique; Pearson, Andrew D.J.

    2015-01-01

    Risk-based treatment approaches for neuroblastoma have been ongoing for decades. However, the criteria used to define risk in various institutional and cooperative groups were disparate, limiting the ability to compare clinical trial results. To mitigate this problem and enhance collaborative research, homogenous pretreatment patient cohorts have been defined by the International Neuroblastoma Risk Group classification system. During the past 30 years, increasingly intensive, multimodality approaches have been developed to treat patients who are classified as high risk, whereas patients with low- or intermediate-risk neuroblastoma have received reduced therapy. This treatment approach has resulted in improved outcome, although survival for high-risk patients remains poor, emphasizing the need for more effective treatments. Increased knowledge regarding the biology and genetic basis of neuroblastoma has led to the discovery of druggable targets and promising, new therapeutic approaches. Collaborative efforts of institutions and international cooperative groups have led to advances in our understanding of neuroblastoma biology, refinements in risk classification, and stratified treatment strategies, resulting in improved outcome. International collaboration will be even more critical when evaluating therapies designed to treat small cohorts of patients with rare actionable mutations. PMID:26304901

  20. Advances in Risk Classification and Treatment Strategies for Neuroblastoma.

    PubMed

    Pinto, Navin R; Applebaum, Mark A; Volchenboum, Samuel L; Matthay, Katherine K; London, Wendy B; Ambros, Peter F; Nakagawara, Akira; Berthold, Frank; Schleiermacher, Gudrun; Park, Julie R; Valteau-Couanet, Dominique; Pearson, Andrew D J; Cohn, Susan L

    2015-09-20

    Risk-based treatment approaches for neuroblastoma have been ongoing for decades. However, the criteria used to define risk in various institutional and cooperative groups were disparate, limiting the ability to compare clinical trial results. To mitigate this problem and enhance collaborative research, homogenous pretreatment patient cohorts have been defined by the International Neuroblastoma Risk Group classification system. During the past 30 years, increasingly intensive, multimodality approaches have been developed to treat patients who are classified as high risk, whereas patients with low- or intermediate-risk neuroblastoma have received reduced therapy. This treatment approach has resulted in improved outcome, although survival for high-risk patients remains poor, emphasizing the need for more effective treatments. Increased knowledge regarding the biology and genetic basis of neuroblastoma has led to the discovery of druggable targets and promising, new therapeutic approaches. Collaborative efforts of institutions and international cooperative groups have led to advances in our understanding of neuroblastoma biology, refinements in risk classification, and stratified treatment strategies, resulting in improved outcome. International collaboration will be even more critical when evaluating therapies designed to treat small cohorts of patients with rare actionable mutations.

  1. Methane Plumes on Mars

    NASA Video Gallery

    Spectrometer instruments attached to several telescopes detect plumes of methane emitted from Mars during its summer and spring seasons. High levels of methane are indicated by warmer colors. The m...

  2. The 2016 Case for Mantle Plumes and a Plume-Fed Asthenosphere (Augustus Love Medal Lecture)

    NASA Astrophysics Data System (ADS)

    Morgan, Jason P.

    2016-04-01

    discrepancies between idealized plume/hotspot models and geochronological observations will also be briefly discussed. A further consequence of the existence of strong deep mantle plumes is that hot plume material should preferentially pond at the base of the lithosphere, draining towards and concentrating beneath the regions where the lithosphere is thinnest, and asthenosphere is being actively consumed to make new tectonic plates - mid-ocean ridges. This plume-fed asthenosphere hypothesis makes predictions for the structure of asthenosphere flow and anisotropy, patterns of continental edge-volcanism linked to lateral plume drainage at continental margins, patterns of cratonic uplift and subsidence linked to passage from hotter plume-influenced to cooler non-plume-influenced regions of the upper mantle, and variable non-volcanic versus volcanic modes of continental extension linked to rifting above '~1425K cool normal mantle' versus 'warm plume-fed asthenosphere' regions of upper mantle. These will be briefly discussed. My take-home message is that "Mantle Plumes are almost certainly real". You can safely bet they will be part of any successful paradigm for the structure of mantle convection. While more risky, I would also recommend betting on the potential reality of the paradigm of a plume-fed asthenosphere. This is still a largely unexplored subfield of mantle convection. Current observations remain very imperfect, but seem more consistent with a plume-fed asthenosphere than with alternatives, and computational and geochemical advances are making good, falsifiable tests increasingly feasible. Make one!

  3. Sulfur plumes off Namibia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Sulfur plumes rising up from the bottom of the ocean floor produce colorful swirls in the waters off the coast of Namibia in southern Africa. The plumes come from the breakdown of marine plant matter by anaerobic bacteria that do not need oxygen to live. This image was acquired by the Moderate Resolution Imaging Spectroradiometer (MODIS) on the Terra satellite on April 24, 2002 Credit: Jacques Descloitres, MODIS Land Rapid Response Team, NASA/GSFC

  4. Plume Measurement System (PLUMES) Calibration Experiment

    DTIC Science & Technology

    1994-08-01

    Atle Lohrmann SonTek, Inc. 7940 Silverton Avenue, No. 105 San Diego, California 92126 and Craig Huhta JIMAR University of Hawaii, Honolulu, Hawaii 96822...Measurement System (PLUMES) Calibration Experiment by Age Lohrmann SonTek, Inc. 7940 Silverton Avenue, No. 105 San Diego, CA 92126 Craig Huhta JIMAR...PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) &. PERFORMING ORGANIZATION SonTek, Inc., 7940 Silverton Avenue, No. 105, San Diego, CA 92126 REPORT NUMBER

  5. Advanced treatment of sodium acetate in water by ozone oxidation.

    PubMed

    Yang, De-Min; Yuan, Jian-Mei

    2014-02-01

    Ozone oxidation is an advanced oxidation process for treatment of organic and inorganic wastewater. In this paper, sodium acetate (according to chemical oxygen demand [COD]) was selected as the model pollutant in water, and the degradation efficiencies and mechanism of sodium acetate in water by ozone oxidation were investigated. The results showed that the ozone oxidation was an effective treatment technology for advanced treatment of sodium acetate in water; the COD removal rate obtained the maximum value of 45.89% from sodium acetate solution when the pH value was 10.82, ozone concentration was 100 mg/L, reaction time was 30 minutes, and reaction temperature was 25 degrees C. The COD removal rate increased first and decreased subsequently with the bicarbonate (HCO3-) concentration from 0 to 200 mg/L, the largest decline being 20.35%. The COD removal rate declined by 25.38% with the carbonate (CO3(2-)) concentration from 0 to 200 mg/L; CO3(2-) has a more obvious scavenging effect to inhibit the formation of hydroxyl free radicals than HCO3-. Calcium chloride (CaCl2) and calcium hydroxide (Ca(OH)2) could enhance the COD removal rate greatly; they could reach 77.35 and 96.53%, respectively, after a reaction time of 30 minutes, which was increased by 31.46 and 50.64%, respectively, compared with only ozone oxidation. It was proved that the main ozone oxidation product of sodium acetate was carbon dioxide (CO2), and the degradation of sodium acetate in the ozone oxidation process followed the mechanism of hydroxyl free radicals.

  6. Cyberknife treatment for advanced or terminal stage hepatocellular carcinoma

    PubMed Central

    Kato, Hiroyuki; Yoshida, Hideo; Taniguch, Hiroyoshi; Nomura, Ryutaro; Sato, Kengo; Suzuki, Ichiro; Nakata, Ryo

    2015-01-01

    AIM: To investigate the safety and efficacy of the Cyberknife treatment for patients with advanced or terminal stage hepatocellular carcinoma (HCC). METHODS: Patients with HCC with extrahepatic metastasis or vascular or bile duct invasion were enrolled between May 2011 and June 2015. The Cyberknife was used to treat each lesion. Treatment response scores were based on Response Evaluation Criteria in Solid Tumors v1.1. The trends of tumor markers, including alpha fetoprotein (AFP) and proteins induced by vitamin K absence II (PIVKA II) were assessed. Prognostic factors for tumor response and tumor markers were evaluated with Fisher’s exact test and a logistic regression model. Survival was evaluated with the Kaplan-Meier method and multivariate analysis was performed using the Cox proportional hazards model. RESULTS: Sixty-five patients with 95 lesions were enrolled. Based on the Barcelona Clinic Liver Cancer classification, all patients were either in the advanced or terminal stage of the disease. The target lesions were as follows: 52 were bone metastasis; 9, lung metastasis; 7, brain metastasis; 9, portal vein invasion; 4, hepatic vein invasion; 4, bile duct invasion; and 10 other lesion types. The response rate and disease control rate were 34% and 53%, respectively. None of the clinical factors correlated significantly with tumor response. Fiducial marker implantation was associated with better control of both AFP (HR = 0.152; 95%CI: 0.026-0.887; P = 0.036) and PIVKA II (HR = 0.035; 95%CI: 0.003-0.342; P = 0.004). The median survival time was 9 mo (95%CI: 5-15 mo). Terminal stage disease (HR = 9.809; 95%CI: 2.589-37.17, P < 0.001) and an AFP of more than 400 ng/mL (HR = 2.548; 95%CI: 1.070-6.068, P = 0.035) were associated with worse survival. A radiation dose higher than 30 Gy (HR = 0.274; 95%CI: 0.093-0.7541, P = 0.012) was associated with better survival. In the 52 cases of bone metastasis, 36 patients (69%) achieved pain relief. One patient had cerebral

  7. [Contemporary methods of treatment in local advanced prostate cancer].

    PubMed

    Brzozowska, Anna; Mazurkiewicz, Maria; Starosławska, Elzbieta; Stasiewicz, Dominika; Mocarska, Agnieszka; Burdan, Franciszek

    2012-10-01

    The prostate cancer is one of the most often cancers amongst males. Its frequency is increasing with age. Thanks to widespread of screening denomination of specific prostate specific antigen (PSA), ultrasonography including the one in transrectal (TRUS), computed tomography, magnetic resonance and especially the awareness of society, the number of patients with low local advance of illness is increasing. The basic method of treatment in such cases is still the surgical removal of prostate with seminal bladder or radiotherapy. To this purpose tele-(IMRT, VMAT) or brachytherapy (J125, Ir192, Pa103) is used. In patients with higher risk of progression the radiotherapy may be associated with hormonotherapy (total androgen blockage-LH-RH analog and androgen). Despite numerous clinical researches conducted there is still no selection of optimal sequence of particular methods. Moreover, no explicit effectiveness was determined. The general rule of treatment in patients suffering from prostate cancer still remains individual selection of therapeutic treatment depending on the age of a patient, general condition and especially patient's general preferences. In case of elderly patients and patients with low risk of progression, recommendation of direct observation including systematical PSA denomination, clinical transrectal examination, TRUS, MR of smaller pelvis or scintigraphy of the whole skeleton may be considered.

  8. An Advanced Leakage Scheme for Neutrino Treatment in Astrophysical Simulations

    NASA Astrophysics Data System (ADS)

    Perego, A.; Cabezón, R. M.; Käppeli, R.

    2016-04-01

    We present an Advanced Spectral Leakage (ASL) scheme to model neutrinos in the context of core-collapse supernovae (CCSNe) and compact binary mergers. Based on previous gray leakage schemes, the ASL scheme computes the neutrino cooling rates by interpolating local production and diffusion rates (relevant in optically thin and thick regimes, respectively) separately for discretized values of the neutrino energy. Neutrino trapped components are also modeled, based on equilibrium and timescale arguments. The better accuracy achieved by the spectral treatment allows a more reliable computation of neutrino heating rates in optically thin conditions. The scheme has been calibrated and tested against Boltzmann transport in the context of Newtonian spherically symmetric models of CCSNe. ASL shows a very good qualitative and a partial quantitative agreement for key quantities from collapse to a few hundreds of milliseconds after core bounce. We have proved the adaptability and flexibility of our ASL scheme, coupling it to an axisymmetric Eulerian and to a three-dimensional smoothed particle hydrodynamics code to simulate core collapse. Therefore, the neutrino treatment presented here is ideal for large parameter-space explorations, parametric studies, high-resolution tests, code developments, and long-term modeling of asymmetric configurations, where more detailed neutrino treatments are not available or are currently computationally too expensive.

  9. AN ADVANCED LEAKAGE SCHEME FOR NEUTRINO TREATMENT IN ASTROPHYSICAL SIMULATIONS

    SciTech Connect

    Perego, A.; Cabezón, R. M.; Käppeli, R.

    2016-04-15

    We present an Advanced Spectral Leakage (ASL) scheme to model neutrinos in the context of core-collapse supernovae (CCSNe) and compact binary mergers. Based on previous gray leakage schemes, the ASL scheme computes the neutrino cooling rates by interpolating local production and diffusion rates (relevant in optically thin and thick regimes, respectively) separately for discretized values of the neutrino energy. Neutrino trapped components are also modeled, based on equilibrium and timescale arguments. The better accuracy achieved by the spectral treatment allows a more reliable computation of neutrino heating rates in optically thin conditions. The scheme has been calibrated and tested against Boltzmann transport in the context of Newtonian spherically symmetric models of CCSNe. ASL shows a very good qualitative and a partial quantitative agreement for key quantities from collapse to a few hundreds of milliseconds after core bounce. We have proved the adaptability and flexibility of our ASL scheme, coupling it to an axisymmetric Eulerian and to a three-dimensional smoothed particle hydrodynamics code to simulate core collapse. Therefore, the neutrino treatment presented here is ideal for large parameter-space explorations, parametric studies, high-resolution tests, code developments, and long-term modeling of asymmetric configurations, where more detailed neutrino treatments are not available or are currently computationally too expensive.

  10. New heat treatment process for advanced high-strength steels

    NASA Astrophysics Data System (ADS)

    Bublíková, D.; Jeníček, Š.; Vorel, I.; Mašek, B.

    2017-02-01

    Today’s advanced steels are required to possess high strength and ductility. It can be achieved by choosing an appropriate steel chemistry which has a substantial effect on the properties obtained by heat treatment. Mechanical properties influenced the presence of retained austenite in the final structure. Steels of this group typically require complicated heat treatment which places great demands on the equipment used. The present paper introduces new procedures aimed at simplifying the heat treatment of high-strength steels with the use of material-technological modelling. Four experimental steels were made and cast, whose main alloying additions were manganese, silicon, chromium, molybdenum and nickel. The steels were treated using the Q-P process with subsequent interrupted quenching. The resulting structure was a mixture of martensite and retained austenite. Strength levels of more than 2000 MPa combined with 10-15 % elongation were obtained. These properties thus offer potential for the manufacture of intricate closed-die forgings with a reduced weight. Intercritical annealing was obtained structure not only on the basis of martensite, but also with certain proportion of bainitic ferrite and retained austenite.

  11. Gemcitabine for the treatment of advanced nonsmall cell lung cancer.

    PubMed

    Toschi, Luca; Cappuzzo, Federico

    2009-02-18

    Gemcitabine is a pyrimidine nucleoside antimetabolite agent which is active in several human malignancies, including nonsmall cell lung cancer (NSCLC). Because of its acceptable toxicity profile, with myelosuppression being the most common adverse event, gemcitabine can be safely combined with a number of cytotoxic agents, including platinum derivatives and new-generation anticancer compounds. In fact, the combination of gemcitabine and cisplatin is a first-line treatment for patients with advanced NSCLC, pharmacoeconomic data indicating that it represents the most cost-effective regimen among platinum-based combinations with third-generation cytotoxic drugs. The drug has been investigated in the context of nonplatinum-based regimens in a number of prospective clinical trials, and might provide a suitable alternative for patients with contraindications to platinum. Recently, gemcitabine-based doublets have been successfully tested in association with novel targeted agents with encouraging results, providing further evidence for the role of the drug in the treatment of NSCLC. In the last few years several attempts have been pursued in order to identify molecular predictors of gemcitabine activity, and recent data support the feasibility of genomic-based approaches to customize treatment with the ultimate goal of improving patient outcome.

  12. Sexual dysfunction in 2013: Advances in epidemiology, diagnosis and treatment

    PubMed Central

    Lee, King Chien Joe; Fahmy, Nader; Brock, Gerald B.

    2013-01-01

    Objectives To provide a contemporary review of the epidemiology, diagnosis and treatment of premature ejaculation (PE) and erectile dysfunction (ED). Methods We searched for English-language articles published in the past 12 months using the PubMed database. Relevant articles on the subjects of sexual dysfunction, ED and PE were selected for review. Conclusions Recent studies on male sexual dysfunction have provided new therapeutic possibilities. Tramadol, a well-used analgesic, has a new role in the treatment of PE. Super-selective targeting of dorsal penile nerves by surgery or cryoablative technologies might become a viable treatment option for refractory PE in the future. The role of ED as a harbinger of important comorbidities allows for the early detection and intervention of these conditions, which can optimise therapeutic outcomes. The long-term effect of chronic phosphodiesterase-5 inhibitors on endothelial dysfunction, the angiogenic potential of low-intensity extracorporeal shock wave therapy, and further advances in drug-eluting endovascular stents might in future allow clinicians to treat ED more definitively. PMID:26558082

  13. Advanced therapies for the treatment of hemophilia: future perspectives

    PubMed Central

    2012-01-01

    Monogenic diseases are ideal candidates for treatment by the emerging advanced therapies, which are capable of correcting alterations in protein expression that result from genetic mutation. In hemophilia A and B such alterations affect the activity of coagulation factors VIII and IX, respectively, and are responsible for the development of the disease. Advanced therapies may involve the replacement of a deficient gene by a healthy gene so that it generates a certain functional, structural or transport protein (gene therapy); the incorporation of a full array of healthy genes and proteins through perfusion or transplantation of healthy cells (cell therapy); or tissue transplantation and formation of healthy organs (tissue engineering). For their part, induced pluripotent stem cells have recently been shown to also play a significant role in the fields of cell therapy and tissue engineering. Hemophilia is optimally suited for advanced therapies owing to the fact that, as a monogenic condition, it does not require very high expression levels of a coagulation factor to reach moderate disease status. As a result, significant progress has been possible with respect to these kinds of strategies, especially in the fields of gene therapy (by using viral and non-viral vectors) and cell therapy (by means of several types of target cells). Thus, although still considered a rare disorder, hemophilia is now recognized as a condition amenable to gene therapy, which can be administered in the form of lentiviral and adeno-associated vectors applied to adult stem cells, autologous fibroblasts, platelets and hematopoietic stem cells; by means of non-viral vectors; or through the repair of mutations by chimeric oligonucleotides. In hemophilia, cell therapy approaches have been based mainly on transplantation of healthy cells (adult stem cells or induced pluripotent cell-derived progenitor cells) in order to restore alterations in coagulation factor expression. PMID:23237078

  14. Development of Advanced Multi-Modality Radiation Treatment Planning Software

    SciTech Connect

    Nigg, D W; Hartmann Siantar, C

    2002-02-19

    The Idaho National Engineering and Environmental Laboratory (INEEL) has long been active in development of advanced Monte-Carlo based computational dosimetry and treatment planning methods and software for advanced radiotherapy, with a particular focus on Neutron Capture Therapy (NCT) and, to a somewhat lesser extent, Fast-Neutron Therapy. The most recent INEEL software product system of this type is known as SERA, Simulation Environment for Radiotherapy Applications. SERA is at a mature level in its life cycle, it has been licensed for research use worldwide, and it has become well established as a computational tool for research. However, along with its strengths, SERA also has some limitations in its structure and computational methodologies. More specifically, it is optimized only for neutron-based applications. Although photon transport can be computed with SERA, the simplified model that is used is designed primarily for photons produced in the neutron transport process. Thus SERA is not appropriate for applications to, for example, standard external-beam photon radiotherapy, which is by far more commonly used in the clinic than neutron based therapy.

  15. Recent advances in the diagnosis and treatment of childhood tuberculosis

    PubMed Central

    Kumar, Mani Kant; Kumar, Prashant; Singh, Anjali

    2015-01-01

    Despite over 2.3 million (26% of global burden) cases of tuberculosis (TB) in India the accurate diagnosis of childhood TB remains a major challenge. Children with TB usually have paucibacillary disease and contribute little to disease transmission within the community. Consequently the treatment of children with TB is often not considered a priority by TB control programmes. Adequate and timely assessment of TB infection in childhood could diminish epidemiological burden as underdiagnosed pediatric patients can eventually evolve in to an active state and have the potential to disseminate the etiological agent Mycobacterium tuberculosis, notably increasing this worldwide public health problem. In this review we discuss the most important recent advances in the diagnosis of childhood TB: (1) Symptom-based approaches, (2) novel immune-based approaches, including in vitro interferon-γ IGRA release assays IGRA tests; and (3) bacteriological and molecular methods that are more rapid and/or less expensive than conventional culture techniques for TB diagnosis and/or drug-resistance testing. Recent advances have improved our ability to diagnose latent infection and active TB in children, nevertheless establishing a diagnosis of either latent infection or active disease in HIV-infected children remains a major challenge. PMID:26283820

  16. Satellite assessment of Mississippi River plume variability: Causes and predictability

    SciTech Connect

    Walker, N.D.

    1996-10-01

    The Mississippi River is the largest river in North America and 6th largest worldwide in terms of discharge. In this study, 5 years (1989--1993) of NOAA Advanced Very High Resolution Radiometer satellite data were used to investigate the variability of the Mississippi River sediment plume and the environmental forcing factors responsible for its variability. Plume variability was determined by extracting information on plume area and plume length from 112 cloud-free satellite images. Correlation and multiple regression techniques were used to quantify these relationships for possible predictive applications. River discharge and wind forcing were identified as the main factors affecting plume variability. Seasonal and interannual variabilities in plume area were similar in magnitude and corresponded closely with large changes in river discharge. However, day-to-day variability in plume size and morphology was more closely associated with changes in the wind field. The plume parameters best predicted by the multiple regression models were plume area, east and west of the delta. Predictive models were improved by separating the data into summer and winter seasons.

  17. Advancements in stem cells treatment of skeletal muscle wasting

    PubMed Central

    Meregalli, Mirella; Farini, Andrea; Sitzia, Clementina; Torrente, Yvan

    2014-01-01

    Muscular dystrophies (MDs) are a heterogeneous group of inherited disorders, in which progressive muscle wasting and weakness is often associated with exhaustion of muscle regeneration potential. Although physiological properties of skeletal muscle tissue are now well known, no treatments are effective for these diseases. Muscle regeneration was attempted by means transplantation of myogenic cells (from myoblast to embryonic stem cells) and also by interfering with the malignant processes that originate in pathological tissues, such as uncontrolled fibrosis and inflammation. Taking into account the advances in the isolation of new subpopulation of stem cells and in the creation of artificial stem cell niches, we discuss how these emerging technologies offer great promises for therapeutic approaches to muscle diseases and muscle wasting associated with aging. PMID:24575052

  18. Radiotherapy combined with surgery as treatment for advanced cervical cancer.

    PubMed

    Perches, R D; Lobaton, A T; Garcia, M C

    1983-12-01

    Experience obtained in a group of 44 patients with advanced cervical cancer is reported here. In this study, patients with residual cancer underwent laparotomy eight weeks after one or two different radiotherapy protocols. Sixty-eight percent of patients underwent radical surgery, 85% of patients pelvic exenterations, and 15% radical hysterectomies. In 27% of patients, no evidence of residual cancer was found in surgical specimens. Radical surgery was well tolerated, and one-third of patients were free of disease for one year or more. Control of disease was obtained in 50% of pelvic exenterations and in 60% of radical hysterectomies, regardless of prognosis, clinical stage or radiotherapy scheme. Although results show an improvement of up to 22% when comparing this to other more conventional treatments, we have concluded that we must obtain a wider experience in order to support our findings.

  19. Advancing addiction treatment: what can we learn from animal studies?

    PubMed

    Wu, Peter H; Schulz, Kalynn M

    2012-01-01

    Substance addiction is a maladaptive behavior characterized by compulsive and uncontrolled self-administration of a substance (drug). Years of research indicate that addictive behavior is the result of complex interactions between the drug, the user, and the environment in which the drug is used; therefore, addiction cannot simply be attributed to the neurobiological actions of a drug. However, despite the obvious complexity of addictive behavior, animal models have both advanced understanding of addiction and contributed importantly to the development of medications to treat this disease. We briefly review recent animal models used to study drug addiction and the contribution of data generated by these animal models for the clinical treatment of addictive disorders.

  20. Human toxocariasis: current advances in diagnostics, treatment, and interventions.

    PubMed

    Moreira, Gustavo Marçal Schmidt Garcia; Telmo, Paula de Lima; Mendonça, Marcelo; Moreira, Angela Nunes; McBride, Alan John Alexander; Scaini, Carlos James; Conceição, Fabricio Rochedo

    2014-09-01

    Toxocariasis is a neglected zoonosis caused by the nematodes Toxocara canis and Toxocara cati. This disease is widespread in many countries, reaching high prevalence independently of the economic conditions. However, the true number of cases of toxocariasis is likely to be underestimated owing to the lack of adequate surveillance programs. Although some diagnostic tests are available, their sensitivity and specificity need to be improved. In addition, treatment options for toxocariasis are limited and are non-specific. Toxocariasis is listed as one of the five most important neglected diseases by the CDC. This review presents recent advances related to the control of toxocariasis, including new immunodiagnostics, therapies, and drug formulations, as well as novel interventions using DNA vaccines, immunomodulators, and probiotics.

  1. Recent advances in pathogenesis, assessment, and treatment of atherosclerosis

    PubMed Central

    Spence, J. David

    2016-01-01

    In recent years, there have been a number of advances in the pathogenesis and treatment of atherosclerosis and in assessing prognosis in carotid atherosclerosis. Risk stratification to improve vascular prevention by identifying patients most likely to benefit from intensive therapy is much improved by measuring carotid plaque burden. In patients with asymptomatic carotid stenosis, a number of modalities can be used to identify the 10-15% who could benefit from endarterectomy or stenting. Transcranial Doppler embolus detection, echolucency and ulceration on 3D ultrasound, intraplaque hemorrhage on magnetic resonance imaging (MRI), and reduced cerebrovascular reserve are useful already; new approaches including plaque texture on ultrasound and imaging of plaque inflammation and early calcification on positron emission tomography/computed tomography (PET/CT) are in development. The discovery that the intestinal microbiome produces vasculotoxic metabolites from dietary constituents such as carnitine in meat (particularly red meat) and phosphatidylcholine from egg yolk and other sources has revolutionized nutritional aspects of vascular prevention. Because many of these vasculotoxic metabolites are removed by the kidney, it is particularly important in patients with renal failure to limit their intake of red meat and egg yolk. A new approach to lowering low-density lipoprotein (LDL) cholesterol by blocking the action of an enzyme that destroys LDL receptors promises to revolutionize vascular prevention once less costly treatments are developed, and a new approach to vascular prevention—“treating arteries instead of risk factors”—shows promise but requires randomized trials. These advances all promise to help in the quest to prevent strokes in high-risk patients. PMID:27540477

  2. Current Advances in Detection and Treatment of Babesiosis

    PubMed Central

    Mosqueda, J; Olvera-Ramírez, A; Aguilar-Tipacamú, G; Cantó, GJ

    2012-01-01

    Babesiosis is a disease with a world-wide distribution affecting many species of mammals principally cattle and man. The major impact occurs in the cattle industry where bovine babesiosis has had a huge economic effect due to loss of meat and beef production of infected animals and death. Nowadays to those costs there must be added the high cost of tick control, disease detection, prevention and treatment. In almost a century and a quarter since the first report of the disease, the truth is: there is no a safe and efficient vaccine available, there are limited chemotherapeutic choices and few low-cost, reliable and fast detection methods. Detection and treatment of babesiosis are important tools to control babesiosis. Microscopy detection methods are still the cheapest and fastest methods used to identify Babesia parasites although their sensitivity and specificity are limited. Newer immunological methods are being developed and they offer faster, more sensitive and more specific options to conventional methods, although the direct immunological diagnoses of parasite antigens in host tissues are still missing. Detection methods based on nucleic acid identification and their amplification are the most sensitive and reliable techniques available today; importantly, most of those methodologies were developed before the genomics and bioinformatics era, which leaves ample room for optimization. For years, babesiosis treatment has been based on the use of very few drugs like imidocarb or diminazene aceturate. Recently, several pharmacological compounds were developed and evaluated, offering new options to control the disease. With the complete sequence of the Babesia bovis genome and the B. bigemina genome project in progress, the post-genomic era brings a new light on the development of diagnosis methods and new chemotherapy targets. In this review, we will present the current advances in detection and treatment of babesiosis in cattle and other animals, with additional

  3. A Brilliant Plume

    NASA Technical Reports Server (NTRS)

    2007-01-01

    The Long Range Reconnaissance Imager (LORRI) on New Horizons captured another dramatic picture of Jupiter's moon Io and its volcanic plumes, 19 hours after the spacecraft's closest approach to Jupiter on Feb. 28, 2007. LORRI took this 75 millisecond exposure at 0035 Universal Time on March 1, 2007, when Io was 2.3 million kilometers (1.4 million miles) from the spacecraft.

    Io's dayside is deliberately overexposed to bring out faint details in the plumes and on the moon's night side. The continuing eruption of the volcano Tvashtar, at the 1 o'clock position, produces an enormous plume roughly 330 kilometers (200 miles) high, which is illuminated both by sunlight and 'Jupiter light.'

    The shadow of Io, cast by the Sun, slices across the plume. The plume is quite asymmetrical and has a complicated wispy texture, for reasons that are still mysterious. At the heart of the eruption incandescent lava, seen here as a brilliant point of light, is reminding scientists of the fire fountains spotted by the Galileo Jupiter orbiter at Tvashtar in 1999.

    The sunlit plume faintly illuminates the surface underneath. 'New Horizons and Io continue to astonish us with these unprecedented views of the solar system's most geologically active body' says John Spencer, deputy leader of the New Horizons Jupiter Encounter Science Team and an Io expert from Southwest Research Institute.

    Because this image shows the side of Io that faces away from Jupiter, the large planet does not illuminate the moon's night side except for an extremely thin crescent outlining the edge of the disk at lower right. Another plume, likely from the volcano Masubi, is illuminated by Jupiter just above this lower right edge. A third and much fainter plume, barely visible at the 2 o'clock position, could be the first plume seen from the volcano Zal Patera.

    As in other New Horizons images of Io, mountains catch the setting Sun just beyond the terminator (the line dividing day and night

  4. Immunotherapy for patients with advanced pancreatic carcinoma: a promising treatment

    PubMed Central

    Liu, Jing; Lian, Zhouyang; Liang, Long; Chen, Wenbo; Luo, Xiaoning; Pei, Shufang; Mo, Xiaokai; Zhang, Lu; Huang, Wenhui; Ouyang, Fusheng; Guo, Baoliang; Liang, Changhong; Zhang, Shuixing

    2017-01-01

    There are limited data on the safety and efficacy of immunotherapy for patients with advanced pancreatic cancer (APC). A meta-analysis of single-arm trials is proposed to assess the efficacy and safety of immunotherapy for APC. Eighteen relevant studies involving 527 patients were identified. The pooled disease control rate (DCR), overall survival (OS), progression free survival (PFS), and 1-year survival rate were estimated as 59.32%, 7.90 months, 4.25 months, and 30.12%, respectively. Subgroup analysis showed that the pooled OS, PFS, and 1-year survival rate were significantly higher for autologous activated lymphocyte therapy compared with peptide-based vaccine therapy (OS: 8.28 months vs. 7.40 months; PFS: 6.04 months vs. 3.86 months; 1-year survival rate: 37.17% vs. 19.74%). Another subgroup analysis demonstrated that the pooled endpoints were estimated as obviously higher for immunotherapy plus chemotherapy compared with immunotherapy alone (DCR: 62.51% vs. 47.63%; OS: 8.67 months vs. 4.91 months; PFS: 4.91 months vs. 3.34 months; 1-year survival rate: 32.32% vs. 21.43%). Of the included trials, seven trials reported no treatment related adverse events , five trials reported (16.6 3.9) % grade 3 adverse events and no grade 4 adverse events. In conclusion, immunotherapy is safe and effective in the treatment of APC. PMID:27992378

  5. Advances in the treatment of hematologic malignancies using immunoconjugates

    PubMed Central

    Palanca-Wessels, Maria Corinna

    2014-01-01

    Monoclonal antibody therapy has revolutionized cancer treatment by significantly improving patient survival both in solid tumors and hematologic malignancies. Recent technological advances have increased the effectiveness of immunotherapy leading to its broader application in diverse treatment settings. Immunoconjugates (ICs) consist of a cytotoxic effector covalently linked to a monoclonal antibody that enables the targeted delivery of its therapeutic payload to tumors based on cell-surface receptor recognition. ICs are classified into 3 groups based on their effector type: immunotoxins (protein toxin), radioimmunoconjugates (radionuclide), and antibody drug conjugates (small-molecule drug). Optimization of each individual component of an IC (antibody, linker, and effector) is essential for therapeutic efficacy. Clinical trials have been conducted to investigate the effectiveness of ICs in hematologic malignancies both as monotherapy and in multiagent regimens in relapsed/refractory disease as well as frontline settings. These studies have yielded encouraging results particularly in lymphoma. ICs comprise an exciting group of therapeutics that promise to play an increasingly important role in the management of hematologic malignancies. PMID:24578502

  6. Recent advances in the medical treatment of Cushing's disease.

    PubMed

    Fleseriu, Maria

    2014-01-01

    Cushing's disease is a condition of hypercortisolism caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma. While rare, it is associated with significant morbidity and mortality, which suggests that early and aggressive intervention is required. The primary, definitive therapy for patients with Cushing's disease in the majority of patients is pituitary surgery, generally performed via a transsphenoidal approach. However, many patients will not achieve remission or they will have recurrences. The consequences of persistent hypercortisolism are severe and, as such, early identification of those patients at risk of treatment failure is exigent. Medical management of Cushing's disease patients plays an important role in achieving long-term remission after failed transsphenoidal surgery, while awaiting effects of radiation or before surgery to decrease the hypercortisolemia and potentially reducing perioperative complications and improving outcome. Medical therapies include centrally acting agents, adrenal steroidogenesis inhibitors and glucocorticoid receptor blockers. Furthermore, several new agents are in clinical trials. To normalize the devastating disease effects of hypercortisolemia, it is paramount that successful patient disease management includes individualized, multidisciplinary care, with close collaboration between endocrinologists, neurosurgeons, radiation oncologists, and general surgeons. This commentary will focus on recent advances in the medical treatment of Cushing's, with a focus on newly approved ACTH modulators and glucocorticoid receptor blockers.

  7. Advances in thyroid cancer treatment: latest evidence and clinical potential

    PubMed Central

    Alonso-Gordoa, T.; Díez, J.J.; Durán, M.

    2015-01-01

    Advanced thyroid carcinoma is an infrequent tumor entity with limited treatment possibilities until recently. The extraordinary improvement in the comprehension of genetic and molecular alterations involving the RAS/RAF/mitogen-activated protein kinase and phosphatidylinositide 3-kinase/Akt/mammalian target of rapamycin signaling and interacting pathways that are involved in tumor survival, proliferation, differentiation, motility and angiogenesis have been the rationale for the development of new effective targeted therapies. Data coming from phase II clinical trials have confirmed the efficacy of those targeted agents against receptors in cell membrane and cytoplasmic molecules. Moreover, four of those investigational drugs, vandetanib, cabozantinib, sorafenib and lenvatinib, have reached a phase III clinical trial with favorable results in progression-free survival and overall survival in medullary thyroid carcinoma and differentiated thyroid carcinoma. Further analysis for an optimal approach has been conducted according to mutational profile and tumor subtypes. However, consistent results are still awaited and the research for adequate prognostic and predictive biomarkers is ongoing. The following report offers a comprehensive review from the rationale to the basis of targeted agents in the treatment of thyroid carcinoma. In addition, current and future therapeutic developments by the inhibition of further molecular targets are discussed in this setting. PMID:25553081

  8. An advanced oxidation process using ionized gas for wastewater treatment.

    PubMed

    Lee, Eun Ju; Chung, Paul Gene; Kwak, Dong Heui; Kim, Lee Hyung; Kim, Min Jeong

    2010-01-01

    This study on removing non-degradable materials in wastewater focused primarily on advanced oxidation methods such as ozone, ozone/UV and ozone/H2O2. Wastewater treatment using an ionized gas from plasma has been actively progressing. The ionized gas involves reactive species such as O2+, O2- cluster, O radical and OH radical. Since the ionized gas method has such outstanding characteristics as relatively simple structures, non-calorification, non-toxicity and low electricity consumption, it evidently of interest as a new process. A series of experiments were conducted to demonstrate the feasibility of ionized gas as a useful element for the diminution of nondegradable organic matters. On the other hand, a large amount of organic matters were changed to hydrophilic and the compounds containing aromatic functional group gradually decreased. The results implied that the ionized gas has been able to degrade the non-biodegradable organic matters. Therefore, the oxidation process by using an ionized gas process could be considered as an effective alternative unit in water and wastewater treatment plants.

  9. Impact of leachate composition on the advanced oxidation treatment.

    PubMed

    Oulego, Paula; Collado, Sergio; Laca, Adriana; Díaz, Mario

    2016-01-01

    Advanced oxidation processes (AOPs) are gaining importance as an alternative to the biological or physicochemical treatments for the management of leachates. In this work, it has been studied the effect of the characteristics of the leachate (content in humic acids, landfill age and degree of stabilization) on the wet oxidation process and final quality of the treated effluent. A high concentration of humic acids in the leachate had a positive effect on the COD removal because this fraction is more easily oxidizable. Additionally, it has been demonstrated that the simultaneous presence of humic acid and the intermediates generated during the oxidation process improved the degradation of this acid, since such intermediates are stronger initiators of free radicals than the humic acid itself. Similar values of COD removals (49% and 51%) and biodegradability indices (0.30 and 0.35) were observed, after 8 h of wet oxidation, for the stabilised leachate (biologically pretreated) and the raw one, respectively. Nevertheless, final colour removal was much higher for the stabilised leachate, achieving values up to 91%, whereas for the raw one only 56% removal was attained for the same reaction time. Besides, wet oxidation treatment was more efficient for the young leachate than for the old one, with final COD conversions of 60% and 37%, respectively. Eventually, a triangular "three-lump" kinetic model, which considered direct oxidation to CO2 and partial oxidation through intermediate compounds, was here proposed.

  10. Myeloproliferative neoplasms: A decade of discoveries and treatment advances.

    PubMed

    Tefferi, Ayalew

    2016-01-01

    Myeloproliferative neoplasms (MPN) are clonal stem cell diseases, first conceptualized in 1951 by William Dameshek, and historically included chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). In 1960, Nowell and Hungerford discovered an invariable association between the Philadelphia chromosome (subsequently shown to harbor the causal BCR-ABL1 mutation) and CML; accordingly, the term MPN is primarily reserved for PV, ET, and PMF, although it includes other related clinicopathologic entities, according to the World Health Organization (WHO) classification system. In 2005, William Vainchenker and others described a Janus kinase 2 mutation (JAK2V617F) in MPN and this was followed by a series of additional descriptions of mutations that directly or indirectly activate JAK-STAT: JAK2 exon 12, myeloproliferative leukemia virus oncogene (MPL) and calreticulin (CALR) mutations. The discovery of these, mostly mutually exclusive, "driver" mutations has contributed to revisions of the WHO diagnostic criteria and risk stratification in MPN. Mutations other than JAK2, CALR and MPL have also been described in MPN and shown to provide additional prognostic information. From the standpoint of treatment, over the last 50 years, Louis Wasserman from the Unites States and Tiziano Barbui from Italy had skillfully organized and led a number of important clinical trials, whose results form the basis for current treatment strategies in MPN. More recently, allogeneic stem cell transplant, as a potentially curative treatment modality, and JAK inhibitors, as palliative drugs, have been added to the overall therapeutic armamentarium in myelofibrosis. In the current review, I will summarize the important advances made in the last 10 years regarding the science and practice of MPN.

  11. Advances in diagnosis and treatment of trigeminal neuralgia

    PubMed Central

    Montano, Nicola; Conforti, Giulio; Di Bonaventura, Rina; Meglio, Mario; Fernandez, Eduardo; Papacci, Fabio

    2015-01-01

    Various drugs and surgical procedures have been utilized for the treatment of trigeminal neuralgia (TN). Despite numerous available approaches, the results are not completely satisfying. The need for more contemporaneous drugs to control the pain attacks is a common experience. Moreover, a number of patients become drug resistant, needing a surgical procedure to treat the neuralgia. Nonetheless, pain recurrence after one or more surgical operations is also frequently seen. These facts reflect the lack of the precise understanding of the TN pathogenesis. Classically, it has been related to a neurovascular compression at the trigeminal nerve root entry-zone in the prepontine cistern. However, it has been evidenced that in the pain onset and recurrence, various neurophysiological mechanisms other than the neurovascular conflict are involved. Recently, the introduction of new magnetic resonance techniques, such as voxel-based morphometry, diffusion tensor imaging, three-dimensional time-of-flight magnetic resonance angiography, and fluid attenuated inversion recovery sequences, has provided new insight about the TN pathogenesis. Some of these new sequences have also been used to better preoperatively evidence the neurovascular conflict in the surgical planning of microvascular decompression. Moreover, the endoscopy (during microvascular decompression) and the intraoperative computed tomography with integrated neuronavigation (during percutaneous procedures) have been recently introduced in the challenging cases. In the last few years, efforts have been made in order to better define the optimal target when performing the gamma knife radiosurgery. Moreover, some authors have also evidenced that neurostimulation might represent an opportunity in TN refractory to other surgical treatments. The aim of this work was to review the recent literature about the pathogenesis, diagnosis, and medical and surgical treatments, and discuss the significant advances in all these fields

  12. Plume primary smoke

    NASA Astrophysics Data System (ADS)

    Chastenet, J. C.

    1993-06-01

    The exhaust from a solid propellant rocket motor usually contains condensed species. These particles, also called 'Primary Smoke', are often prejudicial to missile detectability and to the guidance system. To avoid operational problems it is necessary to know and quantify the effects of particles on all aspects of missile deployment. A brief description of the origin of the primary smoke is given. It continues with details of the interaction between particles and light as function of both particles and light properties (nature, size, wavelength, etc). The effects of particles on plume visibility, attenuation of an optical beam propagated through the plume and the contribution of particles on optical signatures of the plume are also described. Finally, various methods used in NATO countries to quantify the primary smoke effects are discussed.

  13. Skylon Aerodynamics and SABRE Plumes

    NASA Technical Reports Server (NTRS)

    Mehta, Unmeel; Afosmis, Michael; Bowles, Jeffrey; Pandya, Shishir

    2015-01-01

    An independent partial assessment is provided of the technical viability of the Skylon aerospace plane concept, developed by Reaction Engines Limited (REL). The objectives are to verify REL's engineering estimates of airframe aerodynamics during powered flight and to assess the impact of Synergetic Air-Breathing Rocket Engine (SABRE) plumes on the aft fuselage. Pressure lift and drag coefficients derived from simulations conducted with Euler equations for unpowered flight compare very well with those REL computed with engineering methods. The REL coefficients for powered flight are increasingly less acceptable as the freestream Mach number is increased beyond 8.5, because the engineering estimates did not account for the increasing favorable (in terms of drag and lift coefficients) effect of underexpanded rocket engine plumes on the aft fuselage. At Mach numbers greater than 8.5, the thermal environment around the aft fuselage is a known unknown-a potential design and/or performance risk issue. The adverse effects of shock waves on the aft fuselage and plumeinduced flow separation are other potential risks. The development of an operational reusable launcher from the Skylon concept necessitates the judicious use of a combination of engineering methods, advanced methods based on required physics or analytical fidelity, test data, and independent assessments.

  14. Where Plumes Live

    NASA Astrophysics Data System (ADS)

    King, S. D.

    2004-12-01

    From the perspective of fluid dynamics, `Plumes or not?' might be the wrong question. Let me begin by defining a few terms. Plume with a `P' is the well-known thermal structure with thin (order 100 km) tail and large, bulbous head that originates at the core-mantle boundary. The thin tail/large, bulbous-head morphology has been generated in a number of laboratory and numerical experiments. It can be seen, for example, on the cover of the famous fluid dynamics text by Batchelor. There is a clearly-defined range of parameters for which this structure is the preferred solution for instabilities arising from a bottom boundary layer in a convecting fluid. For example, a strong temperature-dependent rheology is needed. By contrast, plume with a `p' is any cylindrical or quasi-cylindrical instability originating from a thermal (or thermo-chemical) boundary layer. In fluid dynamics plume is sometimes used interchangeable with jet. Unless there is a very small temperature drop across the core-mantle boundary or a rather remarkable balance between temperature and composition at the base of the mantle, there are almost certainly plumes. (Note the little p.) Are these plumes the thermal structures with thin (order 100 km) tails and large bulbous heads or could they be broad, hot regions such as the degree 2 pattern seen in global seismic tomography images of the lower mantle, or the disconnected droplets seen in chaotic convection? To study this question, I will present a sequence of numerical `experiments' that illustrate the morphology of instabilities from a basal thermal boundary layer, i.e., plumes. Some of the aspects I will present include: spherical geometry, temperature-and pressure-dependence of rheology, internal heating, pressure-dependent coefficient of thermal expansion, variable coefficient of thermal diffusivity, phase transformations, and compositional layering at the base of the mantle. The goal is to map out the parameters and conditions where Plumes live

  15. Rocket plume burn hazard.

    PubMed

    Stoll, A M; Piergallini, J R; Chianta, M A

    1980-05-01

    By use of miniature rocket engines, the burn hazard posed by exposure to ejection seat rocket plume flames was determined in the anaesthetized rat. A reference chart is provided for predicting equivalent effects in human skin based on extrapolation of earlier direct measurements of heat input for rat and human burns. The chart is intended to be used in conjunction with thermocouple temperature measurements of the plume environment for design and modification of escape seat system to avoid thermal injury on ejection from multiplace aircraft.

  16. LAMP Observes the LCROSS Plume

    NASA Video Gallery

    This video shows LAMP’s view of the LCROSS plume. The first half of the animation shows the LAMP viewport scanning across the horizon, passing through the plume, and moving on. The second half of...

  17. Hydrostatic Modeling of Buoyant Plumes

    NASA Astrophysics Data System (ADS)

    Stroman, A.; Dewar, W. K.; Wienders, N.; Deremble, B.

    2014-12-01

    The Deepwater Horizon oil spill in the Gulf of Mexico has led to increased interest in understanding point source convection dynamics. Most of the existing oil plume models use a Lagrangian based approach, which computes integral measures such as plume centerline trajectory and plume radius. However, this approach doesn't account for feedbacks of the buoyant plume on the ambient environment. Instead, we employ an Eulerian based approach to acquire a better understanding of the dynamics of buoyant plumes. We have performed a series of hydrostatic modeling simulations using the MITgcm. Our results show that there is a dynamical response caused by the presence of the buoyant plume, in that there is a modification of the background flow. We find that the buoyant plume becomes baroclinically unstable and sheds eddies at the neutral buoyancy layer. We also explore different scenarios to determine the effect of the buoyancy source and the temperature stratification on the evolution of buoyant plumes.

  18. EUV analysis of polar plumes

    NASA Technical Reports Server (NTRS)

    Ahmad, I. A.; Withbroe, G. L.

    1977-01-01

    Three polar plumes were studied using Skylab Mg X and O VI data. The plumes lie within the boundaries of a polar coronal hole. We find that the mean temperature of the plumes is about 1.1 million K and that they have a small vertical temperature gradient. Densities are determined and found consistent with white light analyses. The variation of density with height in the plumes is compared with that expected for hydrostatic equilibrium. As is the case for other coronal features, polar plumes will be a source of solar wind if the magnetic field lines are open. On the basis of the derived plume model and estimates of the numbers of plumes in polar coronal holes, it appears that polar plumes contain about 15% of the mass in a typical polar hole and occupy about 10% of the volume.

  19. Advanced Reduction Processes: A New Class of Treatment Processes

    PubMed Central

    Vellanki, Bhanu Prakash; Batchelor, Bill; Abdel-Wahab, Ahmed

    2013-01-01

    Abstract A new class of treatment processes called advanced reduction processes (ARPs) is proposed. ARPs combine activation methods and reducing agents to form highly reactive reducing radicals that degrade oxidized contaminants. Batch screening experiments were conducted to identify effective ARPs by applying several combinations of activation methods (ultraviolet light, ultrasound, electron beam, and microwaves) and reducing agents (dithionite, sulfite, ferrous iron, and sulfide) to degradation of four target contaminants (perchlorate, nitrate, perfluorooctanoic acid, and 2,4 dichlorophenol) at three pH-levels (2.4, 7.0, and 11.2). These experiments identified the combination of sulfite activated by ultraviolet light produced by a low-pressure mercury vapor lamp (UV-L) as an effective ARP. More detailed kinetic experiments were conducted with nitrate and perchlorate as target compounds, and nitrate was found to degrade more rapidly than perchlorate. Effectiveness of the UV-L/sulfite treatment process improved with increasing pH for both perchlorate and nitrate. We present the theory behind ARPs, identify potential ARPs, demonstrate their effectiveness against a wide range of contaminants, and provide basic experimental evidence in support of the fundamental hypothesis for ARP, namely, that activation methods can be applied to reductants to form reducing radicals that degrade oxidized contaminants. This article provides an introduction to ARPs along with sufficient data to identify potentially effective ARPs and the target compounds these ARPs will be most effective in destroying. Further research will provide a detailed analysis of degradation kinetics and the mechanisms of contaminant destruction in an ARP. PMID:23840160

  20. [Novelties in the treatment for advanced renal-cell cancer].

    PubMed

    Maráz, Anikó

    2011-04-24

    Therapeutic options in advanced renal-cell cancer have expanded through better understanding of molecular pathology and development of novel targeted therapeutics. Vascular endothelial growth factor, the key ligand of angiogenesis, has a major role in the progression of vascularized kidney tumors and this is the target molecule of modern medications. The three types of the mechanism of action of current therapies are: monoclonal antibodies blocking directly vascular endothelial growth factor ligand (bevacizumab), tyrosine-kinase inhibitors blocking vascular endothelial growth factor receptors (sorafenib, sunitinib, pazopanib) and inhibitors of the intracellular mTOR-kinase (temsirolimus, everolimus). Based on randomized studies, sunitinib, pazopanib or interferon-α-bevacizumab combination should be the first-line therapy in patients with good/moderate prognosis, while temsirolimus is recommended in those with poor prognosis. Following an ineffective cytokine therapy sorafenib or pazopanib are the second-line treatment. In case of tyrosine-kinase inhibitor inefficacy, current evidence favors everolimus. Patient outcome can further be improved by the involvement of more modern and effective target products.

  1. Treatment of advanced neuroblastoma with I-131 meta-iodobenzylguanidine

    SciTech Connect

    Garaventa, A.; Guerra, P.; Arrighini, A.; Bertolazzi, L.; Bestagno, M.; De Bernardi, B.; Lanino, E.; Villavecchia, G.P.; Claudiani, F. )

    1991-02-15

    From February 1986 to December 1988, 31 children with advanced pretreated neuroblastoma were treated with 131-I meta-Iodobenzylguanidine (131-MIBG). Thirteen children had been resistant to first-line therapy, three had suffered a local relapse, and fourteen had suffered a disseminated relapse without over bone marrow infiltration. One child was treated initially because of resistance to first-line therapy, and subsequently for a local relapse. A total of 72 courses of 131-MIBG was administered, with doses ranging from 2.8 to 6.0 GBq (median, 3.7 GBq). One child received five courses, two four courses, 13 three courses, four two courses, and 12 one course of 131-MIBG. The most common toxic effect was thrombocytopenia, with a platelet level of less than 50,000/cmm occurring after 19 of 60 evaluable courses. A leukocyte count less than 1000/cmm was seen only once. There were six major responses (two complete) lasting 4 to 9 months, and two minor responses lasting longer than 38 and 44 months. Responses were seen more commonly in children whose only lesion was a residual primary tumor and in children who had not been pretreated who experienced disseminated relapse. Further studies of the role of 131-I meta-Iodobenzylguanidine in treatment of neuroblastoma are needed.

  2. Enceladus' Water Vapour Plumes

    NASA Technical Reports Server (NTRS)

    Hansen, Candice J.; Esposito, L.; Colwell, J.; Hendrix, A.; Matson, Dennis; Parkinson, C.; Pryor, W.; Shemansky, D.; Stewart, I.; Tew, J.; Yung, Y.

    2006-01-01

    A viewgraph presentation on the discovery of Enceladus water vapor plumes is shown. Conservative modeling of this water vapor is also presented and also shows that Enceladus is the source of most of the water required to supply the neutrals in Saturn's system and resupply the E-ring against losses.

  3. Double Diffusive Plumes

    NASA Astrophysics Data System (ADS)

    Sutherland, Bruce; Lee, Brace

    2008-11-01

    Sour gas flares attempt to dispose of deadly H2S gas through combustion. What does not burn rises as a buoyant plume. But the gas is heavier than air at room temperature, so as the rising gas cools eventually it becomes negatively buoyant and descends back to the ground. Ultimately, our intent is to predict the concentrations of the gas at ground level in realistic atmospheric conditions. As a first step towards this goal we have performed laboratory experiments examining the structure of a steady state plume of hot and salty water that rises buoyantly near the source and descends as a fountain after it has cooled sufficiently. We call this a double-diffusive plume because its evolution is dictated by the different (turbulent) diffusivities of heat and salt. A temperature and conductivity probe measures both the salinity and temperature along the centreline of the plume. The supposed axisymmetric structure of the salinity concentration as it changes with height is determined by light-attenuation methods. To help interpret the results, a theory has been successfully adapted from the work of Bloomfield and Kerr (2000), who developed coupled equations describing the structure of fountains. Introducing a new empirical parameter for the relative rates of turbulent heat and salt diffusion, the predictions are found to agree favourably with experimental results.

  4. Evaluation of Visible Plumes.

    ERIC Educational Resources Information Center

    Brennan, Thomas

    Developed for presentation at the 12th Conference on Methods in Air Pollution and Industrial Hygiene Studies, University of Southern California, April, 1971, this outline discusses plumes with contaminants that are visible to the naked eye. Information covers: (1) history of air pollution control regulations, (2) need for methods of evaluating…

  5. PLUME and research sotware

    NASA Astrophysics Data System (ADS)

    Baudin, Veronique; Gomez-Diaz, Teresa

    2013-04-01

    The PLUME open platform (https://www.projet-plume.org) has as first goal to share competences and to value the knowledge of software experts within the French higher education and research communities. The project proposes in its platform the access to more than 380 index cards describing useful and economic software for this community, with open access to everybody. The second goal of PLUME focuses on to improve the visibility of software produced by research laboratories within the higher education and research communities. The "development-ESR" index cards briefly describe the main features of the software, including references to research publications associated to it. The platform counts more than 300 cards describing research software, where 89 cards have an English version. In this talk we describe the theme classification and the taxonomy of the index cards and the evolution with new themes added to the project. We will also focus on the organisation of PLUME as an open project and its interests in the promotion of free/open source software from and for research, contributing to the creation of a community of shared knowledge.

  6. Buoyant plume calculations

    SciTech Connect

    Penner, J.E.; Haselman, L.C.; Edwards, L.L.

    1985-01-01

    Smoke from raging fires produced in the aftermath of a major nuclear exchange has been predicted to cause large decreases in surface temperatures. However, the extent of the decrease and even the sign of the temperature change, depend on how the smoke is distributed with altitude. We present a model capable of evaluating the initial distribution of lofted smoke above a massive fire. Calculations are shown for a two-dimensional slab version of the model and a full three-dimensional version. The model has been evaluated by simulating smoke heights for the Hamburg firestorm of 1943 and a smaller scale oil fire which occurred in Long Beach in 1958. Our plume heights for these fires are compared to those predicted by the classical Morton-Taylor-Turner theory for weakly buoyant plumes. We consider the effect of the added buoyancy caused by condensation of water-laden ground level air being carried to high altitude with the convection column as well as the effects of background wind on the calculated smoke plume heights for several fire intensities. We find that the rise height of the plume depends on the assumed background atmospheric conditions as well as the fire intensity. Little smoke is injected into the stratosphere unless the fire is unusually intense, or atmospheric conditions are more unstable than we have assumed. For intense fires significant amounts of water vapor are condensed raising the possibility of early scavenging of smoke particles by precipitation. 26 references, 11 figures.

  7. Ablation Plume Dynamics in a Background Gas

    SciTech Connect

    Amoruso, Salvatore; Schou, Joergen; Lunney, James G.

    2010-10-08

    The expansion of a plume in a background gas of pressure comparable to that used in pulsed laser deposition (PLD) has been analyzed in terms of the model of Predtechensky and Mayorov (PM). This approach gives a relatively clear and simple description of the essential hydrodynamics during the expansion. The model also leads to an insightful treatment of the stopping behavior in dimensionless units for plumes and background gases of different atomic/molecular masses. The energetics of the plume dynamics can also be treated with this model. Experimental time-of-flight data of silver ions in a neon background gas show a fair agreement with predictions from the PM-model. Finally we discuss the validity of the model, if the work done by the pressure of the background gas is neglected.

  8. Plume dynamics in heterogeneous porous media

    NASA Astrophysics Data System (ADS)

    Neufeld, Jerome A.; Huppert, Herbert E.

    2008-11-01

    Buoyancy driven flows in layered porous media are present in many geological settings and play an important role in the mixing of fluids, from the dispersal of pollutants in underground aquifers to enhanced oil recovery techniques and, of more recent importance, the sequestration of carbon dioxide (CO2). Seismic images of the rise of a buoyant CO2 plume at Sleipner in the North Sea indicate that these plumes are greatly influenced by a vertical array of thin lenses of relatively low permeability material. We model propagation of CO2 at each layer as a gravity current in a porous medium which propagates along, and drains through, a thin, low permeability seal. Drainage, driven both by hydrostatic pressure and the body force on the draining fluid, leads to an initial rapid advance followed by a gradual retreat of the current to a steady-state. By incorporating a vertical array of these single layer models we are able to capture the rise of the buoyant plume in layered reservoirs. We find that the plume is characterized by a broad head with a tail given by the steady state extent.

  9. Dynamics of thermochemical plumes: 2. Complexity of plume structures and its implications for mapping mantle plumes

    NASA Astrophysics Data System (ADS)

    Lin, Shu-Chuan; van Keken, Peter E.

    2006-03-01

    The mantle plume hypothesis provides explanations for several major observations of surface volcanism. The dynamics of plumes with purely thermal origin has been well established, but our understanding of the role of compositional variations in the Earth's mantle on plume formation is still incomplete. In this study we explore the structures of plumes originating from a thermochemical boundary layer at the base of the mantle in an attempt to complement fluid dynamical studies of purely thermal plumes. Our numerical experiments reveal diverse characteristics of thermochemical plumes that frequently deviate from the classic features of plumes. In addition, owing to the interplay between the thermal and compositional buoyancy forces, the morphology, temperature, and flow fields in both the plume head and plume conduit are strongly time-dependent. The entrainment of the dense layer and secondary instabilities developed in the boundary layer contribute to lateral heterogeneities and enhance stirring processes in the plume head. Our models show that substantial topography of the compositional layer can develop simultaneously with the plumes. In addition, plumes may be present in the lower mantle for more than 70 million years. These features may contribute to the large low seismic velocity provinces beneath the south central Pacific, the southern Atlantic Ocean, and Africa. Our model results support the idea that the dynamics of mantle plumes is much more complicated than conventional thinking based on studies of purely thermal plumes. The widely used criteria for mapping mantle plumes, such as a vertically continuous low seismic velocity signature and strong surface topography swell, may not be universally applicable. We propose that the intrinsic density contrast of the distinct composition may reduce the associated topography of some large igneous provinces such as Ontong Java.

  10. Sampling by mantle plumes : the legacy of the plume source

    NASA Astrophysics Data System (ADS)

    Brandeis, G.; Touitou, F.; Davaille, A.

    2013-12-01

    Plumes in the Earth's mantle are considered to be at the origin of intraplate volcanism (or hotspots). They continue to fascinate the scientific community by the heterogeneity of the material they sample on the surface of our planet. To characterize what part of the mantle is sampled by plumes, we have developed a laboratory model for laminar thermal plumes at high Prandtl number, in a fluid whose viscosity depends strongly on the temperature. This study describes the precise phenomenology of the plume and proposes scaling laws for the speed and temperature of the conduit of the plume. We show a strong dependence of these features of the plume with the Rayleigh number and viscosity ratio. Our visualization technique allows for the simultaneous non-intrusive measurements of the temperature, deformation and velocity fields. By calculating numerically the advection of passive markers through the experimental velocity field, we found that (1) the hot center of the plume conduit only consists of fluid which has passed through the thermal boundary layer ("TBL") at the bottom of the tank from which the plume was issued. Moreover, as material is stretched by velocity gradients, it is also in the thermal boundary layer that most of the material stretching occurs (2). The fluid is then transported in the conduit without lateral mixing, and further stretched vertically by the lateral velocity gradients. Since it is only the hot upwelling plume center which melts and therefore is sampled by volcanic activity, (1) implies that the plume geochemical signature is representative of the material located in the deep TBL of the mantle from which the plume is issued. On the other hand, (2) implies that filaments, pancakes, and concentric or bimodal zonation of the plume at the surface all result from different distributions of the heterogeneities in the plume source, filaments being the most generic case. Finally, we apply the scaling laws to the case of Hawaii.

  11. ADVANCED OXIDATION TECHNOLOGIES FOR THE TREATMENT OF CONTAMINATED GROUNDWATER

    EPA Science Inventory

    This paper presents information on two pilot-field appliations of advanced oxidation technologies for contaminated groundwater with organis. The two UV/oxidation technologies were developed by Ultrox International of Santa Ana, California and Peroxidatrion Systems, Inc. of Tucso...

  12. Psychotherapy and Psychosocial Treatment: Recent Advances and Future Directions.

    PubMed

    Plakun, Eric M

    2015-09-01

    Psychotherapy and psychosocial treatment have been shown to be effective forms of treatment of a range of individual and complex comorbid disorders. The future role of psychotherapy and psychosocial treatment depends on several factors, including full implementation of mental health parity, correction of underlying false assumptions that shape treatment, payment priorities and research, identification and teaching of common factors or elements shared by effective psychosocial therapies, and adequate teaching of psychotherapy and psychosocial treatment.

  13. Towards Simulating Non-Axisymmetric Influences on Aircraft Plumes for Signature Prediction

    NASA Technical Reports Server (NTRS)

    Kenzakowski, D. C.; Shipman, J. D.; Dash, S. M.

    2000-01-01

    A methodology for efficiently including three-dimensional effects on aircraft plume signature is presented. First, exploratory work on the use of passive mixing enhancement devices, namely chevrons and tabs, in IR signature reduction for external turbofan plumes is demonstrated numerically and experimentally. Such small attachments, when properly designed, cause an otherwise axisymmetric plume to have significant 3D structures, affecting signature prediction. Second, an approach for including non-axisymmetric and installation effects in plume signature prediction is discussed using unstructured methodology. Unstructured flow solvers, using advanced turbulence modeling and plume thermochemistry, facilitate the modeling of aircraft effects on plume structure that previously have been neglected due to gridding complexities. The capabilities of the CRUNCH unstructured Navier-Stokes solver for plume modeling is demonstrated for a passively mixed turbofan nozzle, a generic fighter nozzle, and a complete aircraft.

  14. P- and S-wave delays caused by thermal plumes

    NASA Astrophysics Data System (ADS)

    Maguire, Ross; Ritsema, Jeroen; van Keken, Peter E.; Fichtner, Andreas; Goes, Saskia

    2016-08-01

    Many studies have sought to seismically image plumes rising from the deep mantle in order to settle the debate about their presence and role in mantle dynamics, yet the predicted seismic signature of realistic plumes remains poorly understood. By combining numerical simulations of flow, mineral-physics constraints on the relationships between thermal anomalies and wave speeds, and spectral-element method based computations of seismograms, we estimate the delay times of teleseismic S and P waves caused by thermal plumes. Wave front healing is incomplete for seismic periods ranging from 10 s (relevant in traveltime tomography) to 40 s (relevant in waveform tomography). We estimate P-wave delays to be immeasurably small (<0.3 s). S-wave delays are larger than 0.4 s even for S waves crossing the conduits of the thinnest thermal plumes in our geodynamic models. At longer periods (>20 s), measurements of instantaneous phase misfit may be more useful in resolving narrow plume conduits. To detect S-wave delays of 0.4-0.8 s and the diagnostic frequency dependence imparted by plumes, it is key to minimize the influence of the heterogeneous crust and upper mantle. We argue that seismic imaging of plumes will advance significantly if data from wide-aperture ocean-bottom networks were available since, compared to continents, the oceanic crust and upper mantle are relatively simple.

  15. Advances in the Diagnosis and Treatment of Acanthamoeba Keratitis

    PubMed Central

    Clarke, Benjamin; Sinha, Arti; Parmar, Dipak N.

    2012-01-01

    This paper aims to review the recent literature describing Acanthamoeba keratitis and outline current thoughts on pathogenesis, diagnosis, and treatment as well as currently emerging diagnostic and treatment modalities. PMID:23304449

  16. Recent advancement or less invasive treatment of percutaneous nephrolithotomy

    PubMed Central

    2015-01-01

    Since its initial introduction in 1976, percutaneous nephrolithotomy (PCNL) has been widely performed for the management of large renal stones and currently is recommended for staghorn calculi, kidney stones larger than 2 cm, and shock wave lithotripsy-resistant lower pole stones greater than 1 cm. However, except for open and laparoscopic surgery, PCNL is the most invasive of the minimally invasive stone surgery techniques. Over the years, technical and instrumental advances have been made in PCNL to reduce morbidity and improve effectiveness. A thorough review of the recent literature identified five major areas of progress for the advancement of PCNL: patient positioning, method of percutaneous access, development of lithotriptors, miniaturized access tracts, and postoperative nephrostomy tube management. This review provides an overview of recent advancements in PCNL and the outcomes of each area of progress and notes how much we achieve with less invasive PCNL. This information may allow us to consider the future role and future developments of PCNL. PMID:26366273

  17. Evolving treatment paradigms for locally advanced and metastatic prostate cancer.

    PubMed

    Dorff, Tanya B; Quek, Marcus L; Daneshmand, Siamak; Pinski, Jacek

    2006-11-01

    While men with early stage prostate cancer typically enjoy long-term survival after definitive management, for those who present with locally advanced or metastatic disease, survival is compromised. Multimodality therapy can prolong survival in these patients, with state-of-the-art options including intensity-modulated radiation or brachytherapy in conjunction with androgen ablation, adjuvant androgen ablation and/or chemotherapy with radical retropubic prostatectomy. In addition, novel biological therapies are being explored to target the unique molecular changes in prostate cancer cells and their interactions with the microenvironment. With these advances the outlook will undoubtedly improve, even for patients presenting with advanced disease. Careful application of these emerging therapies to a select group of prostate cancer patients most likely to obtain benefit from them is the challenge for urologists, medical oncologists and radiation oncologists for the future.

  18. Representative Atmospheric Plume Development for Elevated Releases

    SciTech Connect

    Eslinger, Paul W.; Lowrey, Justin D.; McIntyre, Justin I.; Miley, Harry S.; Prichard, Andrew W.

    2014-02-01

    An atmospheric explosion of a low-yield nuclear device will produce a large number of radioactive isotopes, some of which can be measured with airborne detection systems. However, properly equipped aircraft may not arrive in the region where an explosion occurred for a number of hours after the event. Atmospheric conditions will have caused the radioactive plume to move and diffuse before the aircraft arrives. The science behind predicting atmospheric plume movement has advanced enough that the location of the maximum concentrations in the plume can be determined reasonably accurately in real time, or near real time. Given the assumption that an aircraft can follow a plume, this study addresses the amount of atmospheric dilution expected to occur in a representative plume as a function of time past the release event. The approach models atmospheric transport of hypothetical releases from a single location for every day in a year using the publically available HYSPLIT code. The effective dilution factors for the point of maximum concentration in an elevated plume based on a release of a non-decaying, non-depositing tracer can vary by orders of magnitude depending on the day of the release, even for the same number of hours after the release event. However, the median of the dilution factors based on releases for 365 consecutive days at one site follows a power law relationship in time, as shown in Figure S-1. The relationship is good enough to provide a general rule of thumb for estimating typical future dilution factors in a plume starting at the same point. However, the coefficients of the power law function may vary for different release point locations. Radioactive decay causes the effective dilution factors to decrease more quickly with the time past the release event than the dilution factors based on a non-decaying tracer. An analytical expression for the dilution factors of isotopes with different half-lives can be developed given the power law expression

  19. Systemic treatment approaches in her2-negative advanced breast cancer—guidance on the guidelines

    PubMed Central

    Joy, A.A.; Ghosh, M.; Fernandes, R.; Clemons, M.J.

    2015-01-01

    Despite advancements in the treatment of early-stage breast cancer, many patients still develop disease recurrence; others present with de novo metastatic disease. For most patients with advanced breast cancer, the primary treatment intent is noncurative—that is, palliative—in nature. The goals of treatment should therefore focus on maximizing symptom control and extending survival. Treatments should be evaluated on an individualized basis in terms of evidence, but also with full respect for the wishes of the patient in terms of acceptable toxicity. Given the availability of extensive reviews on the roles of endocrine therapy and her2 (human epidermal growth factor receptor 2)–targeted therapies for advanced disease, we focus here mainly on treatment guidelines for the non-endocrine management of her2-negative advanced breast cancer in a Canadian health care context. PMID:25848337

  20. Towards personalized perioperative treatment for advanced gastric cancer

    PubMed Central

    Miao, Ru-Lin; Wu, Ai-Wen

    2014-01-01

    Gastric cancer is one of the most frequently diagnosed cancers worldwide. Although the rate of gastric cancer has declined dramatically over the past decades in most developed Western countries, it has not declined in East Asia. Currently, a radical gastrectomy is still the only curative treatment for gastric cancer. Over the last twenty years, however, surgery alone has been replaced by a multimodal perioperative approach. To achieve the maximum benefit from the perioperative treatment, a thorough evaluation of the tumor must first be performed. A complete assessment of gastric cancer is divided into two parts: staging and histology. According to the stage and histology of the cancer, perioperative chemotherapy or radiochemotherapy can be implemented, and perioperative targeted therapies such as trastuzumab may also play a role in this field. However, perioperative treatment approaches have not been widely accepted until a series of clinical trials were performed to evaluate the value of perioperative treatment. Although multimodal perioperative treatment has been widely applied in clinical practice, personalization of perioperative treatment represents the next stage in the treatment of gastric cancer. Genomic-guided treatment and efficacy prediction using molecular biomarkers in perioperative treatment are of great importance in the evolution of treatment and may become an ideal treatment method. PMID:25206266

  1. Seismic Imaging of Mantle Plumes

    NASA Astrophysics Data System (ADS)

    Nataf, Henri-Claude

    The mantle plume hypothesis was proposed thirty years ago by Jason Morgan to explain hotspot volcanoes such as Hawaii. A thermal diapir (or plume) rises from the thermal boundary layer at the base of the mantle and produces a chain of volcanoes as a plate moves on top of it. The idea is very attractive, but direct evidence for actual plumes is weak, and many questions remain unanswered. With the great improvement of seismic imagery in the past ten years, new prospects have arisen. Mantle plumes are expected to be rather narrow, and their detection by seismic techniques requires specific developments as well as dedicated field experiments. Regional travel-time tomography has provided good evidence for plumes in the upper mantle beneath a few hotspots (Yellowstone, Massif Central, Iceland). Beneath Hawaii and Iceland, the plume can be detected in the transition zone because it deflects the seismic discontinuities at 410 and 660 km depths. In the lower mantle, plumes are very difficult to detect, so specific methods have been worked out for this purpose. There are hints of a plume beneath the weak Bowie hotspot, as well as intriguing observations for Hawaii. Beneath Iceland, high-resolution tomography has just revealed a wide and meandering plume-like structure extending from the core-mantle boundary up to the surface. Among the many phenomena that seem to take place in the lowermost mantle (or D''), there are also signs there of the presence of plumes. In this article I review the main results obtained so far from these studies and discuss their implications for plume dynamics. Seismic imaging of mantle plumes is still in its infancy but should soon become a turbulent teenager.

  2. Mantle plumes and continental tectonics.

    PubMed

    Hill, R I; Campbell, I H; Davies, G F; Griffiths, R W

    1992-04-10

    Mantle plumes and plate tectonics, the result of two distinct modes of convection within the Earth, operate largely independently. Although plumes are secondary in terms of heat transport, they have probably played an important role in continental geology. A new plume starts with a large spherical head that can cause uplift and flood basalt volcanism, and may be responsible for regional-scale metamorphism or crustal melting and varying amounts of crustal extension. Plume heads are followed by narrow tails that give rise to the familiar hot-spot tracks. The cumulative effect of processes associated with tail volcanism may also significantly affect continental crust.

  3. Alternative treatments in advanced hepatocellular carcinoma patients with progressive disease after sorafenib treatment: a prospective multicenter cohort study

    PubMed Central

    Nakano, Masahito; Tanaka, Masatoshi; Kuromatsu, Ryoko; Nagamatsu, Hiroaki; Satani, Manabu; Niizeki, Takashi; Okamura, Shusuke; Iwamoto, Hideki; Shimose, Shigeo; Shirono, Tomotake; Noda, Yu; Koga, Hironori; Torimura, Takuji

    2016-01-01

    Sorafenib is an oral multikinase inhibitor that has been approved to treat advanced hepatocellular carcinoma (HCC), though it is unclear how much benefit advanced HCC patients with progressive disease (PD) derive from sorafenib treatment. This study aimed to assess survival risk factors and evaluate therapeutic strategies for advanced HCC patients with PD after sorafenib treatment. We analyzed the clinical data and treatment outcomes for 315 consecutive advanced HCC patients treated with sorafenib. Univariate analyses of overall survival identified therapeutic effect as an independent risk factor in all patients. Among all patients, 141 developed PD. Of those, 58 (41%) were treated with sorafenib monotherapy, 70 (50%) with agents other than sorafenib, and 13 (9%) were not treated at all. The median survival time was 6.1 months for PD patients with sorafenib monotherapy and 12.2 months for those administered alternative treatments (p < 0.0001). Our results indicated that sorafenib treatment may have negative long-term therapeutic effects in advanced HCC patients with PD, and that alternative treatments should be considered for these patients after sorafenib administration. PMID:27462865

  4. [Advanced Treatment of Effluent from Industrial Park Wastewater Treatment Plant by Ferrous Ion Activated Sodium Persulfate].

    PubMed

    Zhu, Song-mei; Zhou, Zhen; Gu, Ling-yun; Jiang, Hai-tao; Ren, Jia-min; Wang, Luo-chun

    2016-01-15

    Fe(II) activated sodium persulfate (PS) technology was used for advanced treatment of effluent from industrial park wastewater treatment plant. Separate and combined effects of PS/COD, Fe(II)/PS and pH on COD and TOC removal were analyzed by the response surface methodology. Variations of organic substances before and after Fe(II)-PS oxidation were characterized by UV-Vis spectrometry, gel chromatography and three-dimensional fluorescence. PS/COD and Fe(II)/PS had significant effect on COD removal, while all the three factors had significant effect on TOC removal. The combined effect of PS/COD and pH had significant effect on COD removal. COD and TOC removal efficiencies reached 50.7% and 60.6% under optimized conditions of PS/COD 3.47, Fe(II)/PS 3.32 and pH 6.5. Fe(II)-PS oxidation converted macromolecular organic substances to small ones, and reduced contents of protein-, humic- and fulvic-like substances.

  5. Acoustic Treatment Design Scaling Methods. Volume 2; Advanced Treatment Impedance Models for High Frequency Ranges

    NASA Technical Reports Server (NTRS)

    Kraft, R. E.; Yu, J.; Kwan, H. W.

    1999-01-01

    The primary purpose of this study is to develop improved models for the acoustic impedance of treatment panels at high frequencies, for application to subscale treatment designs. Effects that cause significant deviation of the impedance from simple geometric scaling are examined in detail, an improved high-frequency impedance model is developed, and the improved model is correlated with high-frequency impedance measurements. Only single-degree-of-freedom honeycomb sandwich resonator panels with either perforated sheet or "linear" wiremesh faceplates are considered. The objective is to understand those effects that cause the simple single-degree-of- freedom resonator panels to deviate at the higher-scaled frequency from the impedance that would be obtained at the corresponding full-scale frequency. This will allow the subscale panel to be designed to achieve a specified impedance spectrum over at least a limited range of frequencies. An advanced impedance prediction model has been developed that accounts for some of the known effects at high frequency that have previously been ignored as a small source of error for full-scale frequency ranges.

  6. Advanced Hybrid Modeling of Hall Thruster Plumes

    DTIC Science & Technology

    2010-06-16

    LVTF. A direct simulation Monte Carlo (DSMC) method3 is used to model collision dynamics, and a Particle-in-Cell ( PIC ) method4 is used to capture...cell ( PIC ) numerical methods on an axisymmetric grid.7 The code has been found to be effective in creating either time-averaged outputs of performance...here. The HPHall code performs an axisymmetric simulation, commonly referred to as “hybrid- PIC ,” treating the electrons via fluid approximation

  7. Liver abscess in advanced hepatocellular carcinoma after sorafenib treatment.

    PubMed

    Shin, Seung Kak; Jung, Young Kul; Yoon, Hyun Hwa; Kwon, Oh Sang; Kim, Yun Soo; Choi, Duck Joo; Kim, Ju Hyun

    2014-01-25

    Hepatocellular carcinoma (HCC) is a critical global health issue and the third most common cause of cancer-related deaths worldwide. The majority of patients who present HCC are already at an advanced stage and their tumors are unresectable. Sorafenib is a multi-kinase inhibitor of the vascular endothelial growth factor pathway and was recently introduced as a therapy for advanced HCC. Furthermore, studies have shown that oral sorafenib has beneficial effects on survival. However, many patients experience diverse side effects, and some of these are severe. Liver abscess development has not been previously documented to be associated with sorafenib administration in HCC. Here, we report the case of a HCC patient that developed a liver abscess while being treated with sorafenib.

  8. Current treatments and advances in pain and anxiety management.

    PubMed

    Huang, David; Wun, Edmund; Stern, Avichai

    2011-07-01

    In light of preoperative and postoperative mortality and morbidity, continued advancement in pain and anxiety management would benefit millions. Although significant strides have been made in the past few decades, it is imperative that research and development continue. This article discusses types of pain and anxiety, the relationship between pain and anxiety, the physiology of pain and anxiety, and current trends in pain and anxiety management.

  9. Reducing Toxicity of Radiation Treatment of Advanced Prostate Cancer

    DTIC Science & Technology

    2015-10-01

    malignant tissues. A major effort focused on the effects these drugs on myeloid (bone marrow-derived) cells. This is based on our finding that...the last progress report we further presented data supporting the notion that the radioprotecive effect of RTA 408 is a ‘class’ effect of drugs that...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Toxicity is a major impediment to effective radiation therapy of locally advanced prostate cancer

  10. SUPERFUND TREATABILITY CLEARINGHOUSE: ADVANCED ELECTRIC REACTOR (AER) FOR THE TREATMENT OF DIOXIN- CONTAMINATED SOILS

    EPA Science Inventory

    This newsletter reports on the Huber Technology Groups (HTG) high temperature advanced hazardous waste treatment technology capable of very high destruction and removal efficiencies of various hazardous wastes. This newsletter addresses the destruction of PCBs in an EPA certifi...

  11. Tomorrow`s energy today for cities and counties -- Alternative wastewater treatment: Advanced Integrated Pond systems

    SciTech Connect

    Not Available

    1993-10-01

    This report provides a discussion of the design, construction, operation, and maintenance of the Advanced Integrated Pond System as an alternative for other more costly municipal waste water treatment plants.

  12. New Targeted Treatment May Slow Disease in Patients with Advanced GIST

    Cancer.gov

    A new oral drug, regorafenib (Stivarga®), may delay the progression of advanced gastrointestinal stromal tumors (GIST) that are resistant to treatment, according to results from an international clinical trial published November 22, 2012, in The Lancet.

  13. Single SCA-plume dynamics

    NASA Astrophysics Data System (ADS)

    Yano, J.-I.; Baizig, Hichem

    2012-11-01

    A fully prognostic prototype of bulk mass-flux convection parameterization is presented. The bulk mass-flux parameterization is formulated by assuming a subgrid-scale system consisting only of a convective plume and environment. Both subcomponents (segments) are assumed to be homogeneous horizontally. This assumption is called the segmentally constant approximation (SCA). The present study introduces this purely geometrical constraint (SCA) into the full nonhydrostatic anelastic system. A continuous-space description of the full system is, thus, replaced by a discretization consisting only of two segments (plume and environment) in the horizontal direction. The resulting discretized system is mathematically equivalent to a 0th order finite volume formulation with the only two finite volumes. The model is presented under a two-dimensional configuration. Interfaces between the plume and the environment segments may either be fixed in time or Lagrangianly advected as two limiting cases. Under this framework, the single-plume dynamics is systematically investigated in a wide phase space of Richardson number, the aspect ratio, and a displacement rate of the plume interfaces relative to the Lagrangian displacement. Advantage of the present model is in evaluating the lateral mixing processes of the plume without invoking an entrainment-detrainment hypothesis. The fractional entrainment-detrainment rate diagnosed from the present model simulations highly varies both over space and time, suggesting a limitation of applying an entrainment-detrainment hypothesis to unsteady plumes, as in the present case, in which circulations of the plume scale dominates over the turbulent mixing process. Furthermore, when the entrainment-plume hypothesis of Morton et al. is adopted for defining the plume-interface displacement rate, the plume continuously expands with time without reaching equilibrium.

  14. The function of advanced treatment process in a drinking water treatment plant with organic matter-polluted source water.

    PubMed

    Lin, Huirong; Zhang, Shuting; Zhang, Shenghua; Lin, Wenfang; Yu, Xin

    2015-08-07

    To understand the relationship between chemical and microbial treatment at each treatment step, as well as the relationship between microbial community structure in biofilms in biofilters and their ecological functions, a drinking water plant with severe organic matter-polluted source water was investigated. The bacterial community dynamics of two drinking water supply systems (traditional and advanced treatment processes) in this plant were studied from the source to the product water. Analysis by 454 pyrosequencing was conducted to characterize the bacterial diversity in each step of the treatment processes. The bacterial communities in these two treatment processes were highly diverse. Proteobacteria, which mainly consisted of beta-proteobacteria, was the dominant phylum. The two treatment processes used in the plant could effectively remove organic pollutants and microbial polution, especially the advanced treatment process. Significant differences in the detection of the major groups were observed in the product water samples in the treatment processes. The treatment processes, particularly the biological pretreatment and O3-biological activated carbon in the advanced treatment process, highly influenced the microbial community composition and the water quality. Some opportunistic pathogens were found in the water. Nitrogen-relative microorganisms found in the biofilm of filters may perform an important function on the microbial community composition and water quality improvement.

  15. Advances in the treatment of opioid use disorders

    PubMed Central

    Woody, George E.

    2017-01-01

    The development of medications for treating persons with opioid use disorders has expanded the number of evidence-based treatment options, particularly for persons with the most severe disorders. It has also improved outcomes compared to psychosocial treatment alone and expanded treatment availability by increasing the number of physicians involved in treatment and the settings where patients can be treated. The medications include methadone, buprenorphine, buprenorphine/naloxone, and extended-release injectable naltrexone. Studies have shown that they are most effective when used over an extended, but as-yet-unspecified, period of time and with counseling and other services, particularly for the many with psychosocial problems. Though controversial in some cultures, well-designed studies in Switzerland, the Netherlands, Germany, and Canada have demonstrated the efficacy of supervised heroin injecting for persons who responded poorly to other treatments, and this treatment option has been approved by Switzerland and a few other E.U. countries. The degree to which medication-assisted therapies are available is dependent on many variables, including national and local regulations, preferences of individual providers and their geographical location, treatment costs, and insurance policies. Greater availability of medication-assisted therapies has become a major focus in the U.S. and Canada, where there has been a marked increase in deaths associated with heroin and prescription opioid use. This paper provides a brief summary of these developments. PMID:28184294

  16. Advances in the diagnosis and treatment of gastric neuroendocrine neoplasms.

    PubMed

    Tan, Huangying

    2016-01-01

    Gastric neuroendocrine neoplasms (g-NENs) are a group of heterogeneous tumors arising from the endocrine cells of stomach. Most g-NENs progresses slowly and have a long disease course; however, some other g-NENs grow rapidly, similar to the progression of gastric adenocarcinoma. g-NENs have complex and diverse clinical manifestations and their prognosis and treatment strategies depend highly on clinical subtype, pathological grade, tumour stage, and other factors. Due to their low prevalence, most clinicians have limited knowledge about g-NENs. Missed diagnosis and excessive/inadequate treatment is common in clinical settings. Thus, the diagnosis and treatment of g-NENs needs to be further standardized.

  17. Targeted Approach to Overcoming Treatment Resistance in Advanced Prostate Cancer

    DTIC Science & Technology

    2014-09-01

    cisplatin .  The  structure  selected  was  the  median  structure  of  the  most...compounds  in  combination  therapy  with   cisplatin .     Figure  11  demonstrates  that  Compound  #12  does  not...improve  treatment  with   cisplatin ,  and  combination   treatment  is  equally  effective.  Combination  treatment

  18. [Therapeutic advances in pharmaceutical treatment of neuropathic pain].

    PubMed

    Attal, N

    2011-12-01

    Neuropathic pain is difficult to treat. Recommended first-line treatments include tricyclic antidepressants and alpha2delta agonists pregabalin and gabapentin for multiple neuropathic conditions, the antidepressants duloxetine and venlafaxine in diabetic painful neuropathies and lidocaine patches for postherapetic neuralgia. Therapeutic prospects include focal therapy with sustained analgesic efficacy (capsaicin patches, botulinum toxin), treatments acting on new targets (i.e., cytokine inhibitors, metabotropic glutamate inhibitors, TRPV1 antagonists). The methodology of clinical trials also tends to take better into account the symptomatic profiles of patients, which should contribute to better prediction or responders to treatment.

  19. Current advances in the treatment of adolescent drug use

    PubMed Central

    Winters, Ken C; Tanner-Smith, Emily E; Bresani, Elena; Meyers, Kathleen

    2014-01-01

    Research on the development and efficacy of drug abuse treatment for adolescents has made great strides recently. Several distinct models have been studied, and these approaches range from brief interventions to intensive treatments. This paper has three primary aims: to provide an overview of conceptual issues relevant to treating adolescents suspected of drug-related problems, including an overview of factors believed to contribute to a substance use disorder, to review the empirical treatment outcome literature, and to identify areas of need and promising directions for future research. PMID:25429247

  20. Space-based observational constraints for 1-D fire smoke plume-rise models

    NASA Astrophysics Data System (ADS)

    Val Martin, Maria; Kahn, Ralph A.; Logan, Jennifer A.; Paugam, Ronan; Wooster, Martin; Ichoku, Charles

    2012-11-01

    We use a plume height climatology derived from space-based Multiangle Imaging Spectroradiometer (MISR) observations to evaluate the performance of a widely used plume-rise model. We initialize the model with assimilated meteorological fields from the NASA Goddard Earth Observing System and estimated fuel moisture content at the location and time of the MISR measurements. Fire properties that drive the plume-rise model are difficult to constrain, and we test the model with four estimates each of active fire area and total heat flux, obtained from Moderate Resolution Imaging Spectroradiometer (MODIS) fire radiative power (FRP) thermal anomalies available for each MISR plume and other empirical data. We demonstrate the degree to which the fire dynamical heat flux (related to active fire area and sensible heat flux) and atmospheric stability structure influence plume rise, although entrainment and possibly other less well constrained factors are also likely to be significant. Using atmospheric stability conditions, MODIS FRP, and MISR plume heights, we find that smoke plumes reaching high altitudes are characterized by higher FRP and weaker atmospheric stability conditions than those at low altitude, which tend to remain confined below the boundary layer, consistent with earlier results. However, over the diversity of conditions studied, the model simulations generally underestimate the plume height dynamic range observed by MISR and do not reliably identify plumes injected into the free troposphere, key information needed for atmospheric models to simulate smoke dispersion. We conclude that embedding in large-scale atmospheric studies an advanced plume-rise model using currently available fire constraints remains a difficult proposition, and we propose a simplified model that crudely constrains plume injection height based on two main physical factors for which some observational constraints often exist. Field experiments aimed at directly measuring fire and smoke

  1. Hybridization of natural systems with advanced treatment processes for organic micropollutant removals: new concepts in multi-barrier treatment.

    PubMed

    Sudhakaran, Sairam; Maeng, Sung Kyu; Amy, Gary

    2013-07-01

    Organic micropollutants (OMPs) represent a major constraint in drinking water supply. In the past, emphasis has been on individual treatment processes comprising conventional treatment (coagulation, sedimentation, and filtration) followed by advanced treatment processes (adsorption, ion-exchange, oxidation, and membrane separation). With the depletion of water resources and high demand for power and chemical usage, efforts need to be made to judiciously use advanced treatment processes. There is a new interest in multiple barriers with synergies in which two coupled processes can function as a hybrid process. Within the context of this paper, the hybrid processes include a natural treatment process coupled with an advanced process. Pilot/full-scale studies have shown efficient removal of OMPs by these hybrid processes. With this hybridization, the usage of resources such as power and chemicals can be reduced. In this study, coupling/hybridization of aquifer recharge and recovery (ARR) with oxidation (O3), advanced oxidation process which involves OH radicals (AOP), nanofiltration (NF), reverse osmosis (RO) and granular activated carbon (GAC) adsorption for OMP removal was studied. O3 or AOP as a pre-treatment and GAC, NF, RO, or UV/chlorination as a post-treatment to ARR was studied. NF can be replaced by RO for removal of OMPs since studies have shown similar performance of NF to RO for removal of many OMPs, thereby reducing costs and providing a more sustainable approach.

  2. Advances in Vitiligo: An Update on Medical and Surgical Treatments.

    PubMed

    Dillon, Alexander B; Sideris, Andrew; Hadi, Ali; Elbuluk, Nada

    2017-01-01

    Vitiligo is one of the most common cutaneous disorders of depigmentation. Although its underlying causes are still being studied and no definitive cure currently exists, recent research has provided insight into pathogenic mechanisms and new treatment options. Objective: The aim of this paper is to provide a comprehensive overview of the medical and surgical therapies for vitiligo with emphasis on the most recent treatment modalities. Design: This review was conducted through a literature search using PubMed and the National institutes of Health's clinicalTrials.gov databases from January 2010 to July 2015. This yielded 86 studies, 12 of which were excluded, and 74 of which were reviewed. Results: Recent studies and ongoing clinical trials indicate that there are many promising new medical and surgical treatment modalities for this chronic condition. Conclusion: A combination of traditional and newer treatments may work synergistically to provide additional improvement in patients' disease state and quality of life.

  3. Advances in Vitiligo: An Update on Medical and Surgical Treatments

    PubMed Central

    Dillon, Alexander B.; Sideris, Andrew; Hadi, Ali

    2017-01-01

    Vitiligo is one of the most common cutaneous disorders of depigmentation. Although its underlying causes are still being studied and no definitive cure currently exists, recent research has provided insight into pathogenic mechanisms and new treatment options. Objective: The aim of this paper is to provide a comprehensive overview of the medical and surgical therapies for vitiligo with emphasis on the most recent treatment modalities. Design: This review was conducted through a literature search using PubMed and the National institutes of Health’s clinicalTrials.gov databases from January 2010 to July 2015. This yielded 86 studies, 12 of which were excluded, and 74 of which were reviewed. Results: Recent studies and ongoing clinical trials indicate that there are many promising new medical and surgical treatment modalities for this chronic condition. Conclusion: A combination of traditional and newer treatments may work synergistically to provide additional improvement in patients’ disease state and quality of life. PMID:28210378

  4. Advanced modeling techniques in application to plasma pulse treatment

    NASA Astrophysics Data System (ADS)

    Pashchenko, A. F.; Pashchenko, F. F.

    2016-06-01

    Different approaches considered for simulation of plasma pulse treatment process. The assumption of a significant non-linearity of processes in the treatment of oil wells has been confirmed. Method of functional transformations and fuzzy logic methods suggested for construction of a mathematical model. It is shown, that models, based on fuzzy logic are able to provide a satisfactory accuracy of simulation and prediction of non-linear processes observed.

  5. Lightning in Colorado forest fire smoke plumes during summer 2012

    NASA Astrophysics Data System (ADS)

    Lang, T. J.; Krehbiel, P. R.; Dolan, B.; Lindsey, D.; Rutledge, S. A.; Rison, W.

    2012-12-01

    May and June 2012 were unusually hot and dry in Colorado, which was suffering from a strong drought. A major consequence of this climatic regime was one of the most destructive forest fire seasons in state history, with hundreds of thousands of acres of forest and grassland consumed by flames, hundreds of homes burned, and several lives lost. Many of these fires occurred within range of the newly installed Colorado Lightning Mapping Array (COLMA), which provides high-resolution observations of discharges over a large portion of the state. The COLMA was installed in advance of the Deep Convective Clouds and Chemistry (DC3) project. High-altitude lightning was observed to occur sporadically in the smoke plumes over three major fires that occurred during early summer: Hewlett Gulch, High Park, and Waldo Canyon. Additionally, the Colorado State University CHILL (CSU-CHILL) and Pawnee radars observed the Hewlett Gulch plume electrify with detailed polarimetric and dual-Doppler measurements, and also provided these same measurements for the High Park plume when it was not producing lightning. Meanwhile, local Next Generation Radars (NEXRADs) provided observations of the electrified High Park and Waldo Canyon plumes. All of these plumes also were observed by geostationary meteorological satellites. These observations provide an unprecedented dataset with which to study smoke plume and pyrocumulus electrification. The polarimetric data - low reflectivity, high differential reflectivity, low correlation coefficient, and noisy differential phase - were consistent with the smoke plumes and associated pyrocumulus being filled primarily with irregularly shaped ash particles. Lightning was not observed in the plumes until they reached over 10 km above mean sea level, which was an uncommon occurrence requiring explosive fire growth combined with increased meteorological instability and reduced wind shear. Plume updraft intensification and echo-top growth led the occurrence of

  6. Atmospheric chemistry in volcanic plumes.

    PubMed

    von Glasow, Roland

    2010-04-13

    Recent field observations have shown that the atmospheric plumes of quiescently degassing volcanoes are chemically very active, pointing to the role of chemical cycles involving halogen species and heterogeneous reactions on aerosol particles that have previously been unexplored for this type of volcanic plumes. Key features of these measurements can be reproduced by numerical models such as the one employed in this study. The model shows sustained high levels of reactive bromine in the plume, leading to extensive ozone destruction, that, depending on plume dispersal, can be maintained for several days. The very high concentrations of sulfur dioxide in the volcanic plume reduces the lifetime of the OH radical drastically, so that it is virtually absent in the volcanic plume. This would imply an increased lifetime of methane in volcanic plumes, unless reactive chlorine chemistry in the plume is strong enough to offset the lack of OH chemistry. A further effect of bromine chemistry in addition to ozone destruction shown by the model studies presented here, is the oxidation of mercury. This relates to mercury that has been coemitted with bromine from the volcano but also to background atmospheric mercury. The rapid oxidation of mercury implies a drastically reduced atmospheric lifetime of mercury so that the contribution of volcanic mercury to the atmospheric background might be less than previously thought. However, the implications, especially health and environmental effects due to deposition, might be substantial and warrant further studies, especially field measurements to test this hypothesis.

  7. Advanced oxidation processes in azo dye wastewater treatment.

    PubMed

    Papić, Sanja; Koprivanac, Natalija; Bozić, Ana Loncarić; Vujević, Dinko; Dragicević, Savka Kusar; Kusić, Hrvoje; Peternel, Igor

    2006-06-01

    The chemical degradation of synthetic azo dyes color index (C.I.) Acid Orange 7, C.I. Direct Orange 39, and C.I. Mordant Yellow 10 has been studied by the following advanced oxidation processes: Fenton, Fenton-like, ozonation, peroxone without or with addition of solid particles, zeolites HY, and NH4ZSM5. Spectrophotometric (UV/visible light spectrum) and total organic carbon measurements were used for determination of process efficiency and reaction kinetics. The degradation rates are evaluated by determining their rate constants. The different hydroxyl radical generation processes were comparatively studied, and the most efficient experimental conditions for the degradation of organic azo dyes solutions were determined.

  8. Medical advances in the treatment of postpartum hemorrhage.

    PubMed

    Ducloy-Bouthors, Anne-Sophie; Susen, Sophie; Wong, Cynthia A; Butwick, Alex; Vallet, Benoit; Lockhart, Evelyn

    2014-11-01

    Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Recent advances in the management of severe bleeding for trauma patients may provide insight into PPH management, but must be applied with caution considering the significant differences between trauma and obstetric patients. In this review, we summarized evidence for current management strategies for patients with major obstetric hemorrhage, including (1) rapid laboratory assessment of coagulopathy, (2) early transfusion of plasma and high plasma-to-red blood cell transfusion ratios in massive PPH, and (3) use of tranexamic acid and fibrinogen concentrates in the setting of PPH complicated by coagulopathy.

  9. Dynamics of suspended sediment plumes in Lake Ontario

    NASA Technical Reports Server (NTRS)

    Pluhowski, E. J. (Principal Investigator)

    1974-01-01

    The author has identified the following significant results. Two unusual turbidity features were detected in imagery obtained over Lake Ontario on September 19, 1973. The location of a submerged sewer outfall was detected in frame 1423-15224-5 about 2 kilometers offshore opposite a treatment plant serving Rochester, New York. The other feature was a thermal heat plume made visible by an erosive eastward moving longshore current. The thermal plume, which extended about 3 kilometers into the lake, results from the discharge of cooling water from a nuclear power plant located 20 miles east of Rochester, New York. Under an offshore wind field, the outer edge of the Niagara River plume extended 30 kilometers into Lake Ontario on September 3, 1973. By way of contrast, a strong west-northwest wind on April 29, 1973, confined the plume to about 3 kilometers of the lake's south shore. The size of the Genesee River plume is largely dependent on discharge. During the spring high flow season, the plume extended over 22 square kilometers of the lake's surface on May 16, 1973. As runoff dwindled with the approach of summer, the plume contracted to less than 1 square kilometer in area by mid-July.

  10. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly and Cushing Disease Paradigms.

    PubMed

    Mooney, Michael A; Simon, Elias D; Little, Andrew S

    2016-01-01

    The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment.

  11. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly and Cushing Disease Paradigms

    PubMed Central

    Mooney, Michael A.; Simon, Elias D.; Little, Andrew S.

    2016-01-01

    The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment. PMID:27517036

  12. Orthodontic treatment for a patient with advanced periodontal disease: 11-year follow-up.

    PubMed

    Tavares, Carlos Alberto Estevanell; Allgayer, Susiane; Calvete, Ernani da Silva; Polido, Waldemar Daudt

    2013-09-01

    This case report demonstrates the interdisciplinary treatment of an adult patient with a Class II malocclusion, convex profile, incompetent lips, gummy smile, and advanced periodontal loss. Initial periodontal-endodontic treatment was followed by orthodontic and orthognathic surgical therapies. An esthetic facial profile, a pleasing smile, an appropriate occlusion, and overall good treatment outcomes, including the periodontal condition, remained stable 11 years after active orthodontic treatment.

  13. Treatment of Locally Advanced Pancreatic Cancer: The Role of Radiation Therapy

    SciTech Connect

    Johung, Kimberly; Saif, Muhammad Wasif; Chang, Bryan W.

    2012-02-01

    Pancreatic cancer remains associated with an extremely poor prognosis. Surgical resection can be curative, but the majority of patients present with locally advanced or metastatic disease. Treatment for patients with locally advanced disease is controversial. Therapeutic options include systemic therapy alone, concurrent chemoradiation, or induction chemotherapy followed by chemoradiation. We review the evidence to date regarding the treatment of locally advanced pancreatic cancer (LAPC), as well as evolving strategies including the emerging role of targeted therapies. We propose that if radiation is used for patients with LAPC, it should be delivered with concurrent chemotherapy and following a period of induction chemotherapy.

  14. The Tensile Properties of Advanced Nickel-Base Disk Superalloys During Quenching Heat Treatments

    NASA Technical Reports Server (NTRS)

    Gabb, Timothy P.; Gayda, John; Kantzos, Pete T.; Biles, Tiffany; Konkel, William

    2001-01-01

    There is a need to increase the temperature capabilities of superalloy turbine disks. This would allow full utilization of higher temperature combustor and airfoil concepts under development. One approach to meet this goal is to modify the processing and chemistry of advanced alloys, while preserving the ability to use rapid cooling supersolvus heat treatments to achieve coarse grain, fine gamma prime microstructures. An important step in this effort is to understand the key high temperature tensile properties of advanced alloys as they exist during supersolvus heat treatments. This could help in projecting cracking tendencies of disks during quenches from supersolvus heat treatments. The objective of this study was to examine the tensile properties of two advanced disk superalloys during simulated quenching heat treatments. Specimens were cooled from the solution heat treatment temperatures at controlled rates, interrupted, and immediately tensile tested at various temperatures. The responses and failure modes were compared and related to the quench cracking tendencies of disk forgings.

  15. Advances in Positive Airway Pressure Treatment Modalities for Hypoventilation Syndromes

    PubMed Central

    Combs, Dan; Shetty, Safal; Parthasarathy, Sairam

    2014-01-01

    SYNOPSIS Rationale Positive airway pressure therapy for hypoventilation syndromes can significantly improve health-related quality of life (HR-QOL), healthcare costs, and even mortality. The sleep-disordered breathing in such individuals are quite complex and require sophisticated devices with algorithms that are designed to accurately detect and effectively treat respiratory events that includes hypoventilation, upper airway obstruction, lower airway obstruction, central apneas and central hypopneas and reduce the work of breathing while maintaining breathing comfort. Objectives The therapeutic physiological rationale for the various advanced PAP modalities and the details about the principles of operation and technology implementation are provided here. Conclusions The physiological rationale for advanced PAP modalities is sound considering the complexity of sleep-disordered breathing in patients with hypoventilation syndromes. Although such devices are increasingly used in clinical practice, the supporting clinical evidence – specifically comparative-effectiveness studies in real-life conditions -- needs to be performed. Moreover, there is much opportunity for further refining these devices that include the ability of the device to reliably monitor gas-exchange, sleep-wakefulness state, and for reducing variability in device efficacy due to provider-selected device-settings. PMID:25346650

  16. Metastasis and bone loss: advancing treatment and prevention.

    PubMed

    Coleman, Robert E; Lipton, Allan; Roodman, G David; Guise, Theresa A; Boyce, Brendon F; Brufsky, Adam M; Clézardin, Philippe; Croucher, Peter I; Gralow, Julie R; Hadji, Peyman; Holen, Ingunn; Mundy, Gregory R; Smith, Matthew R; Suva, Larry J

    2010-12-01

    Tumor metastasis to the skeleton affects over 400,000 individuals in the United States annually, more than any other site of metastasis, including significant proportions of patients with breast, prostate, lung and other solid tumors. Research on the bone microenvironment and its role in metastasis suggests a complex role in tumor growth. Parallel preclinical and clinical investigations into the role of adjuvant bone-targeted agents in preventing metastasis and avoiding cancer therapy-induced bone loss have recently reported exciting and intriguing results. A multidisciplinary consensus conference convened to review recent progress in basic and clinical research, assess gaps in current knowledge and prioritize recommendations to advance research over the next 5 years. The program addressed three topics: advancing understanding of metastasis prevention in the context of bone pathophysiology; developing therapeutic approaches to prevent metastasis and defining strategies to prevent cancer therapy-induced bone loss. Several priorities were identified: (1) further investigate the effects of bone-targeted therapies on tumor and immune cell interactions within the bone microenvironment; (2) utilize and further develop preclinical models to study combination therapies; (3) conduct clinical studies of bone-targeted therapies with radiation and chemotherapy across a range of solid tumors; (4) develop biomarkers to identify patients most likely to benefit from bone-targeted therapies; (5) educate physicians on bone loss and fracture risk; (6) define optimal endpoints and new measures of efficacy for future clinical trials; and (7) define the optimum type, dose and schedule of adjuvant bone-targeted therapy.

  17. Advanced pancreatic adenocarcinoma: a review of current treatment strategies and developing therapies

    PubMed Central

    Teague, Andrea; Lim, Kian-Huat

    2015-01-01

    Pancreatic adenocarcinoma is one of the deadliest solid malignancies. A large proportion of patients are diagnosed with locally advanced or metastatic disease at the time of presentation and, unfortunately, this severely limits the number of patients who can undergo surgical resection, which offers the only chance for cure. Recent therapeutic advances for patients with advanced pancreatic cancer have extended overall survival, but prognosis still remains grim. Given that traditional chemotherapy is ineffective in curing advanced pancreatic adenocarcinoma, current research is taking a multidirectional approach in the hopes of developing more effective treatments. This article reviews the major clinical trial data that is the basis for the current chemotherapy regimens used as first- and second-line treatments for advanced pancreatic adenocarcinoma. We also review the current ongoing clinical trials, which include the use of agents targeting the oncogenic network signaling of K-Ras, agents targeting the extracellular matrix, and immune therapies. PMID:25755680

  18. Advances in the treatment of neurodegenerative disorders employing nanoparticles.

    PubMed

    Spuch, Carlos; Saida, Ortolano; Navarro, Carmen

    2012-04-01

    Nanoparticles could potentially revolutionise treatment for neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD) and strokes. Nanotechnologies hold great promise in brain therapy as they protect the therapeutic agent and allow its sustained release; the nanoparticles can be used as gene delivery vehicles. The application of neurotrophic factors is able to modulate neuronal survival and synaptic connectivity and it is a promising therapeutic approach for many neurodegenerative diseases, however, due to limitations posed by the restrictive blood brain barrier (BBB), it is very difficult to ensure long-term administration in the brain. Drug delivery to the brain remains the major challenge for the treatment of all neurodegenerative diseases because of the numerous protective barriers surrounding the central nervous system (CNS). New therapeutics with the capacity to cross the BBB is critically needed for treatment of these diseases. In recent years, nanotechnology had patented new formulations and has evolved as a new treatment for brain diseases, especially for neurodegenerative diseases, where genetically engineered cells can be used to deliver specific growth factors to target cells. Overall, the aim of this review is to summarize the last patents, clinical trials and news related with nanoparticles technology for the treatment of neurodegenerative diseases.

  19. [Advances in the treatment of chronic lymphocytic leukaemia].

    PubMed

    Mozas, Pablo; Delgado, Julio

    2016-11-18

    Chronic lymphocytic leukemia (CLL), a proliferation of mature B cells, is one of the most prevalent haematological malignancies. Progress has been made in its treatment during the last few decades, and chemoimmunotherapy based on fludarabine, cyclophosphamide and rituximab is considered the treatment of choice for patients with standard-risk CLL and good performance status. However, due to the characterization of high-risk biological subgroups and its presentation in elderly patients and/or with comorbidities, targeted therapies, such as B-cell receptor inhibitors, have been developed and approved during the last few years. The current review examines traditional therapeutic strategies and focuses on new small molecules that already represent promising elements of the CLL treatment landscape.

  20. Recent advances in the treatment of orthostatic hypotension

    NASA Technical Reports Server (NTRS)

    Robertson, D.; Davis, T. L.

    1995-01-01

    Orthostatic hypotension is a fall in blood pressure on standing that causes symptoms of dizziness, visual changes, and discomfort in the head and neck. The goal of treatment is the improvement of the patient's functional capacity, rather than a target blood pressure. For treatment to be successful, it must be individualized. Non-pharmalogic interventions include carefully managed exercise, scheduled activities, and monitoring of the environmental temperature. Agents such as fludrocortisone, midodrine, and epoetin alfa offer successful pharmacologic interventions. Although these measures ease the symptoms of orthostatic hypotension, current approaches neither reverse nor stabilize the disease process in autonomic disorders.

  1. Advances in the surgical treatment of morbid obesity.

    PubMed

    Stefater, Margaret A; Kohli, Rohit; Inge, Thomas H

    2013-02-01

    Due to the rapidly expanding prevalence of obesity, bariatric surgery is becoming an increasingly popular treatment option. Bariatric surgeries including Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) produce long-term weight loss and metabolic improvement, reducing mortality. This review discusses the important benefits and risks of RYGB and VSG, highlighting hypothesized mechanisms for these effects. We present data suggesting that VSG, albeit a newer procedure, may be as effective as RYGB with fewer adverse effects including less surgical risk, reduced nutritional deficiency, and less incidence of dumping syndrome. This may position VSG as an increasingly important procedure, particularly for the treatment of pediatric obesity.

  2. Sex Therapy: Advances in Paradigms, Nomenclature, and Treatment

    ERIC Educational Resources Information Center

    Althof, Stanley

    2010-01-01

    Objective: The author reviews the historical paradigms that have influenced the treatment of sexual problems, changes in the diagnostic nomenclature, and recent innovations in sex therapy. Methods: The author reviews the literature and provides expert opinion. Results: The author gives a historical overview of how theoretical models of…

  3. NASA/LaRC jet plume research

    NASA Technical Reports Server (NTRS)

    Seiner, John M.; Ponton, Michael K.; Manning, James C.

    1992-01-01

    The following provides a summary for research being conducted by NASA/LaRC and its contractors and grantees to develop jet engine noise suppression technology under the NASA High Speed Research (HSR) program for the High Speed Civil Transport (HSCT). The objective of this effort is to explore new innovative concepts for reducing noise to Federally mandated guidelines with minimum compromise on engine performance both in take-off and cruise. The research program is divided into four major technical areas: (1) jet noise research on advanced nozzles; (2) plume prediction and validation; (3) passive and active control; and (4) methodology for noise prediction.

  4. Development and evaluation of a state-of-the-science reactive plume model

    SciTech Connect

    Karamchandani, P.; Santos, L.; Sykes, I.; Zhang, Y.; Tonne, C.; Seigneur, C.

    2000-03-01

    The authors describe the development and evaluation of a new reactive plume model that combines a state-of-the-science puff model with an optimized chemistry model that accurately represents the chemistry of a power plant plume at various stages of its evolution. The puff model uses a second-order closure scheme, allowing for an accurate treatment of dispersion and the influence of turbulent concentration fluctuations on chemical rates. The model was tested using helicopter plume measurements from the 1995 Southern Oxidants Study (SOS) Nashville/Middle Tennessee Ozone Study. The model was applied for 6 days in June and July of 1995, and the model's ability to estimate physical and chemical plume characteristics, such as plume width and reactive species concentrations, was evaluated using the helicopter measurements. The best model results are for July 7, 1995, a case corresponding to a high NO{sub x} isolated power plant plume traveling over rural regions--model estimates of NO{sub x}, NO{sub y}, and O{sub 3} are highly correlated with measured values, and most of the measured plume centerline concentrations are reproduced to within 30%. For scenarios involving the interaction of the tracked plume with urban plumes or with other power plant plumes, model estimates of ozone concentrations are poorly correlated with observations, emphasizing the difficulty of characterizing such plumes from both measurement and modeling perspectives.

  5. The Green Propellant Infusion Mission Thruster Performance Testing for Plume Diagnostics

    NASA Technical Reports Server (NTRS)

    Deans, Matthew C.; Reed, Brian D.; Arrington, Lynn A.; Williams, George J.; Kojima, Jun J.; Kinzbach, McKenzie I.; McLean, Christopher H.

    2014-01-01

    The Green Propellant Infusion Mission (GPIM) is sponsored by NASA's Space Technology Mission Directorate (STMD) Technology Demonstration Mission (TDM) office. The goal of GPIM is to advance the technology readiness level of a green propulsion system, specifically, one using the monopropellant, AF-M315E, by demonstrating ground handling, spacecraft processing, and on-orbit operations. One of the risks identified for GPIM is potential contamination of sensitive spacecraft surfaces from the effluents in the plumes of AF-M315E thrusters. NASA Glenn Research Center (GRC) is conducting activities to characterize the effects of AF-M315E plume impingement and deposition. GRC has established individual plume models of the 22-N and 1-N thrusters that will be used on the GPIM spacecraft. The model simulations will be correlated with plume measurement data from Laboratory and Engineering Model 22-N, AF-M315E thrusters. The thrusters are currently being tested in a small rocket, altitude facility at NASA GRC. A suite of diagnostics, including Raman spectroscopy, Rayleigh spectroscopy, and Schlieren imaging are being used to acquire plume measurements of AF-M315E thrusters. Plume data will include temperature, velocity, relative density, and species concentration. The plume measurement data will be compared to the corresponding simulations of the plume model. The GRC effort will establish a data set of AF-M315E plume measurements and a plume model that can be used for future AF-M315E applications.

  6. Microalgae-based advanced municipal wastewater treatment for reuse in water bodies.

    PubMed

    Wang, Jing-Han; Zhang, Tian-Yuan; Dao, Guo-Hua; Xu, Xue-Qiao; Wang, Xiao-Xiong; Hu, Hong -Ying

    2017-04-01

    Reuse of secondary municipal effluent from wastewater treatment plants in water bodies could effectively alleviate freshwater resource shortage. However, excessive nutrients must be efficiently removed to prevent eutrophication. Compared with other means of advanced wastewater treatment, microalgae-based processes display overwhelming advantages including efficient and simultaneous N and P removal, no requirement of additional chemicals, O2 generation, CO2 mitigation, and potential value-added products from harvested biomass. One particular challenge of microalgae-based advanced municipal wastewater treatment compared to treatment of other types of wastewater is that concentrations of nutrients and N:P ratios in secondary municipal effluent are much lower and imbalanced. Therefore, there should be comprehensive considerations on nutrient removal from this specific type of effluent. Removal of nutrients and organic substances, and other environmental benefits of microalgae-based advanced municipal wastewater treatment systems were summarized. Among the existing studies on microalgal advanced nutrient removal, much information on major parameters is absent, rendering performances between studies not really comparable. Mechanisms of microalgae-based nitrogen and phosphorus removal were respectively analyzed to better understand advanced nutrient removal from municipal secondary effluent. Factors influencing microalgae-based nutrient removal were divided into intrinsic, environmental, and operational categories; several factors were identified in each category, and their influences on microalgal nutrient removal were discussed. A multiplicative kinetic model was integrated to estimate microalgal growth-related nutrient removal based majorly on environmental and intrinsic factors. Limitations and prospects of future full-scale microalgae-based advanced municipal wastewater treatment were also suggested. The manuscript could offer much valuable information for future

  7. Ozonation products of triclosan in advanced wastewater treatment.

    PubMed

    Chen, Xijuan; Richard, Jessica; Liu, Yaling; Dopp, Elke; Tuerk, Jochen; Bester, Kai

    2012-05-01

    Triclosan is an antimicrobial agent widely used in many household and personal care products. Widespread use of this compound has led to the elevated concentrations of triclosan in wastewater, wastewater treatment plants and receiving waters. In this study removal of triclosan by aqueous ozone was investigated and the degradation products formed during ozonation of an aqueous solution of triclosan were analyzed by GC-MS and HPLC-MS/MS. The following transformation products have been identified: 2,4-dichlorophenol, chloro-catecol, mono-hydroxy-triclosan and di-hydroxy-triclosan during treatment process. Cytotoxicity and genotoxicity of pure triclosan and 2,4-dichlorophenol have been investigated and the results showed reduced genotoxic effects after ozonation, though the respective chlorophenol is harmful to aquatic organisms.

  8. Advances in the topical treatment of acne and rosacea.

    PubMed

    Ceilley, Roger I

    2004-01-01

    Acne and rosacea are common skin diseases which may present similarly and both involve inflammation. Both can result in significant cosmetic impairment and lead to quality of life decrements if not optimally treated. The conventional approach for both diseases involves the use of topical therapy to treat inflammatory lesions in combination, when needed, with a systemic or topical antibiotic. An important issue in the management of both diseases at present is the need to reduce antibiotic usage due to the increasing problem of bacterial resistance. One of the emerging treatment paradigms that is becoming increasingly useful as an antibiotic-sparing strategy is the use of procedural therapies in combination with medical management. Such procedural modalities include lasers, intense pulsed light (IPL), and photodynamic therapies (PDT). Topical regimens are used pre-treatment and following physical modalities for maintenance of remission.

  9. Recent advances in treatment of severe primary immunodeficiencies

    PubMed Central

    Gennery, Andrew

    2015-01-01

    Primary immunodeficiencies are rare, inborn errors that result in impaired, disordered or uncontrolled immune responses. Whilst symptomatic and prophylactic treatment is available, hematopoietic stem cell transplantation is an option for many diseases, leading to cure of the immunodeficiency and establishing normal physical and psychological health. Newborn screening for some diseases, whilst improving outcomes, is focusing research on safer and less toxic treatment strategies, which result in durable and sustainable immune function without adverse effects. New conditioning regimens have reduced the risk of hematopoietic stem cell transplantation, and new methods of manipulating stem cell sources should guarantee a donor for almost all patients. Whilst incremental enhancements in transplantation technique have gradually improved survival outcomes over time, some of these new applications are likely to radically alter our approach to treating primary immunodeficiencies. PMID:26918153

  10. Reducing Toxicity of Radiation Treatment of Advanced Prostate Cancer

    DTIC Science & Technology

    2014-10-01

    Prior to irradiation and drug treamtent mice were pretreated with the CD11b blocking antibody M1/70. Blocking recruitment of CD11b+ cells...Figure 1. Effects of signal transduction modifiers on survival of lethally irradiated mice. A, survival of mice pretreated (24 hours) with the NF-kB...activity of an NF- kB–responsive promoter driving NanoLuc (NLuc) expression are shown. Pretreatment images were acquired 2 days before treatment with

  11. Acute Myeloid Leukemia: Advancements in Diagnosis and Treatment

    PubMed Central

    Yu, Meng-Ge; Zheng, Hu-Yong

    2017-01-01

    Objective: Leukemia is the most common pediatric malignancy and a major cause of morbidity and mortality in children. Among all subtypes, a lack of consensus exists regarding the diagnosis and treatment of acute myeloid leukemia (AML). Patient survival rates have remained modest for the past three decades in AML. Recently, targeted therapy has emerged as a promising treatment. Data Sources: We searched the PubMed database for recently published research papers on diagnostic development, target therapy, and other novel therapies of AML. Clinical trial information was obtained from ClinicalTrials.gov. For the major purpose of this review that is to outline the latest therapeutic development of AML, we only listed the ongoing clinical trials for reference. However, the published results of complete clinical trials were also mentioned. Study Selection: This article reviewed the latest developments related to the diagnosis and treatment of AML. In the first portion, we provided some novel insights on the molecular basis of AML, as well as provided an update on the classification of AML. In the second portion, we summarized the results of research on potential molecular therapeutic agents including monoclonal antibodies, tyrosine kinase/Fms-like tyrosine kinase 3 (FLT3) inhibitors, epigenetic/demethylating agents, and cellular therapeutic agents. We will also highlight ongoing research and clinical trials in pediatric AML. Results: We described clonal evolution and how it changes our view on leukemogenesis, treatment responses, and disease relapse. Pediatric-specific genomic mapping was discussed with a novel diagnostic method highlighted. In the later portion of this review, we summarized the researches on potential molecular therapeutic agents including monoclonal antibodies, tyrosine kinase/FLT3 inhibitors, epigenetic/demethylating agents, and cellular therapeutic agents. Conclusion: Gene sequencing techniques should set the basis for next-generation diagnostic

  12. The impact of advanced wastewater treatment technologies and wastewater strength on the energy consumption of large wastewater treatment plants

    NASA Astrophysics Data System (ADS)

    Newell, Timothy

    Wastewater treatment is an energy intensive process often requiring the use of advanced treatment technologies. Stricter effluent standards have resulted in an increase in the number of wastewater treatment plants (WWTPs) with advanced treatment over time. Accordingly, associated energy consumption has also increased. Concerns about lowering operating costs for WWTPs and reducing associated greenhouse gas generation present an incentive to investigate energy use in WWTPs. This research investigated the impact of wastewater strength and the introduction of advanced treatment technologies, to replace traditional technologies on energy use to treat wastewater in WWTPs. Major unit processes were designed for a 100 MGD plant and variables controlling energy were identified and used to compute energy consumption. Except for primary clarification and plate and frame press dewatering, energy consumption computed using fundamental equations are within values in the literature. Results show that energy consumption for dissolved air flotation thickeners, centrifuges, gravity thickeners, and aeration basins are heavily influence by wastewater strength. Secondary treatment and tertiary treatment require a significant amount of energy. Secondary treatment requires 104 times the energy of preliminary treatment, 17 times the energy of solids processing, and 2.5 times the energy of tertiary treatment. Secondary treatment requires 41 times the energy of preliminary treatment, and 7 times the energy of solids processing. The results of this research provide a means of estimating energy consumption in the design and operation phase of a WWTP. By using the fundamental equations and methodology presented, alternative technologies can be compared or targeted for future energy savings implementation. Limitations of the methodology include design assumptions having to be made carefully, as well as assumptions of motor and equipment efficiencies.

  13. DISCUSSION ON ADVANCES IN THE TREATMENT OF URÆMIA

    PubMed Central

    1948-01-01

    Uræmia is common, little is known of its actual nature and treatment has therefore been unsatisfactory. The kidney is not only an organ of excretion but guards the chemical and physical constitution of the extracellular fluids. In uræmia, urea and other products of metabolism including the toxic phenols accumulate. That the physical and chemical composition of the extracellular fluids, excluding protein, can be influenced by contact across a semi-permeable membrane is the basic concept of the treatment of uræmia by dialysis, whether by means of the artificial kidney or by peritoneal lavage. The principles of treatment of uræmia are: (1) To remove the cause. (2) Reduce the load on the kidney. (3) Assist or take over the function of the failing kidney in the hope that it may recover. (4) To relieve symptoms without thereby prejudicing recovery. Dialysis can be effected by peritoneal lavage or by conducting the circulating blood through a tube of semi-permeable membrane. The composition of the dialysing fluid is of the utmost importance the aim being to keep the physical and chemical balance of the extracellular fluid within the normal range and to encourage the diffusion of toxic metabolic products. The excessive use of parenteral fluids and diuretics in uræmia may be harmful. A number of cases of peritoneal dialysis are described. PMID:18872157

  14. Advances in diagnosis and treatment of metastatic cervical cancer

    PubMed Central

    2016-01-01

    Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases. PMID:27171673

  15. Technology advances in hospital practices: robotics in treatment of patients.

    PubMed

    Rosiek, Anna; Leksowski, Krzysztof

    2015-06-01

    Laparoscopic cholecystectomy is widely considered as the treatment of choice for acute cholecystitis. The safety of the procedure and its minimal invasiveness made it a valid treatment option for a patient not responding to antibiotic therapy. Our research shows that patients positively assess this treatment method, but the world's tendency is to turn to a more sophisticated method utilizing robot-assisted surgery as a gold standard. Providing patient with minimally invasive surgical procedures that utilize the state-of-the-art equipment like the da Vinci Robotic Surgical System underscores the commitment to high-quality patient care while enhancing patient safety. The advantages include minimal invasive scarring, less pain and bleeding, faster recovery time, and shorter hospital stay. The move toward less invasive and less morbid procedures and a need to re-create the true open surgical experience have paved the way for the development and application of robotic and computer-assisted systems in surgery in Poland as well as the rest of the world.

  16. Advances in medical revascularisation treatments in acute ischemic stroke.

    PubMed

    Asadi, H; Yan, B; Dowling, R; Wong, S; Mitchell, P

    2014-01-01

    Urgent reperfusion of the ischaemic brain is the aim of stroke treatment and there has been ongoing research to find a drug that can promote vessel recanalisation more completely and with less side effects. In this review article, the major studies which have validated the use and safety of tPA are discussed. The safety and efficacy of other thrombolytic and anticoagulative agents such as tenecteplase, desmoteplase, ancrod, tirofiban, abciximab, eptifibatide, and argatroban are also reviewed. Tenecteplase and desmoteplase are both plasminogen activators with higher fibrin affinity and longer half-life compared to alteplase. They have shown greater reperfusion rates and improved functional outcomes in preliminary studies. Argatroban is a direct thrombin inhibitor used as an adjunct to intravenous tPA and showed higher rates of complete recanalisation in the ARTTS study with further studies which are now ongoing. Adjuvant thrombolysis techniques using transcranial ultrasound are also being investigated and have shown higher rates of complete recanalisation, for example, in the CLOTBUST study. Overall, development in medical therapies for stroke is important due to the ease of administration compared to endovascular treatments, and the new treatments such as tenecteplase, desmoteplase, and adjuvant sonothrombolysis are showing promising results and await further large-scale clinical trials.

  17. Advances in diagnosis and treatment of metastatic cervical cancer.

    PubMed

    Li, Haoran; Wu, Xiaohua; Cheng, Xi

    2016-07-01

    Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.

  18. Advances in the Classification and Treatment of Osteogenesis Imperfecta.

    PubMed

    Thomas, Inas H; DiMeglio, Linda A

    2016-02-01

    Osteogenesis imperfecta (OI) is a rare disorder of type 1 collagen with 13 currently identified types attributable to inherited abnormalities in type 1 collagen amount, structure, or processing. The disease is characterized by an increased susceptibility to bony fracture. In addition to the skeletal phenotype, common additional extraskeletal manifestations include blue sclerae, dentinogenesis imperfecta, vascular fragility, and hearing loss. Medical management is focused on minimizing the morbidity of fractures, pain, and bone deformities by maximizing bone health. Along with optimizing Vitamin D status and calcium intake and physical/occupational therapy, individualized surgical treatment may be indicated. Pharmacological therapy with bisphosphonate medications is now routinely utilized for moderate to severe forms and appears to have a good safety profile and bone health benefits. New therapies with other anti-resorptives as well as anabolic agents and transforming growth factor (TGF)β antibodies are in development. Other potential treatment modalities could include gene therapy or mesenchymal cell transplant. In the future, treatment choices will be further individualized in order to reduce disease morbidity and mortality.

  19. Advances in the surgical treatment of fecal incontinence.

    PubMed

    Person, Benjamin; Wexner, Steven D

    2005-03-01

    Although surgery for fecal incontinence has been shown to be effective, it is still very challenging and sometimes frustrating. Overlapping sphincteroplasty, by far the most common procedure, is effective in patients with sphincter defects; however, recent data suggest that success rates tend to deteriorate over time. A thorough preoperative evaluation incorporates numerous factors, including patient characteristics, severity of incontinence, type and size of the sphincter defect as assessed by physical examination, anal ultrasound, and anorectal physiology studies including anal manometry, electromyography, and pudendal nerve terminal motor latency assessment. The use of these evaluation methods has allowed better patient assignment for a variety of new alternative treatment options. Innovations in the surgical treatment of fecal incontinence range from simple, office-based sphincter augmentation techniques to surgical implantation of mechanical devices. This article reviews 5 alternative surgical treatment options for fecal incontinence: injection of carbon-coated beads in the submucosa of the anal canal, radiofrequency energy delivery, stimulated graciloplasty, artificial bowel sphincter, and sacral nerve stimulation.

  20. Advances in the treatment of cutaneous lupus erythematosus.

    PubMed

    Kuhn, A; Landmann, A; Wenzel, J

    2016-07-01

    Lupus erythematosus (LE) is a multifactorial autoimmune disease with clinical manifestations of differing severity which may present with skin manifestations as primary sign of the disease (cutaneous lupus erythematosus, CLE) or as part of a disease spectrum (systemic lupus erythematosus, SLE). To date, no drugs are approved specifically for the treatment of CLE and only single agents have been applied in randomized controlled trials. Therefore, topical and systemic agents are used "off-label", primarily based on open-label studies, case series, retrospective analyses, and expert opinions. In contrast, several agents, such as hydroxychloroquine, chloroquine, cyclophosphamide, azathioprine, and belimumab, are approved for the treatment of SLE. Recent approaches in the understanding of the molecular pathogenesis of LE enabled the development of further new agents, which target molecules such as interleukin 6 (IL-6) and interferon (IFN). Only single trials, however, applied these new agents in patients with cutaneous involvement of the disease and/or included endpoints which evaluated the efficacy of these agents on skin manifestations. This article provides an updated review on new and recent approaches in the treatment of CLE.

  1. Buckling of Chemical Wave Plumes

    NASA Astrophysics Data System (ADS)

    Rogers, Michael C.; Morris, Stephen W.

    2004-03-01

    Chemical wave fronts are found in many autocatalytic chemical reactions, such as the iodate oxidation of arsenous acid. In vertical capillary tubes, ascending chemical wave fronts show convective behavior when a dimensionless driving parameter S exceeds a critical value Sc ˜ 100. S ∝ a^3, where a is the radius of the tube. In the iodate arsenous-acid reaction, the density jump that drives convection is created by both the partial molal density decrease of the product solution and by thermal expansion due to the slight exothermicity of the reaction. We observed strongly supercritical ascending chemical wave plumes in vertical tubes with S 10^7. We report on the motion of these plumes in experiments where both the viscosity and the temperature of the reactant fluid are control parameters. We find experimentally that the background temperature of the reactant fluid has a significant influence on the behavior of the plumes. Above a critical temperature, plumes rise straight up the tube, whereas below this temperature, plumes go through an initial stage of buckling before they surrender to straight rising motion. The flow induced by the chemical plumes can be visualized using tracer particles. The buckling behavior of the plumes may arise from the Kelvin-Helmholtz instability, as in the case of a fluid jet descending through stratified surroundings [Pesci et al., Phys. Rev. E, 68, 056305 (2003)].

  2. Impact of Advanced Health Care Directives on Treatment Decisions by Physicians in Patients with Acute Stroke

    PubMed Central

    Qureshi, Adnan I; Chaudhry, Saqib A.; Connelly, Bo; Abott, Emily; Janjua, Tariq; Kim, Stanley H.; Miley, Jefferson T.; Rodriguez, Gustavo J.; Uzun, Guven; Watanabe, Masaki

    2012-01-01

    Background The implementation of advance health care directives, prepared by almost half of the adult population in United States remains relatively under studied. We determined the impact of advance health care directives on treatment decisions by multiple physicians in stroke patients. Methods A de-identified summary of clinical and radiological records of 28 patients with stroke was given to six stroke physicians who were not involved in the care of the patients. Each physician independently rated 28 treatment decisions per patient in the presence or absence of advance health care directives 1 month apart to allow memory washout. The percentage agreement to treat/intervene per patient and proportion of treatment withheld as a group were estimated for each of the 28 treatment decision items. We also determined the interobserver reliability between the two raters (attorneys) in interpretation of 6 items characterizing the adequacy of documentation within the 28 advance health care directives. Results The percentage agreement among physician raters for treatment decisions in 28 stroke patients was highest for treatment of hyperpyrexia (100%, 100%) and lowest for intensive care unit monitoring duration based on family-physician considerations outside of accepted criteria within institution (68%, 69%) in presence and absence of advance care health directives. The physician rater agreement in choosing “yes” was highest for “routine complexity” treatment decisions and lowest for “moderate complexity” treatment decisions. The choice of withholding treatment in routine complexity,” “moderate complexity,” or “high complexity” treatment decisions was remarkably similar among raters in presence or absence of advance care health directives. The only treatment decision that showed an impact of advance care health directives was intensive care unit monitoring withheld in 32% of treatment decisions in presence of directives (compared with 8% in the absence

  3. Surgical treatment of advanced colorectal cancer in the elderly.

    PubMed

    Chiappa, Antonio; Zbar, Andrew P; Bertani, Emilio; Biffi, Roberto; Luca, Fabrizio; Pace, Ugo; Viale, Giuseppe; Pruneri, Giancarlo; Orecchia, Roberto; Lazzari, Roberta; Biella, Francesca; Grassi, Carmine; Zampino, Giulia; Fazio, Nicola; Della Vigna, Paolo; Andreoni, Luca; Andreoni, Bruno

    2005-01-01

    The aim of the study was to compare the short and long-term outcomes of older and younger colorectal cancer patients with advanced disease resected with a curative intent. Six hundred and ninety-two patients were analysed. Four hundred and seventy-nine patients were younger than 70 years (Group 1), and 213 were 70 years of age or above (Group 2). The overall perioperative mortality rate in the younger group was 0.8% (n = 7), as against 1.4% (n = 3) in the elderly group (p = NS). The morbidity rates were 35% and 42%, respectively (p = NS). At univariate analysis, the elderly patients had a worse overall survival compared to the younger group, when only patients undergoing postoperative chemo-radiotherapy were considered (54% vs 67% overall survival at 5 years; p = 0.03). Using logistic regression analysis, tumour stage (p < 0.0001) and radicality of surgery (p < 0.0001) correlated significantly with overall survival rates in the elderly. Colorectal surgery for malignancy can be performed safely in the elderly with acceptable morbidity and mortality rates and long-term survival.

  4. Conjunctival melanoma: a review of conceptual and treatment advances

    PubMed Central

    Lim, Li-Anne; Madigan, Michele C; Conway, R Max

    2013-01-01

    The aim of this study was to review the available literature and identify recent advances in the classification and management of conjunctival melanoma (CM) for clinicians working in this field. English-based articles were identified using the MEDLINE® database, and additional cited works not detected in the initial search were also obtained. Articles were assessed according to the Australian National Health and Medical Research Council levels of evidence criteria. Review of the literature indicated that the current classification and management of CM is predominantly based upon primarily nonrandomized, single-institution, retrospective case series. While these studies provide the basis for the recent seventh edition of the tumor node metastasis staging classification, this classification more accurately reflects the current knowledge of prognostic factors for CM. Application of this revised classification system together with prospective trials will provide the opportunity for future consistent and comparable data collection across centers, and it will improve the quality of evidence upon which current classification and management of CM is based. Furthermore, the high risk of local recurrence with current standard management suggests that adjuvant therapy, particularly mitomycin C and/or brachytherapy, may improve outcomes regardless of clinical staging. Finally, the use of sentinel lymph node biopsy may have significant benefit for a select group of CM patients. PMID:23515569

  5. Recent advances of sonodynamic therapy in cancer treatment

    PubMed Central

    Wan, Guo-Yun; Liu, Yang; Chen, Bo-Wei; Liu, Yuan-Yuan; Wang, Yin-Song; Zhang, Ning

    2016-01-01

    Sonodynamic therapy (SDT) is an emerging approach that involves a combination of low-intensity ultrasound and specialized chemical agents known as sonosensitizers. Ultrasound can penetrate deeply into tissues and can be focused into a small region of a tumor to activate a sonosensitizer which offers the possibility of non-invasively eradicating solid tumors in a site-directed manner. In this article, we critically reviewed the currently accepted mechanisms of sonodynamic action and summarized the classification of sonosensitizers. At the same time, the breath of evidence from SDT-based studies suggests that SDT is promising for cancer treatment. PMID:27807500

  6. Advances in the pharmacological treatment of Graves' orbitopathy.

    PubMed

    Ruchała, Marek; Sawicka-Gutaj, Nadia

    2016-07-01

    Graves' orbitopathy has a deteriorating effect on patients' appearance and vision, thus significantly decreases their quality of life. A multidisciplinary team of endocrinologists, ophthalmologists, head and neck surgeons, nuclear medicine physicians, radiologists, and psychologists should constitute a standard health care team for those patients. It is vital that the therapy is based on an individual approach, with patients being well informed and involved in the decision-making process. Generally, traditional therapies include immunosuppression with steroids, orbital irradiation and surgical decompression. Novel treatment modalities include: biological agents, somatostatin analogs, antioxidants, methotrexate. Better insight into pathogenesis of Graves' orbitopathy is the only chance for targeted therapy development.

  7. Advancements in the treatment of head lice in pediatrics.

    PubMed

    Eisenhower, Christine; Farrington, Elizabeth Anne

    2012-01-01

    Head lice infestations occur commonly each year in children of all socioeconomic statuses. However, head lice have become more of a nuisance as resistance to first-line agents, such as permethrin 1% and pyrethrins, has increased. Newer topical products provide unique mechanisms of action without current signs of resistance. As with older agents, proper application of products must be emphasized to ensure that treatment is effective. In addition, nonpharmacologic measures should be taken to avoid reinfestation in the patient and to prevent the spread of lice to close personal contacts.

  8. [Advances in the treatment of wound bacterial infection with phage].

    PubMed

    Cui, Zelong

    2015-10-01

    The treatment of wound bacterial infection is an extremely difficult problem in clinic, especially in patients with large wounds which are infected by multidrug resistant, pan-resistant or omni-resistant bacteria. In recent years, with a grim prospect of antibiotic resistance, phage therapy is re-valued by researchers after being ignored for nearly half a century. Phage therapy has made great achievements in prevention and control of bacterial infection of open wounds. This review is mainly focused on the latest research progress of phage therapy in wound bacterial infection.

  9. Advance in the pathogenesis and treatment of Wilson disease

    PubMed Central

    2012-01-01

    Wilson disease is an autosomal recessive disorder of copper metabolism. Diagnosis depends primarily on clinical features, biochemical parameters and the presence of the Kayser-Fleischer ring. Genetic analysis for mutations within ATP7B is a convincing diagnostic tool. The traditional treatment for WD includes chelation of excessive copper accumulation and reduction of copper intake. Medical therapy is effective but WD is not yet curable. Liver transplantation is especially helpful for patients who fail to respond to medical therapy or present with fulminant liver failure, although evaluation of its long-term effect are still in need. PMID:23210912

  10. Removal of organic wastewater contaminants in septic systems using advanced treatment technologies

    USGS Publications Warehouse

    Wilcox, J.D.; Bahr, J.M.; Hedman, C.J.; Hemming, J.D.C.; Barman, M.A.E.; Bradbury, K.R.

    2009-01-01

    The detection of pharmaceuticals and other organic wastewater contaminants (OWCs) in ground water and surface-water bodies has raised concerns about the possible ecological impacts of these compounds on nontarget organisms. On-site wastewater treatment systems represent a potentially significant route of entry for organic contaminants to the environment. In this study, effluent samples were collected and analyzed from conventional septic systems and from systems using advanced treatment technologies. Six of 13 target compounds were detected in effluent from at least one septic system. Caffeine, paraxanthine, and acetaminophen were the most frequently detected compounds, and estrogenic activity was detected in 14 of 15 systems. The OWC concentrations were significantly lower in effluent after sand filtration (p < 0.01) or aerobic treatment (p < 0.05) as compared with effluent that had not undergone advanced treatment. In general, concentrations in conventional systems were comparable to those measured in previous studies of municipal wastewater treatment plant (WWTP) influent, and concentrations in systems after advanced treatment were comparable to previously measured concentrations in WWTP effluent. These data indicate that septic systems using advanced treatment can reduce OWCs in treated effluent to similar concentrations as municipal WWTPs. Copyright ?? 2009 by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America. All rights reserved.

  11. 78 FR 41436 - Proposed Revision to Treatment of Non-Safety Systems for Passive Advanced Light Water Reactors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-10

    ... COMMISSION Proposed Revision to Treatment of Non-Safety Systems for Passive Advanced Light Water Reactors... Treatment of Non-Safety Systems (RTNSS) for Passive Advanced Light Water Reactors.'' The NRC seeks public...- Safety Systems (RTNSS) for Passive Advanced Light Water Reactors.'' This area includes a revised...

  12. Recent advances in pharmacological treatment of irritable bowel syndrome

    PubMed Central

    Lazaraki, Georgia; Chatzimavroudis, Grigoris; Katsinelos, Panagiotis

    2014-01-01

    Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disordered defecation in the absence of identifiable structural or biochemical abnormalities. IBS imposes a significant economic burden to the healthcare system. Alteration in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, gut motility, visceral hypersensitivity, and immune system factors are currently believed to influence the pathogenesis of IBS. It is possible that there is an interaction of one or more of these etiologic factors leading to heterogeneous symptoms of IBS. IBS treatment is predicated upon the patient’s most bothersome symptoms. Despite the wide range of medications and the high prevalence of the disease, to date no completely effective remedy is available. This article reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Drugs are categorized according to their administration for IBS-C, IBS-D or abdominal pain predominant IBS. PMID:25083060

  13. Clinical report of the treatment of locally advanced lung cancer.

    PubMed

    Petrovich, Z; Mietlowski, W; Ohanian, M; Cox, J

    1977-07-01

    This paper discusses the results of the treatment of 345 patients entered in the Veterans Administration Lung Group Protocol 13L. The study was activated March 1972, and closed for the patient accesion March 1975. All patients had a histological diagnosis of primary lung cancer considered clinically non-resectable or inoperable. Patients were equally randomized into two groups, radiotherapy alone or radiotherapy with chemotherapy. The analysis of the data included: treatment regimen, radiation dose, initial performance status, performance status change, cell type, duration of survival, quality of survival and age. The strongest influence on median survival was the level of radiation dose. The small cell carcinoma patients treated with radiotherapy and chemotherapy showed significant improvement in the median survival (38.2 weeks) over the patients treated with radiotherapy alone (20.6 weeks). The patients treated with radiotherapy and chemotherapy also showed improvement in performance status more frequently than the patients treated with radiotherapy alone. Other parameters of the analysis will be presented.

  14. Recent advances in pharmacological treatment of irritable bowel syndrome.

    PubMed

    Lazaraki, Georgia; Chatzimavroudis, Grigoris; Katsinelos, Panagiotis

    2014-07-21

    Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients' quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disordered defecation in the absence of identifiable structural or biochemical abnormalities. IBS imposes a significant economic burden to the healthcare system. Alteration in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, gut motility, visceral hypersensitivity, and immune system factors are currently believed to influence the pathogenesis of IBS. It is possible that there is an interaction of one or more of these etiologic factors leading to heterogeneous symptoms of IBS. IBS treatment is predicated upon the patient's most bothersome symptoms. Despite the wide range of medications and the high prevalence of the disease, to date no completely effective remedy is available. This article reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Drugs are categorized according to their administration for IBS-C, IBS-D or abdominal pain predominant IBS.

  15. Sorafenib for the treatment of advanced hepatocellular carcinoma with extrahepatic metastasis: a prospective multicenter cohort study.

    PubMed

    Nakano, Masahito; Tanaka, Masatoshi; Kuromatsu, Ryoko; Nagamatsu, Hiroaki; Tajiri, Nobuyoshi; Satani, Manabu; Niizeki, Takashi; Aino, Hajime; Okamura, Shusuke; Iwamoto, Hideki; Shimose, Shigeo; Shirono, Tomotake; Koga, Hironori; Torimura, Takuji

    2015-12-01

    Sorafenib, an oral multikinase inhibitor, is approved for advanced hepatocellular carcinoma (HCC) treatment. However, its therapeutic effect in advanced HCC patients with extrahepatic metastasis remains uncertain. This study aimed to prospectively assess the efficacy, safety, and survival risk factors and evaluate the prognostic impact of sorafenib treatment in advanced HCC patients with or without extrahepatic metastasis. Between May 2009 and March 2014, 312 consecutive advanced HCC patients who received sorafenib were enrolled in this study. We evaluated their characteristics and compared the clinical outcomes of those with and without extrahepatic metastasis. Of the enrolled patients, 245 (81%) received sorafenib treatment for more than 1 month, with a median duration of 3.6 months. Eighteen patients demonstrated partial response to sorafenib therapy, 127 had stable disease, and 134 had progressive disease at the first radiologic assessment. The median survival time (MST) and progression-free survival (PFS) were 10.3 and 3.6 months, respectively. Multivariate analysis identified gender, Child-Pugh class, baseline serum des-gamma-carboxy prothrombin level, and treatment duration as independent risk factors for survival. Extrahepatic metastasis was detected in 178 patients. However, the MST, PFS, and therapeutic effect were comparable between patients with and without extrahepatic metastasis. The independent risk factors for decreased overall survival in patients with extrahepatic metastasis were similar to those affecting all patients. Our results indicated that sorafenib could be administered for hepatic reserve and as long-term treatment for advanced HCC patients regardless of their extrahepatic metastasis status.

  16. Additional treatment of wastewater reduces endocrine disruption in wild fish--a comparative study of tertiary and advanced treatments.

    PubMed

    Baynes, Alice; Green, Christopher; Nicol, Elizabeth; Beresford, Nicola; Kanda, Rakesh; Henshaw, Alan; Churchley, John; Jobling, Susan

    2012-05-15

    Steroid estrogens are thought to be the major cause of feminization (intersex) in wild fish. Widely used wastewater treatment technologies are not effective at removing these contaminants to concentrations thought to be required to protect aquatic wildlife. A number of advanced treatment processes have been proposed to reduce the concentrations of estrogens entering the environment. Before investment is made in such processes, it is imperative that we compare their efficacy in terms of removal of steroid estrogens and their feminizing effects with other treatment options. This study assessed both steroid removal and intersex induction in adult and early life stage fish (roach, Rutilus rutilus). Roach were exposed directly to either secondary (activated sludge process (ASP)), tertiary (sand filtrated (SF)), or advanced (chlorine dioxide (ClO(2)), granular activated charcoal (GAC)) treated effluents for six months. Surprisingly, both the advanced GAC and tertiary SF treatments (but not the ClO(2) treatment) significantly removed the intersex induction associated with the ASP effluent; this was not predicted by the steroid estrogen measurements, which were higher in the tertiary SF than either the GAC or the ClO(2). Therefore our study highlights the importance of using both biological and chemical analysis when assessing new treatment technologies.

  17. Recent advances in the diagnosis and treatment of influenza pneumonia.

    PubMed

    Marzoratti, Lucia; Iannella, Hernán A; Gómez, Victoria Fernández; Figueroa, Sandra B

    2012-06-01

    A potentially fatal complication of influenza infection is the development of pneumonia, caused either directly by the influenza virus, or by secondary bacterial infection. Pneumonia related to the 2009 influenza A pandemic was found to be underestimated by commonly used pneumonia severity scores in many cases, and to be rapidly progressive, leading to respiratory failure. Confirmation of etiology by laboratory testing is warranted in such cases. Rapid antigen and immunofluorescence testing are useful screening tests, but have limited sensitivity. Confirmation of pandemic H1N1 influenza A infection can only be made by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) or viral culture. The most effective preventive measure is annual influenza vaccination in selected individuals. Decisions to administer antiviral medications for influenza treatment or chemoprophylaxis should be based upon clinical and epidemiological factors, and should not be delayed by confirmatory laboratory testing results. Neuraminidase inhibitors (NI) are the agents of choice.

  18. Collagenase Clostridium histolyticum : emerging practice patterns and treatment advances

    PubMed Central

    Warwick, David; Arandes-Renú, José M.; Pajardi, Giorgio; Witthaut, Jörg; Hurst, Lawrence C.

    2016-01-01

    Abstract Objective: This study aims to provide a comprehensive review of the role of Collagenase Clostridium histolyticum (CCH). Methods: This review is based on a literature review and practical experience. Results: This review provides practical management strategies for using collagenase by sharing clinical experiences over the past few years; logistical aspects of in-clinic treatment, lessons learned, and novel approaches to correct traditionally hard-to-treat contractures are discussed. In addition a brief, yet comprehensive overview is provided on the pathophysiology of the disease, the mechanism of collagenase action and results of clinical studies. Conclusion: CCH has an evolving role as one of the tools available for treating Dupuytren's disease. PMID:27050718

  19. Advances in pathogenesis and treatment of ANCA-associated vasculitis.

    PubMed

    Kallenberg, Cees G M

    2014-10-01

    Anti-neutrophil cytoplasmic autoantibodies (ANCA) directed to proteinase 3 (PR3-ANCA) and myeloperoxidase (MPO-ANCA) are sensitive and specific markers for their associated diseases, granulomatosis with polyangiitis (GPA, formerly Wegener's granulomatosis) and microscopic polyangiitis (MPA), respectively. Clinical observations suggest but do not prove that ANCA are involved in the pathogenesis of GPA and MPA. In vivo and in vitro experimental data strongly suggest if not prove that MPO-ANCA underlie the pathological lesions seen in MPO-ANCA associated MPA. This is less clear for PR3-ANCA associated GPA in which, besides small-vessel vasculitis, granulomatous inflammation is apparent. Here, cellular immunity appears to play an additional role. Insight into the pathogenetic events involved in these diseases has resulted in new ways of treatment that target the specific pathways that underlie the development of the lesions.

  20. Advances in the treatment of diseased equine cheek teeth.

    PubMed

    Tremaine, Henry

    2013-08-01

    The last decade has seen a number of studies that have illuminated our knowledge of hypsodont dental disease and re-examined some of the traditionally performed practices. In addition there has been a major interest in routine preventative dentistry and non-traumatic treatments. These have highlighted some potential risks of the use of modern tools when applied to traditional techniques. This has also led to a reflective review of equine dentistry with the emphasis on attempting to preserve and salvage dental and periodontal tissues, with minimal trauma. In addition, precise imaging and instrumentation have facilitated minimally invasive techniques in conscious sedated horses, and there is renewed interest in comparative dentistry leading to trials with restorative techniques that are practiced in other species.

  1. Diagnosis, pathogenesis and treatment of myositis: recent advances

    PubMed Central

    Carstens, P-O; Schmidt, J

    2014-01-01

    Dermatomyositis (DM), polymyositis (PM), necrotizing myopathy (NM) and inclusion body myositis (IBM) are four distinct subtypes of idiopathic inflammatory myopathies – in short myositis. Recent studies have shed some light on the unique pathogenesis of each entity. Some of the clinical features are distinct, but muscle biopsy is indispensable for making a reliable diagnosis. The use of magnetic resonance imaging of skeletal muscles and detection of myositis-specific autoantibodies have become useful additions to our diagnostic repertoire. Only few controlled trials are available to substantiate current treatment approaches for myositis and hopes are high that novel modalities will become available within the next few years. In this review we provide an up-to-date overview of the pathogenesis and diagnostic approach of myositis. We aim to present a guide towards therapeutic and general management. PMID:23981102

  2. Uveitis: advances in understanding of pathogenesis and treatment.

    PubMed

    Read, Russell W

    2006-08-01

    Uveitis is a leading cause of blindness affecting individuals of all ages, genders, and races. Uveitis may be due to autoimmune, infectious, toxic, malignant, or traumatic processes. Some evidence supports an association between conditions previously presumed to be autoimmune and viral infectious agents. For autoimmune uveitis, therapy is nonspecific, typically beginning with corticosteroids. For nonresponsive disease or for corticosteroid sparing, recent reports on mycophenolate mofetil, infliximab, and interferon therapy show success for various forms of uveitis. Treatment of the complications of uveitis, especially cystoid macular edema, is difficult. Vitamin E appears to offer little benefit, whereas octreotide may be effective. Recent collaborative efforts at standardization in the field should enhance studies on these conditions.

  3. Advances in the Treatment of Fragile X Syndrome

    PubMed Central

    Hagerman, Randi J.; Berry-Kravis, Elizabeth; Kaufmann, Walter E.; Ono, Michele Y.; Tartaglia, Nicole; Lachiewicz, Ave; Kronk, Rebecca; Delahunty, Carol; Hessl, David; Visootsak, Jeannie; Picker, Jonathan; Gane, Louise; Tranfaglia, Michael

    2010-01-01

    The FMR1 mutations can cause a variety of disabilities, including cognitive deficits, attention-deficit/hyperactivity disorder, autism, and other socioemotional problems, in individuals with the full mutation form (fragile X syndrome) and distinct difficulties, including primary ovarian insufficiency, neuropathy and the fragile X-associated tremor/ataxia syndrome, in some older premutation carriers. Therefore, multigenerational family involvement is commonly encountered when a proband is identified with a FMR1 mutation. Studies of metabotropic glutamate receptor 5 pathway antagonists in animal models of fragile X syndrome have demonstrated benefits in reducing seizures, improving behavior, and enhancing cognition. Trials of metabotropic glutamate receptor 5 antagonists are beginning with individuals with fragile X syndrome. Targeted treatments, medical and behavioral interventions, genetic counseling, and family supports are reviewed here. PMID:19117905

  4. COMPARING AND LINKING PLUMES ACROSS MODELING APPROACHES

    EPA Science Inventory

    River plumes carry many pollutants, including microorganisms, into lakes and the coastal ocean. The physical scales of many stream and river plumes often lie between the scales for mixing zone plume models, such as the EPA Visual Plumes model, and larger-sized grid scales for re...

  5. Electrical Charging of Volcanic Plumes

    NASA Astrophysics Data System (ADS)

    James, M. R.; Wilson, L.; Lane, S. J.; Gilbert, J. S.; Mather, T. A.; Harrison, R. G.; Martin, R. S.

    2008-06-01

    Many explosive terrestrial volcanic eruptions are accompanied by lightning and other atmospheric electrical phenomena. The plumes produced generate large perturbations in the surface atmospheric electric potential gradient and high charge densities have been measured on falling volcanic ash particles. The complex nature of volcanic plumes (which contain gases, solid particles, and liquid drops) provides several possible charging mechanisms. For plumes rich in solid silicate particles, fractoemission (the ejection of ions and atomic particles during fracture events) is probably the dominant source of charge generation. In other plumes, such as those created when lava enters the sea, different mechanisms, such as boiling, may be important. Further charging mechanisms may also subsequently operate, downwind of the vent. Other solar system bodies also show evidence for volcanism, with activity ongoing on Io. Consequently, volcanic electrification under different planetary scenarios (on Venus, Mars, Io, Moon, Enceladus, Tethys, Dione and Triton) is also discussed.

  6. Electrical Charging of Volcanic Plumes

    NASA Astrophysics Data System (ADS)

    James, M. R.; Wilson, L.; Lane, S. J.; Gilbert, J. S.; Mather, T. A.; Harrison, R. G.; Martin, R. S.

    Many explosive terrestrial volcanic eruptions are accompanied by lightning and other atmospheric electrical phenomena. The plumes produced generate large perturbations in the surface atmospheric electric potential gradient and high charge densities have been measured on falling volcanic ash particles. The complex nature of volcanic plumes (which contain gases, solid particles, and liquid drops) provides several possible charging mechanisms. For plumes rich in solid silicate particles, fractoemission (the ejection of ions and atomic particles during fracture events) is probably the dominant source of charge generation. In other plumes, such as those created when lava enters the sea, different mechanisms, such as boiling, may be important. Further charging mechanisms may also subsequently operate, downwind of the vent. Other solar system bodies also show evidence for volcanism, with activity ongoing on Io. Consequently, volcanic electrification under different planetary scenarios (on Venus, Mars, Io, Moon, Enceladus, Tethys, Dione and Triton) is also discussed.

  7. Collapsing plumes and resurrecting fountains

    NASA Astrophysics Data System (ADS)

    van den Bremer, Ton; Hunt, Gary

    2012-11-01

    We explore the range of behaviour predicted for steady plumes and fountains that undergo an increase or decrease in buoyancy which arise due to phase changes or chemical reactions. We model these changes in the simplest possible way by assuming a quadratic relationship between the density and the temperature of the fluid. We thereby extend the model of Caulfield & Woods (`95) to include the most recent developments in the literature on steady releases of buoyancy emitted vertically from horizontal area sources in unconfined quiescent environments of uniform density based on the plume model of Morton, Taylor & Turner (`56). We provide closed-form solutions and identify four classes of solution: collapsing plumes, resurrecting fountains, plumes with enhanced buoyancy and fountains with enhanced negative buoyancy. We provide criteria for each category of behaviour in terms of the source-value of two non-dimensional quantities: the Richardson number and a temperature parameter.

  8. Erlotinib in the treatment of advanced non-small cell lung cancer: an update for clinicians

    PubMed Central

    Wang, Yongsheng; Schmid-Bindert, Gerald

    2012-01-01

    Inhibition of epidermal growth factor receptor (EGFR) has become an important target in the treatment of advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib, two small molecular agents that target the tyrosine kinase domain of the EGFR, were approved in many countries for the treatment of locally advanced or metastatic NSCLC as a second- or third-line regimen. Since then, randomized trials have evaluated the role of these two targeted agents alone or combined with chemotherapy in maintenance and first-line settings. This review summarizes the results of recent clinical trials with these tyrosine kinase inhibitors, with a focus on erlotinib, as first-line treatment towards a form of personalized medicine aimed at improving clinical outcome in advanced NSCLC. PMID:22229045

  9. Development of Advanced Multi-Modality Radiation Treatment Planning Software for Neutron Radiotherapy and Beyond

    SciTech Connect

    Nigg, D; Wessol, D; Wemple, C; Harkin, G; Hartmann-Siantar, C

    2002-08-20

    The Idaho National Engineering and Environmental Laboratory (INEEL) has long been active in development of advanced Monte-Carlo based computational dosimetry and treatment planning methods and software for advanced radiotherapy, with a particular focus on Neutron Capture Therapy (NCT) and, to a somewhat lesser extent, Fast-Neutron Therapy. The most recent INEEL software system of this type is known as SERA, Simulation Environment for Radiotherapy Applications. As a logical next step in the development of modern radiotherapy planning tools to support the most advanced research, INEEL and Lawrence Livermore National Laboratory (LLNL), the developers of the PEREGRTNE computational engine for radiotherapy treatment planning applications, have recently launched a new project to collaborate in the development of a ''next-generation'' multi-modality treatment planning software system that will be useful for all modern forms of radiotherapy.

  10. Orofacial hereditary haemorrhagic telangiectasia: high power diode laser in early and advanced lesion treatment

    NASA Astrophysics Data System (ADS)

    Tempesta, Angela; Franco, Simonetta; Miccoli, Simona; Suppressa, Patrizia; De Falco, Vincenzo; Crincoli, Vito; Lacaita, Mariagrazia; Giuliani, Michele; Favia, Gianfranco

    2014-01-01

    Hereditary Haemorrhagic Telangiectasia (HHT) is a muco-cutaneous inherited disease. Symptoms are epistaxis, visceral arterio-venous malformations, multiple muco-cutaneous telangiectasia with the risk of number increasing enlargement, bleeding, and super-infection. The aim of this work is to show the dual Diode Laser efficacy in preventive treatment of Early Lesions (EL < 2mm) and therapeutic treatment of Advanced Lesions (AL < 2mm). 21 patients affected by HHT with 822 muco-cutaneous telangiectatic nodules have been treated in several sessions with local anaesthesia and cooling of treated sites. EL preventive treatment consists of single Laser impulse (fibre 320) in ultrapulsed mode (2 mm single point spot). AL therapeutic treatment consists of repeated Laser impulses in pulsed mode (on 200ms / off 400ms). According to the results, Diode Laser used in pulsed and ultra-pulsed mode is very effective as noninvasive treatment both in early and advanced oral and perioral telangiectasia.

  11. Advances in diagnosis and treatment of Helicobacter pylori infection.

    PubMed

    Ranjbar, Reza; Behzadi, Payam; Farshad, Shohreh

    2017-03-06

    Helicobacter pylori is a Gram-negative motile bacterium causative agent of acute and chronic digestive and extra-digestive human infections. According to different reports worldwide, H. pylori symptomatic and asymptomatic infections are a global problem. The statistical investigations show a percentage of 50 for people who are involved in H. pylori acute/chronic digestive and/or extra-digestive infections around the world. This review focuses on digestive and extra-digestive diseases caused by H. pylori, the related virulence factors, diagnostic techniques including non-invasive and invasive diagnostics and treatment. There is an abundance of diagnostics for detection and identification of H. pylori. The availability, cost, and the condition of test performance may differ from place to place. To increase the level of reliability in association with diagnostic tools for detecting H. pylori, several techniques must be applied at once as multi-diagnostic technique. Furthermore, there are several pharmacotherapies which can be used for complete eradication of H. pylori infection.

  12. Non-US advanced low-level radwaste treatment systems

    NASA Astrophysics Data System (ADS)

    Oyen, L. C.; Tucker, R. F., Jr.

    1981-09-01

    A review of power plant radwaste treatment practices and research in Canada, Japan, Korea and Europe is given. In addition to a review of the available English language literature, visits were made to power plants and research centers in Europe and Japan and to private and government agencies in Korea. the nuclear research centers and power plants which were visited in Japan made use of volume reduction (VR) techniques and on site storage facilities. VR techniques were in use at the two major nuclear research centers in West Germany, and several power plants have made plans to use VR systems. Research on leaching was also being carried out in Japan because they intend to dispose of low level radioactive waste by deep sea disposal. Information concerning the VR systems in Canada included in this report is based on a trip to the Bruce Nuclear Power Development Station in 1977 and on reports and personal communications with Ontario Hydro engineers. The status of the work on radwaste VR systems and radwaste incinerators in the United States is updated along with other significant events concerning VR systems.

  13. Advances in antiangiogenic treatment of small-cell lung cancer

    PubMed Central

    Lu, Hongyang; Jiang, Zhiming

    2017-01-01

    Small-cell lung cancer (SCLC), a poorly differentiated neuroendocrine malignancy, has a rapid growth rate, strong aggressiveness, early metastases, and poor prognosis. Angiogenesis greatly contributes to the metastatic process of SCLC, which has a higher vascularization compared with non-small-cell lung cancer (NSCLC). SCLC might constitute an ideal malignancy for assessing new antiangiogenic drugs and therapeutic strategies. Combining bevacizumab with paclitaxel has therapeutic benefits in chemoresistant, relapsed SCLC. The cisplatin–etoposide and bevacizumab combination, as the first-line treatment for extensive-stage SCLC, can improve progression-free survival (PFS), with an acceptable toxicity profile. Ziv-aflibercept combined with topotecan is promising for platinum-refractory SCLC. Chemotherapy combined with thalidomide cannot prolong survival. Maintenance sunitinib of 37.5 mg/day in extensive-stage SCLC patients following induction chemotherapy with platinum/etoposide improves median PFS by 1.6 months. Serum angiopoietin-2 concentrations and vascular endothelial growth factor levels correlate with poor prognosis. Bevacizumab, ziv-aflibercept, and sunitinib are worthy of further evaluation. Thalidomide, sorafenib, pomalidomide, and cediranib may not be suitable for SCLC. PMID:28138259

  14. Recent advances in the treatment of Acanthamoeba keratitis.

    PubMed

    Kumar, Raman; Lloyd, David

    2002-08-15

    Infection of the eye caused by Acanthamoeba species constitutes a burgeoning and unsolved problem. Of individuals with Acanthamoeba keratitis, 85% wear contact lenses; abrasion of the cornea is implicated. Corneal infection often can be prevented by good lens care and hygiene. Severe Acanthamoeba keratitis often can be very difficult to treat; surgery can be less than successful and may lead to further problems. The encysted stage in the life cycle of Acanthamoeba species appears to cause the most problems; many biocides are ineffective in killing the highly resistant cysts. Combination therapy--that is, use of 2 or 3 biocides, sometimes with antibacterial antibiotics--appears to work best. Recurrence is common if treatment is stopped prematurely. Immunologic methods are being investigated as a form of prevention, and oral immunization of animals recently has been successful in the prevention of Acanthamoeba keratitis by inducing immunity before infection occurs. Immunization thus may eventually become the best approach for reduction of the incidence of amebic infection in humans.

  15. Dystonia--new advances in classification, genetics, pathophysiology and treatment.

    PubMed

    Skogseid, I M

    2014-01-01

    Dystonia is a heterogeneous movement disorder and has been defined as 'a syndrome of sustained muscle contractions, frequently causing twisted and repetitive movements, or abnormal postures'. The classification of dystonia has developed along with increasing knowledge, and different schemes have been suggested, including age at onset, body distribution, and etiology as the main differentiating factors. A revised definition and a new classification of dystonia have now been proposed by a group of leading dystonia experts and will be referred here. The discovery of the first two gene mutations causing primary generalized dystonia (DYT1-TOR1A and DYT6-THAP1) has facilitated studies on pathogenesis and pathophysiology of primary dystonias, by comparing neurophysiology between manifesting and non-manifesting carriers, and by studying the molecular biology of the mutant gene products. During recent years, several other gene mutations causing primary dystonia, dystonia-plus, and paroxysmal dystonia disorders have been discovered. Only during the last year, by the use of whole-exome sequencing techniques, mutations in three different genes in families with predominantly cervical dystonia were found, which may lead to improved insight into the pathogenesis also of the more frequent focal dystonias. Botulinum neurotoxin (BoNT) and deep brain stimulation (DBS) have revolutionized the symptomatic treatment for dystonia during the last two decades and continue to be refined to improve efficacy and expand their indications. Unfortunately, no progress has been made in the oral medication of dystonia. Current and future new insights into pathogenetic and pathophysiological mechanisms of dystonia will hopefully lead to improvement also in this area soon.

  16. Dynamics and structure of thermo-chemical mantle plumes: Are numerical models consistent with observations?

    NASA Astrophysics Data System (ADS)

    Dannberg, J.; Sobolev, S. V.

    2013-12-01

    structures they form in the upper mantle. Modelling shows that high plume temperature and/or volume together with low content of eclogite result in plumes directly advancing to the base of the lithosphere. Due to the high eclogite density in a region between 300 and 400 km depth, plumes with slightly lower buoyancy (due to higher content of eclogite or lower temperature) pond there and form pools or a second layer of hot material. These structures become asymmetric when the plume interacts with the quickly moving overlying plate. Further reduction of buoyancy leads to plumes accumulating at 300 - 400 km depth range and never approaching the base of the lithosphere, but instead heating the adjacent mantle material above to form smaller secondary plumes. Our models also suggest that thermo-chemical plumes ascend in the mantle much slower compared to thermal plumes, have thicker plume tails and cause a much smaller (hundred meters scale) surface uplift. The conversion of plume excess temperatures to anomalies in seismic velocity shows that thermo-chemical low-buoyancy plumes can explain a variety of features observed by seismic tomography much better than purely thermal plumes.

  17. Sonidegib, a novel smoothened inhibitor for the treatment of advanced basal cell carcinoma.

    PubMed

    Doan, Hung Q; Silapunt, Sirunya; Migden, Michael R

    2016-01-01

    Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. If left untreated, BCCs can become locally aggressive or even metastasize. Currently available treatments include local destruction, surgery, and radiation. Systemic options for advanced disease are limited. The Hedgehog (Hh) pathway is aberrantly activated in a majority of BCCs and in other cancers. Hh pathway inhibitors are targeted agents that inhibit the aberrant activation of the Hh pathway, with smoothened being a targeted component. Sonidegib is a novel smoothened inhibitor that was recently approved by the US Food and Drug Administration. This review focuses on BCC pathogenesis and the clinical efficacy of sonidegib for the treatment of advanced BCC.

  18. Sonidegib, a novel smoothened inhibitor for the treatment of advanced basal cell carcinoma

    PubMed Central

    Doan, Hung Q; Silapunt, Sirunya; Migden, Michael R

    2016-01-01

    Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. If left untreated, BCCs can become locally aggressive or even metastasize. Currently available treatments include local destruction, surgery, and radiation. Systemic options for advanced disease are limited. The Hedgehog (Hh) pathway is aberrantly activated in a majority of BCCs and in other cancers. Hh pathway inhibitors are targeted agents that inhibit the aberrant activation of the Hh pathway, with smoothened being a targeted component. Sonidegib is a novel smoothened inhibitor that was recently approved by the US Food and Drug Administration. This review focuses on BCC pathogenesis and the clinical efficacy of sonidegib for the treatment of advanced BCC. PMID:27695345

  19. Advanced optical condition monitoring. [of rocket engines

    NASA Technical Reports Server (NTRS)

    Cross, G.; Barkhoudarian, S.

    1991-01-01

    The application of Advanced Optical Condition Monitoring to optical leak detection and plume spectrometry is discussed. The development of these selected sensors for propulsion system monitoring is addressed.

  20. Patterns of treatment and costs of intermediate and advanced hepatocellular carcinoma management in four Italian centers

    PubMed Central

    Colombo, Giorgio Lorenzo; Cammà, Calogero; Attili, Adolfo Francesco; Ganga, Roberto; Gaeta, Giovanni Battista; Brancaccio, Giuseppina; Franzini, Jean Marie; Volpe, Marco; Turchetti, Giuseppe

    2015-01-01

    Background Hepatocellular carcinoma (HCC) is a severe health condition associated with high hospitalizations and mortality rates, which also imposes a relevant economic burden. Purpose The aim of the present survey is to investigate treatment strategies and related costs for HCC in the intermediate and advanced stages of the disease. Patients and methods The survey was conducted in four Italian centers through structured interviews with physicians. Information regarding the stage of disease, treatments performed, and related health care resource consumption was included in the questionnaire. Direct health care cost per patient associated with the most relevant treatments such as sorafenib, transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) was evaluated. Results Between 2013 and 2014, 285 patients with HCC were treated in the four participating centers; of these, 80 were in intermediate stage HCC (Barcelona Clinic Liver Cancer Classification [BCLC] B), and 57 were in the advanced stage of the disease (BCLC C). In intermediate stage HCC, the most frequent first-line treatment was TACE (63%) followed by sorafenib (15%), radiofrequency ablation (14%), and TARE (1.3%). In the advanced stage of HCC, the most frequently used first-line therapy was sorafenib (56%), followed by best supportive care (21%), TACE (18%), and TARE (3.5%). The total costs of treatment per patient amounted to €12,214.54 with sorafenib, €13,418.49 with TACE, and €26,106.08 with TARE. Both in the intermediate and in the advanced stage of the disease, variability in treatment patterns among centers was observed. Conclusion The present analysis raises for the first time the awareness of the overall costs incurred by the Italian National Healthcare System for different treatments used in intermediate and advanced HCC. Further investigations would be important to better understand the effective health care resource usage. PMID:26527877

  1. Impact of Treatment for Depression on Desire for Hastened Death in Patients With Advanced AIDS

    PubMed Central

    Breitbart, William; Rosenfeld, Barry; Gibson, Christopher; Kramer, Michael; Li, Yuelin; Tomarken, Alexis; Nelson, Christian; Pessin, Hayley; Esch, Julie; Galietta, Michele; Garcia, Nerina; Brechtl, John; Schuster, Michael

    2013-01-01

    Background Despite the development of multi-drug regimens for HIV, palliative care and quality-of-life issues in patients with advanced AIDS remain important areas of clinical investigation. Objective Authors assessed the impact of treatment for depression on desire for hastened death in patients with advanced AIDS. Method Patients with advanced AIDS (N=372) were interviewed shortly after admission to a palliative-care facility, and were reinterviewed monthly for the next 2 months. Patients diagnosed with a major depressive syndrome were provided with antidepressant treatment and reinterviewed weekly. Desire for hastened death was assessed with two questionnaire measures. Results Desire for death was highly associated with depression, and it decreased dramatically in patients who responded to antidepressant treatment. Little change in desire for hastened death was observed in patients whose depression did not improve. Although improved depression was not significantly associated with the use of antidepressant medication, those individuals prescribed antidepressant medication showed the largest decreases in desire for hastened death. Discussion Successful treatment for depression appears to substantially decrease desire for hastened death in patients with advanced AIDS. The authors discuss implications of these findings for palliative-care treatment and the physician-assisted suicide debate. PMID:20332284

  2. The Potential of Combined Immunotherapy and Antiangiogenesis for the Synergistic Treatment of Advanced NSCLC.

    PubMed

    Manegold, Christian; Dingemans, Anne-Marie C; Gray, Jhanelle E; Nakagawa, Kazuhiko; Nicolson, Marianne; Peters, Solange; Reck, Martin; Wu, Yi-Long; Brustugun, Odd Terje; Crinò, Lucio; Felip, Enriqueta; Fennell, Dean; Garrido, Pilar; Huber, Rudolf M; Marabelle, Aurélien; Moniuszko, Marcin; Mornex, Françoise; Novello, Silvia; Papotti, Mauro; Pérol, Maurice; Smit, Egbert F; Syrigos, Kostas; van Meerbeeck, Jan P; van Zandwijk, Nico; Chih-Hsin Yang, James; Zhou, Caicun; Vokes, Everett

    2017-02-01

    Over the past few years, there have been considerable advances in the treatments available to patients with metastatic or locally advanced NSCLC, particularly those who have progressed during first-line treatment. Some of the treatment options available to patients are discussed here, with a focus on checkpoint inhibitor immunotherapies (nivolumab and pembrolizumab) and antiangiogenic agents (bevacizumab, ramucirumab, and nintedanib). It is hypothesized that combining immunotherapy with antiangiogenic treatment may have a synergistic effect and enhance the efficacy of both treatments. In this review, we explore the theory and potential of this novel treatment option for patients with advanced NSCLC. We discuss the growing body of evidence that proangiogenic factors can modulate the immune response (both by reducing T-cell infiltration into the tumor microenvironment and through systemic effects on immune-regulatory cell function), and we examine the preclinical evidence for combining these treatments. Potential challenges are also considered, and we review the preliminary evidence of clinical efficacy and safety with this novel combination in a variety of solid tumor types.

  3. Active Volcanic Plumes on Io

    NASA Technical Reports Server (NTRS)

    1997-01-01

    This color image, acquired during Galileo's ninth orbit around Jupiter, shows two volcanic plumes on Io. One plume was captured on the bright limb or edge of the moon (see inset at upper right), erupting over a caldera (volcanic depression) named Pillan Patera after a South American god of thunder, fire and volcanoes. The plume seen by Galileo is 140 kilometers (86 miles) high and was also detected by the Hubble Space Telescope. The Galileo spacecraft will pass almost directly over Pillan Patera in 1999 at a range of only 600 kilometers (373 miles).

    The second plume, seen near the terminator (boundary between day and night), is called Prometheus after the Greek fire god (see inset at lower right). The shadow of the 75-kilometer (45- mile) high airborne plume can be seen extending to the right of the eruption vent. The vent is near the center of the bright and dark rings. Plumes on Io have a blue color, so the plume shadow is reddish. The Prometheus plume can be seen in every Galileo image with the appropriate geometry, as well as every such Voyager image acquired in 1979. It is possible that this plume has been continuously active for more than 18 years. In contrast, a plume has never been seen at Pillan Patera prior to the recent Galileo and Hubble Space Telescope images.

    North is toward the top of the picture. The resolution is about 6 kilometers (3.7 miles) per picture element. This composite uses images taken with the green, violet and near infrared filters of the solid state imaging (CCD) system on NASA's Galileo spacecraft. The images were obtained on June 28, 1997, at a range of more than 600,000 kilometers (372,000 miles).

    The Jet Propulsion Laboratory, Pasadena, CA manages the Galileo mission for NASA's Office of Space Science, Washington, DC. JPL is an operating division of California Institute of Technology (Caltech).

    This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page

  4. Sky-scattered solar radiation based plume transmissivity measurement to quantify soot emissions from flares.

    PubMed

    Johnson, Matthew R; Devillers, Robin W; Yang, Chen; Thomson, Kevin A

    2010-11-01

    For gas flares typical of the upstream energy industry and similar point sources, most current methods for characterizing soot emissions are based on plume opacity rather than a quantitative measure of mass flux. The absence of more quantitative approaches is indicative of the inherent complexity of soot and the difficulties in characterizing emissions in an unbounded plume. A new experimental approach has been developed for the investigation of soot emissions in industrial plumes. Referred to as sky-LOSA, the diagnostic permits evaluation of 2D spatially resolved monochromatic sky-light transmissivity data over the width of a plume, where sky-light intensities behind the plume are obtained via an interpolation algorithm. By using Rayleigh-Debye-Gans Fractal Aggregate theory to relate transmissivity data to soot concentrations, and with knowledge of the velocity of the plume, it is possible to quantify mass flow rates of soot in a plume. Experiments on an unconfined lab-scale soot plume were used to support a detailed uncertainty analysis under a wide range of conditions and to estimate sensitivity limits of the technique. Results suggest field measurements of soot emission from flare plumes should be possible with overall uncertainties of less than 32%. This represents a significant advancement over existing techniques based on opacity measurements.

  5. Complete Remission of Locally Advanced Penile Squamous Cell Carcinoma after Multimodality Treatment

    PubMed Central

    Meng, Yifan; Bernie, Helen Levey; Weng, Tzu-Hua; Ling, Dean-An; Messing, Edward M.; Guancial, Elizabeth

    2016-01-01

    Treatment of locally advanced penile squamous cell carcinoma (pSCC) remains highly controversial secondary to disease rarity and lack of prospective randomized controlled trials. The current mainstays of care are multi-modality treatment with neoadjuvant chemotherapy and surgery. However, clinicians often have difficulty making recommendations for patients unable to tolerate chemotherapy or surgery due to scarcity of data to guide clinical decision-making. We report two cases of locally advanced pSCC that achieved complete remission after treatment with cisplatin-based neoadjuvant chemotherapy and surgery in one case, and concurrent cisplatin chemoradiation in a second, supporting the use of chemotherapy as part of first-line multimodal therapy. We also discuss additional treatment options for patients unable to tolerate traditional chemotherapy regimens. PMID:28191294

  6. Advanced treatment process for pharmaceuticals, endocrine disruptors, and flame retardants removal.

    PubMed

    Sundaram, Vijay; Emerick, Robert W; Shumaker, Stanley E

    2014-02-01

    The objective of this project was to demonstrate the effectiveness of an advanced treatment process that did not utilize reverse osmosis for the removal of pharmaceuticals, endocrine disruptors and flame retardants (collectively referred as contaminants of emerging concern [CECs]) from municipal effluent. The advanced treatment process consisted of (in the order of use): membrane filtration, ozonation (O3), and biologically active carbon (BAC) filtration. Ozone dosage of 5 mg/L or more was needed for desired CEC removal. Biologically active carbon removed flame retardants, and ozonation byproducts including NDMA and aldehydes. The project successfully demonstrated 1) the removal of a wide range of CECs, 2) reduction of estrogen activity to background levels, and 3) removal of ozonation byproducts. Treatment was achieved at lower costs and power utilization than reverse osmosis and without generating a concentrate stream. Results from this project could make CEC removal feasible, especially in situations where reverse osmosis treatment is infeasible.

  7. Advanced primary pulmonary lymphoepithelioma-like carcinoma: clinical manifestations, treatment, and outcome

    PubMed Central

    Lin, Chun-Yu; Chen, Ying-Jen; Hsieh, Meng-Heng; Wang, Chih-Wei

    2017-01-01

    Background Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is rare, with better clinical outcomes than other lung cancers. However, reports on advanced LELC characteristics and prognosis are lacking. Methods This retrospective study included adults diagnosed with advanced LELC (at least stage IIIA) between January 2003 and December 2015. Clinical characteristics, treatment modalities, and outcomes were recorded. Results Study population comprised 23 patients with a mean age of 63.7±10.6 years. The Eastern Cooperative Oncology Group status on diagnosis was 0 in five patients and 1 in the others. Most patients received multimodality treatment and all received cisplatin-based chemotherapy. Median follow-up duration was 28.8 months. The median progression free survival (PFS) was 14.6 months in patients received palliative chemotherapy. There were nine (39.1%) deaths. The median overall survival (OS) was not achieved. Until July 31, 2016, median OS was 54.1 months for stage IIIB and 27.6 months for stage IV. There was no significant difference in OS among all stages. No prognostic factors were found. Conclusions Advanced LELC responded well to cisplatin-based chemotherapy and/or radiotherapy. Main tumor resection is probably beneficial for advanced LELC. Long-term survival is possible for advanced LELC after multimodality treatment. PMID:28203414

  8. Plumes, orogenesis, and supercontinental fragmentation

    NASA Astrophysics Data System (ADS)

    Dalziel, I. W. D.; Lawver, L. A.; Murphy, J. B.

    2000-05-01

    A time-space relationship between large igneous provinces (LIPS), present day hot spots, and the fragmentation of Pangea has been documented over several decades, but the cause of fragmentation has remained elusive. LIPS are regarded either as the result of impingement of a mantle plume on the base of the lithosphere, or as the initial products of adiabatic decompression melting of anomalously hot mantle. Do LIPS therefore constitute evidence of an active role for plumes from the deep mantle in supercontinental fragmentation, or are they merely the first indications of a large-scale but near-surface tectonic process? Two long recognized and enigmatic orogenic events may offer a solution to this geologically important 'chicken or egg' conundrum. The reconstructed early Mesozoic Gondwanide fold belt of South America, southern Africa, and Antarctica, could have resulted from 'plume-modified orogeny', flattening of a downgoing lithospheric slab due to the buoyancy of a plume rising beneath a continental margin subduction zone. If so, the ˜180 Ma Karroo and Ferrar LIPS associated with the opening of the ocean basin between East and West Gondwanaland at ˜165 Ma resulted from impingement of this plume and are unrelated to the thermal insulation of the shallow mantle beneath Gondwanaland. It would then follow that the plume itself played an active, possibly critical, role in the initial breakup of the supercontinent. The Late Paleozoic 'Ancestral Rockies' deformation in the southwestern United States could be yet another example of orogeny driven by a plume that initiated the break-up of Pangea approximately 15 Myr earlier in the Central Atlantic region.

  9. Complex tephra dispersion from 3D plume modeling using ATHAM

    NASA Astrophysics Data System (ADS)

    Nicholson, B. C.; Kobs-Nawotniak, S. E.

    2014-12-01

    Most volcanic hazard assessments are based on a classic inversion tool for tephra deposits that relies on a simple integral model to explain the eruption plume. While this tool is adequate for first-order predictions of tephra deposition under no-wind conditions, the simplifying assumptions make it unreliable for ambient winds >10 m/s. Advances in computational power now make it possible to improve the inversion tool using 3D fluid dynamics. We do this with the physics-based Active Tracer High-resolution Atmospheric Model (ATHAM) to model tephra dispersion and deposition from volcanic eruption columns. The model, when run in 3D, is able to capture the complex morphology of bent plumes. Tephra distributions produced by these morphologies differ significantly from distributions created by idealized advection solutions, reflecting the effects of counter-rotating vortex pairs, puffing modes, or plume bifurcation. The modeled tephra deposition better captures the complex effects of wind-plume interaction, allowing us to update classic inversion tools with more realistic weak plume conditions consistent with typical historical explosive eruptions.

  10. AATSR Based Volcanic Ash Plume Top Height Estimation

    NASA Astrophysics Data System (ADS)

    Virtanen, Timo H.; Kolmonen, Pekka; Sogacheva, Larisa; Sundstrom, Anu-Maija; Rodriguez, Edith; de Leeuw, Gerrit

    2015-11-01

    The AATSR Correlation Method (ACM) height estimation algorithm is presented. The algorithm uses Advanced Along Track Scanning Radiometer (AATSR) satellite data to detect volcanic ash plumes and to estimate the plume top height. The height estimate is based on the stereo-viewing capability of the AATSR instrument, which allows to determine the parallax between the satellite's nadir and 55◦ forward views, and thus the corresponding height. AATSR provides an advantage compared to other stereo-view satellite instruments: with AATSR it is possible to detect ash plumes using brightness temperature difference between thermal infrared (TIR) channels centered at 11 and 12 μm. The automatic ash detection makes the algorithm efficient in processing large quantities of data: the height estimate is calculated only for the ash-flagged pixels. Besides ash plumes, the algorithm can be applied to any elevated feature with sufficient contrast to the background, such as smoke and dust plumes and clouds. The ACM algorithm can be applied to the Sea and Land Surface Temperature Radiometer (SLSTR), scheduled for launch at the end of 2015.

  11. A Novel Therapeutic Modality for Advanced-Stage Prostate Cancer Treatment

    DTIC Science & Technology

    2015-10-01

    There is an urgent need to develop effective therapies for the treatment of advanced stage prostate cancer (PrCa) due to their limited or no response to...metastatic PrCa. Our results illustrated that ORM treatment effectively inhibited invasion and motility of PrCa cells. Further, we observed that ORM... effectively inhibits metastasis associated protein 1 (MTA1) in PrCa cells. MTA1 has been reported to be very tightly associated with cancer metastasis in

  12. [Image guided and robotic treatment--the advance of cybernetics in clinical medicine].

    PubMed

    Fosse, E; Elle, O J; Samset, E; Johansen, M; Røtnes, J S; Tønnessen, T I; Edwin, B

    2000-01-10

    The introduction of advanced technology in hospitals has changed the treatment practice towards more image guided and minimal invasive procedures. Modern computer and communication technology opens up for robot aided and pre-programmed intervention. Several robotic systems are in clinical use today both in microsurgery and in major cardiac and orthopedic operations. As this trend develops, professions which are new in this context such as physicists, mathematicians and cybernetic engineers will be increasingly important in the treatment of patients.

  13. Advances in sickle cell disease treatment: from drug discovery until the patient monitoring.

    PubMed

    dos Santos, Jean Leandro; Lanaro, Carolina; Chin, Chung Man

    2011-04-01

    Sickle cell disease (SCD) is one of the most prevalent hematological diseases in the world. Despite the immense progress in molecular knowledge about SCD in last years few therapeutical sources are currently available. Nowadays the treatment is performed mainly with drugs such as hydroxyurea or other fetal hemoglobin inducers and chelating agents. This review summarizes current knowledge about the treatment and the advancements in drug design in order to discover more effective and safe drugs. Patient monitoring methods in SCD are also discussed.

  14. Technical analysis of advanced wastewater-treatment systems for coal-gasification plants

    SciTech Connect

    Not Available

    1981-03-31

    This analysis of advanced wastewater treatment systems for coal gasification plants highlights the three coal gasification demonstration plants proposed by the US Department of Energy: The Memphis Light, Gas and Water Division Industrial Fuel Gas Demonstration Plant, the Illinois Coal Gasification Group Pipeline Gas Demonstration Plant, and the CONOCO Pipeline Gas Demonstration Plant. Technical risks exist for coal gasification wastewater treatment systems, in general, and for the three DOE demonstration plants (as designed), in particular, because of key data gaps. The quantities and compositions of coal gasification wastewaters are not well known; the treatability of coal gasification wastewaters by various technologies has not been adequately studied; the dynamic interactions of sequential wastewater treatment processes and upstream wastewater sources has not been tested at demonstration scale. This report identifies key data gaps and recommends that demonstration-size and commercial-size plants be used for coal gasification wastewater treatment data base development. While certain advanced treatment technologies can benefit from additional bench-scale studies, bench-scale and pilot plant scale operations are not representative of commercial-size facility operation. It is recommended that coal gasification demonstration plants, and other commercial-size facilities that generate similar wastewaters, be used to test advanced wastewater treatment technologies during operation by using sidestreams or collected wastewater samples in addition to the plant's own primary treatment system. Advanced wastewater treatment processes are needed to degrade refractory organics and to concentrate and remove dissolved solids to allow for wastewater reuse. Further study of reverse osmosis, evaporation, electrodialysis, ozonation, activated carbon, and ultrafiltration should take place at bench-scale.

  15. Recent advances in approach to treatment of genetic disorders: clinicians perspective.

    PubMed

    Gupta, Neerja; Kabra, Madhulika

    2007-05-01

    There is no cure for most of the genetic disorders. The only option in most situations is prevention by counseling and prenatal diagnosis. However, over a decade, with the completion of the human genome project and other advances there is better understanding of pathogenesis, improvement in diagnostic strategies and various treatment avenues are opening up for these disorders. The aim of this article is to make the pediatricians aware of the approaches to treatment of common genetic disorders and recent available therapeutic interventions.

  16. Hospice referral after inpatient psychiatric treatment of individuals with advanced dementia from a nursing home.

    PubMed

    Epstein-Lubow, Gary; Fulton, Ana Tuya; Marino, Louis J; Teno, Joan

    2015-06-01

    This report addresses the discharge disposition following inpatient psychiatric treatment for advanced dementia. The total population included 685 305 Medicare fee-for-service decedents with advanced cognitive and functional impairment, with a mean age of 85.9 years who had resided in a nursing home. In the last 90 days of life, 1027 (0.15%) persons received inpatient psychiatry treatment just prior to the place of care where the individual died. Discharge dispositions included 132 (12.9%) persons to a medical hospital, 728 (70.9%) to nursing home without hospice services, 73 (7.1%) to hospice services in a nursing home, 32 (3.1%) to home without hospice services, and 16 (1.6%) to hospice services at home. Overall, the rate of referral to hospice services for advanced dementia was relatively low.

  17. 26 CFR 1.612-3 - Depletion; treatment of bonus and advanced royalty.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Depletion; treatment of bonus and advanced royalty. 1.612-3 Section 1.612-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.612-3 Depletion;...

  18. Bromine oxidation in volcanic plumes

    NASA Astrophysics Data System (ADS)

    Bobrowski, N.; Vogel, L.; Kern, C.; Giuffrida, G. B.; Delgado-Granados, H.; Platt, U.

    2009-04-01

    Volcanoes are very strong sources of hydrogen, carbon, sulphur and halogen compounds, as well as of particles. Some gases only behave as passive tracers; others interact and affect the formation, growth or chemical characteristics of aerosol particles in a complex system. Recent measurements of halogen radicals in volcanic plumes showed that volcanic plumes are chemically very active. Kinetic considerations (Oppenheimer et al., 2006) and detailed calculations with an atmospheric chemistry model (Bobrowski et al., 2007) explain the halogen chemistry mainly with photochemical reactions involving both, the gas and particle phase. They reproduce the measured gas-phase concentrations quite well. However, temporal evolution of BrO in the early plume is not well described in the models. The understanding of chemical kinetics of BrO formation is still not complete. Recent measurement results (Vogel et al., 2008) do not fit with initial model calculation. The new data lead to the suggestion that the BrO formation could be much faster during the first few minutes after emission than initially suggested. Old and recent data sets will be confronted, compared and possible causes of their differences discussed. The measurements considered were taken at Mt. Etna (Italy), Villarica (Chile), and Popocatépetl (Mexico) volcanoes. Additionally, at Mt Etna the emission consists of up to four individual plumes from four summit craters. The differences between the individual plumes have been investigated during the last years and will be presented.

  19. Stationary Plasma Thruster Plume Characteristics

    NASA Technical Reports Server (NTRS)

    Myers, Roger M.; Manzella, David H.

    1994-01-01

    Stationary Plasma Thrusters (SPT's) are being investigated for application to a variety of near-term missions. This paper presents the results of a preliminary study of the thruster plume characteristics which are needed to assess spacecraft integration requirements. Langmuir probes, planar probes, Faraday cups, and a retarding potential analyzer were used to measure plume properties. For the design operating voltage of 300 V the centerline electron density was found to decrease from approximately 1.8 x 10 exp 17 cubic meters at a distance of 0.3 m to 1.8 X 10 exp 14 cubic meters at a distance of 4 m from the thruster. The electron temperature over the same region was between 1.7 and 3.5 eV. Ion current density measurements showed that the plume was sharply peaked, dropping by a factor of 2.6 within 22 degrees of centerline. The ion energy 4 m from the thruster and 15 degrees off-centerline was approximately 270 V. The thruster cathode flow rate and facility pressure were found to strongly affect the plume properties. In addition to the plume measurements, the data from the various probe types were used to assess the impact of probe design criteria

  20. Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment

    PubMed Central

    McCauley, Jenna L; Killeen, Therese; Gros, Daniel F.; Brady, Kathleen T.; Back, Sudie E.

    2013-01-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are prevalent and frequently co-occur. Comorbid PTSD/SUD is associated with a more complex and costly clinical course when compared with either disorder alone, including increased chronic physical health problems, poorer social functioning, higher rates of suicide attempts, more legal problems, increased risk of violence, worse treatment adherence, and less improvement during treatment. In response, psychosocial treatment options have increased substantially over the past decade and integrated approaches – treatments that address symptoms of both PTSD and SUD concurrently –are fast becoming the preferred model for treatment. This paper reviews the prevalence, etiology and assessment practices as well as advances in the behavioral and pharmacologic treatment of comorbid PTSD and SUDs. PMID:24179316

  1. Sickle cell disease in childhood: Part II. Diagnosis and treatment of major complications and recent advances in treatment.

    PubMed

    Wethers, D L

    2000-09-15

    Treatment advances over the past 25 years have significantly decreased morbidity and mortality in children with sickle cell disease. Aggressive management of fever, early diagnosis of acute chest syndrome, judicious use of transfusions and proper treatment of pain can improve quality of life and prognosis for these children. Prophylactic hydroxyurea therapy has been shown to reduce the incidence and severity of pain crises in adults with sickle cell disease and has been effective in limited studies conducted in children. Research into stem cell transplantation provides hope that a cure for sickle cell disease may be possible.

  2. PHOTOCHEMICAL SIMULATIONS OF POINT SOURCE EMISSIONS WITH THE MODELS-3 CMAQ PLUME-IN-GRID APPROACH

    EPA Science Inventory

    A plume-in-grid (PinG) approach has been designed to provide a realistic treatment for the simulation the dynamic and chemical processes impacting pollutant species in major point source plumes during a subgrid scale phase within an Eulerian grid modeling framework. The PinG sci...

  3. Advances in Personalized Targeted Treatment of Metastatic Melanoma and Non-Invasive Tumor Monitoring

    PubMed Central

    Klinac, Dragana; Gray, Elin S.; Millward, Michael; Ziman, Mel

    2013-01-01

    Despite extensive scientific progress in the melanoma field, treatment of advanced stage melanoma with chemotherapeutics and biotherapeutics has rarely provided response rates higher than 20%. In the past decade, targeted inhibitors have been developed for metastatic melanoma, leading to the advent of more personalized therapies of genetically characterized tumors. Here we review current melanoma treatments and emerging targeted molecular therapies. In particular we discuss the mutant BRAF inhibitors Vemurafenib and Dabrafenib, which markedly inhibit tumor growth and advance patients’ overall survival. However this response is almost inevitably followed by complete tumor relapse due to drug resistance hampering the encouraging initial responses. Several mechanisms of resistance within and outside the MAPK pathway have now been uncovered and have paved the way for clinical trials of combination therapies to try and overcome tumor relapse. It is apparent that personalized treatment management will be required in this new era of targeted treatment. Circulating tumor cells (CTCs) provide an easily accessible means of monitoring patient relapse and several new approaches are available for the molecular characterization of CTCs. Thus CTCs provide a monitoring tool to evaluate treatment efficacy and early detection of drug resistance in real time. We detail here how advances in the molecular analysis of CTCs may provide insight into new avenues of approaching therapeutic options that would benefit personalized melanoma management. PMID:23515890

  4. Denosumab treatment of inoperable or locally advanced giant cell tumor of bone

    PubMed Central

    Borkowska, Aneta; Goryń, Tomasz; Pieńkowski, Andrzej; Wągrodzki, Michał; Jagiełło-Wieczorek, Ewelina; Rogala, Paweł; Szacht, Milena; Rutkowski, Piotr

    2016-01-01

    Giant cell tumor of bone (GCTB) is an osteolytic, locally aggressive tumor that rarely metastasizes and typically occurs in the bones. At present, the primary treatment for GCTB is curettage with local adjuvants. Giant cells express receptor activator of nuclear factor-κB ligand (RANKL). Denosumab, a RANKL inhibitor appears to present an effective therapeutic option in advanced cases of GCTB. The aim of the present study was to confirm the efficacy of denosumab in large group of patients with locally advanced GCTB. A total of 35 patients with histologically confirmed GCTB that were treated with denosumab with no participation in clinical trials between May 2013 and September 2015 were included in the present study. Denosumab treatment was administered until complete tumor resection was feasible or tumor progression or unacceptable toxicity had occurred. The mean denosumab treatment duration was 7.4 months. A total of 17 patients received surgery following denosumab treatment: 11 patients underwent wide en bloc resection with prosthesis implantation in 10 cases and 6 patients were treated with intralesional curettage. Tumor progression was observed in 2 patients that underwent intralesional curettage without prosthesis implantation. In addition, tumor progression was observed during denosumab treatment in 2 patients that had previously undergone radiotherapy. The overall 1-year progression-free survival rate was 92.8%. Thus, for patients with advanced, unresectable, progressive or symptomatic pretreated GCTB, denosumab provides a therapeutic option not previously available, which has become the standard therapy in multidisciplinary management of GCTB. PMID:28101196

  5. Denosumab treatment of inoperable or locally advanced giant cell tumor of bone.

    PubMed

    Borkowska, Aneta; Goryń, Tomasz; Pieńkowski, Andrzej; Wągrodzki, Michał; Jagiełło-Wieczorek, Ewelina; Rogala, Paweł; Szacht, Milena; Rutkowski, Piotr

    2016-12-01

    Giant cell tumor of bone (GCTB) is an osteolytic, locally aggressive tumor that rarely metastasizes and typically occurs in the bones. At present, the primary treatment for GCTB is curettage with local adjuvants. Giant cells express receptor activator of nuclear factor-κB ligand (RANKL). Denosumab, a RANKL inhibitor appears to present an effective therapeutic option in advanced cases of GCTB. The aim of the present study was to confirm the efficacy of denosumab in large group of patients with locally advanced GCTB. A total of 35 patients with histologically confirmed GCTB that were treated with denosumab with no participation in clinical trials between May 2013 and September 2015 were included in the present study. Denosumab treatment was administered until complete tumor resection was feasible or tumor progression or unacceptable toxicity had occurred. The mean denosumab treatment duration was 7.4 months. A total of 17 patients received surgery following denosumab treatment: 11 patients underwent wide en bloc resection with prosthesis implantation in 10 cases and 6 patients were treated with intralesional curettage. Tumor progression was observed in 2 patients that underwent intralesional curettage without prosthesis implantation. In addition, tumor progression was observed during denosumab treatment in 2 patients that had previously undergone radiotherapy. The overall 1-year progression-free survival rate was 92.8%. Thus, for patients with advanced, unresectable, progressive or symptomatic pretreated GCTB, denosumab provides a therapeutic option not previously available, which has become the standard therapy in multidisciplinary management of GCTB.

  6. Gaining momentum: New options and opportunities for the treatment of advanced melanoma.

    PubMed

    Michielin, Olivier; Hoeller, Christoph

    2015-09-01

    Before 2011, patients with advanced or metastatic melanoma had a particularly poor long-term prognosis. Since traditional treatments failed to confer a survival benefit, patients were preferentially entered into clinical trials of investigational agents. A greater understanding of the epidemiology and biology of disease has underpinned the development of newer therapies, including six agents that have been approved in the EU, US and/or Japan: a cytotoxic T-lymphocyte antigen-4 inhibitor (ipilimumab), two programmed cell death-1 receptor inhibitors (nivolumab and pembrolizumab), two BRAF inhibitors (vemurafenib and dabrafenib) and a MEK inhibitor (trametinib). The availability of these treatments has greatly improved the outlook for patients with advanced melanoma; however, a major consideration for physicians is now to determine how best to integrate these agents into clinical practice. Therapeutic decisions are complicated by the need to consider patient and disease characteristics, and individual treatment goals, alongside the different efficacy and safety profiles of agents with varying mechanisms of action. Long-term survival, an outcome largely out of reach with traditional systemic therapies, is now a realistic goal, creating the additional need to re-establish how clinical benefit is evaluated. In this review we summarise the current treatment landscape in advanced melanoma and discuss the promise of agents still in development. We also speculate on the future of melanoma treatment and discuss how combination and sequencing approaches may be used to optimise patient care in the future.

  7. Recent biologic and genetic advances in neuroblastoma: Implications for diagnostic, risk stratification, and treatment strategies.

    PubMed

    Newman, Erika A; Nuchtern, Jed G

    2016-10-01

    Neuroblastoma is an embryonic cancer of neural crest cell lineage, accounting for up to 10% of all pediatric cancer. The clinical course is heterogeneous ranging from spontaneous regression in neonates to life-threatening metastatic disease in older children. Much of this clinical variance is thought to result from distinct pathologic characteristics that predict patient outcomes. Consequently, many research efforts have been focused on identifying the underlying biologic and genetic features of neuroblastoma tumors in order to more clearly define prognostic subgroups for treatment stratification. Recent technological advances have placed emphasis on the integration of genetic alterations and predictive biologic variables into targeted treatment approaches to improve patient survival outcomes. This review will focus on these recent advances and the implications they have on the diagnostic, staging, and treatment approaches in modern neuroblastoma clinical management.

  8. Substance use disorders: Recent advances in treatment and models of care.

    PubMed

    Abou-Saleh, Mohammed T

    2006-09-01

    Drug and alcohol misuse is a global health problem with great health economic costs to substance misusers, their families, and their communities. It is associated with high physical and psychiatric morbidity, and with high mortality. There are serious obstacles to its treatment, including the stigma associated with it. Major advances in assessment and treatment have enabled health professionals to tackle drug and alcohol problems in a variety of settings, including primary care setting. This overview focuses on recent advances in the treatment of substance use disorders and on optimal models of care and services, with reference to studies conducted in the United Arab Emirates. Community surveys in Dubai and Al-Ain have shown a high prevalence of these disorders. It is proposed that these problems be dealt with in primary care settings, and it has been found that primary health care workers have a key role to play and are often in an ideal position to coordinate the community's response.

  9. Immediately loaded fixed maxillary implant treatment for a patient with advanced periodontal disease: a clinical report.

    PubMed

    Binon, Paul

    2010-12-01

    Patients with a failing maxillary dentition typically require an extended treatment sequence that involves extractions, interim prosthesis wear, grafting and subsequent implant placement, and restoration with an implant-supported fixed or bar-retained prosthesis. Established maxillary implant protocols can take up to 15 or more months to complete. The purpose of this report is to describe a treatment sequence using zygomatic implants in a patient with advanced periodontal disease. A fixed prosthesis was fabricated without grafting, resulting in a shortened treatment time.

  10. Treatment of obstructive sleep apnea with mandibular advancement appliance over prostheses: A case report

    PubMed Central

    Guimarães, Thais Moura; Colen, Sâmia; Cunali, Paulo Afonso; Rossi, Rowdley; Dal-Fabbro, Cibele; Ferraz, Otávio; Tufik, Sergio; Bittencourt, Lia

    2015-01-01

    Treatment with a mandibular advancement device (MAD) is recommended for mild obstructive sleep apnea (OSA), primary snoring and as a secondary option for Continuous Positive Airway Pressure, because it has better adherence and acceptance. However, edentulous patients do not have supports to hold the MAD. This study aimed to present a possible to OSA treatment with MAD in over complete upper and partial lower dentures. The patient, a 38-year-old female with mild OSA, was treated with a MAD. The respiratory parameter, such as apnea–hypopnea index, arousal index and oxyhemoglobin saturation was improved after treatment. PMID:26483952

  11. Effectiveness of Maxillomandibular advancement (MMA) surgery in sleep apnea treatment: Case report.

    PubMed

    Ferraz, Otávio; Guimarães, Thais M; Rossi, Rowdley R; Cunali, Paulo A; Fabbro, Cibele Dal; Chaves, Cauby M; Maluly, Milton; Bittencourt, Lia; Tufik, Sergio

    2016-01-01

    Obstructive sleep apnea (OSA) is characterized by episodes of pharyngeal collapse during sleep. Craniofacial alterations such as retrognathia are often found in OSA patients. Maxillomandibular advancement (MMA) surgeries increase the pharyngeal space and are a treatment option for OSA. The aim of this study was to present a successful case of MMA surgery in the treatment of OSA. A patient with moderate OSA (apnea-hypopnea index (AHI)=25.2) and mandibular retrognathism and Maxillomandibular asymmetry underwent MMA surgery. The apnea-hypopnea index (AHI) were considerably improved after six months (IAH =6.7) and one year of treatment (IAH=0.2).

  12. Migration and natural fate of a coal tar creosote plume. 2. Mass balance and biodegradation indicators

    NASA Astrophysics Data System (ADS)

    King, Mark W. G.; Barker, James F.; Devlin, John F.; Butler, Barbara J.

    1999-10-01

    A source of coal tar creosote was emplaced below the water table at CFB Borden to investigate natural attenuation processes for complex biodegradable mixtures. A mass balance indicated that ongoing transformation occurred for seven study compounds. Phenol migrated as a discrete slug plume and almost completely disappeared after 2 years, after being completely leached from the source early in the study. The m-xylene plume migrated outward to a maximum distance at approximately 2 years, and then receded back towards the source as the rate of mass flux out of the source decreased to below the overall rate of plume transformation. Carbazole showed similar behaviour, although the reversal in plume development occurred more slowly. The dibenzofuran plume remained relatively constant in extent and mass over the last 2 years of monitoring, despite constant source input over this period, providing evidence that the dibenzofuran plume was at steady state. Meanwhile, the naphthalene and 1-methylnaphthalene plumes continued to advance and increase in mass over the observation period, although at a decreasing rate. The phenanthrene plume was also subject to transformation, although measurement of the rate was less conclusive due to the higher proportion of sorbed mass for this compound. Three lines of evidence are presented to evaluate whether the observed plume mass loss was due to microbial biodegradation. Measurement of redox-sensitive parameters in the vicinity of the plume showed the types of changes that would be expected to occur due to plume biodegradation: dissolved oxygen and SO 42- decreased in groundwater within the plume while significant increases were noted for Fe 2+, Mn 2+ and methane. Further evidence that plume mass loss was microbially-mediated was provided by the accumulation of aromatic acids within the plume. Measurements of phospholipid fatty acids (PLFA) in aquifer material indicated that microbial biomass and turnover rate were greater within the plume

  13. Simulation of Europa's water plume .

    NASA Astrophysics Data System (ADS)

    Lucchetti, A.; Cremonese, G.; Schneider, N. M.; Plainaki, C.; Mazzotta Epifani, E.; Zusi, M.; Palumbo, P.

    Plumes on Europa would be extremely interesting science and mission targets, particularly due to the unique opportunity to obtain direct information on the subsurface composition, thereby addressing Europa's potential habitability. The existence of water plume on the Jupiter's moon Europa has been long speculated until the recent discover. HST imaged surpluses of hydrogen Lyman alpha and oxygen emissions above the southern hemisphere in December 2012 that are consistent with two 200 km high plumes of water vapor (Roth et al. 2013). In previous works ballistic cryovolcanism has been considered and modeled as a possible mechanism for the formation of low-albedo features on Europa's surface (Fagents et al. 2000). Our simulation agrees with the model of Fagents et al. (2000) and consists of icy particles that follow ballistic trajectories. The goal of such an analysis is to define the height, the distribution and the extension of the icy particles falling on the moon's surface as well as the thickness of the deposited layer. We expect to observe high albedo regions in contrast with the background albedo of Europa surface since we consider that material falling after a cryovolcanic plume consists of snow. In order to understand if this phenomenon is detectable we convert the particles deposit in a pixel image of albedo data. We consider also the limb view of the plume because, even if this detection requires optimal viewing geometry, it is easier detectable in principle against sky. Furthermore, we are studying the loss rates due to impact electron dissociation and ionization to understand how these reactions decrease the intensity of the phenomenon. We expect to obtain constraints on imaging requirements necessary to detect potential plumes that could be useful for ESA's JUICE mission, and in particular for the JANUS camera (Palumbo et al. 2014).

  14. Modeling Leaking Gas Plume Migration

    SciTech Connect

    Silin, Dmitriy; Patzek, Tad; Benson, Sally M.

    2007-08-20

    In this study, we obtain simple estimates of 1-D plume propagation velocity taking into account the density and viscosity contrast between CO{sub 2} and brine. Application of the Buckley-Leverett model to describe buoyancy-driven countercurrent flow of two immiscible phases leads to a transparent theory predicting the evolution of the plume. We obtain that the plume does not migrate upward like a gas bubble in bulk water. Rather, it stretches upward until it reaches a seal or until the fluids become immobile. A simple formula requiring no complex numerical calculations describes the velocity of plume propagation. This solution is a simplification of a more comprehensive theory of countercurrent plume migration that does not lend itself to a simple analytical solution (Silin et al., 2006). The range of applicability of the simplified solution is assessed and provided. This work is motivated by the growing interest in injecting carbon dioxide into deep geological formations as a means of avoiding its atmospheric emissions and consequent global warming. One of the potential problems associated with the geologic method of sequestration is leakage of CO{sub 2} from the underground storage reservoir into sources of drinking water. Ideally, the injected green-house gases will stay in the injection zone for a geologically long time and eventually will dissolve in the formation brine and remain trapped by mineralization. However, naturally present or inadvertently created conduits in the cap rock may result in a gas leak from primary storage. Even in supercritical state, the carbon dioxide viscosity and density are lower than those of the indigenous formation brine. Therefore, buoyancy will tend to drive the CO{sub 2} upward unless it is trapped beneath a low permeability seal. Theoretical and experimental studies of buoyancy-driven supercritical CO{sub 2} flow, including estimation of time scales associated with plume evolution, are critical for developing technology

  15. Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors

    PubMed Central

    Fecher, Leslie A; Sharfman, William H

    2015-01-01

    Cutaneous basal cell carcinoma (BCC) is the most common human cancer and its incidence is rising worldwide. Ultraviolet radiation exposure, including tanning bed use, as well as host factors play a role in its development. The majority of cases are treated and cured with local therapies including surgery. Yet, the health care costs of diagnosis and treatment of BCCs in the US is substantial. In the United States, the cost of nonmelanoma skin cancer care in the Medicare population is estimated to be US$426 million per year. While rare, locally advanced BCCs that can no longer be controlled with surgery and/or radiation, and metastatic BCCs do occur and can be associated with significant morbidity and mortality. Vismodegib (GDC-0449), a smoothened inhibitor targeted at the hedgehog pathway, is the first US Food and Drug Association (FDA)-approved agent in the treatment of locally advanced, unresectable, and metastatic BCCs. This class of agents appears to be changing the survival rates in advanced BCC patients, but appropriate patient selection and monitoring are important. Multidisciplinary assessments are essential for the optimal care and management of these patients. For some patients with locally advanced BCC, treatment with a hedgehog inhibitor may eliminate the need for an excessively disfiguring or morbid surgery. PMID:26604681

  16. Microbial populations in contaminant plumes

    NASA Astrophysics Data System (ADS)

    Haack, Sheridan K.; Bekins, Barbara A.

    Efficient biodegradation of subsurface contaminants requires two elements: (1) microbial populations with the necessary degradative capabilities, and (2) favorable subsurface geochemical and hydrological conditions. Practical constraints on experimental design and interpretation in both the hydrogeological and microbiological sciences have resulted in limited knowledge of the interaction between hydrogeological and microbiological features of subsurface environments. These practical constraints include: (1) inconsistencies between the scales of investigation in the hydrogeological and microbiological sciences, and (2) practical limitations on the ability to accurately define microbial populations in environmental samples. However, advances in application of small-scale sampling methods and interdisciplinary approaches to site investigations are beginning to significantly improve understanding of hydrogeological and microbiological interactions. Likewise, culture-based and molecular analyses of microbial populations in subsurface contaminant plumes have revealed significant adaptation of microbial populations to plume environmental conditions. Results of recent studies suggest that variability in subsurface geochemical and hydrological conditions significantly influences subsurface microbial-community structure. Combined investigations of site conditions and microbial-community structure provide the knowledge needed to understand interactions between subsurface microbial populations, plume geochemistry, and contaminant biodegradation. La biodégradation efficace des polluants souterrains requiert deux éléments: des populations microbiennes possédant les aptitudes nécessaires à la dégradation, et des conditions géochimiques et hydrologiques souterraines favorables. Des contraintes pratiques sur la conception et l'interprétation des expériences à la fois en microbiologie et en hydrogéologie ont conduit à une connaissance limitée des interactions entre les

  17. Mobile Bay turbidity plume study

    NASA Technical Reports Server (NTRS)

    Crozier, G. F.

    1976-01-01

    Laboratory and field transmissometer studies on the effect of suspended particulate material upon the appearance of water are reported. Quantitative correlations were developed between remotely sensed image density, optical sea truth data, and actual sediment load. Evaluation of satellite image sea truth data for an offshore plume projects contours of transmissivity for two different tidal phases. Data clearly demonstrate the speed of change and movement of the optical plume for water patterns associated with the mouth of Mobile bay in which relatively clear Gulf of Mexico water enters the bay on the eastern side. Data show that wind stress in excess of 15 knots has a marked impact in producing suspended sediment loads.

  18. What is changing in radiotherapy for the treatment of locally advanced nonsmall cell lung cancer patients? A review.

    PubMed

    Giaj-Levra, Niccoló; Ricchetti, Francesco; Alongi, Filippo

    2016-01-01

    Radiotherapy treatment continues to have a relevant impact in the treatment of nonsmall cell cancer (NSCLC). Use of concurrent chemotherapy and radiotherapy is considered the gold standard in the treatment of locally advanced NSCLC but clinical outcomes are not satisfactory. Introduction of new radiotherapy technology and chemotherapy regimens are under investigation in this setting with the goal to improve unsatisfactory results. We report how radiotherapy is changing in the treatment of locally advanced NSCLC.

  19. Results of the IAVCEI inter-comparison study of eruptive plume models

    NASA Astrophysics Data System (ADS)

    Costa, Antonio

    2016-04-01

    Volcanic plume heights are key observable data for estimating crucial parameters such as mass flow rate, and they are commonly used as input for dispersal models of tephra particles. Therefore, quantitative relationships between plume heights and eruption conditions are required. During the last decades, many 1D, 2D, and 3D models of volcanic plume have been proposed. In order to investigate the dependence of plume dynamics on the models and their assumptions, we carried out an inter-comparison study of the recent plume models (nine 1D models based on the buoyant plume theory and four 3D models). The study was designed as a test in which a set of common input parameters was given for two reference eruptions, representing a strong and a weak eruption column under different meteorological conditions. Comparing the results of the different models has allowed us to evaluate their capabilities and target areas for improvement. Despite their different formulations, the 1D and 3D models provide reasonably consistent predictions of some of the key global descriptors of the volcanic plumes. Variability in modeled plume height, estimated as standard deviation, is within ~20% for the weak plume and ~10% for the strong plume. Predictions of neutral buoyancy level are also in reasonably good agreement among the different models, with a standard deviation ranging from 9 to 19% (the latter for the weak plume in a windy atmosphere). Overall, these discrepancies are in the range of observational uncertainty of column height. However, there are important differences amongst models in terms of local properties along the plume axis, particularly for the strong plume. The analysis suggests that the simplified treatment of entrainment in 1D models is adequate to resolve the general behavior of the weak plume. However, it appears clearly inadequate to capture complex features of the strong plume, such as large vortices, partial column collapse, or gravitational fountaining that strongly

  20. Coastal nitrogen plumes and their relationship with seagrass distribution

    NASA Astrophysics Data System (ADS)

    Fernandes, Milena B.; Benger, Simon; Stuart-Williams, Hilary; Gaylard, Sam; Bryars, Simon

    2015-12-01

    Urbanised coastlines are affected by cumulative impacts from a variety of anthropogenic stressors, but spatial information on the distribution of these stressors at the local scale is scarce, hindering the ability of managers to prioritise mitigation options. This work investigated the spatial footprint of land-based nitrogen discharges to a metropolitan coastline and assessed the potential role of this stressor alone on seagrass dynamics at the scale of the ecosystem. The macroalga Caulocystis cephalornithos was used as a time-integrative sampler of nitrogen in the water column over 202 sites monitored across an area of ˜800 km2. The stable isotopic signature of nitrogen in tissues (δ15N) was used to map plumes of anthropogenic origin. The surface area of these plumes was found to be proportional to nitrogen loads from land. The largest plume was associated with discharges from an industrialised estuary and a wastewater treatment plant, where a monthly nitrogen load in excess of 110 tonnes affected an area >80 km2. The location and size of the plumes changed with seasons as a result of wind forcing and rainfall/wastewater reuse. The location of the plumes was compared to published seagrass distribution obtained from video transects. Dense seagrass meadows only occurred in areas unimpacted by plumes throughout the year, mostly in shallow (<5 m) regions for Amphibolis antarctica, and deeper (5-10 m) for Posidonia sp., possibly as a result of this species higher tolerance of low light conditions. This higher tolerance might also explain why Posidonia sp. is observed to preferentially recolonise areas of previous loss in the region. While a decrease in the spatial footprint of nutrient plumes has created conditions for natural seagrass recolonisation in some areas, it did not halt seagrass loss in others, suggesting the influence of additional stressors such as wave dynamics and light attenuation due to turbid/coloured stormwater.

  1. Overview of NASA GRCs Green Propellant Infusion Mission Thruster Testing and Plume Diagnostics

    NASA Technical Reports Server (NTRS)

    Deans, Matthew C.; Reed, Brian D.; Yim, John T.; Arrington, Lynn A.; Williams, George J.; Kojima, Jun J.; McLean, Christopher H.

    2014-01-01

    The Green Propellant Infusion Mission (GPIM) is sponsored by NASA's Space Technology Mission Directorate (STMD) Technology Demonstration Mission (TDM) office. The goal of GPIM is to advance the technology readiness level of a green propulsion system, specifically, one using the monopropellant, AF-M315E, by demonstrating ground handling, spacecraft processing, and on-orbit operations. One of the risks identified for GPIM is potential contamination of sensitive spacecraft surfaces from the effluents in the plumes of AF-M315E thrusters. NASA Glenn Research Center (GRC) is conducting activities to characterize the effects of AF-M315E plume impingement and deposition. GRC has established individual plume models of the 22-N and 1-N thrusters that will be used on the GPIM spacecraft. The models describe the pressure, temperature, density, Mach number, and species concentration of the AF-M315E thruster exhaust plumes. The models are being used to assess the impingement effects of the AF-M315E thrusters on the GPIM spacecraft. The model simulations will be correlated with plume measurement data from Laboratory and Engineering Model 22-N, AF-M315E thrusters. The thrusters will be tested in a small rocket, altitude facility at NASA GRC. The GRC thruster testing will be conducted at duty cycles representatives of the planned GPIM maneuvers. A suite of laser-based diagnostics, including Raman spectroscopy, Rayleigh spectroscopy, Schlieren imaging, and physical probes will be used to acquire plume measurements of AFM315E thrusters. Plume data will include temperature, velocity, relative density, and species concentration. The plume measurement data will be compared to the corresponding simulations of the plume model. The GRC effort will establish a data set of AF-M315E plume measurements and a plume model that can be used for future AF-M315E applications.

  2. Molecular Profiling-Selected Therapy for Treatment of Advanced Pancreaticobiliary Cancer: A Retrospective Multicenter Study.

    PubMed

    Epelbaum, Ron; Shacham-Shmueli, Einat; Klein, Baruch; Agbarya, Abed; Brenner, Baruch; Brenner, Ronen; Gez, Eliahu; Golan, Talia; Hubert, Ayala; Purim, Ofer; Temper, Mark; Tepper, Ella; Voss, Andreas; Russell, Kenneth; Dvir, Addie; Soussan-Gutman, Lior; Stemmer, Salomon M; Geva, Ravit

    2015-01-01

    This multicenter cohort study assessed the impact of molecular profiling (MP) on advanced pancreaticobiliary cancer (PBC). The study included 30 patients treated with MP-guided therapy after failing ≥ 1 therapy for advanced PBC. Treatment was considered as having benefit for the patient if the ratio between the longest progression-free survival (PFS) on MP-guided therapy and the PFS on the last therapy before MP was ≥ 1.3. The null hypothesis was that ≤ 15% of patients gain such benefit. Overall, ≥ 1 actionable (i.e., predictive of response to specific therapies) biomarker was identified/patient. Immunohistochemistry (the most commonly used method for guiding treatment decisions) identified 1-6 (median: 4) actionable biomarkers per patient. After MP, patients received 1-4 (median: 1) regimens/patient (most commonly, FOLFIRI/XELIRI). In a decision-impact analysis, of the 27 patients for whom treatment decisions before MP were available, 74.1% experienced a treatment decision change in the first line after MP. Twenty-four patients were evaluable for clinical outcome analysis; in 37.5%, the PFS ratio was ≥ 1.3. In one-sided exact binomial test versus the null hypothesis, P = 0.0015; therefore, the null hypothesis was rejected. In conclusion, our analysis demonstrated the feasibility, clinical decision impact, and potential clinical benefits of MP-guided therapy in advanced PBC.

  3. Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study.

    PubMed

    Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika

    2014-01-01

    Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

  4. Molecular Profiling-Selected Therapy for Treatment of Advanced Pancreaticobiliary Cancer: A Retrospective Multicenter Study

    PubMed Central

    Epelbaum, Ron; Shacham-Shmueli, Einat; Klein, Baruch; Agbarya, Abed; Brenner, Baruch; Brenner, Ronen; Gez, Eliahu; Golan, Talia; Hubert, Ayala; Purim, Ofer; Temper, Mark; Tepper, Ella; Voss, Andreas; Russell, Kenneth; Dvir, Addie; Soussan-Gutman, Lior; Stemmer, Salomon M.; Geva, Ravit

    2015-01-01

    This multicenter cohort study assessed the impact of molecular profiling (MP) on advanced pancreaticobiliary cancer (PBC). The study included 30 patients treated with MP-guided therapy after failing ≥1 therapy for advanced PBC. Treatment was considered as having benefit for the patient if the ratio between the longest progression-free survival (PFS) on MP-guided therapy and the PFS on the last therapy before MP was ≥1.3. The null hypothesis was that ≤15% of patients gain such benefit. Overall, ≥1 actionable (i.e., predictive of response to specific therapies) biomarker was identified/patient. Immunohistochemistry (the most commonly used method for guiding treatment decisions) identified 1–6 (median: 4) actionable biomarkers per patient. After MP, patients received 1–4 (median: 1) regimens/patient (most commonly, FOLFIRI/XELIRI). In a decision-impact analysis, of the 27 patients for whom treatment decisions before MP were available, 74.1% experienced a treatment decision change in the first line after MP. Twenty-four patients were evaluable for clinical outcome analysis; in 37.5%, the PFS ratio was ≥1.3. In one-sided exact binomial test versus the null hypothesis, P = 0.0015; therefore, the null hypothesis was rejected. In conclusion, our analysis demonstrated the feasibility, clinical decision impact, and potential clinical benefits of MP-guided therapy in advanced PBC. PMID:26161408

  5. Exhaust Nozzle Plume and Shock Wave Interaction

    NASA Technical Reports Server (NTRS)

    Castner, Raymond S.; Elmiligui, Alaa; Cliff, Susan

    2013-01-01

    Fundamental research for sonic boom reduction is needed to quantify the interaction of shock waves generated from the aircraft wing or tail surfaces with the exhaust plume. Both the nozzle exhaust plume shape and the tail shock shape may be affected by an interaction that may alter the vehicle sonic boom signature. The plume and shock interaction was studied using Computational Fluid Dynamics simulation on two types of convergent-divergent nozzles and a simple wedge shock generator. The nozzle plume effects on the lower wedge compression region are evaluated for two- and three-dimensional nozzle plumes. Results show that the compression from the wedge deflects the nozzle plume and shocks form on the deflected lower plume boundary. The sonic boom pressure signature of the wedge is modified by the presence of the plume, and the computational predictions show significant (8 to 15 percent) changes in shock amplitude.

  6. Advanced oxidation treatment of physico-chemically pre-treated olive mill industry effluent.

    PubMed

    Gomec, Cigdem Y; Erdim, Esra; Turan, Ilknur; Aydin, Ali F; Ozturk, Izzet

    2007-08-01

    In this study, the applicability of physico-chemical methods was investigated for the pre-treatment of the olive mill effluents prior to the discharge into the common sewerage ending with a municipal wastewater treatment plant. The samples were taken from an olive oil industry operated as three-phase process located in Turkey. Various pre-treatment methods including acid craking, polyelectrolyte and lime additions were applied. Advanced oxidation study using Fenton's process was also investigated following pre-treatment by acid cracking and cationic polyelectrolyte. Acid cracking alone gave satisfactory treatment efficiencies and polyelectrolite additions to the acid-cracked samples enhanced treatment efficiency. Since a complete treatment plant is available at the end of the sewer system, results indicated that the effluents of the investigated industry could be discharged into the municipal sewerage in the case of total chemical oxygen demand (COD(tot)), suspended solid (SS) and volatile suspended solid (VSS) concentrations according to the Turkish Water Pollution Control Regulation after pre-treatment with 5 ppm anionic polyelectrolyte following acid cracking. The minimum COD(tot), SS and VSS removals were observed when raw wastewater was pre-treated with lime and the discharge standards to the municipal sewer system could not be met. Advanced oxidation with Fenton's process was applied after acid cracking and cationic polyelectrolyte treatment in order to investigate further reduction in chemical oxygen demand (COD) concentration for minimizing the influence of this industrial discharge on the existing municipal wastewater treatment plant. Results indicated that COD(tot) removal increased up to 89% from 74% after Fenton's oxidation for the acid cracked samples in which cationic polyelectrolite (10 ppm) was added.

  7. Eyjafjallajokull Volcano Plume Particle-Type Characterization from Space-Based Multi-angle Imaging

    NASA Technical Reports Server (NTRS)

    Kahn, Ralph A.; Limbacher, James

    2012-01-01

    The Multi-angle Imaging SpectroRadiometer (MISR) Research Aerosol algorithm makes it possible to study individual aerosol plumes in considerable detail. From the MISR data for two optically thick, near-source plumes from the spring 2010 eruption of the Eyjafjallaj kull volcano, we map aerosol optical depth (AOD) gradients and changing aerosol particle types with this algorithm; several days downwind, we identify the occurrence of volcanic ash particles and retrieve AOD, demonstrating the extent and the limits of ash detection and mapping capability with the multi-angle, multi-spectral imaging data. Retrieved volcanic plume AOD and particle microphysical properties are distinct from background values near-source, as well as for overwater cases several days downwind. The results also provide some indication that as they evolve, plume particles brighten, and average particle size decreases. Such detailed mapping offers context for suborbital plume observations having much more limited sampling. The MISR Standard aerosol product identified similar trends in plume properties as the Research algorithm, though with much smaller differences compared to background, and it does not resolve plume structure. Better optical analogs of non-spherical volcanic ash, and coincident suborbital data to validate the satellite retrieval results, are the factors most important for further advancing the remote sensing of volcanic ash plumes from space.

  8. Smoke Plume Over Eastern Canada

    NASA Technical Reports Server (NTRS)

    2007-01-01

    In late May, a massive smoke plume hundreds of kilometers across blew eastward over New Brunswick toward the Atlantic Ocean. On May 26, 2007, the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA's Terra satellite captured this image at 11:40 a.m. local time. By the time MODIS took this picture, the smoke appeared to have completely detached itself from the source, a large fire burning in southwestern Quebec, beyond the western edge of this image. In this image, the smoke appears as a gray-beige opaque mass with fuzzy, translucent edges. The plume is thickest in the southwest and diminishes toward the northeast. Just southwest of the plume is a red outline indicating a hotspot an area where MODIS detected anomalously warm surface temperatures, such as those resulting from fires. This hotspot, however, is not the source for this smoke plume. According to a bulletin from the National Oceanic and Atmospheric Administration, the southwestern Quebec fire was the source. According to reports from the Canadian Interagency Forest Fire Centre on May 29, that fire was estimated at 63,211 hectares (156,197 acres), and it was classified as 'being held.' At the same time, more than 20 wildfires burned in Quebec, news sources reported, and firefighters from other Canadian provinces and the United States had been brought in to provide reinforcements for the area's firefighters.

  9. Heat sources for mantle plumes

    NASA Astrophysics Data System (ADS)

    Beier, C.; Rushmer, T.; Turner, S. P.

    2008-06-01

    Melting anomalies in the Earth's upper mantle have often been attributed to the presence of mantle plumes that may originate in the lower mantle, possibly from the core-mantle boundary. Globally, mantle plumes exhibit a large range in buoyancy flux that is proportional to their temperature and volume. Plumes with higher buoyancy fluxes should have higher temperatures and experience higher degrees of partial melting. This excess heat in mantle plumes could reflect either (1) an enrichment of the heat-producing elements (HPE: U, Th, K) in their mantle source leading to an increase of heat production by radioactive decay, (2) material transport from core to mantle (either advective or diffusive), or (3) conductive heat transport across the core-mantle boundary. The advective/diffusive transport of heat may result in a physical contribution of material from the core to the lower mantle. If core material is incorporated into the lower mantle, mantle plumes with a higher buoyancy flux should have higher core tracers, e.g., increased 186Os, 187Os, and Fe concentrations. Geophysical and dynamic modeling indicate that at least Afar, Easter, Hawaii, Louisville, and Samoa may all originate at the core-mantle boundary. These plumes encompass the whole range of known buoyancy fluxes from 0.9 Mg s-1 (Afar) to 8.7 Mg s-1 (Hawaii), providing evidence that the buoyancy flux is largely independent of other geophysical parameters. In an effort to explore whether the heat-producing elements are the cause of excess heat we looked for correlations between fractionation-corrected concentrations of the HPE and buoyancy flux. Our results suggest that there is no correlation between HPE concentrations and buoyancy flux (with and without an additional correction for variable degrees of partial melting). As anticipated, K, Th, and U are positively correlated with each other (e.g., Hawaii, Iceland, and Galapagos have significantly lower concentrations than, e.g., Tristan da Cunha, the Canary

  10. Chesapeake Bay plume dynamics from LANDSAT

    NASA Technical Reports Server (NTRS)

    Munday, J. C., Jr.; Fedosh, M. S.

    1981-01-01

    LANDSAT images with enhancement and density slicing show that the Chesapeake Bay plume usually frequents the Virginia coast south of the Bay mouth. Southwestern (compared to northern) winds spread the plume easterly over a large area. Ebb tide images (compared to flood tide images) show a more dispersed plume. Flooding waters produce high turbidity levels over the shallow northern portion of the Bay mouth.

  11. Downwelling wind, tides, and estuarine plume dynamics

    NASA Astrophysics Data System (ADS)

    Lai, Zhigang; Ma, Ronghua; Huang, Mingfen; Chen, Changsheng; Chen, Yong; Xie, Congbin; Beardsley, Robert C.

    2016-06-01

    The estuarine plume dynamics under a downwelling-favorable wind condition were examined in the windy dry season of the Pearl River Estuary (PRE) using the PRE primitive-equation Finite-Volume Community Ocean Model (FVCOM). The wind and tide-driven estuarine circulation had a significant influence on the plume dynamics on both local and remote scales. Specifically, the local effect of downwelling-favorable winds on the plume was similar to the theoretical descriptions of coastal plumes, narrowing the plume width, and setting up a vertically uniform downstream current at the plume edge. Tides tended to reduce these plume responses through local turbulent mixing and advection from upstream regions, resulting in an adjustment of the isohalines in the plume and a weakening of the vertically uniform downstream current. The remote effect of downwelling-favorable winds on the plume was due to the wind-induced estuarine sea surface height (SSH), which strengthened the estuarine circulation and enhanced the plume transport accordingly. Associated with these processes, tide-induced mixing tended to weaken the SSH gradient and thus the estuarine circulation over a remote influence scale. Overall, the typical features of downwelling-favorable wind-driven estuarine plumes revealed in this study enhanced our understanding of the estuarine plume dynamics under downwelling-favorable wind conditions.

  12. Advances in the Classification and Treatment of Mastocytosis: Current Status and Outlook toward the Future.

    PubMed

    Valent, Peter; Akin, Cem; Hartmann, Karin; Nilsson, Gunnar; Reiter, Andreas; Hermine, Olivier; Sotlar, Karl; Sperr, Wolfgang R; Escribano, Luis; George, Tracy I; Kluin-Nelemans, Hanneke C; Ustun, Celalettin; Triggiani, Massimo; Brockow, Knut; Gotlib, Jason; Orfao, Alberto; Schwartz, Lawrence B; Broesby-Olsen, Sigurd; Bindslev-Jensen, Carsten; Kovanen, Petri T; Galli, Stephen J; Austen, K Frank; Arber, Daniel A; Horny, Hans-Peter; Arock, Michel; Metcalfe, Dean D

    2017-03-02

    Mastocytosis is a term used to denote a heterogeneous group of conditions defined by the expansion and accumulation of clonal (neoplastic) tissue mast cells in various organs. The classification of the World Health Organization (WHO) divides the disease into cutaneous mastocytosis, systemic mastocytosis, and localized mast cell tumors. On the basis of histomorphologic criteria, clinical parameters, and organ involvement, systemic mastocytosis is further divided into indolent systemic mastocytosis and advanced systemic mastocytosis variants, including aggressive systemic mastocytosis and mast cell leukemia. The clinical impact and prognostic value of this classification has been confirmed in numerous studies, and its basic concept remains valid. However, refinements have recently been proposed by the consensus group, the WHO, and the European Competence Network on Mastocytosis. In addition, new treatment options are available for patients with advanced systemic mastocytosis, including allogeneic hematopoietic stem cell transplantation and multikinase inhibitors directed against KIT D816V and other key signaling molecules. Our current article provides an overview of recent advances in the field of mastocytosis, with emphasis on classification, prognostication, and emerging new treatment options in advanced systemic mastocytosis. Cancer Res; 77(6); 1-10. ©2017 AACR.

  13. Modelling the plasma plume of an assist source in PIAD

    NASA Astrophysics Data System (ADS)

    Wauer, Jochen; Harhausen, Jens; Foest, Rüdiger; Loffhagen, Detlef

    2016-09-01

    Plasma ion assisted deposition (PIAD) is a technique commonly used to produce high-precision optical interference coatings. Knowledge regarding plasma properties is most often limited to dedicated scenarios without film deposition. Approaches have been made to gather information on the process plasma in situ to detect drifts which are suspected to cause limits in repeatability of resulting layer properties. Present efforts focus on radiance monitoring of the plasma plume of an Advanced Plasma Source (APSpro, Bühler) by optical emission spectroscopy to provide the basis for an advanced plasma control. In this contribution modelling results of the plume region are presented to interpret these experimental data. In the framework of the collisional radiative model used, 15 excited neutral argon states in the plasma are considered. Results of the species densities show good consistency with the measured optical emission of various argon 2 p - 1 s transitions. This work was funded by BMBF under grant 13N13213.

  14. Identifying locally advanced basal cell carcinoma eligible for treatment with vismodegib: an expert panel consensus.

    PubMed

    Peris, Ketty; Licitra, Lisa; Ascierto, Paolo A; Corvò, Renzo; Simonacci, Marco; Picciotto, Franco; Gualdi, Giulio; Pellacani, Giovanni; Santoro, Armando

    2015-01-01

    Basal cell carcinoma (BCC) is the most common skin cancer worldwide. Most occur on the head and neck, where cosmetic and functional outcomes are critical. BCC can be locally destructive if not diagnosed early and treated appropriately. Surgery is the treatment of choice for the majority of high-risk lesions. Aggressive, recurrent or unresectable tumors can be difficult to manage. Until recently, no approved systemic therapy was available for locally advanced or metastatic BCC inappropriate for surgery or radiotherapy. Vismodegib provides a systemic treatment option. However, a consensus definition of advanced BCC is lacking. A multidisciplinary panel with expertise in oncology, dermatology, dermatologic surgery and radiation oncology proposes a consensus definition based on published evidence and clinical experience.

  15. Curative effect of the recent photofrin photodynamic adjuvant treatment on young patients with advanced colorectal cancer

    PubMed Central

    SUN, BO; LI, WEI; LIU, NING

    2016-01-01

    Advanced colorectal cancer has a high mortality rate and conventional treatments have poor therapeutic effects. The aim of the present study was to analyze the recent curative effect and adverse reaction of photofrin photodynamic adjuvant treatment on young patients with advanced colorectal cancer. A total of 23 patients with advanced colorectal cancer who had accepted semiconductor laser photodynamic adjuvant treatment were selected as the observation group. In addition, 30 patients who had accepted concurrent radiotherapy and chemotherapy during the same period served as the control group. The observation group received photofrin (2 mg/kg) intravenously in 100 ml of 5% glucose, followed by the introduction of the endoscopic optical fiber to deliver laser radiation with an intensity of 630 nm wavelength pulse power. After 2 days, necrotic tissues were removed and irradiation of the original or new tumor lesions was performed and necrotic tissues were removed. The total effective rate and survival time was higher and the length of hospital stay was shorter in the observation group in comparison with the control group. The differences were statistically significant (P<0.05). The number of patients in the control and observation groups with symptoms of hematochezia, change in bowel habit, intestinal stimulation and incomplete intestinal obstruction were reduced. Additionally, the reduced ratio of the observation group was significantly increased in comparison with the control group (P<0.05). The adverse reaction rate of the observation group was lower than that of the control group and this difference was also statistically significant (P<0.05). In conclusion, use of photodynamic treatment for young patients with advanced colorectal cancer can effectively improve the clinical symptoms and reduce complications. PMID:26998124

  16. Vinflunine in the treatment of advanced urothelial cancer: clinical evidence and experience

    PubMed Central

    Gerullis, Holger; Wawroschek, Friedhelm; Köhne, Claus-Henning; Ecke, Thorsten Holger

    2016-01-01

    Vinflunine (VFL) has been approved in Europe for second-line treatment of metastatic and advanced urothelial cancer after failure of platin-containing therapy. Since approval, the drug has been investigated in few clinical trials. Most of the currently available reports describe experiences with VFL in a daily clinical setting. This review gives a short overview on clinical experiences and clinical trials involving VFL since the approval of this drug in 2009. PMID:28042310

  17. Advanced diagnostic imaging and surgical treatment of an odontogenic retromasseteric abscess in a guinea pig.

    PubMed

    Capello, V; Lennox, A

    2015-02-01

    A two-year-old guinea pig presented for difficulty chewing. Examination and diagnostic imaging, including computed tomography and magnetic resonance, revealed an odontogenic retromasseteric abscess associated with a mandibular cheek tooth. Treatment included removal of the abscess and marsupialisation of the surgical site for repeated debridement and healing by second intention. Unique features of this case included the use of advanced diagnostic imaging and utilisation of marsupialisation for surgical correction.

  18. High intensity focused ultrasound treatment of small renal masses: Clinical effectiveness and technological advances

    PubMed Central

    Nabi, G.; Goodman, C.; Melzer, A.

    2010-01-01

    The review summarises the technological advances in the application of high-intensity focused ultrasound for small renal masses presumed to be cancer including the systematic review of its clinical application. Current progress in the area of magnetic resonance image guided ultrasound ablation is also appraised. Specifically, organ tracking and real time monitoring of temperature changes during the treatment are discussed. Finally, areas of future research interest are outlined. PMID:21116349

  19. Prediction of rocket plume radiative heating using backward Monte-Carlo method

    NASA Technical Reports Server (NTRS)

    Wang, K. C.

    1993-01-01

    A backward Monte-Carlo plume radiation code has been developed to predict rocket plume radiative heating to the rocket base region. This paper provides a description of this code and provides sample results. The code was used to predict radiative heating to various locations during test firings of 48-inch solid rocket motors at NASA Marshall Space Flight Center. Comparisons with test measurements are provided. Predictions of full scale sea level Redesigned Solid Rocket Motor (RSRM) and Advanced Solid Rocket Motor (ASRM) plume radiative heating to the Space Shuttle external tank (ET) dome center were also made. A comparison with the Development Flight Instrumentation (DFI) measurements is also provided.

  20. Advanced treatment of effluents from an industrial park wastewater treatment plant by ferrous ion activated persulfate oxidation process.

    PubMed

    Zhu, Songmei; Zhou, Zhen; Jiang, Haitao; Ye, Jianfeng; Ren, Jiamin; Gu, Lingyun; Wang, Luochun

    The advanced oxidation technology, ferrous ion (Fe(II)) activated persulfate (PS) producing sulfate radicals, was used for the advanced treatment of effluent from an integrated wastewater treatment plant in a papermaking industrial park. Separate and interactive effects of PS dosage, Fe(II)/PS ratio and initial pH on chemical oxygen demand (COD) removal were analyzed by the response surface methodology (RSM). The results showed that Fe(II)-PS system was effective in COD removal from the secondary effluent. PS dosage was the most dominant factor with positive influence on COD removal, followed by initial pH value. The optimum conditions with COD removal of 54.4% were obtained at PS/COD of 2.2, initial pH of 6.47 and Fe(II)/PS of 1.89. UV-visible spectrum analysis showed that after RSM optimization, Fe(II)-PS system effectively degraded large organic molecules into small ones, and decreased humification degree of the effluent. Three-dimensional fluorescence analysis demonstrated that aromatic protein and fulvic substances were fully decomposed by the Fe(II)-PS treatment.

  1. Comprehensive treatment in a case with advanced chronic periodontitis: a 15-year follow-up.

    PubMed

    Zafiropoulos, Gregory-George; Rebbe, Jochen

    2010-01-01

    This case report describes the comprehensive treatment of generalized, advanced periodontal disease and full-mouth rehabilitation in an adult patient. Given the extensive periodontal tissue destruction, a systematic approach was needed to determine restoration possibilities and patient expectations. Subsequent oral rehabilitation was accomplished with fixed dentures in the mandible and a removable denture in the maxilla. In the maxilla, strategically important anchor teeth were replaced with implants and a palate-free horseshoe-shaped removable denture was fabricated, using telescopic crowns as abutments. This case indicates that long-term post-treatment periodontal stability can be ensured only by full patient cooperation and consistent periodontal maintenance.

  2. Endocrine therapy for hormone treatment-naïve advanced breast cancer.

    PubMed

    Martin, Miguel; Lopez-Tarruella, Sara; Gilarranz, Yolanda Jerez

    2016-08-01

    A proportion of patients with hormone receptor-positive locally advanced or metastatic breast cancer will not have received prior endocrine therapy. However, there are limited clinical data specifically in these patients. We conducted a review of randomized phase II and III clinical studies of anastrozole, letrozole, exemestane, palbociclib, and fulvestrant to determine the evidence base supporting use of specific endocrine therapies in this patient population. From our findings, there is a paucity of clinical studies in patients with endocrine therapy-naïve disease; however, it appears that first-line treatment effects are consistent between patients who have and have not received prior endocrine treatment.

  3. Advances in understanding itching and scratching: a new era of targeted treatments

    PubMed Central

    Sanders, Kristen M.; Nattkemper, Leigh A.; Yosipovitch, Gil

    2016-01-01

    Chronic itch is a significant health burden with few effective treatments. As such, itch researchers seek to understand the mechanisms behind itch and to find potential targets for treatment. The field of itch research is dynamic, and many advances have been made so far this decade. In particular, major steps forward include the identification of new peripheral and central itch mediators and modulators, the discovery of greater roles for immune cells and glia in itch transmission, and a focus on the brain processing of itching and scratching. Finally, several new therapeutic interventions for itch have shown success in clinical trials. PMID:27610225

  4. Successful Surface Treatments for Reducing Instabilities in Advanced Nickel-base Superalloys for Turbine Blades

    NASA Technical Reports Server (NTRS)

    Locci, Ivan E.; MacKay, Rebecca A.; Garg, Anita; Ritzert, Frank J.

    2004-01-01

    An optimized carburization treatment has been developed to mitigate instabilities that form in the microstructures of advanced turbine airfoil materials. Current turbine airfoils consist of a single crystal superalloy base that provides the mechanical performance of the airfoil, a thermal barrier coating (TBC) that reduces the temperature of the base superalloy, and a bondcoat between the superalloy and the TBC, that improves the oxidation and corrosion resistance of the base superalloy and the spallation resistance of the TBC. Advanced nickel-base superalloys containing high levels of refractory metals have been observed to develop an instability called secondary reaction zone (SRZ), which can form beneath diffusion aluminide bondcoats. This instability between the superalloy and the bondcoat has the potential of reducing the mechanical properties of thin-wall turbine airfoils. Controlled gas carburization treatments combined with a prior stress relief heat treatment and adequate surface preparation have been utilized effectively to minimize the formation of SRZ. These additional processing steps are employed before the aluminide bondcoat is deposited and are believed to change the local chemistry and local stresses of the surface of the superalloy. This paper presents the detailed processing steps used to reduce SRZ between platinum aluminide bondcoats and advanced single crystal superalloys.

  5. Salvage treatment with apatinib for advanced non-small-cell lung cancer

    PubMed Central

    Song, Zhengbo; Yu, Xinmin; Lou, Guangyuan; Shi, Xun; Zhang, Yiping

    2017-01-01

    Objective No definitive chemotherapeutic regimen has been established in patients with non-small-cell lung cancer (NSCLC) who failed second- or third-line treatment. The aim of this study was to evaluate apatinib, a VEGFR-2 inhibitor, in advanced NSCLC as salvage treatment. Methods We evaluated the efficacy and toxicity of apatinib in patients with previously treated advanced NSCLC from 2014 to 2015 in Zhejiang Cancer Hospital. Survival analysis was performed by the Kaplan–Meier method. Results Forty-two patients were included in the present study. Four patients achieved partial response, and 22 achieved stable disease, representing a response rate of 9.5% and a disease control rate of 61.9%. Median progression-free survival and overall survival were 4.2 and 6.0 months, respectively. The toxicities associated with apatinib were generally acceptable with a total grade 3/4 toxicity of 50%. Conclusion Apatinib appears to have some activity against advanced NSCLC when utilized as salvage treatment. PMID:28367065

  6. Treatment of winery wastewater by physicochemical, biological and advanced processes: a review.

    PubMed

    Ioannou, L A; Li Puma, G; Fatta-Kassinos, D

    2015-04-09

    Winery wastewater is a major waste stream resulting from numerous cleaning operations that occur during the production stages of wine. The resulting effluent contains various organic and inorganic contaminants and its environmental impact is notable, mainly due to its high organic/inorganic load, the large volumes produced and its seasonal variability. Several processes for the treatment of winery wastewater are currently available, but the development of alternative treatment methods is necessary in order to (i) maximize the efficiency and flexibility of the treatment process to meet the discharge requirements for winery effluents, and (ii) decrease both the environmental footprint, as well as the investment/operational costs of the process. This review, presents the state-of-the-art of the processes currently applied and/or tested for the treatment of winery wastewater, which were divided into five categories: i.e., physicochemical, biological, membrane filtration and separation, advanced oxidation processes, and combined biological and advanced oxidation processes. The advantages and disadvantages, as well as the main parameters/factors affecting the efficiency of winery wastewater treatment are discussed. Both bench- and pilot/industrial-scale processes have been considered for this review.

  7. Electrochemical advanced oxidation and biological processes for wastewater treatment: a review of the combined approaches.

    PubMed

    Ganzenko, Oleksandra; Huguenot, David; van Hullebusch, Eric D; Esposito, Giovanni; Oturan, Mehmet A

    2014-01-01

    As pollution becomes one of the biggest environmental challenges of the twenty-first century, pollution of water threatens the very existence of humanity, making immediate action a priority. The most persistent and hazardous pollutants come from industrial and agricultural activities; therefore, effective treatment of this wastewater prior to discharge into the natural environment is the solution. Advanced oxidation processes (AOPs) have caused increased interest due to their ability to degrade hazardous substances in contrast to other methods, which mainly only transfer pollution from wastewater to sludge, a membrane filter, or an adsorbent. Among a great variety of different AOPs, a group of electrochemical advanced oxidation processes (EAOPs), including electro-Fenton, is emerging as an environmental-friendly and effective treatment process for the destruction of persistent hazardous contaminants. The only concern that slows down a large-scale implementation is energy consumption and related investment and operational costs. A combination of EAOPs with biological treatment is an interesting solution. In such a synergetic way, removal efficiency is maximized, while minimizing operational costs. The goal of this review is to present cutting-edge research for treatment of three common and problematic pollutants and effluents: dyes and textile wastewater, olive processing wastewater, and pharmaceuticals and hospital wastewater. Each of these types is regarded in terms of recent scientific research on individual electrochemical, individual biological and a combined synergetic treatment.

  8. National consensus in China on diagnosis and treatment of patients with advanced breast cancer

    PubMed Central

    Hu, Xichun; Jiang, Zefei; Li, Huiping; Chen, Jiayi; Cui, Shude; Li, Qing; Liao, Ning; Liu, Donggeng; Liu, Jian; Lu, Jinsong; Shen, Kunwei; Sun, Tao; Teng, Yuee; Tong, Zhongsheng; Wang, Shulian; Wang, Xiang; Wang, Xiaojia; Wang, Yongsheng; Wu, Jiong; Yuan, Peng; Zhang, Pin; Zhang, Qingyuan; Zheng, Hong; Pang, Da; Ren, Guosheng; Shao, Zhimin; Shen, Zhenzhou; Song, Erwei; Song, Santai

    2015-01-01

    The recently available guidelines on the management of advanced breast cancer (ABC) organized by Chinese Anti-Cancer Association, Committee of Breast Cancer Society (CACA-CBCS) do not elucidate ABC in details. To instruct clinicians in treatment of ABC, a Chinese expert consensus meeting on diagnosis and treatment of ABC was held in June 2014 and a consensus is developed. The following consensus provides the level of evidence and supporting documents for each recommendation, and introduces research topics to be urgently addressed. Notably, the consensus on diagnosis and treatment of ABC in China is developed to be applied nationwide. In different areas, multidisciplinary treatment (MDT) tailored to the each patient and the disease itself should be applied based on the basic principles of modern oncology. PMID:26605288

  9. The Influence of Frontal Lobe Tumors and Surgical Treatment on Advanced Cognitive Functions.

    PubMed

    Fang, Shengyu; Wang, Yinyan; Jiang, Tao

    2016-07-01

    Brain cognitive functions affect patient quality of life. The frontal lobe plays a crucial role in advanced cognitive functions, including executive function, meta-cognition, decision-making, memory, emotion, and language. Therefore, frontal tumors can lead to serious cognitive impairments. Currently, neurosurgical treatment is the primary method to treat brain tumors; however, the effects of the surgical treatments are difficult to predict or control. The treatment may both resolve the effects of the tumor to improve cognitive function or cause permanent disabilities resulting from damage to healthy functional brain tissue. Previous studies have focused on the influence of frontal lesions and surgical treatments on patient cognitive function. Here, we review cognitive impairment caused by frontal lobe brain tumors.

  10. Recent advances and industrial viewpoint for biological treatment of wastewaters by oleaginous microorganisms.

    PubMed

    Huang, Chao; Luo, Mu-Tan; Chen, Xue-Fang; Xiong, Lian; Li, Xiao-Mei; Chen, Xin-De

    2017-02-20

    Recently, technology of using oleaginous microorganisms for biological treatment of wastewaters has become one hot topic in biochemical and environmental engineering for its advantages such as easy for operation in basic bioreactor, having potential to produce valuable bio-products, efficient wastewaters treatment in short period, etc. To promote its industrialization, this article provides some comprehensive analysis of this technology such as its advances, issues, and outlook especially from industrial viewpoint. In detail, the types of wastewaters can be treated and the kinds of oleaginous microorganisms used for biological treatment are introduced, the potential of industrial application and issues (relatively low COD removal, low lipid yield, cost of operation, and lack of scale up application) of this technology are presented, and some critical outlook mainly on co-culture method, combination with other treatments, process controlling and adjusting are discussed systematically. By this article, some important information to develop this technology can be obtained.

  11. Energy efficient--advanced oxidation process for treatment of cyanide containing automobile industry wastewater.

    PubMed

    Mudliar, R; Umare, S S; Ramteke, D S; Wate, S R

    2009-05-30

    Destruction of cyanide (CN) from an automobile industry wastewater by advance oxidation process (AOP) has been evaluated. The operating conditions (in an indigenously designed photoreactor) for three different treatment strategies have been optimized. The treatment strategies involved use of, ultra violet light (UV), hydrogen peroxide (H(2)O(2)) and ozone (O(3)) in various combinations. Treatment of automobile industry wastewater (250 mg/L CN) showed fastest CN destruction, which was significantly (P<0.05) faster than that observed with synthetic wastewater (with similar CN concentration). A combined application of H(2)O(2)/O(3) was found to be the best option for maximum CN destruction. This treatment allows CN to reach the regional/international limit (of 0.02 mg/L) for safe industrial wastewater discharges to the receiving water bodies. The specific energy consumption by the photoreactor following this treatment was comparable to that obtained by conventional treatments, which use photocatalyst. Since the present treatment does not use catalyst, it provides an excellent energy efficient and economical option for treatment and safe disposal of CN containing industrial wastewater.

  12. Integration of advanced oxidation processes at mild conditions in wet scrubbers for odourous sulphur compounds treatment.

    PubMed

    Vega, Esther; Martin, Maria J; Gonzalez-Olmos, Rafael

    2014-08-01

    The effectiveness of different advanced oxidation processes on the treatment of a multicomponent aqueous solution containing ethyl mercaptan, dimethyl sulphide and dimethyl disulphide (0.5 mg L(-1) of each sulphur compound) was investigated with the objective to assess which one is the most suitable treatment to be coupled in wet scrubbers used in odour treatment facilities. UV/H2O2, Fenton, photo-Fenton and ozone treatments were tested at mild conditions and the oxidation efficiency obtained was compared. The oxidation tests were carried out in magnetically stirred cylindrical quartz reactors using the same molar concentration of oxidants (hydrogen peroxide or ozone). The results show that ozone and photo-Fenton are the most efficient treatments, achieving up to 95% of sulphur compounds oxidation and a mineralisation degree around 70% in 10 min. Furthermore, the total costs of the treatments taking into account the capital and operational costs were also estimated for a comparative purpose. The economic analysis revealed that the Fenton treatment is the most economical option to be integrated in a wet scrubber to remove volatile organic sulphur compounds, as long as there are no space constraints to install the required reactor volume. In the case of reactor volume limitation or retrofitting complexities, the ozone and photo-Fenton treatments should be considered as viable alternatives.

  13. Magnetite nanoparticles for cancer diagnosis, treatment, and treatment monitoring: recent advances

    PubMed Central

    Revia, Richard A.; Zhang, Miqin

    2016-01-01

    The development of nanoparticles (NPs) for use in all facets of oncological disease detection and therapy has shown great progress over the past two decades. NPs have been tailored for use as contrast enhancement agents for imaging, drug delivery vehicles, and most recently as a therapeutic component in initiating tumor cell death in magnetic and photonic ablation therapies. Of the many possible core constituents of NPs, such as gold, silver, carbon nanotubes, fullerenes, manganese oxide, lipids, micelles, etc., iron oxide (or magnetite) based NPs have been extensively investigated due to their excellent superparamagnetic, biocompatible, and biodegradable properties. This review addresses recent applications of magnetite NPs in diagnosis, treatment, and treatment monitoring of cancer. Finally, some views will be discussed concerning the toxicity and clinical translation of iron oxide NPs and the future outlook of NP development to facilitate multiple therapies in a single formulation for cancer theranostics. PMID:27524934

  14. Insights into Coignimbrite Plume Dynamics from Numerical Models

    NASA Astrophysics Data System (ADS)

    Engwell, S. L.; De'Michieli Vitturi, M.; Barsotti, S.; Eychenne, J.; Esposti Ongaro, T.; Neri, A.

    2014-12-01

    Great advances have been made in recent years to better understand and model the processes that occur in Plinian plumes. However, comparatively little work has been conducted on modeling coignimbrite plumes, which form as fine-grained material is lofted from the top of pyroclastic density currents, rising into the atmosphere due to buoyancy. This fundamental difference in source condition (gas thrust vs. buoyancy) means that the parameters used to describe Plinian plumes, for example initial source radius, upwards velocity, temperature, gas mass fraction and grain-size distribution are not appropriate for modeling coignimbrite events. In this study, the ash flow model of Bursik and Woods (1996) is coupled with a plume model (Bursik 2001, Barsotti et al. 2008) to investigate the controls on coignimbrite plume formation, and once formed, the height and dynamics of the plume. Sensitivity analysis was conducted using DAKOTA software and results show that source temperature and gas mass fraction play a key role in controlling when 'lift-off' occurs. Once formed, maximum plume height is controlled by the source radius, the temperature at 'liftoff' and the entrainment assumption. Finally, we use the May 18th 1980 Mount St. Helens co-blast eruption to test the application of an ash dispersion model, specifically VOLCALPUFF (Barsotti et al., 2008), to the coignimbrite problem, with the specific aim of distinguishing differences in application for coignimbrite and Plinian events. The results highlight the importance of coignimbrite events when considering ash fall hazard and a requirement to treat such events separately to Plinian events. Andrews, B.J. and Manga, M.. JVGR , 225-226, 30-44, 2012 Barsotti, S, Neri, A, and Scire, JS. The vol-calpuff model for atmospheric ash dispersal: 1. Approach and physical formulation. JGR, 113(B03208), 2008 Bursik, M. Effect of wind on the rise height of volcanic plumes. GRL, 28(18), 3621-3624, 2001. Bursik, M and Woods, A. W. The dynamics

  15. Turbulent forces within river plumes affect spread

    NASA Astrophysics Data System (ADS)

    Bhattacharya, Atreyee

    2012-08-01

    When rivers drain into oceans through narrow mouths, hydraulic forces squeeze the river water into buoyant plumes that are clearly visible in satellite images. Worldwide, river plumes not only disperse freshwater, sediments, and nutrients but also spread pollutants and organisms from estuaries into the open ocean. In the United States, the Columbia River—the largest river by volume draining into the Pacific Ocean from North America—generates a plume at its mouth that transports juvenile salmon and other fish into the ocean. Clearly, the behavior and spread of river plumes, such as the Columbia River plume, affect the nation's fishing industry as well as the global economy.

  16. Liquid Booster Module (LBM) plume flowfield model

    NASA Technical Reports Server (NTRS)

    Smith, S. D.

    1981-01-01

    A complete definition of the LBM plume is important for many Shuttle design criteria. The exhaust plume shape has a significant effect on the vehicle base pressure. The LBM definition is also important to the Shuttle base heating, aerodynamics and the influence of the exhaust plume on the launch stand and environment. For these reasons a knowledge of the LBM plume characteristics is necessary. A definition of the sea level LBM plume as well as at several points along the Shuttle trajectory to LBM, burnout is presented.

  17. Inland Treatment of the Brine Generated from Reverse Osmosis Advanced Membrane Wastewater Treatment Plant Using Epuvalisation System

    PubMed Central

    Qurie, Mohannad; Abbadi, Jehad; Scrano, Laura; Mecca, Gennaro; Bufo, Sabino A.; Khamis, Mustafa; Karaman, Rafik

    2013-01-01

    The reverse osmosis (RO) brine generated from the Al-Quds University wastewater treatment plant was treated using an epuvalisation system. The advanced integrated wastewater treatment plant included an activated sludge unit, two consecutive ultrafiltration (UF) membrane filters (20 kD and 100 kD cutoffs) followed by an activated carbon filter and a reverse osmosis membrane. The epuvalisation system consisted of salt tolerant plants grown in hydroponic channels under continuous water flowing in a closed loop system, and placed in a greenhouse at Al-Quds University. Sweet basil (Ocimum basilicum) plants were selected, and underwent two consecutive hydroponic flowing stages using different brine-concentrations: an adaptation stage, in which a 1:1 mixture of brine and fresh water was used; followed by a functioning stage, with 100% brine. A control treatment using fresh water was included as well. The experiment started in April and ended in June (2012). At the end of the experiment, analysis of the effluent brine showed a remarkable decrease of electroconductivity (EC), PO43−, chemical oxygen demand (COD) and K+ with a reduction of 60%, 74%, 70%, and 60%, respectively, as compared to the influent. The effluent of the control treatment showed 50%, 63%, 46%, and 90% reduction for the same parameters as compared to the influent. Plant growth parameters (plant height, fresh and dry weight) showed no significant difference between fresh water and brine treatments. Obtained results suggest that the epuvalisation system is a promising technique for inland brine treatment with added benefits. The increasing of channel number or closed loop time is estimated for enhancing the treatment process and increasing the nutrient uptake. Nevertheless, the epuvalisation technique is considered to be simple, efficient and low cost for inland RO brine treatment. PMID:23823802

  18. Inland treatment of the brine generated from reverse osmosis advanced membrane wastewater treatment plant using epuvalisation system.

    PubMed

    Qurie, Mohannad; Abbadi, Jehad; Scrano, Laura; Mecca, Gennaro; Bufo, Sabino A; Khamis, Mustafa; Karaman, Rafik

    2013-07-03

    The reverse osmosis (RO) brine generated from the Al-Quds University wastewater treatment plant was treated using an epuvalisation system. The advanced integrated wastewater treatment plant included an activated sludge unit, two consecutive ultrafiltration (UF) membrane filters (20 kD and 100 kD cutoffs) followed by an activated carbon filter and a reverse osmosis membrane. The epuvalisation system consisted of salt tolerant plants grown in hydroponic channels under continuous water flowing in a closed loop system, and placed in a greenhouse at Al-Quds University. Sweet basil (Ocimum basilicum) plants were selected, and underwent two consecutive hydroponic flowing stages using different brine-concentrations: an adaptation stage, in which a 1:1 mixture of brine and fresh water was used; followed by a functioning stage, with 100% brine. A control treatment using fresh water was included as well. The experiment started in April and ended in June (2012). At the end of the experiment, analysis of the effluent brine showed a remarkable decrease of electroconductivity (EC), PO43-, chemical oxygen demand (COD) and K+ with a reduction of 60%, 74%, 70%, and 60%, respectively, as compared to the influent. The effluent of the control treatment showed 50%, 63%, 46%, and 90% reduction for the same parameters as compared to the influent. Plant growth parameters (plant height, fresh and dry weight) showed no significant difference between fresh water and brine treatments. Obtained results suggest that the epuvalisation system is a promising technique for inland brine treatment with added benefits. The increasing of channel number or closed loop time is estimated for enhancing the treatment process and increasing the nutrient uptake. Nevertheless, the epuvalisation technique is considered to be simple, efficient and low cost for inland RO brine treatment.

  19. A novel electrospun polysulfone fiber membrane: application to advanced treatment of secondary bio-treatment sewage.

    PubMed

    Xu, Z; Gu, Q; Hu, H; Li, F

    2008-01-01

    Electrospun nanofibers and fine fibers have been used to remove submicron particles in air filtration. In this paper, direct-and polyaluminium chloride (PAC) pre-coagulation filtration of secondary bio-treatment sewage was studied using electrospun polysulfone fiber membrane (EPSFM). According to the results obtained, for direct filtration, suspended solids (SS), chemical oxygen demand (COD(Cr)) and NH3-N decreased 86.7, 71.2, 91.7% respectively, in filtrate of secondary bio-treatment sewage, while for PAC pre-coagulation filtration, the removal rate of SS, COD(Cr) and NH3-N reached 91.3, 85.3, 93.3 % respectively. EPSFM had a high efficiency in removing NH3-N, COD(Cr) and SS, especially for micron and submicron particles. EPSFM can reduce the content of some toxic metals, such as Cu, Zn and Ti, through interception and adsorption mechanism and can also remove dissolved organic matter such as humics and proteins through interception mechanism. EPSFM can remove some of volatile organic chemicals (VOCs) by adsorption and filtration, the removal rate of VOCs was in the range of 59-100 %. The number of VOCs in secondary bio-treatment sewage and its filtrate from direct filtration were 27 and 18 respectively, the major VOCs were benzene-, cyclohexane-, adamantine- and hydrocarbon derivates.

  20. Treatment manuals and the advancement of psychoanalytic knowledge: The Treatment Manual of the Tavistock Adult Depression Study.

    PubMed

    Taylor, David

    2015-06-01

    This paper has two aims: first, it seeks to understand the absence of treatment manuals in psychoanalysis. Secondly, it summarizes the treatment manual of the Tavistock Adult Depression Study, which describes the form of psychoanalytic psychotherapy whose effectiveness has been evaluated both in the Tavistock Adult Depression Study (TADS); and in the German Die Langzeittherapie bei chronischen Depressionen (LAC) Studie. Throughout the history of psychoanalysis, opinions about treatment manuals, empirical research and their antecedents have been deeply divided. After tracing the often polarized unfolding of these matters, the paper proposes that emotional and cognitive difficulties as well as scientific ones underpin their persistence. It is suggested that greater familiarity with them may lead to better combinations of outcome research and psychoanalysis: for example, the Tavistock manual seeks to match one account of the objects, aims, values, spirit and methods of psychoanalysis (as well as of connected forms of psychoanalytic psychotherapy); and also to meet what is required of treatment manuals by random allocation controlled trials. It has been a crucial element in the above studies of the outcome of long-term psychoanalytic psychotherapies with chronically depressed patients. After describing the Tavistock Manual, the paper concludes suggesting that, if appropriately constructed, treatment manuals can make a contribution to the advancement of specifically psychoanalytic knowledge.

  1. Nab-paclitaxel as alternative treatment regimen in advanced cholangiocellular carcinoma

    PubMed Central

    Unseld, Matthias; Scheithauer, Werner; Weigl, Roman; Kornek, Gabriela; Stranzl, Nadja; Bianconi, Daniela; Brunauer, Georg; Steger, Guenther; Zielinski, Christoph C.

    2016-01-01

    Background Advanced cholangiocellular carcinoma has a poor prognosis with limited therapeutic options. Nab-paclitaxel has recently been described to be beneficial in metastatic pancreatic cancer improving overall and progression free survival (PFS). The potential antitumor activity of nab-paclitaxel in cholangiocellular carcinoma is hitherto unknown. Methods We retrospectively analyzed an institutional cholangiocellular carcinoma registry to determine the potential biological activity of nab-paclitaxel in advanced intrahepatic cholangiocellular carcinoma. Disease control rate (DCR), PFS and overall survival (OS) upon nab-paclitaxel based treatment, after failure of platinum-containing first-line combination chemotherapy, was assessed. Results Twelve patients were identified. Five of 12 patients (42%) received nab-paclitaxel as second line, and 7 patients (56%) as third-line treatment. The objective DCR with nab-paclitaxel was 83% (10/12 patients). One patient had a complete remission (CR), two patients had a partial remission (PR) and 7 patients had stable disease (SD). Disease was rated progressive in two patients. In all 12 patients receiving nab-paclitaxel the median time to progression was 6 months (range, 2.1–19.5 months). Median OS after initiation of nab-paclitaxel treatment was 9 months (2.1–28.4 months). The median time of survival after diagnosis of advanced disease was 21.5 months, whereby 3 patients were alive at the date of censoring (04/01/2015). Conclusions This is the first report suggesting substantial antitumor activity of nab-paclitaxel in advanced cholangiocellular carcinoma. In this small series, nab-paclitaxel based salvage chemotherapy appears to have a biological activity by controlling the disease and positively affecting survival. Randomized trials in this disease entity and subgroup of patients are urged. PMID:27563449

  2. Estimation of Volcanic Ash Plume Top Height using AATSR

    NASA Astrophysics Data System (ADS)

    Virtanen, Timo; Kolmonen, Pekka; Sogacheva, Larisa; Sundström, Anu-Maija; Rodriguez, Edith; de Leeuw, Gerrit

    2015-04-01

    The AATSR Correlation Method (ACM) height estimation algorithm is presented. The algorithm uses Advanced Along Track Scanning Radiometer (AATSR) satellite data to detect volcanic ash plumes and to estimate the plume top height. The height estimate is based on the stereo-viewing capability of the AATSR instrument, which allows to determine the parallax between the satellite's 55° forward and nadir views, and thus the corresponding height. Besides the stereo view, AATSR provides another advantage compared to other satellite based instruments. With AATSR it is possible to detect ash plumes using brightness temperature difference between thermal infrared (TIR) channels centered at 11 and 12 µm. The automatic ash detection makes the algorithm efficient in processing large quantities of data: the height estimate is calculated only for the ash-flagged pixels. In addition, it is possible to study the effect of using different wavelengths in the height estimate, ranging from visible (555 nm) to thermal infrared (12 µm). The ACM algorithm can be applied to the Sea and Land Surface Temperature Radiometer (SLSTR), scheduled for launch at the end of 2015. Accurate information on the volcanic ash position is important for air traffic safety. The ACM algorithm can provide valuable data of both horizontal and vertical ash dispersion. These data may be useful for comparisons with existing volcanic ash dispersion models and retrieval methods. We present ACM plume top height estimate results for the Eyjafjallajökull eruption, and comparisons against available ground based and satellite observations.

  3. Plasma plume MHD power generator and method

    DOEpatents

    Hammer, James H.

    1993-01-01

    Highly-conducting plasma plumes are ejected across the interplanetary magnetic field from a situs that is moving relative to the solar wind, such as a spacecraft or an astral body, such as the moon, having no magnetosphere that excludes the solar wind. Discrete plasma plumes are generated by plasma guns at the situs extending in opposite directions to one another and at an angle, preferably orthogonal, to the magnetic field direction of the solar wind plasma. The opposed plumes are separately electrically connected to their source by a low impedance connection. The relative movement between the plasma plumes and the solar wind plasma creates a voltage drop across the plumes which is tapped by placing the desired electrical load between the electrical connections of the plumes to their sources. A portion of the energy produced may be used in generating the plasma plumes for sustained operation.

  4. Evaluation of advanced treatment technologies for the elimination of pharmaceutical compounds.

    PubMed

    Baumgarten, S; Schröder, H Fr; Charwath, C; Lange, M; Beier, S; Pinnekamp, J

    2007-01-01

    Pharmaceuticals and their metabolites have developed as ecotoxicologically relevant micropollutants in the aquatic environment. During conventional biological wastewater treatment they are eliminated insufficiently and therefore reach surface waters via discharges. They are either partially or completely non-biodegradable and/or hardly eliminable by activated sludge adsorption because they often have polar structures. Membrane bioreactor treatment (MBR) was applied to pre-treat wastewater containing pharmaceutical compounds, e.g., antibiotics like floxacins and their synthetic precursor compounds. Our objectives were to eliminate these persistent target compounds from wastewater prior to discharge into receiving waters. Therefore an advanced treatment applying MBR combined with different chemical and physicochemical processes was performed. The addition of powdered activated carbon (PAC), nano filtration (NF), reverse osmosis (UO) or ozone (O3) and O3/UV were applied to MBR permeate spiked with the selected target compounds. Treatment efficiency was assessed using conventional inorganic and organic chemical analyses besides advanced physicochemical methods like liquid chromatography coupled with mass and tandem mass spectrometry (LC-MS and -MS-MS).

  5. Electrochemotherapy for the Treatment of Unresectable Locoregionally Advanced Cutaneous Melanoma: A Systematic Review.

    PubMed

    Aguado-Romeo, M J; Benot-López, S; Romero-Tabares, A

    2017-03-01

    Electrochemotherapy is a therapeutic option for the treatment of cutaneous and subcutaneous metastases from melanoma and other tumors. The procedure consists of the administration of anticancer drugs followed by locally applied electrical impulses to achieve an effect known as electroporation, which facilitates entry into the cytosol of drugs that cannot cross the cell membrane. The aim of this review is to evaluate the evidence that supports the use of electrochemotherapy as a therapeutic strategy in melanoma. We conducted a qualitative systematic review of the literature using advanced searches of bibliographic databases and full text reviews. Seven studies (3 systematic reviews and 4 cases series) were selected. The quality of the evidence was not good, but the coincidence of results for certain variables supports their consistency. Results of the meta-analyses favored electrochemotherapy over chemotherapy. Electrochemotherapy appears to be an effective procedure for the local treatment of malignant tumor nodules (evidence of intermediate or low quality). This inexpensive method is simple to apply, well tolerated, and achieves objective responses under certain circumstances. There is no evidence that electrochemotherapy alters the natural course of the disease and it should therefore be considered a palliative treatment. With an evidence level of 1- (minus), electrochemotherapy can be recommended for the palliative treatment of unresectable, locoregionally advanced melanoma (grade B recommendation).

  6. [Occurrence and distribution of volatile organic compounds in conventional and advanced drinking water treatment processes].

    PubMed

    Chen, Xi-Chao; Luo, Qian; Chen, Hu; Wei, Zi; Wang, Zi-Jian; Xu, Ke-Wen

    2013-12-01

    A series of experiments were conducted to study the occurrence and distribution of volatile organic compounds (VOCs) in conventional and advanced drinking water treatment processes of 3 water treatment plants in Lianyungang City. Results showed that 30 compounds of 3 classes were detected from 67 kinds of VOCs in all the samples collected. The concentrations of carbonyl compounds, halogenated hydrocarbons and benzenes detected were in the ranges of 0.04-61.27, 0.02-35.61 and 0.07-2.33 microg x L(-1) respectively. Comparing the changes of different VOCs in three drinking water treatment plants, conventional chlorination process could effectively remove benzenes but meanwhile produced trihalomethanes (THMs). Additional advanced treatment ozonation-biological activated carbon process could decrease the formation of THMs during pre-chlorination but produced new risky contaminants like carbonyl compounds. The changes of VOCs in tap water were also investigated. It was found that carbonyl compounds produced by ozonation could be further transformed to THMs with residual chlorine. However, the health risks of all detected compounds in tap water were at a low level, except that the carcinogenic risk of crotonaldehydes (9.3 x 10(-5)-2.2 x 10(-4)) was slightly higher than the US EPA threshold (10(-6)-10(-4)).

  7. Neoadjuvant treatment for advanced esophageal cancer: response assessment before surgery and how to predict response to chemoradiation before starting treatment

    PubMed Central

    Hölscher, Arnulf H.; Schmidt, Matthias; Warnecke-Eberz, Ute

    2015-01-01

    Patients with advanced esophageal cancer (T3-4, N) have a poor prognosis. Chemoradiation or chemotherapy before esophagectomy with adequate lymphadenectomy is the standard treatment for patients with resectable advanced esophageal carcinoma. However, only patients with major histopathologic response (regression to less than 10% of the primary tumor) after preoperative treatment will have a prognostic benefit of preoperative chemoradiation. Using current therapy regimens about 40% to 50% of the patients show major histopathological response. The remaining cohort does not benefit from this neoadjuvant approach but might benefit from earlier surgical resection. Therefore, it is an aim to develop tools for response prediction before starting the treatment and for early response assessment identifying responders. The current review discusses the different imaging techniques and the most recent studies about molecular markers for early response prediction. The results show that [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) has a good sensitivity but the specificity is not robust enough for routine clinical use. Newer positron emission tomography detector technology, the combination of FDG-PET with computed tomography, additional evaluation criteria and standardization of evaluation may improve the predictive value. There exist a great number of retrospective studies using molecular markers for prediction of response. Until now the clinical use is missing. But the results of first prospective studies are promising. A future perspective may be the combination of imaging technics and special molecular markers for individualized therapy. Another aspect is the response assessment after finishing neoadjuvant treatment protocol. The different clinical methods are discussed. The results show that until now no non-invasive method is valid enough to assess complete histopathological response. PMID:26157318

  8. Bioelectro-Fenton: evaluation of a combined biological-advanced oxidation treatment for pharmaceutical wastewater.

    PubMed

    Ganzenko, Oleksandra; Trellu, Clement; Papirio, Stefano; Oturan, Nihal; Huguenot, David; van Hullebusch, Eric D; Esposito, Giovanni; Oturan, Mehmet A

    2017-01-31

    Electro-Fenton (EF), an advanced oxidation process, can be combined with a biological process for efficient treatment of wastewater containing refractory pollutants such as pharmaceuticals. In this study, a biological process was implemented in a sequencing batch reactor (SBR), which was either preceded or followed by EF treatment. The main goal was to evaluate the potential of two sequences of a combined electrochemical-biological process: EF/SBR and SBR/EF for the treatment of real wastewater spiked with 0.1 mM of caffeine and 5-fluorouracil. The biological removal of COD and pharmaceuticals was improved by extending the acclimation time and increasing concentration of biomass in the SBR. Hardly biodegradable caffeine and COD were completely removed during the EF post-treatment (SBR/EF). During the EF/SBR sequence, complete removal of pharmaceuticals was achieved by EF within 30 min at applied current 800 mA. With a current of 500 and 800 mA, the initially very low BOD5/COD ratio increased up to 0.38 and 0.58, respectively, after 30 min. The efficiency of the biological post-treatment was influenced by the biodegradability enhancement after EF pre-treatment. The choice of an adequate sequence of such a combined process is significantly related to the wastewater characteristics as well as the treatment objectives.

  9. Development of nanomaterial-enabled advanced oxidation techniques for treatment of organic micropollutants

    NASA Astrophysics Data System (ADS)

    Oulton, Rebekah Lynn

    Increasing demand for limited fresh water resources necessitates that alternative water sources be developed. Nonpotable reuse of treated wastewater represents one such alternative. However, the ubiquitous presence of organic micropollutants such as pharmaceuticals and personal care products (PPCPs) in wastewater effluents limits use of this resource. Numerous investigations have examined PPCP fate during wastewater treatment, focusing on their removal during conventional and advanced treatment processes. Analysis of influent and effluent data from published studies reveals that at best 1-log10 concentration unit of PPCP removal can generally be achieved with conventional treatment. In contrast, plants employing advanced treatment methods, particularly ozonation and/or membranes, remove most PPCPs often to levels below analytical detection limits. However, membrane treatment is cost prohibitive for many facilities, and ozone treatment can be very selective. Ozone-recalcitrant compounds require the use of Advanced Oxidation Processes (AOPs), which utilize highly reactive hydroxyl radicals (*OH) to target resistant pollutants. Due to cost and energy use concerns associated with current AOPs, alternatives such as catalytic ozonation are under investigation. Catalytic ozonation uses substrates such as activated carbon to promote *OH formation during ozonation. Here, we show that multi-walled carbon nanotubes (MWCNTs) represent another viable substrate, promoting *OH formation during ozonation to levels exceeding activated carbon and equivalent to conventional ozone-based AOPs. Via a series of batch reactions, we observ a strong correlation between *OH formation and MWCNT surface oxygen concentrations. Results suggest that deprotonated carboxyl groups on the CNT surface are integral to their reactivity toward ozone and corresponding *OH formation. From a practical standpoint, we show that industrial grade MWCNTs exhibit similar *OH production as their research

  10. Laser immunotherapy for treatment of patients with advanced breast cancer and melanoma

    NASA Astrophysics Data System (ADS)

    Li, Xiaosong; Hode, Tomas; Guerra, Maria C.; Ferrel, Gabriela L.; Nordquist, Robert E.; Chen, Wei R.

    2011-02-01

    Laser immunotherapy (LIT) was developed for the treatment of metastatic tumors. It combines local selective photothermal interaction and active immunological stimulation to induce a long-term, systemic anti-tumor immunity. During the past sixteen years, LIT has been advanced from bench-top to bedside, with promising outcomes. In our pre-clinical and preliminary clinical studies, LIT has demonstrated the capability in inducing immunological responses, which not only can eradicate the treated primary tumors, but also can eliminate untreated metastases at distant sites. Specifically, LIT has been used to treat advanced melanoma and breast cancer patients during the past five years. LIT was shown to be effective in controlling both primary tumors and distant metastases in late-stage patients, who have failed conventional therapies such as surgery, chemotherapy, radiation, and other more advanced approaches. The methodology and the development of LIT are presented in this paper. The patients' responses to LIT are also reported in this paper. The preliminary results obtained in these studies indicated that LIT could be an effective modality for the treatment of patients with late-stage, metastatic cancers, who are facing severely limited options.

  11. Clinical use of cabozantinib in the treatment of advanced kidney cancer: efficacy, safety, and patient selection

    PubMed Central

    Yu, Steven S; Quinn, David I; Dorff, Tanya B

    2016-01-01

    Clear cell (cc) renal cell carcinoma (RCC) is the most common type of cancer found in the kidney accounting for ~90% of all kidney cancers. In 2012, there were ~337,000 new cases of RCC diagnosed worldwide with an estimated 143,000 deaths, with the highest incidence and mortality in Western countries. Despite improvements in cancer control achieved with VEGF- and mTOR-targeted therapy for RCC, progression remains virtually universal and additional therapies are needed. The pivotal results of the METEOR trial led to cabozantinib’s designation as a breakthrough drug by the US Food and Drug Administration and its approval for treatment of advanced RCC in 2016. Subsequent data from the CABOSUN trial, where caboxantinib is compared with sunitinib, will provide information on the relative activity of cabozantinib as first-line therapy for ccRCC. We review the development of cabozantinib in advanced RCC and its role in the treatment landscape for advanced RCC. PMID:27713636

  12. Recent Advances in Diagnosis, Prevention, and Treatment of Human Respiratory Syncytial Virus

    PubMed Central

    Bawage, Swapnil Subhash; Tiwari, Pooja Munnilal; Singh, Shree Ram

    2013-01-01

    Human respiratory syncytial virus (RSV) is a common cause of respiratory infection in infants and the elderly, leading to significant morbidity and mortality. The interdisciplinary fields, especially biotechnology and nanotechnology, have facilitated the development of modern detection systems for RSV. Many anti-RSV compounds like fusion inhibitors and RNAi molecules have been successful in laboratory and clinical trials. But, currently, there are no effective drugs for RSV infection even after decades of research. Effective diagnosis can result in effective treatment, but the progress in both of these facets must be concurrent. The development in prevention and treatment measures for RSV is at appreciable pace, but the implementation into clinical practice still seems a challenge. This review attempts to present the promising diverse research approaches and advancements in the area of diagnosis, prevention, and treatment that contribute to RSV management. PMID:24382964

  13. Efficacy of an advanced sewage treatment plant in southeast Queensland, Australia, to remove estrogenic chemicals.

    PubMed

    Leusch, Frederic D L; Chapman, Heather F; Korner, Wolfgang; Gooneratne, S Ravi; Tremblay, Louis A

    2005-08-01

    The estrogenicity profile of domestic sewage during treatment at a medium-sized (3800 EP) advanced biological nutrient removal plant in Queensland, Australia, was characterized using a sheep estrogen receptor binding assay (ERBA) and the MCF-7 breast cancer cell proliferation assay (E-Screen). The raw influent was highly estrogenic (20-54 ng/L EEq), and primary treatment resulted in a slight increase in estrogenicity that was detected in one of the assays (6-80 ng/L). Concurrent chemical analysis suggested that most of the estrogenicity in the influent was due to natural hormones (>48%). Secondary activated sludge treatment followed by nitrification/denitrification effectively removed > 95% of the estrogenic activity (to <0.75-2.6 ng/L), and estrogenicity of the final tertiary-treated effluent was below the detection limit of both assays (<0.75 ng/L).

  14. Ozone catalysed with solids as an advanced oxidation process for landfill leachate treatment.

    PubMed

    Tizaoui, C; Mansouri, L; Bousselmi, L

    2007-01-01

    Heterogeneous catalytic ozonation (HCO) of wastewater is gaining both research and industrial interests. It is proved to be an advanced oxidation process since it involves hydroxyl radicals as oxidation species. Few studies have been carried out to test HCO in the treatment of landfill leachates. This work has been carried out to test three types of catalysts: activated carbon (AC), expanded perlite (EP) and titanium dioxide (TiO2) combined with ozone at 80 g/m3 gas concentration for the treatment of a leachate generated by Jebel Chakir landfill site near Tunis-capital of Tunisia. The work has shown a reduction in COD of about 45% and an increase in biodegradability (BOD5/COD) from 0.1 to 0.34. A catalyst concentration of 0.7 g/L was found optimal for the treatment of the leachate.

  15. The "Conflicted Dying": The Active Search for Life Extension in Advanced Cancer Through Biomedical Treatment.

    PubMed

    Mohammed, Shan; Peter, Elizabeth; Gastaldo, Denise; Howell, Doris

    2016-03-01

    Using a poststructural perspective, we examine the subjectivities that are produced when advanced cancer patients seek life extension through biomedical treatments. Seven case studies were developed that included 20 interviews with patients, family, nurses, and physicians recruited from a tertiary hospital in Canada, 30 documents, and 5 hours of participant observation. We identify seven types of subjectivity: (a) the Desperate Subject, (b) the Cancer Expert Subject, (c) the Proactive Subject, (d) the Productive Subject, (e) the Mistrusting Subject, (f) the Model Patient Subject, and (g) the Suffering Subject. We characterize the "conflicted dying," a contemporary figure who holds multiple perspectives about seeking curative treatment despite the acknowledgment of death. Using active strategies to gain access to treatment, this figure resists traditional arrangements of power/knowledge established by health care providers. We suggest that the search for life extension is a process of shaping the self to fit certain aesthetical traits associated with surviving cancer.

  16. Cancer of the Pancreas: Molecular Pathways and Current Advancement in Treatment

    PubMed Central

    Polireddy, Kishore; Chen, Qi

    2016-01-01

    Pancreatic cancer is one of the most lethal cancers among all malignances, with a median overall survival of <1 year and a 5-year survival of ~5%. The dismal survival rate and prognosis are likely due to lack of early diagnosis, fulminant disease course, high metastasis rate, and disappointing treatment outcome. Pancreatic cancers harbor a variety of genetic alternations that render it difficult to treat even with targeted therapy. Recent studies revealed that pancreatic cancers are highly enriched with a cancer stem cell (CSC) population, which is resistant to chemotherapeutic drugs, and therefore escapes chemotherapy and promotes tumor recurrence. Cancer cell epithelial to mesenchymal transition (EMT) is highly associated with metastasis, generation of CSCs, and treatment resistance in pancreatic cancer. Reviewed here are the molecular biology of pancreatic cancer, the major signaling pathways regulating pancreatic cancer EMT and CSCs, and the advancement in current clinical and experimental treatments for pancreatic cancer. PMID:27471566

  17. Advances in 4D Treatment Planning for Scanned Particle Beam Therapy — Report of Dedicated Workshops

    PubMed Central

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-01-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue. PMID:24354749

  18. Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea

    PubMed Central

    Park, Pona; Jeon, Hyoung Won; Han, Doo Hee; Won, Tae-Bin; Kim, Dong-Young; Rhee, Chae-Seo; Kim, Hyun Jik

    2016-01-01

    Abstract Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP. This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA. Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively. The MAD treatment resulted in a significant reduction in apnea–hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA. These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP. PMID:27861349

  19. Irritants in cigarette smoke plumes

    SciTech Connect

    Ayer, H.E.; Yeager, D.W.

    1982-11-01

    Concentrations of the irritants formaldehyde and acrolein in side stream cigarette smoke plumes are up to three orders of magnitude above occupational limits, readily accounting for eye and nasal irritation. ''Low-tar'' cigarettes appear at least as irritating as other cigarettes. More than half the irritant is associated with the particulate phase of the smoke, permitting deposition throughout the entire respiratory tract and raising the issue of whether formaldehyde in smoke is associated with bronchial cancer.

  20. Tuberculosis--advances in development of new drugs, treatment regimens, host-directed therapies, and biomarkers.

    PubMed

    Wallis, Robert S; Maeurer, Markus; Mwaba, Peter; Chakaya, Jeremiah; Rustomjee, Roxana; Migliori, Giovanni Battista; Marais, Ben; Schito, Marco; Churchyard, Gavin; Swaminathan, Soumya; Hoelscher, Michael; Zumla, Alimuddin

    2016-04-01

    Tuberculosis is the leading infectious cause of death worldwide, with 9·6 million cases and 1·5 million deaths reported in 2014. WHO estimates 480,000 cases of these were multidrug resistant (MDR). Less than half of patients who entered into treatment for MDR tuberculosis successfully completed that treatment, mainly due to high mortality and loss to follow-up. These in turn illustrate weaknesses in current treatment regimens and national tuberculosis programmes, coupled with operational treatment challenges. In this Review we provide an update on recent developments in the tuberculosis drug-development pipeline (including new and repurposed antimicrobials and host-directed drugs) as they are applied to new regimens to shorten and improve outcomes of tuberculosis treatment. Several new or repurposed antimicrobial drugs are in advanced trial stages for MDR tuberculosis, and two new antimicrobial drug candidates are in early-stage trials. Several trials to reduce the duration of therapy in MDR and drug-susceptible tuberculosis are ongoing. A wide range of candidate host-directed therapies are being developed to accelerate eradication of infection, prevent new drug resistance, and prevent permanent lung injury. As these drugs have been approved for other clinical indications, they are now ready for repurposing for tuberculosis in phase 2 clinical trials. We assess risks associated with evaluation of new treatment regimens, and highlight opportunities to advance tuberculosis research generally through regulatory innovation in MDR tuberculosis. Progress in tuberculosis-specific biomarkers (including culture conversion, PET and CT imaging, and gene expression profiles) can support this innovation. Several global initiatives now provide unique opportunities to tackle the tuberculosis epidemic through collaborative partnerships between high-income countries and middle-income and low-income countries for clinical trials training and research, allowing funders to

  1. The ice plumes of Europa

    NASA Astrophysics Data System (ADS)

    Sparks, William

    2014-10-01

    It is of extreme interest to NASA and the scientific community that evidence has been found for plumes of water ice venting from the polar regions of Europa (Roth et al 2014) - spectroscopic detection of off-limb line emission from the dissociation products of water. We were awarded Cycle 21 time to seek direct images of the Europa exosphere, including Enceladus-like plumes if present, basing our study on FUV images of Europa as it transits the smooth face of Jupiter. We also obtained a necessary FUV image of Europa out of transit. These observations provide additional evidence for the presence of ice plumes on Europa. Here, we propose to augment our previous imaging work and to seek an initial, efficient characterization of off-limb emission as Europa orbits Jupiter. Such images provide sensitive flux and column density limits, with exceptional spatial resolution. In transit, our strategy can place firm limits on, or measurements of, absorbing columns, their distribution with altitude above the surface of Europa, and constrain their wavelength dependence and hence composition. Out of transit, geometrical and surface brightness considerations can help us distinguish between continuum FUV emission from forward- or back-scattering, from line emission, or, though we might prefer otherwise, from more subtle instrumental artifacts than hitherto understood. If the ice fountains of Europa arise from the deep ocean, we have gained access to probably the most astrobiologically interesting location in the Solar System.

  2. The Effect of Solution Heat Treatment on an Advanced Nickel-Base Disk Alloy

    NASA Technical Reports Server (NTRS)

    Gayda, J.; Gabb, T. P.; Kantzos, P. T.

    2004-01-01

    Five heat treat options for an advanced nickel-base disk alloy, LSHR, have been investigated. These included two conventional solution heat treat cycles, subsolvus/oil quench and supersolvus/fan cool, which yield fine grain and coarse grain microstructure disks respectively, as well as three advanced dual microstructure heat treat (DMHT) options. The DMHT options produce disks with a fine grain bore and a coarse grain rim. Based on an overall evaluation of the mechanical property data, it was evident that the three DMHT options achieved a desirable balance of properties in comparison to the conventional solution heat treatments for the LSHR alloy. However, one of the DMHT options, SUB/DMHT, produced the best set of properties, largely based on dwell crack growth data. Further evaluation of the SUB/DMHT option in spin pit experiments on a generic disk shape demonstrated the advantages and reliability of a dual grain structure at the component level.

  3. Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract

    SciTech Connect

    Kalra, J.; Cortes, E.; Chen, S.; Krumholz, B.; Rovinsky, J.J.; Molho, L.; Seltzer, V.; Papantoniou, P.; Lee, J.Y.

    1985-07-01

    Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest that the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma.

  4. Molecular targeted therapy in the treatment of advanced stage non-small cell lung cancer (NSCLC).

    PubMed

    Kumarakulasinghe, Nesaretnam Barr; van Zanwijk, Nico; Soo, Ross A

    2015-04-01

    Historically, patients with advanced stage non-small cell lung cancer (NSCLC) were treated with chemotherapy alone, but a therapeutic plateau has been reached. Advances in the understanding of molecular genetics have led to the recognition of multiple molecularly distinct subsets of NSCLC. This in turn has led to the development of rationally directed molecular targeted therapy, leading to improved clinical outcomes. Tumour genotyping for EGFR mutations and ALK rearrangement has meant chemotherapy is no longer given automatically as first-line treatment but reserved for when patients do not have a 'druggable' driver oncogene. In this review, we will address the current status of clinically relevant driver mutations and emerging new molecular subsets in lung adenocarcinoma and squamous cell carcinoma, and the role of targeted therapy and mechanisms of acquired resistance to targeted therapy.

  5. Overview of recent advances in treatment planning for ion beam radiotherapy

    NASA Astrophysics Data System (ADS)

    Krämer, Michael; Scifoni, Emanuele; Schmitz, Frederike; Sokol, Olga; Durante, Marco

    2014-10-01

    To achieve practical calculations of dose delivery in ion beam radiotherapy, the physical models of beam propagation need to be properly implemented and supplemented by models describing the complex mechanisms of radiation damage in the biological tissues. TRiP98 is the first and most advanced treatment planning system for particles, in which physical and biological models have been incorporated to develop a clinically applicable tool for dose optimization and delivery. We report our recent advances in TRiP98 code development, in particular towards hypoxia-driven and multi-modal dose optimization. We also discuss the present needs and possible extensions of our models for which input from nanoscale physics is required. Contribution to the Topical Issue "Nano-scale Insights into Ion-beam Cancer Therapy", edited by Andrey V. Solov'yov, Nigel Mason, Paulo Limão-Vieira and Malgorzata Smialek-Telega.

  6. Coastal river plumes: Collisions and coalescence

    NASA Astrophysics Data System (ADS)

    Warrick, Jonathan A.; Farnsworth, Katherine L.

    2017-02-01

    Plumes of buoyant river water spread in the ocean from river mouths, and these plumes influence water quality, sediment dispersal, primary productivity, and circulation along the world's coasts. Most investigations of river plumes have focused on large rivers in a coastal region, for which the physical spreading of the plume is assumed to be independent from the influence of other buoyant plumes. Here we provide new understanding of the spreading patterns of multiple plumes interacting along simplified coastal settings by investigating: (i) the relative likelihood of plume-to-plume interactions at different settings using geophysical scaling, (ii) the diversity of plume frontal collision types and the effects of these collisions on spreading patterns of plume waters using a two-dimensional hydrodynamic model, and (iii) the fundamental differences in plume spreading patterns between coasts with single and multiple rivers using a three-dimensional hydrodynamic model. Geophysical scaling suggests that coastal margins with numerous small rivers (watershed areas < 10,000 km2), such as found along most active geologic coastal margins, were much more likely to have river plumes that collide and interact than coastal settings with large rivers (watershed areas > 100,000 km2). When two plume fronts meet, several types of collision attributes were found, including refection, subduction and occlusion. We found that the relative differences in pre-collision plume densities and thicknesses strongly influenced the resulting collision types. The three-dimensional spreading of buoyant plumes was found to be influenced by the presence of additional rivers for all modeled scenarios, including those with and without Coriolis and wind. Combined, these results suggest that plume-to-plume interactions are common phenomena for coastal regions offshore of the world's smaller rivers and for coastal settings with multiple river mouths in close proximity, and that the spreading and fate of

  7. Coastal river plumes: Collisions and coalescence

    USGS Publications Warehouse

    Warrick, Jonathan; Farnsworth, Katherine L

    2017-01-01

    Plumes of buoyant river water spread in the ocean from river mouths, and these plumes influence water quality, sediment dispersal, primary productivity, and circulation along the world’s coasts. Most investigations of river plumes have focused on large rivers in a coastal region, for which the physical spreading of the plume is assumed to be independent from the influence of other buoyant plumes. Here we provide new understanding of the spreading patterns of multiple plumes interacting along simplified coastal settings by investigating: (i) the relative likelihood of plume-to-plume interactions at different settings using geophysical scaling, (ii) the diversity of plume frontal collision types and the effects of these collisions on spreading patterns of plume waters using a two-dimensional hydrodynamic model, and (iii) the fundamental differences in plume spreading patterns between coasts with single and multiple rivers using a three-dimensional hydrodynamic model. Geophysical scaling suggests that coastal margins with numerous small rivers (watershed areas < 10,000 km2), such as found along most active geologic coastal margins, were much more likely to have river plumes that collide and interact than coastal settings with large rivers (watershed areas > 100,000 km2). When two plume fronts meet, several types of collision attributes were found, including refection, subduction and occlusion. We found that the relative differences in pre-collision plume densities and thicknesses strongly influenced the resulting collision types. The three-dimensional spreading of buoyant plumes was found to be influenced by the presence of additional rivers for all modeled scenarios, including those with and without Coriolis and wind. Combined, these results suggest that plume-to-plume interactions are common phenomena for coastal regions offshore of the world’s smaller rivers and for coastal settings with multiple river mouths in close proximity, and that the spreading and

  8. Advanced Mixed Waste Treatment Project melter system preliminary design technical review meeting

    SciTech Connect

    Eddy, T.L.; Raivo, B.D.; Soelberg, N.R.; Wiersholm, O.

    1995-02-01

    The Idaho National Engineering Laboratory Advanced Mixed Waste Treatment Project sponsored a plasma are melter technical design review meeting to evaluate high-temperature melter system configurations for processing heterogeneous alpha-contaminated low-level radioactive waste (ALLW). Thermal processing experts representing Department of Energy contractors, the Environmental Protection Agency, and private sector companies participated in the review. The participants discussed issues and evaluated alternative configurations for three areas of the melter system design: plasma torch melters and graphite arc melters, offgas treatment options, and overall system configuration considerations. The Technical Advisory Committee for the review concluded that graphite arc melters are preferred over plasma torch melters for processing ALLW. Initiating involvement of stakeholders was considered essential at this stage of the design. For the offgas treatment system, the advisory committee raised the question whether to a use wet-dry or a dry-wet system. The committee recommended that the waste stream characterization, feed preparation, and the control system are essential design tasks for the high-temperature melter treatment system. The participants strongly recommended that a complete melter treatment system be assembled to conduct tests with nonradioactive surrogate waste material. A nonradioactive test bed would allow for inexpensive design and operational changes prior to assembling a system for radioactive waste treatment operations.

  9. Systemic treatment and targeted therapy in patients with advanced hepatocellular carcinoma

    PubMed Central

    Tazi, El Mehdi; Essadi, Ismail; M’rabti, Hind; Touyar, Anass; Errihani, PR Hassan

    2011-01-01

    Background: Advanced hepatocellular carcinoma (HCC) is a malignancy of global importance: it is the sixth most common cancer and the third most common cause of cancer-related mortality worldwide. Despite decades of efforts by many investigators, systemic chemotherapy or hormone therapy has failed to demonstrate improved survival in patients with HCC.. Ongoing studies are evaluating the efficacy and tolerability of combining Sorafenib with erlotinib and other targeted agents or chemotherapy. Aims: On the basis of placebo-controlled, randomized phase III trials, Sorafenib has shown improved survival benefits in advanced HCC and has set a new standard for future clinical trials. The successful clinical development of Sorafenib in HCC has ushered in the era of molecularly targeted agents in this disease, which is discussed in this educational review. Material and Methods: Many molecularly targeted agents that inhibit angiogenesis, epidermal growth factor receptor, and mammalian target of rapamycin are at different stages of clinical development in advanced HCC. Future research should continue to unravel the mechanism of hepatocarcinogenesis and to identify key relevant molecular targets for therapeutic intervention. Identification and validation of potential surrogate and predictive biomarkers hold promise to individualize patients’ treatment to maximize clinical benefit and minimize the toxicity and cost of targeted agents. Results: Systemic therapy with various classes of agents, including hormone and cytotoxic agents, has provided no or marginal benefits. Improved understanding of the mechanism of hepatocarcinogenesis, coupled with the arrival of many newly developed molecularly targeted agents, has provided the unique opportunity to study some of these novel agents in advanced HCC. Conclusions: The demonstration of improved survival benefits by Sorafenib in advanced HCC has ushered in the era of molecular-targeted therapy in this disease, with many agents

  10. Critical appraisal of pazopanib as treatment for patients with advanced metastatic renal cell carcinoma.

    PubMed

    Bukowski, Ronald M

    2011-01-01

    The management of renal cell carcinoma (RCC) has undergone significant changes during the past 10 years, with the treatment of metastatic RCC undergoing the most radical changes. These developments reflect an enhanced understanding of this tumor's underlying biology, which was then translated into the development of a new treatment paradigm. Current therapeutic approaches for the management of patients with metastatic RCC utilize knowledge of histology, molecular abnormalities, clinical prognostic factors, the natural history of this malignancy, and the treatment efficacy and toxicity of available agents. The treatment options available for patients with metastatic RCC have changed dramatically over the past 6 years. Interferon-α and interleukin-2 were the previous mainstays of therapy, but since December 2005, six new agents have been approved in the US for the treatment of advanced RCC. Three are multi-targeted tyrosine kinase inhibitors (TKI) including sunitinib, sorafenib, and pazopanib, two target the mammalian target of rapamycin (temsirolimus and everolimus), and one is a humanized monoclonal antibody (bevacizumab in combination with interferon-α). The current review focuses on the newest TKI available to treat patients with metastatic RCC, pazopanib. The development of this agent both preclinically and clinically is reviewed. The efficacy and safety data from the pivotal clinical trials are discussed, and the potential role of pazopanib in the treatment of patients with metastatic RCC in comparison to other treatment alternatives is critically appraised. This agent has a favorable overall risk benefit, and the available data demonstrate efficacy in patients with metastatic RCC who are either treatment-naïve or cytokine refractory. It therefore represents another alternative for treatment of metastatic RCC patients.

  11. Seismically imaging the Afar plume

    NASA Astrophysics Data System (ADS)

    Hammond, J. O.; Kendall, J. M.; Bastow, I. D.; Stuart, G. W.; Keir, D.; Ayele, A.; Ogubazghi, G.; Ebinger, C. J.; Belachew, M.

    2011-12-01

    Plume related flood basalt volcanism in Ethiopia has long been cited to have instigated continental breakup in northeast Africa. However, to date seismic images of the mantle beneath the region have not produced conclusive evidence of a plume-like structure. As a result the nature and even existence of a plume in the region and its role in rift initiation and continental rupture are debated. Previous seismic studies using regional deployments of sensors in East-Africa show that low seismic velocities underlie northeast Africa, but their resolution is limited to the top 200-300km of the Earth. Thus, the connection between the low velocities in the uppermost mantle and those imaged in global studies in the lower mantle is unclear. We have combined new data from Afar, Ethiopia with 6 other regional experiments and global network stations across Ethiopia, Eritrea, Djibouti and Yemen, to produce high-resolution models of upper mantle P- and S- wave velocities to the base of the transition zone. Relative travel time tomographic inversions show that the top 100km is dominated by focussed low velocity zones, likely associated with melt in the lithosphere/uppermost asthenosphere. Below these depths a broad SW-NE oriented sheet like upwelling extends down to the top of the transition zone. Within the transition zone two focussed sharp-sided low velocity regions exist: one beneath the Western Ethiopian plateau outside the rift valley, and the other beneath the Afar depression. The nature of the transition zone anomalies suggests that small upwellings may rise from a broader low velocity plume-like feature in the lower mantle. This interpretation is supported by numerical and analogue experiments that suggest the 660km phase change and viscosity jump may impede flow from the lower to upper mantle creating a thermal boundary layer at the base of the transition zone. This allows smaller, secondary upwellings to initiate and rise to the surface. Our images of secondary upwellings

  12. Current therapeutic strategies of anti-HER2 treatment in advanced breast cancer patients

    PubMed Central

    Nowara, Elżbieta

    2016-01-01

    The HER2/neu (ERBB2) oncogene is amplified and/or overexpressed in approximately 20% of breast cancers, and is a strong prognostic factor for relapse and poor overall survival, particularly in node-positive patients. It is also an important predictor for response to trastuzumab, which has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. Treatment with the anti-HER2 humanized monoclonal antibody – trastuzumab significantly improves progression-free and overall survival among patients with HER2-positive breast cancer. However, in most patients with HER2-positive metastatic breast cancer, the disease progresses occurred, what cause the need for new targeted therapies for advanced disease. In clinical trials, there are tested new drugs to improve the results of treatment for this group of patients. This paper presents new drugs introduced into clinical practice for treatment of advanced breast cancer, whose molecular target are receptors of the HER2 family. In addition, new therapeutic strategies and drugs that are currently in clinical researches are discussed. PMID:27095932

  13. Benefits of early and prolonged fulvestrant treatment in 848 postmenopausal advanced breast cancer patients.

    PubMed

    Warm, Mathias; Kates, Ronald; Overkamp, Friedrich; Thomas, Anke; Harbeck, Nadia

    2011-01-01

    Response to fulvestrant and survival in postmenopausal hormone-sensitive advanced breast cancer was investigated within a non-randomized, In-Practice Evaluation Program, with the aim of optimizing treatment decisions. 848 patients (median age 64 years; 52% co-morbidity; 78% prior palliative therapy; median 4 prior regimens) received monthly fulvestrant injections (250 mg/month) and were followed-up three-monthly for 9 months. Clinical benefit (PFS ≥ 24 weeks) occurred in 532/848 (62.7%); stable disease (SD) in 627/848 patients (74%), including 62 complete and 177 partial responses. Best response was delayed in 115 patients. Estimated 9-month overall survival (OS) was 89%; 9-month event-free survival (EFS) was 71%. Indicators of disease aggressiveness affected response and survival, but number of fulvestrant cycles was the key OS and EFS determinant. The patients with SD at 3 months benefitted from continued fulvestrant. Excluding deaths, 7 serious adverse events occurred (none attributable to fulvestrant). No new or unexpected safety issues arose; 90% of the patients and physicians rated fulvestrant tolerability as "very good" or "good". In the largest prospective, fulvestrant-treated cohort to date, advanced breast cancer patients achieving SD or better after 3 months of treatment gained survival benefit by prolonging fulvestrant therapy-independent of disease and treatment history.

  14. Vismodegib, a small-molecule inhibitor of the hedgehog pathway for the treatment of advanced cancers.

    PubMed

    De Smaele, Enrico; Ferretti, Elisabetta; Gulino, Alberto

    2010-06-01

    Vismodegib (GDC-0449) is a small, orally administrable molecule, belonging to the 2-arylpyridine class, which was discovered by Genentech Inc under a collaboration with Curis Inc. Vismodegib inhibits the Hedgehog (Hh) pathway, which is involved in tumorigenesis, thus providing a strong rationale for its use in the treatment of a variety of cancers. Vismodegib suppresses Hh signaling by binding to and interfering with smoothened, a membrane protein that provides positive signals to the Hh signaling pathway. Preclinical studies demonstrated the antitumor activity of vismodegib in mouse models of medulloblastoma (MB) and in xenograft models of colorectal and pancreatic cancer. Phase I clinical trials in patients with advanced basal cell carcinoma (BCC) and MB highlighted an objective response to vismodegib. Reported side effects were minor, with only one grade 4 adverse event. Vismodegib is currently undergoing phase II clinical trials for the treatment of advanced BCC, metastatic colorectal cancer, ovarian cancer, MB and other solid tumors. Because of its low toxicity and specificity for the Hh pathway, this drug has potential advantages compared with conventional chemotherapy, and may also be used in combination treatments. Clinical trials with other Hh inhibitors are also ongoing and their therapeutic potential will need to be compared with vismodegib.

  15. Apatinib treatment combined with chemotherapy for advanced epithelial ovarian cancer: a case report

    PubMed Central

    Deng, Linghui; Wang, Yue; Lu, Wenbin; Liu, Qian; Wu, Jie; Jin, Jianhua

    2017-01-01

    Apatinib is a novel oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2, which has been proved by clinical trials to be effective and safe for patients with chemotherapy-refractory gastric cancer. To date, there is no study or case report on apatinib treatment for patients with ovarian cancer. Here, we present the case of a 50-year-old Chinese woman with advanced ovarian cancer, who received apatinib at a daily dose of 500 mg for 28 days per cycle after failure of fourth-line chemotherapy. Favorable oncologic outcome was achieved in this case after treatment with apatinib. The patient’s progression-free survival is now 11.3 months, and she is taking apatinib and capecitabine as maintenance treatment. The common side effect of apatinib was fatigue; however, the toxicity of apatinib was controllable and tolerable. Thus, apatinib may be an option for chemotherapy-refractory advanced epithelial ovarian cancer, but this still warrants further investigation. PMID:28352185

  16. 75 FR 48356 - Advancing the Development of Medical Products Used In the Prevention, Diagnosis, and Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... HUMAN SERVICES Food and Drug Administration Advancing the Development of Medical Products Used In the... ``Advancing the Development of Medical Products Used in the Prevention, Diagnosis, and Treatment of Neglected... the development of medical products (drugs, biological products, and medical devices) used in...

  17. [Clinical and histopathological results after the neo-adjuvant treatment of advanced rectal tumors].

    PubMed

    Varga, László; Baradnay, Gellért; Hohn, József; Simonka, Zsolt; Hideghéthy, Katalin; Maráz, Anikó; Nikolényi, Alíz; Veréb, Blanka; Tiszlavicz, László; Németh, István; Mán, Eszter; Lázár, György

    2010-06-01

    The role of the surgical intervention is decisive in treating colorectal tumors. The neo-adjuvant radio-chemotherapy has improved the efficacy of the treatment of advanced rectum tumors. In order to decrease the size and stage of advanced rectal carcinoma and to increase the rate of resecability, we introduced neoadjuvant radio-chemotherapy. We carried out neo-adjuvant and surgical treatment in case of 67 patients with rectal adenocarcinoma (T 2-4 N 1-2 M 0 ) between June 1, 2005 and July 31, 2008. The average age of the patients was 61.2 years, the division according to sex was 44 males/23 females. Regarding the local stage of the rectal process or the proximity to the sphincter, we applied radio-chemotherapy (radiotherapy 25 times altogether 45 Gy and on the first and last week for 5-5 days they received 350 mg/m 2 /day 5-FU and 20 mg/m 2 /day leucovorin chemotherapy, recently complemented with 3 x 1.8 Gy advanced boost radiation aiming at the macroscopic tumor site with security zone). Patients underwent surgery 8 weeks on average after restaging examinations. Thirty-eight patients underwent anterior rectal resection with double stapler procedure; there were 18 abdominoperineal rectal extirpations, 7 Hartmann operations and 4 per annum excisions. Compared to the preoperative staging, the histological evaluation of the resected specimens showed total remission (pT 0 N 0 ) in 11% and partial remission in 43%. The morbidity necessitating reoperation was 5.9%, without mortality and suture insufficiency. The long-term neo-adjuvant oncological treatment led to down-staging of rectal tumors in most cases and increased the resecability and rate of resection operations.

  18. A survey to determine current practice patterns in the surgical treatment of advanced thumb carpometacarpal osteoarthrosis

    PubMed Central

    Brunton, Lance M.

    2010-01-01

    Background The purpose of this study was to determine current practice patterns and examine the influence of recent evidence in the surgical treatment of advanced thumb carpometacarpal (CMC) osteoarthrosis. Methods A survey was sent to 2,536 American Society for Surgery of the Hand members. Information regarding specialty training, years of experience, annual cases performed, treatment of choice, technique, and postoperative immobilization was collected. Respondents were asked whether their current treatment of choice differs from what they performed 5 years ago and about the importance of ligament reconstruction and “interposition” to thumb CMC arthroplasty success. Results One thousand twenty-four respondents completed the survey (40% response rate). Treatment of choice was trapeziectomy with ligament reconstruction and tendon interposition (68%), regardless of specialty training, years of experience, and annual cases performed. Over 70% favored treatment that was not different from what they performed 5 years ago. Less than 3% of respondents perform a trapeziectomy alone; only 14 surgeons have changed to this procedure in the last 5 years. Only 35% of the 822 respondents who perform a ligament reconstruction and 14% of the 764 respondents who perform an interposition believe those techniques are “extremely important” to thumb CMC arthroplasty success. Conclusions Despite recent evidence that suggests neither ligament reconstruction nor tendon interposition confers any additional benefit over trapeziectomy alone, few respondents have converted to the simpler procedure. Either the current evidence is not convincing enough to drastically change practice patterns, or other factors apart from this evidence have a greater influence on surgical decision-making for advanced thumb CMC osteoarthrosis. Electronic supplementary material The online version of this article (doi:10.1007/s11552-010-9275-7) contains supplementary material, which is available to

  19. Nanovectors for anti-cancer drug delivery in the treatment of advanced pancreatic adenocarcinoma

    PubMed Central

    Hsueh, Chung-Tzu; Selim, Julie H; Tsai, James Y; Hsueh, Chung-Tsen

    2016-01-01

    Liposome, albumin and polymer polyethylene glycol are nanovector formulations successfully developed for anti-cancer drug delivery. There are significant differences in pharmacokinetics, efficacy and toxicity between pre- and post-nanovector modification. The alteration in clinical pharmacology is instrumental for the future development of nanovector-based anticancer therapeutics. We have reviewed the results of clinical studies and translational research in nanovector-based anti-cancer therapeutics in advanced pancreatic adenocarcinoma, including nanoparticle albumin-bound paclitaxel and nanoliposomal irinotecan. Furthermore, we have appraised the ongoing studies incorporating novel agents with nanomedicines in the treatment of pancreatic adenocarcinoma. PMID:27610018

  20. TREATMENT OF METAL-LADEN HAZARDOUS WASTES WITH ADVANCED CLEAN COAL TECHNOLOGY BY-PRODUCTS

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini

    1999-05-11

    This fifteenth quarterly report describes work done during the fifteenth three-month period of the University of Pittsburgh's project on the ''Treatment of Metal-Laden Hazardous Wastes with Advanced Clean Coal Technology By-Products.'' This report describes the activities of the project team during the reporting period. The principal work has focused upon new laboratory evaluation of samples from Phase 1, discussions with MAX Environmental Technologies, Inc., on the field work of Phase 2, preparing and giving presentations, and making and responding to several outside contacts.

  1. TREATMENT OF METAL-LADEN HAZARDOUS WASTES WITH ADVANCED CLEAN COAL TECHNOLOGY BY-PRODUCTS

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini

    1999-01-01

    This seventeenth quarterly report describes work done during the seventeenth three-month period of the University of Pittsburgh's project on the ''Treatment of Metal-Laden Hazardous Wastes with Advanced Clean Coal Technology By-Products.'' This report describes the activities of the project team during the reporting period. The principal work has focused upon new laboratory evaluation of samples from Phase 1, discussions with MAX Environmental Technologies, Inc., on the field work of Phase 2, giving a presentation, submitting a manuscript and making and responding to one outside contact.

  2. TREATMENT OF METAL-LADEN HAZARDOUS WASTES WITH ADVANCED CLEAN COAL TECHNOLOGY BY-PRODUCTS

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini

    1999-06-01

    This sixteenth quarterly report describes work done during the sixteenth three-month period of the University of Pittsburgh's project on the ''Treatment of Metal-Laden Hazardous Wastes with Advanced Clean Coal Technology By-Products.'' This report describes the activities of the project team during the reporting period. The principal work has focused upon new laboratory evaluation of samples from Phase 1, discussions with MAX Environmental Technologies, Inc., on the field work of Phase 2, giving a presentation, and making and responding to several outside contacts.

  3. Treatment of metal-laden hazardous wastes with advanced Clean Coal Technology by-products

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini

    1999-04-12

    This twelfth quarterly report describes work done during the twelfth three-month period of the University of Pittsburgh's project on the ``Treatment of Metal-Laden Hazardous Wastes with Advanced Clean Coal Technology By-Products.'' This report describes the activities of the project team during the reporting period. The principal work has focused upon new laboratory evaluation of samples from Phase 1, discussions with MAX Environmental Technologies, Inc., on the field work of Phase 2, preparing and giving presentations, and making and responding to a number of outside contacts.

  4. Advanced soft-tissue sarcoma and treatment options: critical appraisal of trabectedin

    PubMed Central

    Desar, Ingrid M E; Constantinidou, Anastasia; Kaal, Suzanne E J; Jones, Robin L; van der Graaf, Winette T A

    2016-01-01

    Soft-tissue sarcomas (STS) are a heterogeneous group of rare solid tumors of mesenchymal origin. This paper reviews the current status of systemic treatment in advanced and metastatic soft tissue sarcomas, with an emphasis on trabectedin. Trabectedin is a unique type of chemotherapeutic agent with multiple potential mechanisms of action. We discuss the putative mechanisms, as well as the toxicity and administration schedules of trabectedin, followed by its efficacy in first-line systemic therapy and beyond first-line systemic therapy. PMID:27574465

  5. Treatment of metal-laden hazardous wastes with advanced Clean Coal Technology by-products

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini; Wiles Elder

    1999-04-05

    This eleventh quarterly report describes work done during the eleventh three-month period of the University of Pittsburgh's project on the ``Treatment of Metal-Laden Hazardous Wastes with Advanced Clean Coal Technology By-Products.'' This report describes the activities of the project team during the reporting period. The principal work has focused upon new laboratory evaluation of samples from Phase 1, discussions with MAX Environmental Technologies, Inc., on the field work of Phase 2, preparing and giving presentations, and making and responding to two outside contacts.

  6. [Advances in the research of pathogenesis and treatment of severe smoke inhalation injury].

    PubMed

    Feng, Shengjuan; Jia, Chiyu; Liu, Zhen; Lyu, Xiaowu

    2016-02-01

    Among the fire victims, respiratory tract injury resulted from smoke inhalation is the major cause of death. Particulate substances in smoke, toxic and harmful gas, and chemical substances act together would rapidly induce the occurrence of dramatic pathophysiologic reaction in the respiratory tract, resulting in acute injury to the respiratory tract, thus inducing serious injury to it and acute respiratory distress syndrome, leading to death of the victims. In recent years, the pathophysiologic mechanism of severe smoke inhalation injury has been gradually clarified, thus appreciable advances in its treatment have been achieved. This paper is a brief review of above-mentioned aspects.

  7. TREATMENT OF METAL-LADEN HAZARDOUS WASTES WITH ADVANCED CLEAN COAL TECHNOLOGY BY-PRODUCTS

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini

    1999-05-10

    This fourteenth quarterly report describes work done during the fourteenth three-month period of the University of Pittsburgh's project on the ''Treatment of Metal-Laden Hazardous Wastes with Advanced Clean Coal Technology By-Products.'' This report describes the activities of the project team during the reporting period. The principal work has focused upon new laboratory evaluation of samples from Phase 1, discussions with MAX Environmental Technologies, Inc., on the field work of Phase 2, preparing presentations, and making and responding to two outside contacts.

  8. Advances in the use of nanocarriers for cancer diagnosis and treatment

    PubMed Central

    Vieira, Débora Braga; Gamarra, Lionel Fernel

    2016-01-01

    ABSTRACT The use of nanocarriers as drug delivery systems for therapeutic or imaging agents can improve the pharmacological properties of commonly used compounds in cancer diagnosis and treatment. Advances in the surface engineering of nanoparticles to accommodate targeting ligands turned nanocarriers attractive candidates for future work involving targeted drug delivery. Although not targeted, several nanocarriers have been approved for clinical use and they are currently used to treat and/or diagnosis various types of cancers. Furthermore, there are several formulations, which are now in various stages of clinical trials. This review examined some approved formulations and discussed the advantages of using nanocarriers in cancer therapy. PMID:27074238

  9. Cork boiling wastewater treatment and reuse through combination of advanced oxidation technologies.

    PubMed

    Ponce-Robles, L; Miralles-Cuevas, S; Oller, I; Agüera, A; Trinidad-Lozano, M J; Yuste, F J; Malato, S

    2016-08-12

    Industrial preparation of cork consists of its immersion for approximately 1 hour in boiling water. The use of herbicides and pesticides in oak tree forests leads to absorption of these compounds by cork; thus, after boiling process, they are present in wastewater. Cork boiling wastewater shows low biodegradability and high acute toxicity involving partial inhibition of their biodegradation when conventional biological treatment is applied. In this work, a treatment line strategy based on the combination of advanced physicochemical technologies is proposed. The final objective is the reuse of wastewater in the cork boiling process; thus, reducing consumption of fresh water in the industrial process itself. Coagulation pre-treatment with 0.5 g/L of FeCl3 attained the highest turbidity elimination (86 %) and 29 % of DOC elimination. Similar DOC removal was attained when using 1 g/L of ECOTAN BIO (selected for ozonation tests), accompanied of 64 % of turbidity removal. Ozonation treatments showed less efficiency in the complete oxidation of cork boiling wastewater, compared to solar photo-Fenton process, under the studied conditions. Nanofiltration system was successfully employed as a final purification step with the aim of obtaining a high-quality reusable permeate stream. Monitoring of unknown compounds by LC-QTOF-MS allowed the qualitative evaluation of the whole process. Acute and chronic toxicity as well as biodegradability assays were performed throughout the whole proposed treatment line.

  10. TREATMENT OF METAL-LADEN HAZARDOUS WASTES WITH ADVANCED CLEAN COAL TECHNOLOGY BY-PRODUCTS

    SciTech Connect

    James T. Cobb, Jr.

    2003-09-12

    Metal-laden wastes can be stabilized and solidified using advanced clean coal technology by-products (CCTBs)--fluid bed combustor ash and spray drier solids. These utility-generated treatment chemicals are available for purchase through brokers, and commercial applications of this process are being practiced by treaters of metal-laden hazardous waste. A complex of regulations governs this industry, and sensitivities to this complex has discouraged public documentation of treatment of metal-laden hazardous wastes with CCTBs. This report provides a comprehensive public documentation of laboratory studies that show the efficacy of the stabilization and solidification of metal-laden hazardous wastes--such as lead-contaminated soils and sandblast residues--through treatment with CCTBs. It then describes the extensive efforts that were made to obtain the permits allowing a commercial hazardous waste treater to utilize CCTBs as treatment chemicals and to install the equipment required to do so. It concludes with the effect of this lengthy process on the ability of the treatment company to realize the practical, physical outcome of this effort, leading to premature termination of the project.

  11. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer1234

    PubMed Central

    Fernandez-Retana, Jorge; Lasa-Gonsebatt, Federico; Lopez-Urrutia, Eduardo; Coronel-Martínez, Jaime; Cantu De Leon, David; Jacobo-Herrera, Nadia; Peralta-Zaragoza, Oscar; Perez-Montiel, Delia; Reynoso-Noveron, Nancy; Vazquez-Romo, Rafael; Perez-Plasencia, Carlos

    2015-01-01

    Cervical cancer (CC) mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC) have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription–polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment. PMID:25926073

  12. Transcript profiling distinguishes complete treatment responders with locally advanced cervical cancer.

    PubMed

    Fernandez-Retana, Jorge; Lasa-Gonsebatt, Federico; Lopez-Urrutia, Eduardo; Coronel-Martínez, Jaime; Cantu De Leon, David; Jacobo-Herrera, Nadia; Peralta-Zaragoza, Oscar; Perez-Montiel, Delia; Reynoso-Noveron, Nancy; Vazquez-Romo, Rafael; Perez-Plasencia, Carlos

    2015-04-01

    Cervical cancer (CC) mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC) have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription-polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment.

  13. Recent advances in diagnosis, treatment, and outcome of congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

    PubMed

    Riepe, Felix G; Sippell, Wolfgang G

    2007-12-01

    Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) is an autosomal-recessive disease causing cortisol deficiency, aldosterone deficiency and hyperandrogenism. Diagnosis of 21-OHD is confirmed by steroid analysis in newborn screening or later on. Standard medical treatment consists of oral glucocorticoid and mineralocorticoid administration in order to suppress adrenal androgens and to compensate for adrenal steroid deficiencies. However, available treatment is far from ideal, and not much is known about the long-term outcome in CAH as trials in patients in adulthood or old age are rare. Here we briefly describe the pathophysiology, clinical picture, genetics and epidemiology of 21-OHD. This is followed by a comprehensive review of the recent advances in diagnosis, treatment and outcome. Novel insights have been gained in the fields of newborn screening, specific steroid measurement utilizing mass spectrometry, genetics, glucocorticoid stress dosing, additive medical therapy, prenatal treatment, side-effects of medical treatment, adrenomedullary involvement, metabolic morbidity, fertility and gender identity. However, many issues are still unresolved, and novel questions, which will have to be answered in the future, arise with every new finding.

  14. Treatment of winery wastewater by electrochemical methods and advanced oxidation processes.

    PubMed

    Orescanin, Visnja; Kollar, Robert; Nad, Karlo; Mikelic, Ivanka Lovrencic; Gustek, Stefica Findri

    2013-01-01

    The aim of this research was development of new system for the treatment of highly polluted wastewater (COD = 10240 mg/L; SS = 2860 mg/L) originating from vine-making industry. The system consisted of the main treatment that included electrochemical methods (electro oxidation, electrocoagulation using stainless steel, iron and aluminum electrode sets) with simultaneous sonication and recirculation in strong electromagnetic field. Ozonation combined with UV irradiation in the presence of added hydrogen peroxide was applied for the post-treatment of the effluent. Following the combined treatment, the final removal efficiencies of the parameters color, turbidity, suspended solids and phosphates were over 99%, Fe, Cu and ammonia approximately 98%, while the removal of COD and sulfates was 77% and 62%, respectively. A new approach combining electrochemical methods with ultrasound in the strong electromagnetic field resulted in significantly better removal efficiencies for majority of the measured parameters compared to the biological methods, advanced oxidation processes or electrocoagulation. Reduction of the treatment time represents another advantage of this new approach.

  15. Advanced treatment of the reverse osmosis concentrate produced during reclamation of municipal wastewater.

    PubMed

    Dialynas, Emmanuel; Mantzavinos, Dionissios; Diamadopoulos, Evan

    2008-11-01

    The work investigated the treatment of the concentrate produced from the reverse osmosis treatment of an MBR effluent. Two conventional chemical processes, coagulation and activated carbon adsorption, and three advanced oxidation processes (electrochemical treatment, photocatalysis and sonolysis) were applied. Coagulation with alum gave dissolved organic carbon (DOC) removals up to 42%, while FeCl(3) achieved higher removals (52%) at lower molar doses. Adsorption with granular activated carbon showed the highest DOC removals up to 91.3% for 5 g/L. The adsorption isotherm was linear with a non-adsorbable organic fraction of around 1.2 mg/L DOC. The three oxidation methods employed, electrolytic oxidation over a boron-doped diamond electrode, UVA/TiO2 photocatalysis and sonolysis at 80 kHz, showed similar behavior: during the first few minutes of treatment there was a moderate removal of DOC followed by further oxidation at a very slow rate. Electrolytic oxidation was capable of removing up to 36% at 17.8A after 30 min of treatment, sonolysis removed up to 34% at 135W after 60 min, while photocatalysis was capable of removing up to 50% at 60 min.

  16. [Outcome of treatment with surgical resection of the remaining tumor after modified M-VAC treatment for advanced urothelial carcinoma].

    PubMed

    Narita, Shintaro; Nakano, Masahiro; Matsuzaki, Masato; Watanabe, Jyunichi; Morikawa, Hiroshi; Murata, Hirokatsu; Oda, Hiroyuki; Komatsu, Hideki

    2005-03-01

    We retrospectively evaluated the effect of the surgical resection of the remaining tumor after modified M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) (m-M-VAC) treatment for locally advanced or metastatic urothelial carcinoma. In m-M-VAC therapy, methotrexate and vinblastine on 15 and 22 days were omitted from the classical M-VAC to avoid the discontinuation and the dose reduction, and duration of 1 course was shortened to 21 days from 28 days of the classical M-VAC. Seven patients with locally invasive or metastatic carcinoma of the renal pelvis, ureter, and bladder, 6 males and 1 female, with a median age 64.1 years, ranging from 49 to 77 years received m-M-VAC chemotherapy without severe side effects. In all patients, the residual viable carcinoma was completely resected and they achieved complete remission. The median survival time was 20 months (range, 7 to 61). Five of these 7 patients were still alive. Two patients had no recurrence and achieved long-term survival (survival duration; 61 and 39 months). Although further studies and long-term follow up are required, these results suggest that patients who present with locally advanced or metastatic urothelial carcinoma may benefit from surgical resection after m-M-VAC.

  17. Predictors of psychological distress in advanced cancer patients under palliative treatments.

    PubMed

    Diaz-Frutos, D; Baca-Garcia, E; García-Foncillas, J; López-Castroman, J

    2016-07-01

    This work aims to investigate the factors associated with psychological distress in advanced cancer patients under palliative treatment. We comprehensively assessed the demographic, psychosocial and health factors of 158 advanced cancer patients. Patients with high and low distress, according to the Hospital Anxiety and Depression Scale, were compared. A regression analysis was built to identify the best predictors of distress. Patients with high psychological distress (81%) were more likely to have lung cancer, suicidal ideation, hopelessness, low quality of life and poor body image than those without. In the multivariate model, only poor emotional functioning (OR = .89; 95% CI = .83-.95; p ≤ .001), hopelessness (OR = .86; 95% CI = .78-.94; p ≤ .001) and body image distortions (OR = .77; 95% CI = .68-.85; p = .005) were retained. High levels of hopelessness, impaired emotional functioning and body image distortions are the main factors associated with psychological distress in patients with advanced cancer. Potential interventions to modify these factors in palliative units are discussed.

  18. [Research progress on the treatment of obstructive sleep apnea and hypopnea syndrome with mandibular advancement device].

    PubMed

    Li, De-hong; Yang, Xiang-hong; Guo, Tian-wen

    2010-04-01

    Obstructive sleep apnea and hypopnea syndrome (OSAHS) is characterized by obstruction of upper airway and respiratory disturbance, excessive daytime sleepiness and tiredness.The possible causes are obesity, hypertension, and upper airway malformations,etc. The location and degree of upper airway structure narrowing in patients have been investigated in many ways, such as X-ray, multi-slices spiral computed tomography, etc. With multi-planar reconstruction technique,3-dimensional construction of upper airway can be established which shows the delicate changes of the upper airway structure. Mandibular advancement device is known as an effective treatment on mild and moderate OSAHS. By advancing the mandible forward, it can increase the space of upper airway, especially the oropharyngeal space. This paper reviewed the methods of investigating on OSAHS and the change of upper airway structure in OSAHS patients treated with mandibular advancement device. Supported by Combined Research Fund of Bureau of Health, Yunan Province and Kunming Medical College(Grant No.2009CD205).

  19. Progress in the treatment of locally advanced clinically resectable rectal cancer.

    PubMed

    Minsky, Bruce D

    2011-12-01

    There have been significant developments in the adjuvant treatment of locally advanced clinically resectable (T3 and/or N+) rectal cancer. Postoperative systemic chemotherapy plus concurrent pelvic irradiation (chemoradiation) significantly improves local control and survival compared with surgery alone. The German Rectal Cancer Trial confirmed that when chemoradiation is delivered preoperatively there is a significant decrease in acute and late toxicity and a corresponding increase in local control and sphincter preservation. Despite these advances, controversies remain. Among these controversies are the role of short-course radiation, whether postoperative adjuvant chemotherapy is necessary for all patients, and if the type of surgery after chemoradiation can be modified based on tumor response. Are there more accurate imaging techniques and/or molecular markers to help identify patients with positive pelvic nodes with the goal of reducing the chance of overtreatment with preoperative therapy. Will more effective systemic agents both improve outcome and modify the need for pelvic irradiation? This review examines the advances in chemoradiation as well as addresses these and other opportunities for improvement.

  20. [Recent advancements in the treatment of renal cell carcinoma--focus on international guidelines].

    PubMed

    Biró, Krisztina; Küronya, Zsófia

    2010-12-01

    Recent advances in understanding the fundamental biology underlying clear-cell RCC have opened the door to a series of targeted agents, such as tyrosine kinase inhibitors (TKIs) or mTOR inhibitors. These new agents have become the standard of care in managing advanced clear-cell RCC. Choice of initial medical management in patients with metastatic clear-cell RCC should be guided by randomised studies. On the evidence available, the first-line therapy in patients with good- or intermediate-risk mRCC should be either sunitinib or pazopanib, or bevacizumab plus interferon. In selected patients sorafenib is an option, as is high-dose interleukin-2 if performance status is good. In patients with poor prognosis, temsirolimus is recommended. In cytokine refractory patients, sorafenib, when patients have progressed on a tyrosine kinase inhibitor everolimus is the agent of choice. Biró K, Küronya Z. Recent advancements in the treatment of renal cell carcinoma - focus on international guidelines.

  1. ABVD as the treatment option in advanced Hodgkin's lymphoma patients older than 45 years.

    PubMed

    Andjelic, Bosko M; Mihaljevic, Biljana S; Jakovic, Ljubomir R

    2012-07-01

    Advanced age is considered an unfavourable prognostic factor for Hodgkin's lymphoma (HL). The optimal treatment for these patients is not yet defined, especially for the advanced stages. We analysed the outcome and prognostic relevance of patient and disease characteristics in 46 advanced stage HL patients who were older than 45 years, treated with ABVD. Elderly patients (>60 year) had a significantly higher rate of comorbidities (p < 0.05). The complete remission rate was significantly lower in elderly patients and in patients with an IPS ≥ 3 (p < 0.05, p < 0.05, respectively). Elderly patients had significantly shorter event-free survival (p < 0.01) and overall survival (p < 0.01) compared to patients of 45-60 year. Extranodal disease, an IPS ≥ 3, bulky disease, an ESR > 50 and the presence of a large mediastinal tumour mass didn't have an influence on survival (p > 0.05). The multivariate Cox regression analysis identified the age of >60 year as an independent prognostic factor. The prospective clinical trials seem to be needed for defining the optimal therapeutic approach in elderly patients.

  2. Targeted delivery of albumin bound paclitaxel in the treatment of advanced breast cancer.

    PubMed

    Di Costanzo, Francesco; Gasperoni, Silvia; Rotella, Virginia; Di Costanzo, Federica

    2009-02-18

    Taxanes are chemotherapeutic agents with a large spectrum of antitumor activity when used as monotherapy or in combination regimens. Paclitaxel and docetaxel have poor solubility and require a complex solvent system for their commercial formulation, Cremophor EL(R) (CrEL) and Tween 80(R) respectively. Both these biological surfactants have recently been implicated as contributing not only to the hypersensitivity reactions, but also to the degree of peripheral neurotoxicity and myelosuppression, and may antagonize the cytotoxicity. Nab-paclitaxel, or nanoparticle albumin-bound paclitaxel (ABI-007; Abraxane(R)), is a novel formulation of paclitaxel that does not employ the CrEL solvent system. Nab-paclitaxel demonstrates greater efficacy and a favorable safety profile compared with standard paclitaxel in patients with advanced disease (breast cancer, non-small cell lung cancer, melanoma, ovarian cancer). Clinical studies in breast cancer have shown that nab-paclitaxel is significantly more effective than standard paclitaxel in terms of overall objective response rate (ORR) and time to progression. Nab-paclitaxel in combination with gemcitabine, capecitabine or bevacizumab has been shown to be very active in patients with advanced breast cancer. An economic analysis showed that nab-paclitaxel would be an economically reasonable alternative to docetaxel or standard paclitaxel in metastatic breast cancer. Favorable tumor ORR and manageable toxicities have been reported for nab-paclitaxel as monotherapy or in combination treatment in advanced breast cancer.

  3. Nimotuzumab Combined with Chemotherapy is a Promising Treatment for Locally Advanced and Metastatic Esophageal Cancer

    PubMed Central

    Han, Xinghua; Lu, Nannan; Pan, Yueyin; Xu, Jianming

    2017-01-01

    Background Nimotuzumab is an anti-EGFR monoclonal antibody which has been widely used in cancer treatment. However, the safety and efficacy of nimotuzumab combined with chemotherapy in locally advanced or metastatic esophageal cancer patients remain unclear. Material/Methods To address this open question, we collected a total data of 21 patients diagnosed with locally advanced or metastatic esophageal cancer between 2012 and 2016 in a, retrospective study. The patient characteristics, efficacy safety, and toxicity were evaluated in our study. Results We observed 1 (4.8%) patient with complete response, 7 (33.3%) patients with partial response, 9 (42.9%) patients with stable response and 4 (19%) patients with progression response. The objective response rate was 38.1% and disease control rate was 81%. The mean progression-free-survival was 7 months and the 18-month overall survival (OS) was 10%. The incidence rate of anemia and leukopenia was 71.4% and 81%, respectively. Two patients showed the serious adverse event of myelosuppression, with nausea, fatigue, and anorexia. No long-term drug-related toxicity was observed during the follow-up. Conclusions Nimotuzumab combined with chemotherapy can achieve promising clinical outcomes in locally advanced or metastatic esophageal cancer, without accumulation of toxicity and was well-tolerated. PMID:28115730

  4. Fouling of anion exchange resin by fluorescence analysis in advanced treatment of municipal wastewaters.

    PubMed

    Li, Haibo; Li, Aimin; Shuang, Chendong; Zhou, Qing; Li, Wentao

    2014-12-01

    The application of anion exchange resins (AERs) has been limited by the critical problem of resin fouling, which increases the volume of the desorption concentrate and decreases treatment efficiency. To date, resin fouling has not been well studied and is poorly understood compared to membrane fouling. To reflect the resin fouling level, a resin fouling index (RFI) was established in this work according to the decrease of DOC removal after regeneration of the resin for the advanced treatment of municipal wastewater. Comparing the linear fitting results between the RFI and the fluorescence intensity indicated that the resin fouling was related to the protein-like substances with fluorescence peak T in the region of excitation wavelength <250 nm and emission wavelength <380 nm. Using their fluorescent characteristics as a label, the protein-like substances causing the fouling were further identified as hydrophilic components with molecular weights greater than 6500 Da.

  5. Kienböck Disease: Recent Advances in the Basic Science, Assessment and Treatment.

    PubMed

    Bain, Gregory Ian; Yeo, Chong Jin; Morse, Levi Philip

    2015-10-01

    Kienböck disease is a disorder of impaired lunate vascularity which ultimately has the potential to lead to marked degeneration of the wrist and impaired wrist function. The aetiology of the avascular necrosis is uncertain, but theories relate to ulnar variance, variability in lunate vascularity and intraosseous pressures. Clinical symptoms can be subtle and variable, requiring a high index of suspicion for the diagnosis. The Lichtmann classification has historically been used to guide management. We present a review of Kienböck disease, with a focus on the recent advances in assessment and treatment. Based on our understanding thus far of the pathoanatomy of Kienböck's disease, we are proposing a pathological staging system founded on the vascularity, osseous and chondral health of the lunate. We also propose an articular-based approach to treatment, with an arthroscopic grading system to guide management.

  6. Advances in the Treatment of Syndromic Midface Hypoplasia Using Monobloc and Facial Bipartition Distraction Osteogenesis

    PubMed Central

    Kumar, Anand R.; Steinbacher, Derek

    2014-01-01

    Midface hypoplasia or retrusion remains a persistent feature of syndromic craniosynostosis years after successful treatment of the cranium. Although expansion of the cranial vault in infancy by traditional fronto-orbital advancement, posterior expansion, or both, can treat the immediate intracranial constriction, midface hypoplasia and its stigmata of exorbitism, sleep apnea, central face concavity, and malocclusion remain suboptimally treated. Initial enthusiasm for the procedures was tempered due to a high rate of infectious complications; timing and indications for surgery continue to stir controversy. During the last decade renewed interest with the monobloc and facial bipartition procedure using distraction osteogenesis with either an internal or external distraction system has decreased morbidity significantly. These procedures have re-emerged as powerful and comprehensive tools in the treatment of syndromic midface hypoplasia. PMID:26417208

  7. Magnetic resonance imaging for planning intracavitary brachytherapy for the treatment of locally advanced cervical cancer.

    PubMed

    Oñate Miranda, M; Pinho, D F; Wardak, Z; Albuquerque, K; Pedrosa, I

    2016-01-01

    Cervical cancer is the third most common gynecological cancer. Its treatment depends on tumor staging at the time of diagnosis, and a combination of chemotherapy and radiotherapy is the treatment of choice in locally advanced cervical cancers. The combined use of external beam radiotherapy and brachytherapy increases survival in these patients. Brachytherapy enables a larger dose of radiation to be delivered to the tumor with less toxicity for neighboring tissues with less toxicity for neighboring tissues compared to the use of external beam radiotherapy alone. For years, brachytherapy was planned exclusively using computed tomography (CT). The recent incorporation of magnetic resonance imaging (MRI) provides essential information about the tumor and neighboring structures making possible to better define the target volumes. Nevertheless, MRI has limitations, some of which can be compensated for by fusing CT and MRI. Fusing the images from the two techniques ensures optimal planning by combining the advantages of each technique.

  8. Lenvatinib therapy for the treatment of patients with advanced renal cell carcinoma.

    PubMed

    Glen, Hilary

    2016-10-01

    Despite advances in metastatic renal cell carcinoma (mRCC) treatments, patients eventually progress and develop resistance to therapies targeting a single pathway. Lenvatinib inhibits VEGFR1-3, FGFR1-4, PDGFRβ, RET and KIT proto-oncogenes. In a randomized, Phase II trial evaluating patients with mRCC who had progressed after one prior VEGF-targeted therapy, progression-free survival was significantly improved with lenvatinib alone or in combination with everolimus versus everolimus alone. This review summarizes the clinical development of lenvatinib in mRCC, and how simultaneous targeting of multiple pathways involved in carcinogenesis and/or therapeutic resistance may improve patient outcomes. Lenvatinib plus everolimus may be a promising second-line treatment in patients with mRCC.

  9. Benign Spine Lesions: Advances in Techniques for Minimally Invasive Percutaneous Treatment.

    PubMed

    Tomasian, A; Wallace, A N; Jennings, J W

    2017-02-09

    Minimally invasive percutaneous imaging-guided techniques have been shown to be safe and effective for the treatment of benign tumors of the spine. Techniques available include a variety of tumor ablation technologies, including radiofrequency ablation, cryoablation, microwave ablation, alcohol ablation, and laser photocoagulation. Vertebral augmentation may be performed after ablation as part of the same procedure for fracture stabilization or prevention. Typically, the treatment goal in benign spine lesions is definitive cure. Painful benign spine lesions commonly encountered in daily practice include osteoid osteoma, osteoblastoma, vertebral hemangioma, aneurysmal bone cyst, Paget disease, and subacute/chronic Schmorl node. This review discusses the most recent advancement and use of minimally invasive percutaneous therapeutic options for the management of benign spine lesions.

  10. Recent Advances in Targeting the EGFR Signaling Pathway for the Treatment of Metastatic Colorectal Cancer.

    PubMed

    Miyamoto, Yuji; Suyama, Koichi; Baba, Hideo

    2017-04-02

    Outcomes for metastatic colorectal cancer (mCRC) patients have been improved by treatment with anti-epidermal growth factor receptor (anti-EGFR) antibodies, particularly when combined with predictive biomarkers to select patients lacking RAS mutations. New technologies such as liquid biopsy and next-generation sequencing have revealed that potential mechanisms of resistance to anti-EGFR therapies act through acquired mutations of KRAS and the EGFR ectodomain. Mutations in cross-talking molecular effectors that participate in downstream EGFR signaling are also negative predictors for anti-EGFR therapy. In the current review, we describe recent advances in anti-EGFR therapy and discuss new treatment strategies to target downstream RAS-MAPK signaling in mCRC.

  11. Constraining the source of mantle plumes

    NASA Astrophysics Data System (ADS)

    Cagney, N.; Crameri, F.; Newsome, W. H.; Lithgow-Bertelloni, C.; Cotel, A.; Hart, S. R.; Whitehead, J. A.

    2016-02-01

    In order to link the geochemical signature of hot spot basalts to Earth's deep interior, it is first necessary to understand how plumes sample different regions of the mantle. Here, we investigate the relative amounts of deep and shallow mantle material that are entrained by an ascending plume and constrain its source region. The plumes are generated in a viscous syrup using an isolated heater for a range of Rayleigh numbers. The velocity fields are measured using stereoscopic Particle-Image Velocimetry, and the concept of the 'vortex ring bubble' is used to provide an objective definition of the plume geometry. Using this plume geometry, the plume composition can be analysed in terms of the proportion of material that has been entrained from different depths. We show that the plume composition can be well described using a simple empirical relationship, which depends only on a single parameter, the sampling coefficient, sc. High-sc plumes are composed of material which originated from very deep in the fluid domain, while low-sc plumes contain material entrained from a range of depths. The analysis is also used to show that the geometry of the plume can be described using a similarity solution, in agreement with previous studies. Finally, numerical simulations are used to vary both the Rayleigh number and viscosity contrast independently. The simulations allow us to predict the value of the sampling coefficient for mantle plumes; we find that as a plume reaches the lithosphere, 90% of its composition has been derived from the lowermost 260-750 km in the mantle, and negligible amounts are derived from the shallow half of the lower mantle. This result implies that isotope geochemistry cannot provide direct information about this unsampled region, and that the various known geochemical reservoirs must lie in the deepest few hundred kilometres of the mantle.

  12. Aggregate particles in the plumes of Enceladus

    NASA Astrophysics Data System (ADS)

    Gao, Peter; Kopparla, Pushkar; Zhang, Xi; Ingersoll, Andrew P.

    2016-01-01

    Estimates of the total particulate mass of the plumes of Enceladus are important to constrain theories of particle formation and transport at the surface and interior of the satellite. We revisit the calculations of Ingersoll and Ewald (Ingersoll, A.P., Ewald, S.P. [2011]. Icarus 216(2), 492-506), who estimated the particulate mass of the Enceladus plumes from strongly forward scattered light in Cassini ISS images. We model the plume as a combination of spherical particles and irregular aggregates resulting from the coagulation of spherical monomers, the latter of which allows for plumes of lower particulate mass. Though a continuum of solutions are permitted by the model, the best fits to the ISS data consist either of low mass plumes composed entirely of small aggregates or high mass plumes composed of mostly spheres. The high particulate mass plumes have total particulate masses of (166 ± 42) × 103 kg, consistent with the results of Ingersoll and Ewald (Ingersoll, A.P., Ewald, S.P. [2011]. Icarus 216(2), 492-506). The low particulate mass plumes have masses of (25 ± 4) × 103 kg, leading to a solid to vapor mass ratio of 0.07 ± 0.01 for the plume. If indeed the plumes are made of such aggregates, then a vapor-based origin for the plume particles cannot be ruled out. Finally, we show that the residence time of the monomers inside the plume vents is sufficiently long for Brownian coagulation to form the aggregates before they are ejected to space.

  13. Real time plume and laser spot recognition in IR camera images

    SciTech Connect

    Moore, K.R.; Caffrey, M.P.; Nemzek, R.J.; Salazar, A.A.; Jeffs, J.; Andes, D.K.; Witham, J.C.

    1997-08-01

    It is desirable to automatically guide the laser spot onto the effluent plume for maximum IR DIAL system sensitivity. This requires the use of a 2D focal plane array. The authors have demonstrated that a wavelength-filtered IR camera is capable of 2D imaging of both the plume and the laser spot. In order to identify the centers of the plume and the laser spot, it is first necessary to segment these features from the background. They report a demonstration of real time plume segmentation based on velocity estimation. They also present results of laser spot segmentation using simple thresholding. Finally, they describe current research on both advanced segmentation and recognition algorithms and on reconfigurable real time image processing hardware based on field programmable gate array technology.

  14. The effects of an ion-thruster exhaust plume on S-band carrier transmission

    NASA Technical Reports Server (NTRS)

    Ackerknecht, W. E.; Stanton, P. H.

    1976-01-01

    The study reported here was undertaken (1) to develop models of the effects of an ion-thruster exhaust plume on S-band signals, and (2) to measure the effects. The results show that an S-band signal passing through an ion-thruster plume is reduced in amplitude and advanced in phase. The mathematical models gave reasonable estimates of the average signal attenuation and phase shift. Negligible fluctuations in the signal amplitude and phase were measured during steady-state thruster operation. However, large jumps in phase occurred when changes were made in the thruster operating state. This study confirms that the thruster plume can have a significant effect on S-band communication link performance; hence the plume effects must be considered in S-band link calculations when electric thrusters are used for spacecraft propulsion.

  15. Advanced treatment of swine wastewater using an agent synthesized from amorphous silica and hydrated lime.

    PubMed

    Tanaka, Yasuo; Hasegawa, Teruaki; Sugimoto, Kiyomi; Miura, Keiichi; Aketo, Tsuyoshi; Minowa, Nobutaka; Toda, Masaya; Kinoshita, Katsumi; Yamashita, Takahiro; Ogino, Akifumi

    2014-01-01

    Advanced treatment using an agent synthesized from amorphous silica and hydrated lime (M-CSH-lime) was developed and applied to swine wastewater treatment. Biologically treated wastewater and M-CSH-lime (approximately 6 w/v% slurry) were fed continuously into a column-shaped reactor from its bottom. Accumulated M-CSH-lime gradually formed a bed layer. The influent permeated this layer and contacted the M-CSH-lime, and the treatment reaction progressed. Treated liquid overflowing from the top of the reactor was neutralized with CO₂gas bubbling. The colour removal rate approximately exceeded 50% with M-CSH-lime addition rates of > 0.15 w/v%. The removal rate of PO(3⁻)(4) exceeded 80% with the addition of>0.03 w/v% of M-CSH-lime. The removal rates of coliform bacteria and Escherichia coli exceeded 99.9% with > 0.1 w/v%. Accumulated M-CSH-lime in the reactor was periodically withdrawn from the upper part of the bed layer. The content of citric-acid-soluble P₂O₅ in the recovered matter was>15% when the weight ratio of influent PO(3⁻)(4) -P to added M-CSH-lime was > 0.15. This content was comparable with commercial phosphorus fertilizer. The inhibitory effect of recovered M-CSH-lime on germination and growth of leafy vegetable komatsuna (Brassica rapa var. perviridis) was evaluated by an experiment using the Neubauer's pot. The recovered M-CSH-lime had no negative effect on germination and growth. These results suggest that advanced water treatment with M-CSH-lime was effective for simultaneous removal of colour, [Formula: see text] and coliform bacteria at an addition rate of 0.03-0.15 w/v%, and that the recovered M-CSH-lime would be suitable as phosphorus fertilizer.

  16. Variations in AOC and microbial diversity in an advanced water treatment plant

    NASA Astrophysics Data System (ADS)

    Yang, B. M.; Liu, J. K.; Chien, C. C.; Surampalli, R. Y.; Kao, C. M.

    2011-10-01

    SummaryThe objective of this study was to evaluate the variations in assimilable organic carbon (AOC) and microbial diversities in an advanced water treatment plant. The efficiency of biofiltration on AOC removal using anthracite and granular activated carbon (GAC) as the media was also evaluated through a pilot-scale column experiment. Effects of hydrological factors (seasonal effects and river flow) on AOC concentrations in raw water samples and hydraulic retention time (HRT) of biofiltration on AOC treatment were also evaluated. Results show that AOC concentrations in raw water and clear water of the plant were about 138 and 27 μg acetate-C/L, respectively. Higher AOC concentrations were observed in wet seasons probably due to the resuspension of organic-contained sediments and discharges of non-point source (NPS) pollutants from the upper catchment. This reveals that seasonal effect played an important role in the variations in influent AOC concentrations. Approximately 82% and 70% of AOC removal efficiencies were observed in GAC and anthracite columns, respectively. Results from column experiment reveal that the applied treatment processes in the plant and biofiltration system were able to remove AOC effectively. Microbial colonization on GAC and anthracite were detected via the observation of scanning electron microscopic (SEM) images. Results of polymerase chain reaction (PCR), denaturing gradient gel electrophoresis (DGGE), and nucleotide sequence analysis reveal significant decrease in microbial diversities after the ozonation process. Higher HRT caused higher microbial contact time, and thus, more microbial colonies and higher microbial diversity were observed in the latter part of the biofilters. Some of the dominant microbial species in the biofiltration columns belonged to the beta- proteobacterium, which might contribute to the AOC degradation. Results of this study provide us insight into the variations in AOC and microbial diversity in the advanced

  17. Oral cancer treatment costs in Greece and the effect of advanced disease

    PubMed Central

    Zavras, Athanasios; Andreopoulos, Nikos; Katsikeris, Nikos; Zavras, Dimitrios; Cartsos, Vassiliki; Vamvakidis, Athanasios

    2002-01-01

    Background The main purpose of the study was to quantify the direct costs of oral cancer treatment to the healthcare system of Greece. Another aim was to identify factors that affect costs and potential cost reduction items. More specifically, we examined the relationship between stage of disease, modality of treatment and total direct costs. Methods The medical records and clinic files of the Oral and Maxillofacial Clinic of the Athens General Hospital "Genimatas" were abstracted to investigate clinical treatment characteristics, including length of hospitalization, modes of treatment, stage of disease etc. Records of 95 patients with oral squamous cell carcinoma (OSSC), with at least six months of follow-up, were examined. The clinical data was then used to calculate actual direct costs, based on 2001 market values. Results The mean total direct costs for OSSC treatment estimated at euro 8,450 or approximately US$ 7,450. Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05). Multi-modality treatment applied mainly to patients in stages III and IV was the factor that affected the cost. Disease stage was also associated with the total duration of hospitalization (p < 0.05). Conclusions The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life. PMID:12133170

  18. Advanced biomaterials and their potential applications in the treatment of periodontal disease.

    PubMed

    Chen, Xi; Wu, Guofeng; Feng, Zhihong; Dong, Yan; Zhou, Wei; Li, Bei; Bai, Shizhu; Zhao, Yimin

    2016-08-01

    Periodontal disease is considered as a widespread infectious disease and the most common cause of tooth loss in adults. Attempts for developing periodontal disease treatment strategies, including drug delivery and regeneration approaches, provide a useful experimental model for the evaluation of future periodontal therapies. Recently, emerging advanced biomaterials including hydrogels, films, micro/nanofibers and particles, hold great potential to be utilized as cell/drug carriers for local drug delivery and biomimetic scaffolds for future regeneration therapies. In this review, first, we describe the pathogenesis of periodontal disease, including plaque formation, immune response and inflammatory reactions caused by bacteria. Second, periodontal therapy and an overview of current biomaterials in periodontal regenerative medicine have been discussed. Third, the roles of state-of-the-art biomaterials, including hydrogels, films, micro/nanofibers and micro/nanoparticles, developed for periodontal disease treatment and periodontal tissue regeneration, and their fabrication methods, have been presented. Finally, biological properties, including biocompatibility, biodegradability and immunogenicity of the biomaterials, together with their current applications strategies are given. Conclusive remarks and future perspectives for such advanced biomaterials are discussed.

  19. Conformal Radiotherapy in the Treatment of Advanced Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension: An Institutional Experience

    SciTech Connect

    Chakraborty, Santam; Ghoshal, Sushmita; Patil, Vijay Maruti; Oinam, Arun Singh; Sharma, Suresh C.

    2011-08-01

    Purpose: To describe the results of conformal radiotherapy in advanced juvenile nasopharyngeal angiofibroma in a tertiary care institution. Methods and Materials: Retrospective chart review was conducted for 8 patients treated with conformal radiotherapy between 2006 and 2009. The median follow-up was 17 months. All patients had Stage IIIB disease with intracranial extension. Radiotherapy was considered as treatment because patients were deemed inoperable owing to extensive intracranial/intraorbital extension or proximity to optic nerve. All but 1 patient were treated with intensity-modulated radiotherapy using seven coplanar fields. Median (range) dose prescribed was 39.6 (30-46) Gy. Actuarial analysis of local control and descriptive analysis of toxicity profile was conducted. Results: Despite the large and complex target volume (median planning target volume, 292 cm{sup 3}), intensity-modulated radiotherapy achieved conformal dose distributions (median van't Reit index, 0.66). Significant sparing of the surrounding organs at risk was obtained. No significant Grade 3/4 toxicities were experienced during or after treatment. Actual local control at 2 years was 87.5%. One patient died 1 month after radiotherapy secondary to massive epistaxis. The remaining 7 patients had progressive resolution of disease and were symptom-free at last follow-up. Persistent rhinitis was the only significant toxicity, seen in 1 patient. Conclusions: Conformal radiotherapy results in good local control with minimal acute and late side effects in juvenile nasopharyngeal angiofibromas, even in the presence of advanced disease.

  20. Technological Advances in the Treatment of Cancer: Combining Modalities to Optimize Outcomes.

    PubMed

    Wong, Eric T; Toms, Steven A; Ahluwalia, Manmeet S

    2015-11-01

    The anticancer treatment modality tumor treating fields (TTFields; Optune, Novocure) use the lower frequency range of the electromagnetic spectrum to destroy tumor cells during mitosis. This treatment has been evaluated in several trials of patients with glioblastoma. In these patients, TTFields are delivered through 4 transducer arrays applied to the scalp. In a phase 3 clinical trial of patients with recurrent glioblastoma, TTFields were as effective as chemotherapy, and were associated with fewer and milder systemic toxicities. Data from a phase 3 trial in newly diagnosed glioblastoma suggested that the addition of TTFields to postoperative radiation therapy and chemotherapy represents an important advance in the management of newly diagnosed glioblastoma. Ongoing clinical trials are investigating the efficacy and safety of TTFields in other tumor types, including pancreatic cancer, mesothelioma, ovarian cancer, and non–small cell lung cancer. Other recent advances in the management of cancer have been seen with immunomodulatory therapy, including immune checkpoint inhibitors. Further study will be necessary to evaluate whether TTFields will enhance or impair other established and newly emerging therapies.

  1. Integrated nitrogen removal biofilter system with ceramic membrane for advanced post-treatment of municipal wastewater.

    PubMed

    Son, Dong-Jin; Yun, Chan-Young; Kim, Woo-Yeol; Zhang, Xing-Ya; Kim, Dae-Gun; Chang, Duk; Sunwoo, Young; Hong, Ki-Ho

    2016-12-01

    The pre-denitrification biofilm process for nitrogen removal was combined with ceramic membrane with pore sizes of 0.05-0.1 µm as a system for advanced post-treatment of municipal wastewater. The system was operated under an empty bed hydraulic retention time of 7.8 h, recirculation ratio of 3, and transmembrane pressure of 0.47 bar. The system showed average removals of organics, total nitrogen, and solids as high as 93%, 80%, and 100%, respectively. Rapid nitrification could be achieved and denitrification was performed in the anoxic filter without external carbon supplements. The residual particulate organics and nitrogen in effluent from biofilm process could be also removed successfully through membrane filtration and the removal of total coliform was noticeably improved after membrane filtration. Thus, a system composed of the pre-denitrification biofilm process with ceramic membrane would be a compact and flexible option for advanced post-treatment of municipal wastewater.

  2. Treatment-related gastrointestinal toxicities and advanced colorectal or pancreatic cancer: A critical update.

    PubMed

    Aprile, Giuseppe; Rihawi, Karim; De Carlo, Elisa; Sonis, Stephen T

    2015-11-07

    Gastrointestinal toxicities (GIT), including oral mucositis, nausea and vomiting, and diarrhea, are common side effects of chemotherapy and targeted agents in patients with advanced colorectal cancer and pancreatic cancer. Being often underreported, it is still difficult to precisely establish their burden in terms of both patient's quality of life and cancer care costs. Moreover, with the use of more intensive upfront combination regimens, the frequency of these toxicities is rapidly growing with a potential negative effect also on patient's outcome, as a result of dose reductions, delays or even discontinuation of active treatments. Thus, identifying patients at higher risk of developing GIT as well as an optimal management are paramount in order to improve patient's compliance and outcome. After the description of the main treatment-induced GIT, we discuss the current knowledge on the pathophysiology of these side effects and comment the scales commonly used to assess and grade them. We then provide a critical update on GIT incidence based on the results of key randomized trials conducted in patients with metastatic colorectal cancer and advanced pancreatic cancer.

  3. Dynamic tension EMG to characterize the effects of DBS treatment of advanced Parkinson's disease.

    PubMed

    Ruonala, V; Pekkonen, E; Rissanen, S; Airaksinen, O; Miroshnichenko, G; Kankaanpää, M; Karjalainen, P

    2014-01-01

    Deep brain stimulation (DBS) is an effective treatment method for motor symptoms of advanced Parkinson's disease. DBS-electrode is implanted to subthalamic nucleus to give precisely allocated electrical stimuli to brain. The optimal stimulus type has to be adjusted individually. Disease severity, main symptoms and biological factors play a role in correctly setting up the device. Currently there are no objective methods to assess the efficacy of DBS, hence the adjustment is based solely on clinical assessment. In optimal case an objectively measurable feature would point the right settings of DBS. Surface electromyographic and kinematic measurements have been used in Parkinson's disease research. As Parkinson's disease symptoms are known to change the EMG signal properties, these methods could be helpful aid in the clinical adjustment of DBS. In this study, 13 patients with advanced Parkinson's disease who received DBS treatment were measured. The patients were measured with seven different settings of the DBS in clinical range including changes in stimulation amplitude, frequency and pulse width. The EMG analysis was based on parameters that characterize EMG signal morphology. Correlation dimension and recurrence rate made the most significant difference in relation to optimal settings. In conclusion, EMG analysis is able to detect differences between the DBS setups, and can help in finding the correct parameters.

  4. Advanced treatment of coking wastewater by coagulation and zero-valent iron processes.

    PubMed

    Lai, Peng; Zhao, Hua-zhang; Wang, Chao; Ni, Jin-ren

    2007-08-17

    Advanced treatment of coking wastewater was investigated experimentally with coagulation and zero-valent iron (ZVI) processes. Particular attention was paid to the effect of dosage and pH on the removal of chemical oxygen demand (COD) in the two processes. The results showed that ZVI was more effective than coagulation for advanced treatment of coking wastewater. The jar tests revealed that maximal COD removal efficiency of 27.5-31.8% could be achieved under the optimal condition of coagulation, i.e. 400mg/L of Fe(2)(SO(4))3 as coagulant at pH 3.0-5.0. On the other hand, the COD removal efficiency could be up to 43.6% under the idealized condition of ZVI upon 10 g/L active carbon and 30 g/L iron being dosed at pH 4.0. The mechanisms for COD removal in ZVI were dominated by coagulation, precipitation and oxidation-reduction. ZVI would also enhance the biodegradability of effluent by increasing BOD5/COD from 0.07 to 0.53. Moreover, some ester compounds could be produced in the reaction. Although ZVI was found more efficient than coagulation in eliminating low molecular weight (<2000 Da) compounds in the wastewater, there were still a few residual contaminants which could hardly be eliminated by either of the process.

  5. Treatment-related gastrointestinal toxicities and advanced colorectal or pancreatic cancer: A critical update

    PubMed Central

    Aprile, Giuseppe; Rihawi, Karim; De Carlo, Elisa; Sonis, Stephen T

    2015-01-01

    Gastrointestinal toxicities (GIT), including oral mucositis, nausea and vomiting, and diarrhea, are common side effects of chemotherapy and targeted agents in patients with advanced colorectal cancer and pancreatic cancer. Being often underreported, it is still difficult to precisely establish their burden in terms of both patient’s quality of life and cancer care costs. Moreover, with the use of more intensive upfront combination regimens, the frequency of these toxicities is rapidly growing with a potential negative effect also on patient’s outcome, as a result of dose reductions, delays or even discontinuation of active treatments. Thus, identifying patients at higher risk of developing GIT as well as an optimal management are paramount in order to improve patient’s compliance and outcome. After the description of the main treatment-induced GIT, we discuss the current knowledge on the pathophysiology of these side effects and comment the scales commonly used to assess and grade them. We then provide a critical update on GIT incidence based on the results of key randomized trials conducted in patients with metastatic colorectal cancer and advanced pancreatic cancer. PMID:26557003

  6. Novel Approaches to Treatment of Advanced Melanoma: A Review on Targeted Therapy and Immunotherapy

    PubMed Central

    Niezgoda, Anna; Niezgoda, Piotr; Czajkowski, Rafał

    2015-01-01

    The incidence of malignant melanoma is increasing. The majority of patients are diagnosed in early stages when the disease is highly curable. However, the more advanced or metastatic cases have always been a challenge for clinicians. The poor prognosis for patients with melanoma is now changing as numerous of promising approaches have appeared recently. The discovery of aberrations of pathways responsible for intracellular signal transduction allowed us to introduce agents specifically targeting the mutated cascades. Numerous clinical studies have been conducted to improve effectiveness of melanoma treatment. From 2011 until now, the U.S. FDA has approved seven novel agents, such as BRAF-inhibitors (vemurafenib 2011, dabrafenib 2013), MEK-inhibitors (trametinib 2013), anti-PD1 antibodies (nivolumab 2014, pembrolizumab 2014), anti-CTLA-4 antibody (ipilimumab 2011), or peginterferon-alfa-2b (2011) intended to be used in most advanced cases of melanoma. Nevertheless, clinicians continue working on new possible methods of treatment as resistance to the novel drugs is a commonly observed problem. This paper is based on latest data published until the end of January 2015. PMID:26171394

  7. Redox conditions for mantle plumes

    NASA Astrophysics Data System (ADS)

    Heister, L. E.; Lesher, C. E.

    2005-12-01

    The vanadium to scandium ratio (V/Sc) for basalts from mid-ocean ridge (MOR) and arc environments has been proposed as a proxy for fO2 conditions during partial melting (e.g. [1] and [2]). Contrary to barometric measurements of the fO2 of primitive lavas, the V/Sc ratio of the upper mantle at mid-ocean ridges and arcs is similar, leading previous authors to propose that the upper mantle has uniform redox potential and is well-buffered. We have attempted to broaden the applicability of the V/Sc parameter to plume-influenced localities (both oceanic and continental), where mantle heterogeneities associated with recycled sediments, mafic crust, and metasomatized mantle, whether of shallow or deep origin, exist. We find that primitive basalts from the North Atlantic Igneous Province (NAIP), Hawaii (both the Loa and Kea trends), Deccan, Columbia River, and Siberian Traps show a range of V/Sc ratios that are generally higher (average ~9) than those for MOR (average ~ 6.7) or arc (average ~7) lavas. Based on forward polybaric decompression modeling, we attribute these differences to polybaric melting and melt segregation within the garnet stability field rather than the presence of a more oxidized mantle in plume-influenced settings. Like MORB, the V/Sc ratios for plume-influenced basalts can be accounted for by an oxidation state approximately one log unit below the Ni-NiO buffer (NNO-1). Our analysis suggests that source heterogeneities have little, if any, resolvable influence on mantle redox conditions, although they have significant influence on the trace element and isotopic composition of mantle-derived melts. We suggest that variations in the redox of erupted lavas is largely a function of shallow lithospheric processes rather than intrinsic to the mantle source, regardless of tectonic setting. [1] Li and Lee (2004) EPSL, [2] Lee et al. (2005) J. of Petrology

  8. Temporal Variation in the Prognosis and Treatment of Advanced Heart Failure - Before and After 2000

    PubMed Central

    Del Carlo, Carlos Henrique; Cardoso, Juliano Novaes; Ochia, Marcelo Eidi; de Oliveira, Mucio Tavares; Ramires, José Antonio Franchini; Pereira-Barretto, Antonio Carlos

    2014-01-01

    Background The treatment of heart failure has evolved in recent decades suggesting that survival is increasing. Objective To verify whether there has been improvement in the survival of patients with advanced heart failure. Methods We retrospectively compared the treatment and follow-up data from two cohorts of patients with systolic heart failure admitted for compensation up to 2000 (n = 353) and after 2000 (n = 279). We analyzed in-hospital death, re-hospitalization and death in 1 year of follow-up. We used Mann-Whitney U test and chi-square test for comparison between groups. The predictors of mortality were identified by regression analysis through Cox proportional hazards model and survival analysis by the Kaplan-Meier survival analysis. Results The patients admitted until 2000 were younger, had lower left ventricular impairment and received a lower proportion of beta-blockers at discharge. The survival of patients hospitalized before 2000 was lower than those hospitalized after 2000 (40.1% vs. 67.4%; p<0.001). The independent predictors of mortality in the regression analysis were: Chagas disease (hazard ratio: 1.9; 95% confidence interval: 1.3-3.0), angiotensin-converting-enzyme inhibitors (hazard ratio: 0.6; 95% confidence interval: 0.4-0.9), beta-blockers (hazard ratio: 0.3; 95% confidence interval: 0.2-0.5), creatinine ≥ 1.4 mg/dL (hazard ratio: 2.0; 95% confidence interval: 1.3-3.0), serum sodium ≤ 135 mEq/L (hazard ratio: 1.8; 95% confidence interval: 1.2-2.7). Conclusions Patients with advanced heart failure showed a significant improvement in survival and reduction in re-hospitalizations. The neurohormonal blockade, with angiotensin-converting-enzyme inhibitors and beta-blockers, had an important role in increasing survival of these patients with advanced heart failure. PMID:24759950

  9. Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

    PubMed Central

    Lee, Hyun-Joo; Kim, Poong-Taek; Deslivia, Maria Florencia; Lee, Suk-Joong; Nam, Sang-Jin

    2015-01-01

    Background Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results. PMID:26330961

  10. Efficacy of prophylactic anti-diarrhoeal treatment in patients receiving Campto for advanced colorectal cancer.

    PubMed

    Duffour, J; Gourgou, S; Seitz, J F; Senesse, P; Boutet, O; Castera, D; Kramar, A; Ychou, M

    2002-01-01

    This study assessed the efficacy of combined prophylactic and curative anti-diarrhoeal medication in advanced colorectal patients treated by irinotecan. Thirty-four pre-treated eligible patients were evaluated. There were 44% women, the median age was 65 and 38% of the patients had a 0 performance status. The patients received sucralfate(4g/d) and nifuroxazide(600 mg/d) prophylactic treatment on days 0-7. In the case of severe diarrhoea, preventive treatment was replaced by loperamide(12 mg/d) and diosmectite (9 g/d). Grade 3 delayed diarrhoea occurred in 18% of patients (90% CI: [9.5-28.9]) and 4.6% of cycles. No grade 4 delayed diarrhoea was observed. Twenty-nine patients (85%) received the preventive treatment at cycle 1, while 14% (90% CI: [6.2-25.7]) experienced grade 3 delayed diarrhoea in 3.7% of cycles for a median 4.5 days. The objective response rate was 8% (90% CI [1.4-23.1]) among the 25 assessable patients. Preventive combined treatment is effective in reducing the incidence of severe delayed diarrhoea, and it should be proposed to patients treated with mono-therapy Campto(r) and evaluated in poly-chemotherapy protocols.

  11. Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

    PubMed Central

    Murray, Bethany; McNew, Brittany

    2015-01-01

    Abstract Purpose This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs). Data sources PubMed searches were conducted using the following keywords: “bipolar disorder and primary care,” restricted to dates 2000 to present; “bipolar disorder and nurse practitioner”; and “bipolar disorder and clinical nurse specialist.” Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals. Conclusions BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients. Implications for practice Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients. PMID:26172568

  12. Recent advances in delivery of drug-nucleic acid combinations for cancer treatment.

    PubMed

    Li, Jing; Wang, Yan; Zhu, Yu; Oupický, David

    2013-12-10

    Cancer treatment that uses a combination of approaches with the ability to affect multiple disease pathways has been proven highly effective in the treatment of many cancers. Combination therapy can include multiple chemotherapeutics or combinations of chemotherapeutics with other treatment modalities like surgery or radiation. However, despite the widespread clinical use of combination therapies, relatively little attention has been given to the potential of modern nanocarrier delivery methods, like liposomes, micelles, and nanoparticles, to enhance the efficacy of combination treatments. This lack of knowledge is particularly notable in the limited success of vectors for the delivery of combinations of nucleic acids with traditional small molecule drugs. The delivery of drug-nucleic acid combinations is particularly challenging due to differences in the physicochemical properties of the two types of agents. This review discusses recent advances in the development of delivery methods using combinations of small molecule drugs and nucleic acid therapeutics to treat cancer. This review primarily focuses on the rationale used for selecting appropriate drug-nucleic acid combinations as well as progress in the development of nanocarriers suitable for simultaneous delivery of drug-nucleic acid combinations.

  13. Irreversible electroporation in the treatment of locally advanced pancreas and liver metastases of colorectal carcinoma

    PubMed Central

    Wichtowski, Mateusz; Nowaczyk, Piotr; Kocur, Jacek

    2016-01-01

    Aim of the study Irreversible electroporation is a new, non-thermal ablation technique in the treatment of parenchymal organ tumors which uses short high voltage pulses of electricity in order to induce apoptosis of targeted cells. In this paper the application of this method of treatment in locally advanced pancreatic cancer (LAPC) and liver cancer is analyzed. Material and methods Between 04.2014 and 09.2014 two patients with LAPC and one with colorectal liver metastasis (CRLM) were qualified for treatment with irreversible electroporation. Both patients remained under constant observation and control. PubMed/Medline, Embase and Google Scholar databases were searched and eight original reports on irreversible electroporation of pancreatic and liver tumors based on the biggest groups of patients were found. Results Two patients with LAPC and one with CRLM were qualified for ablation with irreversible electroporation. In all three patients a successful irreversible electroporation (IRE) procedure of the whole tumor was conducted. In the minimum seven-month follow-up 100% local control was achieved – without progression. In the literature review the local response to treatment ranged from 41% to 100%. The event-free survival rate in six-month observation was 94%. Conclusions Ablation with irreversible electroporation is a new non-thermal ablation technique which has been demonstrated, both in the previously published studies and in the cases described in this paper, as a safe and efficient therapeutic method for patients with LAPC and CRLM. PMID:27095938

  14. Treatment of gingival recessions by guided tissue regeneration and coronally advanced flap.

    PubMed

    Banihashemrad, Ali; Aghassizadeh, Ershad; Radvar, Mehrdad

    2009-01-01

    Gingival recession refers to the denudation of root surface caused by apical migration of the gingival margin as a result of destruction of the covering gingival tissue of the affected area. It is among the most frequent problems presented by periodontal patients and may have different etiologies and sequels. So far, several techniques have been devised and tested to treat gingival recession. The aim of this study was to assess the effectiveness of using a GTR resorbable collagen membrane in conjunction with coronally advanced flap (CAF) as compared to CAF alone in the treatment of Miller's Class I & II gingival recessions. Seven patients took part in the study, each providing either two or four facial recessions of 3 mm. to 6 mm., totaling 11 pairs of gingival recessions. The two paired sites within each patient were randomly assigned to one of the two treatments mentioned above. Prior to and six months after treatments, the following clinical parameters were measured and recorded: recession depth; probing pocket depth; clinical attachment level; width of keratinized gingiva; and width of recession. After six months, recession depth showed a mean reduction of 67.88% and 57.42% in the "GTR + CAF" and "CAF alone" groups, respectively. The mean difference between the groups was 1+/-0.33 mm (P=0.03). The results of this study indicate that Miller's Class I & II gingival recessions are amenable to treatment using the GTR technique with satisfactory outcome.

  15. Maxillary, mandibular, and chin advancement: treatment planning based on airway anatomy in obstructive sleep apnea.

    PubMed

    Schendel, Stephen; Powell, Nelson; Jacobson, Richard

    2011-03-01

    Surgical correction of obstructive sleep apnea (OSA) syndrome involves understanding a number of parameters, of which the 3-dimensional airway anatomy is important. Visualization of the upper airway based on cone beam computed tomography scans and automated computer analysis is an aid in understanding normal and abnormal airway conditions and their response to surgery. The goal of surgical treatment of OSA syndrome is to enlarge the velo-oropharyngeal airway by anterior/lateral displacement of the soft tissues and musculature by maxillary, mandibular, and possibly, genioglossus advancement. Knowledge of the specific airway obstruction and characteristics based on 3-dimensional studies permits a directed surgical treatment plan that can successfully address the area or areas of airway obstruction. The end occlusal result can be improved when orthodontic treatment is combined with the surgical plan. The individual with OSA, though, is more complicated than the usual orthognathic patient, and both the medical condition and treatment length need to be judiciously managed when OSA and associated conditions are present. The perioperative management of the patient with OSA is more complex and the margin for error is reduced, and this needs to be taken into consideration and the care altered as indicated.

  16. Simulation of plume rise: Study the effect of stably stratified turbulence layer on the rise of a buoyant plume from a continuous source by observing the plume centroid

    NASA Astrophysics Data System (ADS)

    Bhimireddy, Sudheer Reddy; Bhaganagar, Kiran

    2016-11-01

    Buoyant plumes are common in atmosphere when there exists a difference in temperature or density between the source and its ambience. In a stratified environment, plume rise happens until the buoyancy variation exists between the plume and ambience. In a calm no wind ambience, this plume rise is purely vertical and the entrainment happens because of the relative motion of the plume with ambience and also ambient turbulence. In this study, a plume centroid is defined as the plume mass center and is calculated from the kinematic equation which relates the rate of change of centroids position to the plume rise velocity. Parameters needed to describe the plume are considered as the plume radius, plumes vertical velocity and local buoyancy of the plume. The plume rise velocity is calculated by the mass, momentum and heat conservation equations in their differential form. Our study focuses on the entrainment velocity, as it depicts the extent of plume growth. This entrainment velocity is made up as sum of fractions of plume's relative velocity and ambient turbulence. From the results, we studied the effect of turbulence on the plume growth by observing the variation in the plume radius at different heights and the centroid height reached before loosing its buoyancy.

  17. Moving forward: advances in the treatment of movement disorders with deep brain stimulation.

    PubMed

    Schiefer, Terry K; Matsumoto, Joseph Y; Lee, Kendall H

    2011-01-01

    The modern era of stereotactic and functional neurosurgery has ushered in state of the art technologies for the treatment of movement disorders, particularly Parkinson's disease (PD), tremor, and dystonia. After years of experience with various surgical therapies, the eventual shortcomings of both medical and surgical treatments, and several serendipitous discoveries, deep brain stimulation (DBS) has risen to the forefront as a highly effective, safe, and reversible treatment for these conditions. Idiopathic advanced PD can be treated with thalamic, globus pallidus internus (GPi), or subthalamic nucleus (STN) DBS. Thalamic DBS primarily relieves tremor while GPi and STN DBS alleviate a wide range of Parkinsonian symptoms. Thalamic DBS is also used in the treatment of other types of tremor, particularly essential tremor, with excellent results. Both primary and various types of secondary dystonia can be treated very effectively with GPi DBS. The variety of anatomical targets for these movement disorders is indicative of the network-level dysfunction mediating these movement disturbances. Despite an increasing understanding of the clinical benefits of DBS, little is known about how DBS can create such wide sweeping neuromodulatory effects. The key to improving this therapeutic modality and discovering new ways to treat these and other neurologic conditions lies in better understanding the intricacies of DBS. Here we review the history and pertinent clinical data for DBS treatment of PD, tremor, and dystonia. While multiple regions of the brain have been targeted for DBS in the treatment of these movement disorders, this review article focuses on those that are most commonly used in current clinical practice. Our search criteria for PubMed included combinations of the following terms: DBS, neuromodulation, movement disorders, PD, tremor, dystonia, and history. Dates were not restricted.

  18. Radiotherapy and Hyperthermia for Treatment of Primary Locally Advanced Cervix Cancer: Results in 378 Patients

    SciTech Connect

    Franckena, Martine Lutgens, Ludy C.; Koper, Peter C.; Kleynen, Catharina E.; Steen-Banasik, Elsbieta M. van der; Jobsen, Jan J.; Leer, Jan Willem; Creutzberg, Carien L.; Dielwart, Michel F.; Norden, Yvette van; Canters, Richard A.M.; Rhoon, Gerard C. van; Zee, Jacoba van der

    2009-01-01

    Purpose: To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series. Methods and Materials: From 1996 to 2005, a total of 378 patients with LACC (International Federation of Gynecology and Obstetrics Stage IB2-IVA) were treated with RHT. External beam radiotherapy (RT) was applied to 46-50.4 Gy and combined with brachytherapy. The hyperthermia (HT) was prescribed once weekly. Primary end points were complete response (CR) and local control. Secondary end points were overall survival, disease-specific survival, and late toxicity. Patient, tumor, and treatment characteristics predictive for the end points were identified in univariate and multivariate analyses. Results: Overall, a CR was achieved in 77% of patients. At 5 years, local control, disease-specific survival, and incidence of late toxicity Common Terminology Criteria for Adverse Events Grade 3 or higher were 53%, 47%, and 12%, respectively. In multivariate analysis, number of HT treatments emerged as a predictor of outcome in addition to commonly identified prognostic factors. Conclusions: The CR, local control, and survival rates are similar to previously observed results of RHT in the randomized Dutch Deep Hyperthermia Trial. Reported treatment results for currently applied combined treatment modalities (i.e., RT with chemotherapy and/or HT) do not permit definite conclusions about which combination is superior. The present results confirm previously shown beneficial effects from adding HT to RT and justify the application of RHT as first-line treatment in patients with LACC as an alternative to chemoradiation.

  19. Approval summary: letrozole in the treatment of postmenopausal women with advanced breast cancer.

    PubMed

    Cohen, Martin H; Johnson, John R; Li, Ning; Chen, Gang; Pazdur, Richard

    2002-03-01

    Letrozole (Femara; Novartis Pharmaceuticals Corp., East Hanover, NJ) is a nonsteroidal inhibitor of aromatase enzyme complex. It inhibits the peripheral conversion of circulating androgens to estrogens. In postmenopausal women, letrozole decreases plasma concentrations of estradiol, estrone, and estrone sulfate by 75-95% from baseline with maximal suppression achieved within 2-3 days of treatment initiation. Suppression is dose related, with doses of >or=0.5 mg giving estrone and estrone sulfate values that were often below assay detection limits. At clinically used dosage, letrozole does not impair adrenal synthesis of glucocorticoids or aldosterone. In 1998, letrozole was approved by the United States Food and Drug Administration (FDA) for the treatment of advanced breast cancer in postmenopausal women, with hormone receptor positive or unknown breast cancer, who had failed one prior antiestrogen treatment (i.e., for "second-line" treatment). Approval was based on two randomized trials comparing tumor RRs of patients receiving 0.5 mg of letrozole, 2.5 mg of letrozole, and either megestrol acetate (MA) or aminoglutethimide. In the megestrol trial, 2.5 mg/day letrozole was superior to 0.5 mg of letrozole and MA (RRs 24, 13, and 16%, respectively), whereas in the aminoglutethimide trial, there was no significant difference in 2.5 mg of letrozole and 0.5 mg of letrozole RRs (20 and 17%). There was a trend toward RR superiority of 2.5 mg of letrozole over aminoglutethimide (P = 0.06). Letrozole (2.5 mg) was the dose chosen for comparison with tamoxifen in the first-line setting. In July 2000, a marketing application for first-line letrozole treatment of postmenopausal women with hormone receptor positive or hormone receptor unknown locally advanced or metastatic breast cancer was submitted to the FDA. A single double-blind, double dummy, randomized, and multicenter trial compared 2.5 mg of letrozole to 20 mg of tamoxifen (456 patients/arm). Letrozole was superior to

  20. Can activated sludge treatments and advanced oxidation processes remove organophosphorus flame retardants?

    PubMed

    Cristale, Joyce; Ramos, Dayana D; Dantas, Renato F; Machulek Junior, Amilcar; Lacorte, Silvia; Sans, Carme; Esplugas, Santiago

    2016-01-01

    This study aims to determine the occurrence of 10 OPFRs (including chlorinated, nonchlorinated alkyl and aryl compounds) in influent, effluent wastewaters and partitioning into sludge of 5 wastewater treatment plants (WWTP) in Catalonia (Spain). All target OPFRs were detected in the WWTPs influents, and the total concentration ranged from 3.67 µg L(-1) to 150 µg L(-1). During activated sludge treatment, most OPFRs were accumulated in the sludge at concentrations from 35.3 to 9980 ng g(-1) dw. Chlorinated compounds tris(2-chloroethyl) phosphate (TCEP), tris(2-chloroisopropyl) phosphate (TCIPP) and tris(2,3-dichloropropyl) phosphate (TDCPP) were not removed by the conventional activated sludge treatment and they were released by the effluents at approximately the same inlet concentration. On the contrary, aryl compounds tris(methylphenyl) phosphate (TMPP) and 2-ethylhexyl diphenyl phosphate (EHDP) together with alkyl tris(2-ethylhexyl) phosphate (TEHP) were not detected in any of the effluents. Advanced oxidation processes (UV/H2O2 and O3) were applied to investigate the degradability of recalcitrant OPFRs in WWTP effluents. Those detected in the effluent sample (TCEP, TCIPP, TDCPP, tributyl phosphate (TNBP), tri-iso-butyl phosphate (TIBP) and tris(2-butoxyethyl) phosphate (TBOEP)) had very low direct UV-C photolysis rates. TBOEP, TNBP and TIBP were degraded by UV/H2O2 and O3. Chlorinated compounds TCEP, TDCPP and TCIPP were the most recalcitrant OPFR to the advanced oxidation processes applied. The study provides information on the partitioning and degradability pathways of OPFR within conventional activated sludge WWTPs.

  1. Degradation pathways of lamotrigine under advanced treatment by direct UV photolysis, hydroxyl radicals, and ozone.

    PubMed

    Keen, Olya S; Ferrer, Imma; Michael Thurman, E; Linden, Karl G

    2014-12-01

    Lamotrigine is recently recognized as a persistent pharmaceutical in the water environment and wastewater effluents. Its degradation was studied under UV and ozone advanced oxidation treatments with reaction kinetics of lamotrigine with ozone (≈4 M(-1)s(-1)), hydroxyl radical [(2.1 ± 0.3) × 10(9)M(-1)s(-1)] and by UV photolysis with low and medium pressure mercury vapor lamps [quantum yields ≈0 and (2.7 ± 0.4)× 10(-4) respectively] determined. All constants were measured at pH 6 and at temperature ≈20°C. The results indicate that lamotrigine is slow to respond to direct photolysis or oxidation by ozone and no attenuation of the contaminant is expected in UV or ozone disinfection applications. The compound reacts rapidly with hydroxyl radicals indicating that advanced oxidation processes would be effective for its treatment. Degradation products were identified under each treatment process using accurate mass time-of-flight spectrometry and pathways of decay were proposed. The main transformation pathways in each process were: dechlorination of the benzene ring during direct photolysis; hydroxyl group addition to the benzene ring during the reaction with hydroxyl radicals; and triazine ring opening after reaction with ozone. Different products that form in each process may be to a varying degree less environmentally stable than the parent lamotrigine. In addition, a novel method of ozone quenching without addition of salts is presented. The new quenching method would allow subsequent mass spectrometry analysis without a solid phase extraction clean-up step. The method involves raising the pH of the sample to approximately 10 for a few seconds and lowering it back and is therefore limited to applications for which temporary pH change is not expected to affect the outcome of the analysis.

  2. The MISR Wildfire Smoke Plume Height Project

    NASA Astrophysics Data System (ADS)

    Nelson, D. L.; Garay, M. J.; Diner, D. J.; Kahn, R. A.

    2010-12-01

    Together the Multi-angle Imaging SpectroRadiometer (MISR) and the Moderate Resolution Imaging Spectoradiometer (MODIS) instruments on the Terra satellite observe several characteristics of wildfire smoke plumes. With support from NASA and the EPA, the MISR team is assembling a database of these observations for North America, Africa, Siberia, Indonesia, etc. that extends back to the beginning of the Terra mission in 2000. The thermal infrared channels on MODIS provide the location of fires and their approximate radiative power. By using an interactive visualization program called the MISR INteractive eXplorer (MINX), users interactively digitize wildfire plumes to retrieve accurate plume heights and wind speeds using a new stereo height retrieval algorithm. This information, along with the locations and directions of individual plumes, their areas and aerosol properties derived from the operational MISR aerosol algorithm, are stored in this publicly accessible database for subsequent analysis (http://www-misr2.jpl.nasa.gov/EPA-Plumes/). The plume database currently contains about 4000 smoke plumes and smoke clouds from North America. An equal number of plumes and clouds for other regions around the world has also been digitized. A few thousand additional plumes are in the process of being incorporated. Smoke plumes in this context are considered to be discrete regions of smoke that can be followed to their fire sources at ground level and have a distinctive shape determined by the direction the smoke is driven downwind. Smoke “clouds” are defined here as regions of dense smoke not clearly associated with specific fire sources, and whose direction of transport is not easily determined. Plume height measurements can be used as a surrogate for injection heights, which are important for modeling smoke transport. Examples of height and wind retrievals for specific plumes will be shown. Those chosen have not only been incorporated in statistical analyses of plume

  3. Radiation Chemistry of Potential Europa Plumes

    NASA Astrophysics Data System (ADS)

    Gudipati, M. S.; Henderson, B. L.

    2014-12-01

    Recent detection of atomic hydrogen and atomic oxygen and their correlation to potential water plumes on Europa [Roth, Saur et al. 2014] invoked significant interest in further understanding of these potential/putative plumes on Europa. Unlike on Enceladus, Europa receives significant amount of electron and particle radiation. If the plumes come from trailing hemisphere and in the high radiation flux regions, then it is expected that the plume molecules be subjected to radiation processing. Our interest is to understand to what extent such radiation alterations occur and how they can be correlated to the plume original composition, whether organic or inorganic in nature. We will present laboratory studies [Henderson and Gudipati 2014] involving pulsed infrared laser ablation of ice that generates plumes similar to those observed on Enceladus [Hansen, Esposito et al. 2006; Hansen, Shemansky et al. 2011] and expected to be similar on Europa as a starting point; demonstrating the applicability of laser ablation to simulate plumes of Europa and Enceladus. We will present results from electron irradiation of these plumes to determine how organic and inorganic composition is altered due to radiation. Acknowledgments:This research was enabled through partial funding from NASA funding through Planetary Atmospheres, and the Europa Clipper Pre-Project. B.L.H. acknowledges funding from the NASA Postdoctoral Program for an NPP fellowship. Hansen, C. J., L. Esposito, et al. (2006). "Enceladus' water vapor plume." Science 311(5766): 1422-1425. Hansen, C. J., D. E. Shemansky, et al. (2011). "The composition and structure of the Enceladus plume." Geophysical Research Letters 38. Henderson, B. L. and M. S. Gudipati (2014). "Plume Composition and Evolution in Multicomponent Ices Using Resonant Two-Step Laser Ablation and Ionization Mass Spectrometry." The Journal of Physical Chemistry A 118(29): 5454-5463. Roth, L., J. Saur, et al. (2014). "Transient Water Vapor at Europa's South

  4. Doublet Versus Single Agent as Second-Line Treatment for Advanced Gastric Cancer

    PubMed Central

    Zhang, Yong; Ma, Bing; Huang, Xiao-Tian; Li, Yan-Song; Wang, Yu; Liu, Zhou-Lu

    2016-01-01

    Abstract The purpose of this study was to perform a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of doublet versus single agent as second-line treatment for advanced gastric cancer (AGC). A comprehensive literature search was performed to identify relevant RCTs. All clinical studies were independently identified by 2 authors for inclusion. Demographic data, treatment regimens, objective response rate (ORR), and progression-free survival (PFS) and overall survival (OS) were extracted and analyzed using Comprehensive Meta-Analysis software (Version 2.0). Ten RCTs involving 1698 pretreated AGC patients were ultimately identified. The pooled results demonstrated that doublet combination therapy as second-line treatment for AGC significantly improved OS (hazard ratio [HR] 0.87, 95% confidence interval [CI]: 0.78–0.97, P = 0.011), PFS (HR 0.79, 95% CI: 0.72–0.87, P < 0.001), and ORR (relative risk [RR] 1.57, 95% CI: 1.27–1.95, P < 0.001). Sub-group analysis according to treatment regimens also showed that targeted agent plus chemotherapy significantly improve OS, PFS, and ORR. However, no significant survival benefits had been observed in doublet cytotoxic chemotherapy when compared with single cytotoxic agent. Additionally, more incidences of grade 3 or 4 myelosuppression toxicities, diarrhea, and fatigue were observed in doublet combination groups, while equivalent frequencies of grade 3 or 4 thrombocytopenia and nausea were found between the 2 groups. In comparison with single cytotoxic agent alone, the addition of targeted agent to mono-chemotherapy as salvage treatment for pretreated AGC patients provide substantial survival benefits, while no significant survival benefits were observed in doublet cytotoxic chemotherapy regimens. PMID:26937908

  5. VISUAL PLUMES MIXING ZONE MODELING SOFTWARE

    EPA Science Inventory

    The US Environmental Protection Agency has a history of developing plume models and providing technical assistance. The Visual Plumes model (VP) is a recent addition to the public-domain models available on the EPA Center for Exposure Assessment Modeling (CEAM) web page. The Wind...

  6. Io with Loki Plume on Bright Limb

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Voyager 1 image of Io showing active plume of Loki on limb. Heart-shaped feature southeast of Loki consists of fallout deposits from active plume Pele. The images that make up this mosaic were taken from an average distance of approximately 490,000 kilometers (340,000 miles).

  7. VISUAL PLUMES MIXING ZONE MODELING SOFTWARE

    EPA Science Inventory

    The U.S. Environmental Protection Agency has a long history of both supporting plume model development and providing mixing zone modeling software. The Visual Plumes model is the most recent addition to the suite of public-domain models available through the EPA-Athens Center f...

  8. Efficacy and safety of maxillomandibular advancement in treatment of obstructive sleep apnoea syndrome.

    PubMed

    Giarda, M; Brucoli, M; Arcuri, F; Benech, R; Braghiroli, A; Benech, A

    2013-02-01

    To assess the effectiveness of maxillomandibular adavancement for treatment of adults with obstructive sleep apnoea, we report the results obtained after maxillomandibular advancement. A group of 16 patients were studied before surgery, at 6 months after surgery and at followup. The analysis included: upper airway endoscopy during Mueller's manoeuvre, lateral cephalometry, polysomnography and Epworth Sleepiness Scale. The results of surgical treatment were divided into "surgical success" and "surgical cure". The former was defined as an AHI < 20 events/hour and a > 50% reduction in AHI after surgical procedure, while the latter was defined as an AHI < 5 events/hour after surgical procedure. At follow-up, all patients had AHI < 20 events/hour with a surgical success rate of 100%. The surgical cure rate was 37.5%, with 6 patients having an AHI < 5 events/hour. Surgical success and long term stability of outcomes confirm the efficacy and safety of MMA for treatment of obstructive sleep apnoea syndrome. However, a continuous follow-up of these patients is necessary to control their lifestyle and to detect possible relapse.

  9. Impact of extraperitoneal lymphadenectomy on treatment and survival in patients with locally advanced cervical cancer.

    PubMed

    Gil-Moreno, Antonio; Díaz-Feijoo, Berta; Pérez-Benavente, Asumpció; del Campo, José M; Xercavins, Jordi; Martínez-Palones, José M

    2008-09-01

    During the last years, and coinciding with the beginning of the concomitant treatment with radio-chemotherapy, a better control of local cervical cancer has been reached, although failures in the systemic control of the illness have been more frequent. One of the main causes is not treating the illness at the level of the para-aortic lymph nodes, basically because their affectation is unknown and because imaging tests have a high percentage of false negative results. At this time, it is when laparoscopic para-aortic lymphadenectomy arises, in order to be able to know the extension of the illness better before treatment. A extraperitoneal laparoscopic approach is described in order to reduce complications derived from a possible extended irradiation. Between August 2001 and October 2007, a total of 69 patients with bulky and locally advanced cervical cancer (FIGO stages IB2, IIA > 4 cm and IIB-IVA) underwent extraperitoneal laparoscopic lymphadenectomy for surgical staging. Extraperitoneal aortic lymphadenectomy by laparoscopic approach is a technique with low morbidity. Special laparoscopic material is not required and if it is performed by a team trained in technical endoscopics it is not difficult. Radio-chemotherapy treatment began immediately after laparoscopy because of its minimal aggression.

  10. Advanced treatment of benzothiazole contaminated waters: comparison of O3, AC, and O3/AC processes.

    PubMed

    Valdés, H; Zaror, C A

    2005-01-01

    Benzothiazole (BT) is a toxic and poorly biodegradable contaminant, usually found in wastewater from rubber related applications. This compound could be effectively eliminated using advanced treatment processes. This paper compares experimental results on detoxification systems based on ozone oxidation, activated carbon adsorption, and simultaneous adsorption-oxidation using ozone in the presence of activated carbon. The effect of pH (2-11), and the presence of radical scavengers (tert-butyl alcohol and sodium carbonate) on process rates and removal efficiencies are assessed at laboratory scale. The experimental system consisted of a 1 L differential circular flow reactor and an ozone generator rated at 5 g O3/h. Results show that ozone oxidation combined with activated carbon adsorption increases the overall BT oxidation rate with respect to the ozonation process and activated carbon adsorption. In the presence of free radical scavenger, only a 44% reduction in BT removal rate is observed in the simultaneous treatment, as compared with 72% when ozonation treatment is used, suggesting that BT oxidation reactions mainly take place on the activated carbon surface.

  11. Advances in targeting insulin-like growth factor signaling pathway in cancer treatment.

    PubMed

    You, Liangkun; Liu, Changyu; Tang, Hexiao; Liao, Yongde; Fu, Shengling

    2014-01-01

    Insulin-like growth factors (IGFs), along with their receptors and binding proteins, play key roles in human cell proliferation, differentiation and apoptosis. There is now substantial evidence suggesting that the IGF system is involved in the pathogenesis and progression of various malignancies. Recent studies have shown that targeting of the IGF-1 receptor (IGF-1R) signaling pathway might be a novel approach for the treatment of cancer. Presently numerous agents featuring different mechanisms of IGF targeting methods such as IGF-1R monoclonal antibodies, IGF-1R tyrosine kinase inhibitors and IGF ligand specific antibodies are being investigated in more than 170 clinical trials and appear to have potential therapeutic efficacy. However, advanced trials reiterate the importance of predictive biomarkers to guide the clinical efforts of these agents. As a result, current research strategies are emerging to identify the most suitable subpopulations of patients that might benefit from these treatments. Furthermore, newly presented toxicity and growth hormone response and implication of hybrid receptors in IGF signaling pathway pose unprecedented challenges in the design and application of anti-IGF agents. On the other hand, cross-talk in downstream signaling between IGF-1R and other tumor promoting pathways and the development of multi-target agents might encourage the IGF-1R-targeted therapies further into comprehensive treatments of cancer. With both challenges and prospects ahead, this paper reviewed the progress in this particular field.

  12. Critical appraisal of rituximab in the maintenance treatment of advanced follicular lymphoma

    PubMed Central

    Aguiar-Bujanda, David; Blanco-Sánchez, María Jesús; Hernández-Sosa, María; Galván-Ruíz, Saray; Hernández-Sarmiento, Samuel

    2015-01-01

    Rituximab is an IgG1, chimeric monoclonal antibody specifically designed to recognize the CD20 antigen expressed on the surface of normal and malignant B-lymphocytes, from the B-cell precursor to the mature B-cells of the germinal center, and by most neoplasms derived from B-cells. After 2 decades of use, rituximab is firmly positioned in the treatment of follicular lymphoma (FL), both in the front line and in the relapsing disease, improving previous results by including it in classical chemotherapy regimens. However, the pharmacology of rituximab continues to generate controversial issues especially regarding the mechanisms of action in vivo. The contribution of rituximab as a maintenance treatment in FL has been significant progress in the management of this disease without an increase in side effects or a decrease in the quality of life of patients. With the widespread use of rituximab, there are new security alerts and side effects not previously detected in the pivotal trials that clinicians should learn to recognize and manage. In this article, we will review the pharmacokinetics and pharmacodynamics of rituximab, the management issues in the treatment of advanced FL focusing on maintenance rituximab, its long-term efficacy and safety profile, and its effect on the quality of life. PMID:26604821

  13. A membrane-integrated advanced scheme for treatment of industrial wastewater: dynamic modeling towards scale up.

    PubMed

    Kumar, Ramesh; Pal, Parimal

    2013-08-01

    Modeling and simulation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with conversion and recovery of ammoniacal nitrogen as value-added struvite fertilizer from coke wastewater. While toxic cyanide was largely removed in a pre-chemical treatment unit using Fenton's reagents under optimized conditions, more than 95% of NH4(+)-N could be recovered as a valuable by-product called struvite through addition of appropriate doses of magnesium and phosphate salts. Water could be turned reusable through a polishing treatment by nanofiltration membranes in a largely fouling free membrane module following a biodegradation step. Mathematical modeling of such an integrated process was done with Haldane-Andrew approach for the associated microbial degradation of phenol by Pseudomonas putida. Residual NH4(+) was degraded by nitrification and denitrification following the modified Monod kinetics. The model could successfully predict the plant performance as reflected in reasonably low relative error (0.03-0.18) and high Willmott d-index (>0.98).

  14. Multi-functional electrospun nanofibres for advances in tissue regeneration, energy conversion & storage, and water treatment.

    PubMed

    Peng, Shengjie; Jin, Guorui; Li, Linlin; Li, Kai; Srinivasan, Madhavi; Ramakrishna, Seeram; Chen, Jun

    2016-03-07

    Tissue regeneration, energy conversion & storage, and water treatment are some of the most critical challenges facing humanity in the 21st century. In order to address such challenges, one-dimensional (1D) materials are projected to play a key role in developing emerging solutions for the increasingly complex problems. Eletrospinning technology has been demonstrated to be a simple, versatile, and cost-effective method in fabricating a rich variety of materials with 1D nanostructures. These include polymers, composites, and inorganic materials with unique chemical and physical properties. In this tutorial review, we first give a brief introduction to electrospun materials with a special emphasis on the design, fabrication, and modification of 1D functional materials. Adopting the perspective of chemists and materials scientists, we then focus on the recent significant progress made in the domains of tissue regeneration (e.g., skin, nerve, heart and bone) and conversion & storage of clean energy (e.g., solar cells, fuel cells, batteries, and supercapacitors), where nanofibres have been used as active nanomaterials. Furthermore, this review's scope also includes the advances in the use of electrospun materials for the removal of heavy metal ions, organic pollutants, gas and bacteria in water treatment applications. Finally a conclusion and perspective is provided, in which we discuss the remaining challenges for 1D electrospun nanomaterials in tissue regeneration, energy conversion & storage, and water treatment.

  15. Recent Advances on Multi-Parameter Flow Cytometry to Characterize Antimicrobial Treatments

    PubMed Central

    Léonard, Lucie; Bouarab Chibane, Lynda; Ouled Bouhedda, Balkis; Degraeve, Pascal; Oulahal, Nadia

    2016-01-01

    The investigation on antimicrobial mechanisms is a challenging and crucial issue in the fields of food or clinical microbiology, as it constitutes a prerequisite to the development of new antimicrobial processes or compounds, as well as to anticipate phenomenon of microbial resistance. Nowadays it is accepted that a cells population exposed to a stress can cause the appearance of different cell populations and in particular sub-lethally compromised cells which could be defined as viable but non-culturable (VBNC). Recent advances on flow cytometry (FCM) and especially on multi-parameter flow cytometry (MP-FCM) provide the opportunity to obtain high-speed information at real time on damage at single-cell level. This review gathers MP-FCM methodologies based on individual and simultaneous staining of microbial cells employed to investigate their physiological state following different physical and chemical antimicrobial treatments. Special attention will be paid to recent studies exploiting the possibility to corroborate MP-FCM results with additional techniques (plate counting, microscopy, spectroscopy, molecular biology techniques, membrane modeling) in order to elucidate the antimicrobial mechanism of action of a given antimicrobial treatment or compound. The combination of MP-FCM methodologies with these additional methods is namely a promising and increasingly used approach to give further insight in differences in microbial sub-population evolutions in response to antimicrobial treatments. PMID:27551279

  16. Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer

    PubMed Central

    Teymoortash, A.; Werner, J. A.

    2012-01-01

    Still today, the status of the cervical lymph nodes is the most important prognostic factor for head and neck cancer. So the individual treatment concept of the lymphatic drainage depends on the treatment of the primary tumor as well as on the presence or absence of suspect lymph nodes in the imaging diagnosis. Neck dissection may have either a therapeutic objective or a diagnostic one. The selective neck dissection is currently the method of choice for the treatment of patients with advanced head and neck cancers and clinical N0 neck. For oncologic reasons, this procedure is generally recommended with acceptable functional and aesthetic results, especially under the aspect of the mentioned staging procedure. In this review article, current aspects on pre- and posttherapeutic staging of the cervical lymph nodes are described and the indication and the necessary extent of neck dissection for head and neck cancer is discussed. Additionally the critical question is discussed if the lymph node metastasis bears an intrinsic risk of metastatic development and thus its removal in a most possible early stage plays an important role. PMID:23320056

  17. The Importance of Supportive Care in Optimizing Treatment Outcomes of Patients with Advanced Prostate Cancer

    PubMed Central

    2012-01-01

    Optimal oncologic care of older men with prostate cancer, including effective prevention and management of the disease and treatment side effects (so-called best supportive care measures) can prolong survival, improve quality of life, and reduce depressive symptoms. In addition, the proportion of treatment discontinuations can be reduced through early reporting and management of side effects. Pharmacologic care may be offered to manage the side effects of androgen-deprivation therapy and chemotherapy, which may include hot flashes, febrile neutropenia, fatigue, and diarrhea. Nonpharmacologic care (e.g., physical exercise, acupuncture, relaxation) has also been shown to benefit patients. At the Georges Pompidou European Hospital, the Program of Optimization of Chemotherapy Administration has demonstrated that improved outpatient follow-up by supportive care measures can reduce the occurrence of chemotherapy-related side effects, reduce cancellations and modifications of treatment, reduce chemotherapy wastage, and reduce the length of stay in the outpatient unit. The importance of supportive care measures to optimize management and outcomes of older men with advanced prostate cancer should not be overlooked. PMID:23015682

  18. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

    PubMed Central

    Aljiffry, Murad; Walsh, Mark J; Molinari, Michele

    2009-01-01

    Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study. PMID:19750567

  19. Effects of advanced wastewater treatment on the quality of White River, Indiana

    USGS Publications Warehouse

    Crawford, Charles G.; Wangsness, David J.

    1991-01-01

    In 1983, the City of Indianapolis, Indiana, completed construction of advanced wastewater treatment (AWT) systems to enlarge and upgrade its existing Belmont Road and Southport Road secondary treatment plants. A nonparametric statistical procedure, a modified form of the Wilcoxon-Mann-Whitney rank-sum test, was used to test for trends in water quality at two upstream and two downstream sites on White River and at the two treatment plants. Results comparing the pre- (1978-1980) and post- (1983-1988) AWT periods show statistically significant improvements in the quality of the treated effluent and of the White River downstream from the plants. Water quality at sites upstream from the city was relatively constant during the period of study. Total ammonia (as N) decreased 14.6 mg/L and BOD5 (five-day biochemical oxygen demand) decreased 10 to 19 mg/L in the two effluents. Total ammonia in the river downstream from the plants decreased 0.8 to 1.9 mg/L and BOD5 decreased 2.3 to 2.5 mg/L. Nitrate (as N) increased 14.5 mg/L in the plant effluents and 2.0 to 2.4 mg/L in the river because of in-plant nitrification. Dissolved oxygen concentration in the river increased about 3 mg/L because of reduced oxygen demand for nitrification and biochemical oxidation processes.

  20. The effect of advanced treatment on chlorine decay in metallic pipes.

    PubMed

    Rossman, Lewis A

    2006-07-01

    Experiments were run to measure what effect advanced treatment might have on the kinetics of chlorine and chloramine decay in metallic pipes that comprise many drinking water distribution systems. A recirculating loop of 6-in diameter unlined ductile iron pipe was used to simulate turbulent flow conditions in a pipe with significant corrosion and tubercle buildup. Conventionally treated test water was subjected to either ozonation, carbon adsorption (GAC), reverse osmosis (RO) or no further treatment before being chlorinated and introduced into the pipeline simulator. Results showed that overall chlorine decay in the simulator was consistently dominated by wall reactions whose first-order rate constants were an order of magnitude higher than those for the bulk water. With free chlorine, the wall rate constants for ozonated and GAC-treated water were about twice those of conventional or RO-treated water. This behavior is believed due to the effect that changes in the organic content of water have on its ability to complex iron and the effect that changes in water conductivity have on pipe wall corrosion. Tests run with chloraminated water showed no statistically significant effect of treatment type and had wall rate constants that were only 40 to 70% as high as those using free chlorine.

  1. Vermicomposting as an advanced biological treatment for industrial waste from the leather industry.

    PubMed

    Nunes, Ramom R; Bontempi, Rhaissa M; Mendonça, Giovane; Galetti, Gustavo; Rezende, Maria Olímpia O

    2016-01-01

    The leather industry (tanneries) generates high amounts of toxic wastes, including solid and liquid effluents that are rich in organic matter and mineral content. Vermicomposting was studied as an alternative method of treating the wastes from tanneries. Vermicompost was produced from the following tannery residues: tanned chips of wet-blue leather, sludge from a liquid residue treatment station, and a mixture of both. Five hundred earthworms (Eisenia fetida) were added to each barrel. During the following 135 days the following parameters were evaluated: pH, total organic carbon (TOC), organic matter (OM), cation exchange capacity (CEC), C:N ratio, and chromium content as Cr (III) and Cr (VI). The results for pH, TOC and OM contents showed decreases in their values during the composting process, whereas values for CEC and total nitrogen rose, indicating that the vermicompost reached maturity. For chromium, at 135 days, all values of Cr (VI) were below the detectable level. Therefore, the Cr (VI) content had probably been biologically transformed into Cr (III), confirming the use of this technique as an advanced biological treatment. The study reinforces the idea that vermicomposting could be introduced as an effective technology for the treatment of industrial tannery waste and the production of agricultural inputs.

  2. Nonsurgical treatment options for basal cell carcinoma - focus on advanced disease.

    PubMed

    Goldenberg, Gary; Hamid, Omid

    2013-12-01

    Basal cell carcinoma (BCC) is the most common cancer in the world. It is typically slow growing and usually effectively managed with surgery. However, BCCs in some patients are unsuitable for surgery or the patient may prefer a nonsurgical treatment. Radiotherapy is a nonsurgical option for the primary treatment of either low- or high-risk BCCs. It is associated with high cure rates, albeit somewhat lower than those observed with Mohs micrographic surgery for high-risk BCCs. Not all patients with BCCs are suitable for radiotherapy. Superficial therapies for BCC include topical imiquimod or 5- fluorouracil and photodynamic therapy (PDT). These therapies are generally associated with somewhat lower clearance rates and/or higher recurrence rates than surgery or radiotherapy, although they may be suitable in patients with low-risk BCCs when surgery or radiotherapy are impractical or less appropriate. An appealing feature of PDT is excellent cosmesis, but PDT is not currently approved by the Food and Drug Administration (FDA), and regimens are not well standardized. Vismodegib is a first-in-class hedgehog pathway inhibitor and recent addition to the armamentarium for the treatment of advanced BCC.

  3. Applicability of an integrated plume rise model for the dispersion from wild-land fires

    NASA Astrophysics Data System (ADS)

    Kukkonen, J.; Nikmo, J.; Sofiev, M.; Riikonen, K.; Petäjä, T.; Virkkula, A.; Levula, J.; Schobesberger, S.; Webber, D. M.

    2014-11-01

    We have presented an overview of a mathematical model, BUOYANT, that was originally designed for the evaluation of the dispersion of buoyant plumes originated from major warehouse fires. The model addresses the variations of the cross-plume integrated properties of a buoyant plume in the presence of a vertically varying atmosphere. The model also includes a treatment for a rising buoyant plume interacting with an inversion layer. We have compared the model predictions with the data of two prescribed wild-land fire experiments. For the SCAR-C experiment in Quinault (US) in 1994, the predicted vertical extents of the plume at maximum plume rise were between 500 and 800 m and between 200 and 700 m, using two alternative meteorological data sets. The corresponding observed injection heights of the aerosol particles measured using an airborne lidar (light detection and ranging) ranged from 250 to 600 m. For the prescribed burning experiment in Hyytiälä (Finland) in 2009, the model predictions were compared with plume elevations and diameters, determined based on particulate matter number concentration measurements onboard an aeroplane. However, the agreement between modelled and measured results substantially depends on how the properties of the source term are evaluated, especially regarding the convective heat fluxes from the fire. The results demonstrate that in field experiments on wild-land fires, there are substantial uncertainties in estimating both (i) the source terms for the atmospheric dispersion computations and (ii) the relevant vertical meteorological profiles.

  4. MicroRNA signatures and treatment response in patients with advanced classical Hodgkin lymphoma.

    PubMed

    Sánchez-Espiridión, Beatriz; Martín-Moreno, Ana M; Montalbán, Carlos; Figueroa, Vianihuini; Vega, Francisco; Younes, Anas; Medeiros, L Jeffrey; Alvés, Francisco J; Canales, Miguel; Estévez, Mónica; Menarguez, Javier; Sabín, Pilar; Ruiz-Marcellán, María C; Lopez, Andrés; Sánchez-Godoy, Pedro; Burgos, Fernando; Santonja, Carlos; López, José L; Piris, Miguel A; Garcia, Juan F

    2013-08-01

    Although specific microRNA (miRNA) signatures in classical Hodgkin lymphoma (cHL) have been proposed, their relationship with clinical outcome remains unclear. Despite treatment advances, a substantial subset of patients with advanced cHL are refractory to standard therapies based on adriamycin and its variants. Global miRNA expression data of 29 advanced cHL patients and five cHL-derived cell lines were used to identify profiles from Hodgkin-Reed-Sternberg (HRS) cells and their non-tumoural microenvironment. A cHL-miRNA signature was identified with 234 miRNAs differentially expressed. A subset of these miRNAs was associated with outcome and selected for study in an independent set of 168 cHL samples using quantitative reverse transcription polymerase chain reaction. Multivariate Cox regression analyses including cross-validation with failure-free survival (FFS) as clinical endpoint revealed a miRNA signature with MIR21, MIR30E, MIR30D and MIR92B* that identified two risk-groups with significant differences in 5-year FFS (81% vs. 35.7%; P < 0.001). Additionally, functional silencing of MIR21 and MIR30D in L428 cells showed increased sensitivity to doxorubicin-induced apoptosis, pointing towards abnormalities of mitochondrial intrinsic and TP53-CDKN1A pathways as related to miRNA deregulation in cHL. These results suggest that clinical outcome in cHL is associated with a specific miRNA signature. Moreover, functional analyses suggest a role for MIR21 and MIR30D in cHL pathogenesis and therapeutic resistance.

  5. Online monitoring of Escherichia coli and Bacillus thuringiensis spore inactivation after advanced oxidation treatment.

    PubMed

    Sherchan, Samendra P; Snyder, Shane A; Gerba, Charles P; Pepper, Ian L

    2014-01-01

    Various studies have shown that advanced oxidation processes (AOPs) such as UV light in combination with hydrogen peroxide is an efficient process for the removal of a large variety of emerging contaminants including microorganisms. The mechanism of destruction in the presence of hydrogen peroxide (H2O2) is the enhanced formation of hydroxyl (·OH) radicals, which have a high oxidation potential. The goal of this study was to utilize in-line advanced oxidation to inactivate microbes, and document the inactivation via an in-line, real-time sensor. Escherichia coli cells and Bacillus thuringiensis spores were exposed to UV/H2O2 treatment in DI water, and the online sensor BioSentry(®) was evaluated for its potential to monitor inactivation in real-time. B. thuringiensis was selected as a non-pathogenic surrogate for B. anthracis, the causative agent of anthrax and a proven biological weapon. UV radiation and UV/H2O2 exposure resulted in a >6 log10 reduction of the viable culturable counts of E. coli vegetative cells, and a 3 log10 reduction of B. thuringiensis spores. Scanning electron microscopy of the treated samples revealed severe damage on the surface of most E. coli cells, yet there was no significant change observed in the morphology of the B. thuringiensis spores. Following AOP exposure, the BioSentry sensor showed an increase in the categories of unknown, rod and spores counts, but overall, did not correspond well with viable count assays. Data from this study show that advanced oxidation processes effectively inactivate E. coli vegetative cells, but not B. thuringiensis spores, which were more resistant to AOP. Further, the BioSentry in-line sensor was not successful in documenting destruction of the microbial cells in real-time.

  6. MicroRNA signatures and treatment response in patients with advanced classical Hodgkin lymphoma

    PubMed Central

    Sánchez-Espiridión, Beatriz; Martín-Moreno, Ana M.; Montalbán, Carlos; Figueroa, Vianihuini; Vega, Francisco; Younes, Anas; Medeiros, L. Jeffrey; Alvés, Francisco J.; Canales, Miguel; Estévez, Mónica; Menarguez, Javier; Sabín, Pilar; Ruiz-Marcellán, María C.; Lopez, Andrés; Sánchez-Godoy, Pedro; Burgos, Fernando; Santonja, Carlos; López, José L.; Piris, Miguel A.; Garcia, Juan F.

    2017-01-01

    Summary Although specific microRNA (miRNA) signatures in classical Hodgkin lymphoma (cHL) have been proposed, their relationship with clinical outcome remains unclear. Despite treatment advances, a substantial subset of patients with advanced cHL are refractory to standard therapies based on adriamycin and its variants. Global miRNA expression data of 29 advanced cHL patients and five cHL-derived cell lines were used to identify profiles from Hodgkin-Reed-Sternberg (HRS) cells and their non-tumoural microenvironment. A cHL-miRNA signature was identified with 234 miRNAs differentially expressed. A subset of these miRNAs was associated with outcome and selected for study in an independent set of 168 cHL samples using quantitative reverse transcription polymerase chain reaction. Multivariate Cox regression analyses including cross-validation with failure-free survival (FFS) as clinical endpoint revealed a miRNA signature with MIR21, MIR30E, MIR30D and MIR92B* that identified two risk-groups with significant differences in 5-year FFS (81% vs. 35% 7%; P < 0·001). Additionally, functional silencing of MIR21 and MIR30D in L428 cells showed increased sensitivity to doxorubicin-induced apoptosis, pointing towards abnormalities of mitochondrial intrinsic and TP53-CDKN1A pathways as related to miRNA deregulation in cHL. These results suggest that clinical outcome in cHL is associated with a specific miRNA signature. Moreover, functional analyses suggest a role for MIR21 and MIR30D in cHL pathogenesis and therapeutic resistance. PMID:23725219

  7. Low-buoyancy thermochemical plumes resolve controversy of classical mantle plume concept

    PubMed Central

    Dannberg, Juliane; Sobolev, Stephan V.

    2015-01-01

    The Earth's biggest magmatic events are believed to originate from massive melting when hot mantle plumes rising from the lowermost mantle reach the base of the lithosphere. Classical models predict large plume heads that cause kilometre-scale surface uplift, and narrow (100 km radius) plume tails that remain in the mantle after the plume head spreads below the lithosphere. However, in many cases, such uplifts and narrow plume tails are not observed. Here using numerical models, we show that the issue can be resolved if major mantle plumes contain up to 15–20% of recycled oceanic crust in a form of dense eclogite, which drastically decreases their buoyancy and makes it depth dependent. We demonstrate that, despite their low buoyancy, large enough thermochemical plumes can rise through the whole mantle causing only negligible surface uplift. Their tails are bulky (>200 km radius) and remain in the upper mantle for 100 millions of years. PMID:25907970

  8. Low-buoyancy thermochemical plumes resolve controversy of classical mantle plume concept.

    PubMed

    Dannberg, Juliane; Sobolev, Stephan V

    2015-04-24

    The Earth's biggest magmatic events are believed to originate from massive melting when hot mantle plumes rising from the lowermost mantle reach the base of the lithosphere. Classical models predict large plume heads that cause kilometre-scale surface uplift, and narrow (100 km radius) plume tails that remain in the mantle after the plume head spreads below the lithosphere. However, in many cases, such uplifts and narrow plume tails are not observed. Here using numerical models, we show that the issue can be resolved if major mantle plumes contain up to 15-20% of recycled oceanic crust in a form of dense eclogite, which drastically decreases their buoyancy and makes it depth dependent. We demonstrate that, despite their low buoyancy, large enough thermochemical plumes can rise through the whole mantle causing only negligible surface uplift. Their tails are bulky (>200 km radius) and remain in the upper mantle for 100 millions of years.

  9. Recent advances in the diagnosis and treatment of primary biliary cholangitis

    PubMed Central

    Huang, Ying-Qiu

    2016-01-01

    Primary biliary cholangitis (PBC), formerly referred to as primary biliary cirrhosis, is an infrequent progressive intrahepatic cholestatic autoimmune illness that can evolve into hepatic fibrosis, hepatic cirrhosis, hepatic failure, and, in some cases, hepatocellular carcinoma. The disease itself is characterized by T-lymphocyte-mediated chronic non-suppurative destructive cholangitis and elevated serum levels of extremely specific anti-mitochondrial autoantibodies (AMAs). In this article, we will not only review epidemiology, risk factors, natural history, predictive scores, radiologic approaches (e.g., acoustic radiation force impulse imaging, vibration controlled transient elastography, and magnetic resonance elastography), clinical features, serological characteristics covering biochemical markers, immunoglobulins, infections markers, biomarkers, predictive fibrosis marker, specific antibodies (including AMAs such as AMA-M2), anti-nuclear autoantibodies [such as anti-multiple nuclear dot autoantibodies (anti-sp100, PML, NDP52, anti-sp140), anti-rim-like/membranous anti-nuclear autoantibodies (anti-gp210, anti-p62), anti-centromere autoantibodies, and some of the novel autoantibodies], histopathological characteristics of PBC, diagnostic advances, and anti-diastole of PBC. Furthermore, this review emphasizes the recent advances in research of PBC in terms of therapies, including ursodeoxycholic acid, budesonide, methotrexate, obeticholic acid, cyclosporine A, fibrates such as bezafibrate and fenofibrate, rituximab, mesenchymal stem cells transplant, and hepatic transplant. Currently, hepatic transplant remains the only optimal choice with acknowledged treatment efficiency for end-stage PBC patients. PMID:27957241

  10. Advances in the Glass Formulations for the Hanford Tank Waste Treatment and Immobilization Plant

    SciTech Connect

    Kruger, Albert A.; Vienna, John D.; Kim, Dong Sang

    2015-01-14

    The Department of Energy-Office of River Protection (DOE-ORP) is constructing the Hanford Tank Waste Treatment and Immobilization Plant (WTP) to treat radioactive waste currently stored in underground tanks at the Hanford site in Washington. The WTP that is being designed and constructed by a team led by Bechtel National, Inc. (BNI) will separate the tank waste into High Level Waste (HLW) and Low Activity Waste (LAW) fractions with the majority of the mass (~90%) directed to LAW and most of the activity (>95%) directed to HLW. The pretreatment process, envisioned in the baseline, involves the dissolution of aluminum-bearing solids so as to allow the aluminum salts to be processed through the cesium ion exchange and report to the LAW Facility. There is an oxidative leaching process to affect a similar outcome for chromium-bearing wastes. Both of these unit operations were advanced to accommodate shortcomings in glass formulation for HLW inventories. A by-product of this are a series of technical challenges placed upon materials selected for the processing vessels. The advances in glass formulation play a role in revisiting the flow sheet for the WTP and hence, the unit operations that were being imposed by minimal waste loading requirements set forth in the contract for the design and construction of the plant. Another significant consideration to the most recent revision of the glass models are the impacts on resolution of technical questions associated with current efforts for design completion.

  11. Transcatheter Arterial Infusion Therapy in the Treatment of Advanced Pancreatic Cancer: A Feasibility Study

    SciTech Connect

    Shibuya, Keiko; Nagata, Yasushi; Itoh, Tuyoshi; Okajima, Kaoru; Murata, Rumi; Takagi, Takehisa; Hiraoka, Masahiro

    1999-05-15

    Purpose: To evaluate the effects of transcatheter arterial infusion (TAI) therapy in 18 patients with advanced pancreatic cancer. Methods: The drugs infused were epirubicin 60 mg, mitomycin C 20 mg, and 5-fluorouracil 500 mg. The efficacy of TAI was evaluated by a tumor marker (CA19-9), computed tomography (CT) findings, and postoperative histopathological specimens. Results: In 10 of 15 cases, the tumor marker level was decreased after TAI therapy. In 6 of 14 cases, CT showed a decrease in the tumor size, and in 1 case, the tumor disappeared completely. In 6 cases the tumor could be resected. Necrosis, fibrosis, and degeneration of cancer cells were seen in 3 of 4 cases for whom a histopathological evaluation was done. The median survival was 11 months. In 17 patients back pain was the chief complaint, and was reduced to a self-controlled level in 10 patients following TAI therapy. No major complications were encountered. Conclusion: TAI appears to be an effective palliative treatment for advanced pancreatic cancer.

  12. Water Vapor Enhancement in Prescribed Fire Plumes

    NASA Astrophysics Data System (ADS)

    Kiefer, C. M.; Clements, C. B.; Potter, B. E.; Strenfel, S. J.

    2008-12-01

    In situ radiosonde measurements were obtained during multiple prescribed fires at the Joseph W. Jones Ecological Research Center at Ichauway, Georgia in March and July of 2008. Data were obtained from prescribed fires conducted in longleaf pine ecosystems. After significant smoke generation was observed, radiosondes were launched downwind of the fire front and rose directly into the smoke plumes. Radiosondes were also launched before each burn to obtain ambient background conditions. This provided a unique dataset of smoke plume moisture to determine how moisture enhancement from fire smoke alters the dynamics of the smoke plume. Preliminary analysis of results show moisture enhancement occurred in all smoke plumes with relative humidity values increasing by 10 to 30 percent and water vapor mixing ratios increasing by 1 to 4 g kg-1. Understanding the moisture enhancement in prescribed fire smoke plumes will help determine the convective dynamics that occur in major wildland fires and convection columns.

  13. Ash plume top height estimation using AATSR

    NASA Astrophysics Data System (ADS)

    Virtanen, T. H.; Kolmonen, P.; Rodríguez, E.; Sogacheva, L.; Sundström, A.-M.; de Leeuw, G.

    2014-08-01

    An algorithm is presented for the estimation of volcanic ash plume top height using the stereo view of the Advanced Along Track Scanning Radiometer (AATSR) aboard Envisat. The algorithm is based on matching top of the atmosphere (TOA) reflectances and brightness temperatures of the nadir and 55° forward views, and using the resulting parallax to obtain the height estimate. Various retrieval parameters are discussed in detail, several quality parameters are introduced, and post-processing methods for screening out unreliable data have been developed. The method is compared to other satellite observations and in situ data. The proposed algorithm is designed to be fully automatic and can be implemented in operational retrieval algorithms. Combined with automated ash detection using the brightness temperature difference between the 11 and 12 μm channels, the algorithm allows efficient simultaneous retrieval of the horizontal and vertical dispersion of volcanic ash. A case study on the eruption of the Icelandic volcano Eyjafjallajökull in 2010 is presented.

  14. Ash plume top height estimate using AATSR

    NASA Astrophysics Data System (ADS)

    Virtanen, T. H.; Kolmonen, P.; Rodríguez, E.; Sogacheva, L.; Sundström, A.-M.; de Leeuw, G.

    2014-04-01

    An algorithm is presented for estimation of volcanic ash plume top height using the stereo view of the Advanced Along Track Scanning Radiometer (AATSR) aboard ENVISAT. The algorithm is based on matching the top of atmosphere (TOA) reflectances and brightness temperatures of the nadir and 55° forward views, and using the resulting parallax to obtain the height estimate. Various retrieval parameters are discussed in detail, several quality parameters are introduced, and post-processing methods for screening out unreliable data have been developed. The method is compared against other satellite observations and in-situ data. The proposed algorithm is designed to be fully automatic, and can be implemented into operational retrieval algorithms. Combined with automated ash detection using the brightness temperature difference between the 11 μm and 12 μm channels, the algorithm allows simultaneous retrieval of horizontal and vertical dispersion of volcanic ash efficiently. A case study on the eruption of the Icelandic volcano Eyjafjallajökull in 2010 is presented. The height estimate method results are validated against available satellite and ground based data.

  15. Therapy for advanced thyroid cancer: treatment of a high risk case.

    PubMed

    Ceriati, F; Cavicchioni, C; Logroscino, C; Pastore, G; Montemaggi, P; Fabiano, A; Mantovani, M; Marino, I R; Ardito, G; De Luca, G

    1987-01-01

    The treatment of a high risk case of an advanced thyroid cancer is reported. The patient had a thyroid cancer with metastatic lesions of the frontal bone, left temporal bone, left sacroiliac joint, lytic destruction of C6 and lytic lesion of C7. A pre-operative immobilization of the cervical spine was performed by a halo cast set on a corset of gypsum. After this, the patient underwent a thyroidectomy and, at the same time, a metallic plate was applied to immobilize C5-C7. A month after he underwent reoperative surgery to stabilize definitively the cervical spine. Subsequently he was treated by TCT and 131I subdivided in several cycles. The latest total body scan demonstrated a complete regression of secondary lesions.

  16. Advances in the treatment of erectile dysfunction: what’s new and upcoming?

    PubMed Central

    Patel, Chintan K.; Bennett, Nelson

    2016-01-01

    Erectile dysfunction adversely affects up to 20% of all men and is the most commonly treated sexual disorder. The public health implications of this condition are significant and represent a challenge for our healthcare system. The physiological pathways responsible for erections have been extensively studied, and much advancement has been made since the introduction of phosphodiesterase 5 inhibitors. Newer agents, such as dopaminergic and melanocortin receptor agonists, which target central erectogenic pathways, are under investigation. Newer formulations and delivery methods of existing medications such as alprostadil will also be introduced in the near future. Furthermore, low-intensity shockwave lithotripsy and stem cell regenerative techniques are innovative approaches to the treatment of erectile dysfunction. PMID:27516878

  17. Locally advanced and metastatic basal cell carcinoma: molecular pathways, treatment options and new targeted therapies.

    PubMed

    Ruiz Salas, Veronica; Alegre, Marta; Garcés, Joan Ramón; Puig, Lluis

    2014-06-01

    The hedgehog (Hh) signaling pathway has been identified as important to normal embryonic development in living organisms and it is implicated in processes including cell proliferation, differentiation and tissue patterning. Aberrant Hh pathway has been involved in the pathogenesis and chemotherapy resistance of different solid and hematologic malignancies. Basal cell carcinoma (BCC) and medulloblastoma are two well-recognized cancers with mutations in components of the Hh pathway. Vismodegib has recently approved as the first inhibitor of one of the components of the Hh pathway (smoothened). This review attempts to provide current data on the molecular pathways involved in the development of BCC and the therapeutic options available for the treatment of locally advanced and metastatic BCC, and the new targeted therapies in development.

  18. Multi-sensor Mapping of Volcanic Plumes and Clouds

    NASA Astrophysics Data System (ADS)

    Realmuto, V. J.

    2006-12-01

    The instruments aboard the NASA series of Earth Observing System satellites provide a rich suite of measurements for the mapping of volcanic plumes and clouds. In this presentation we focus on analyses of data acquired with the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), Atmospheric Infrared Sounder (AIRS), Moderate-Resolution Imaging Spectrometer (MODIS), and Multiangle Imaging SpectroRadiometer (MISR). ASTER, MODIS, AIRS, and MISR provide complimentary information on the quantity and distribution of sulfur dioxide, silicate ash, and sulfate aerosols within plumes. In addition, MISR data are used to derive estimates of cloud-top altitude, wind direction, and wind speed. The key to multi-sensor mapping is the availability of a standard set of tools for the processing of data from different instruments. To date we have used the MAP_SO2 toolkit to analyze the thermal infrared (TIR) data from MODIS, ASTER, and AIRS. MAP_SO2, a graphic user interface to the MODTRAN radiative transfer model, provides tools for the estimation of emissivity spectra, water vapor and ozone correction factors, surface temperature, and concentrations of SO2. We use the MISR_Shift toolkit to estimate plume-top altitudes and local wind vectors. Our continuous refinement of MAP_SO2 has resulted in lower detection limits for SO2 and lower sensitivity to the presence of sulfate aerosols and ash. Our plans for future refinements of MAP_SO2 include the incorporation of AIRS-based profiles of atmospheric temperature, water vapor and ozone, and MISR-based maps of plume-top altitude into the plume map