Science.gov

Sample records for advanced plume treatment

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

    NASA Astrophysics Data System (ADS)

    Kelly, James T.; Baker, Kirk R.; Napelenok, Sergey L.; Roselle, Shawn J.

    2015-06-01

    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 these impacts using Eulerian grid photochemical models are the brute-force (B-F) method, the decoupled direct method (DDM), and advanced plume treatment (APT). Here, we systematically inter-compare and assess the B-F, DDM, and APT approaches using hypothetical sources in a consistent modeling platform for a wide range of source conditions (i.e., emissions amount and composition, location within two California air basins, and stack parameters). The impacts of NOx and VOC sources on ozone and SO2 sources on PM2.5 sulfate calculated by these methods are in general agreement. The agreement is evident in the similar magnitudes, spatial patterns, and strong correlations among the impacts. This result, along with previous model evaluations based on similar Eulerian grid modeling, builds confidence in the reliability of the impact estimates. Disagreement among methods is evident in calculations of PM2.5 nitrate impacts associated with NH3 and NOx sources. Numerical instabilities in DDM sensitivity calculations compromise the nitrate impact estimates from that approach. The B-F and APT methods, which use brute-force differencing to identify impacts, are affected by numerical artifacts to a lesser degree than (H)DDM, with the artifacts being more prominent for APT than B-F. Overall, our results indicate that the (H)DDM, B-F, and APT approaches are viable for use in estimating single-source impacts for ozone and secondary PM2.5 sulfate, while the B-F method appears to be the most reliable for estimating nitrate impacts. There is a need for additional field study measurements to better constrain model estimates of single-source secondary impacts.

  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 plume deflector analysis program. [advanced solid rocket motor

    NASA Technical Reports Server (NTRS)

    Dawson, Michael C.; Douglas, Freddie, III; Orlin, Peter A.

    1992-01-01

    This paper presents analytical conclusions resulting from subscale solid rocket motor tests and flowfield modeling for a plume deflector. Loads, flow characteristics, and corresponding material behavior were predicted or observed and will be used in final design of the deflector. The efforts resulted in quantifiable size reductions and lower cost material selections, which will significantly reduce the deflector cost while meeting performance requirements.

  4. ASRM subscale plume deflector testing. [advanced solid rocket motor

    NASA Technical Reports Server (NTRS)

    Douglas, Freddie, III; Dawson, Michael C.; Orlin, Peter A.

    1992-01-01

    This paper reports the results of the scale model (1/22) testing of candidate refractory materials to be used as surface coatings for a solid rocket motor plume deflector structure. Five ROM tests were conducted to acquire data to support the selection, thickness determination, and placement of the materials. All data acquisition was achieved through nonintrusive methods. The tests demonstrated that little or no reductions in performance of the full-scale deflector would be experienced if the most economical materials were selected for construction.

  5. Effects of plume-scale versus grid-scale treatment of aircraft exhaust photochemistry

    NASA Astrophysics Data System (ADS)

    Cameron, Mary A.; Jacobson, Mark Z.; Naiman, Alexander D.; Lele, Sanjiva K.

    2013-11-01

    is a study to examine the impact of modeling photochemistry from aircraft emissions in an expanding plume versus at the grid scale in an atmospheric model. Differences in model treatments for a single flight occurred at all altitudes during takeoff, cruise, and landing. After 10 h, the plume treatment decreased grid-scale ozone production by 33%, methane destruction by 30%, and carbon monoxide destruction by 32% at cruise altitude compared with the grid-scale treatment. The plume treatment changed the odd nitrogen partitioning by ~10%. For multiple overlapping flights at cruise altitude, final ozone, methane, and carbon monoxide perturbations decreased by 77, 68, and 74%, respectively, compared with the grid-scale treatment. Enhanced mixing with ambient air reduced the plume-scale and grid-scale differences. The persistent differences in photochemical activity indicate that individual plume treatment should be incorporated into 3-D modeling studies.

  6. In situ sequential treatment of a mixed contaminant plume

    NASA Astrophysics Data System (ADS)

    Morkin, M.; Devlin, J. F.; Barker, J. F.; Butler, B. J.

    2000-10-01

    Groundwater plumes often contain a mixture of contaminants that cannot easily be remediated in situ using a single technology. The purpose of this research was to evaluate an in situ treatment sequence for the control of a mixed organic plume (chlorinated ethenes and petroleum hydrocarbons) within a Funnel-and-Gate. A shallow plume located in the unconfined aquifer at Alameda Point, CA, was found to contain up to 218,000 μg/l of cis-1,2 dichloroethene (cDCE), 16,000 μg/l of vinyl chloride (VC) and <1000 μg/l of 1,1 dichloroethene (1,1 DCE), trans-1,2 dichloroethene ( trans-1,2 DCE) and trichloroethene (TCE). Total benzene, toluene, ethylbenzene and xylenes (BTEX) concentrations were <10,000 μg/l. Contaminated groundwater was funneled into a gate, 3.0 m wide, 4.5 m long and 6.0 m deep (keyed into the underlying aquitard) where treatment occurred. The initial gate segment consisted of granular iron, for the reductive dechlorination of the higher chlorinated ethenes. The second segment, the biosparge zone, promoted aerobic biodegradation of petroleum hydrocarbons and any remaining lesser-chlorinated compounds, stimulated by dissolved oxygen (DO) and carbon dioxide (CO 2) additions via an in situ sparge system (CO 2 was used to neutralize the high pH produced from reactions in the iron wall). Groundwater was drawn through the gate by pumping two wells located at the sealed, downgradient, end. Over a 4-month period an estimated 1350 g of cDCE flowed into the treatment gate and the iron wall removed 1230 g, or 91% of the mass. The influent mass of VC was 572 g and the iron wall removed 535 g, corresponding to 94% mass removal. The other chlorinated ethenes had significantly lower influent masses (3 to 108 g) and the iron wall removed the majority of the mass resulting in >96% mass removal for any of the compounds. In spite of these high removal percentages, laboratory column tests indicated that at these levels of chlorinated contaminants, surface saturation of the

  7. Remote sensing of volcanic plumes using the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER)

    NASA Astrophysics Data System (ADS)

    Henney, Lorna Alison

    The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) has been used to quantify SO2 emissions from passively degassing volcanoes. This dissertation explores ASTER's capability to detect SO 2 with satellite validation, enhancement techniques and extensive processing of images at a variety of volcanoes. ASTER is compared to the Mini UV Spectrometer (MUSe), a ground based instrument, to determine if reasonable SO2 fluxes can be quantified from a plume emitted from Lascar, Chile. The two sensors were in good agreement with ASTER proving to be a reliable detector of SO2. ASTER illustrated the advantages of imaging a plume in 2D, with better temporal resolution than the MUSe. SO2 plumes in ASTER imagery are not always discernible in the raw TIR data. Principal Component Analysis (PCA) and Decorrelation Stretch (DCS) enhancement techniques were compared to determine how well they highlight a variety of volcanic plumes. DCS produced a consistent output and the composition of the plumes was easy to identify from explosive eruptions. As the plumes became smaller and lower in altitude they became harder to distinguish using DCS. PCA proved to be better at identifying smaller low altitude plumes. ASTER was used to investigate SO2 emissions at Lascar, Chile. Activity at Lascar has been characterized by cyclic behavior and persistent degassing (Matthews et al. 1997). Previous studies at Lascar have primarily focused on changes in thermal infrared anomalies, neglecting gas emissions. Using the SO2 data along with changes in thermal anomalies and visual observations it is evident that Lascar is at the end an eruptive cycle that began in 1993. Declining gas emissions and crater temperatures suggest that the conduit is sealing. ASTER and the Ozone Monitoring Instrument (OMI) were used to determine the annual contribution of SO2 to the troposphere from the Central and South American volcanic arcs between 2000 and 2011. Fluxes of 3.4 Tg/a for Central America and 3

  8. Rebound of a coal tar creosote plume following partial source zone treatment with permanganate

    NASA Astrophysics Data System (ADS)

    Thomson, N. R.; Fraser, M. J.; Lamarche, C.; Barker, J. F.; Forsey, S. P.

    2008-11-01

    The long-term management of dissolved plumes originating from a coal tar creosote source is a technical challenge. For some sites stabilization of the source may be the best practical solution to decrease the contaminant mass loading to the plume and associated off-site migration. At the bench-scale, the deposition of manganese oxides, a permanganate reaction byproduct, has been shown to cause pore plugging and the formation of a manganese oxide layer adjacent to the non-aqueous phase liquid creosote which reduces post-treatment mass transfer and hence mass loading from the source. The objective of this study was to investigate the potential of partial permanganate treatment to reduce the ability of a coal tar creosote source zone to generate a multi-component plume at the pilot-scale over both the short-term (weeks to months) and the long-term (years) at a site where there is > 10 years of comprehensive synoptic plume baseline data available. A series of preliminary bench-scale experiments were conducted to support this pilot-scale investigation. The results from the bench-scale experiments indicated that if sufficient mass removal of the reactive compounds is achieved then the effective solubility, aqueous concentration and rate of mass removal of the more abundant non-reactive coal tar creosote compounds such as biphenyl and dibenzofuran can be increased. Manganese oxide formation and deposition caused an order-of-magnitude decrease in hydraulic conductivity. Approximately 125 kg of permanganate were delivered into the pilot-scale source zone over 35 days, and based on mass balance estimates < 10% of the initial reactive coal tar creosote mass in the source zone was oxidized. Mass discharge estimated at a down-gradient fence line indicated > 35% reduction for all monitored compounds except for biphenyl, dibenzofuran and fluoranthene 150 days after treatment, which is consistent with the bench-scale experimental results. Pre- and post-treatment soil core data

  9. 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.

  10. 40 CFR 35.2101 - Advanced treatment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 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...

  11. 40 CFR 35.2101 - Advanced treatment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 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...

  12. 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...

  13. 40 CFR 35.2101 - Advanced treatment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 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...

  14. 40 CFR 35.2101 - Advanced treatment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 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...

  15. 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.

  16. 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)

  17. 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

  18. Melanoma Treatments: Advances and Mechanisms.

    PubMed

    Marzuka, Alexander; Huang, Laura; Theodosakis, Nicholas; Bosenberg, Marcus

    2015-11-01

    Advances in the understanding of the molecular pathogenesis of melanoma and in cancer immunology have led to the rational design and recent clinical implementation of a variety of novel therapies for metastatic melanoma. BRAF and MEK inhibitors that target the MAPK pathway have high rates of clinical response in BRAF-mutant melanoma. Therapies that modulate the immune response to melanoma, including monoclonal antibodies that interfere with pathways that inhibit T-cell function, have been shown to be effective in melanoma. Lessons learned from these encouraging results are driving the development of new treatments for melanoma and other cancers. This review will focus on the science and clinical findings related to targeted therapies that inhibit BRAF or MEK as well as the immunotherapies that block the CTLA-4 or PD-1 pathways. Other experimental and combinatorial therapeutic approaches will also be discussed. PMID:25899612

  19. Recent Advances of Portable Multi-Sensor Technique of Volcanic Plume Measurement

    NASA Astrophysics Data System (ADS)

    Shinohara, H.

    2005-12-01

    A technique has been developed to estimate chemical composition volcanic gases based on the measurement of volcanic plumes at distance from a source vent by the use of a portable multi-sensor system consisting a humidity sensor, an SO2 electrochemical sensor and a CO2 IR analyzer (Shinohara, 2005). Since volcanic plume is a mixture of the atmosphere and volcanic gases, the volcanic gas composition can be estimated by subtracting the atmospheric background from the plume data. This technique enabled us to estimate concentration ratios of major volcanic gas species (i.e., H2O, CO2 and SO2) without any complicated chemical analyses even for gases emitted from an inaccessible open vent. Since the portable multi-sensor system was light (~ 5 kg) and small enough to carry in a medium size backpack, we could apply this technique to measure volcanic plumes at summit of various volcanoes including those which require us a tough climbing, such as Villarrica volcano, Chile. We further improved the sensor system and the measurements techniques, including application of LI-840 IR H2O and CO2 analyzer, H2S electrochemical sensor and H2 semi-conductor sensor. Application of the new LI-840 analyzer enabled us to measure H2O concentration in the plume with similar response time with CO2 concentration. The H2S electrochemical sensor of Komyo Co. has a chemical filter to removed SO2 to achieve a low sensitivity (0.1%) to SO2, and we can measure a high SO2/H2S ratio up to 1000. The semi-conductor sensor can measure H2 concentration in the range from the background level in the atmosphere (~0.5 ppm) to ~50 ppm. Response of the H2 sensor is slower (90% response time = ~90 sec) than other sensors in particular in low concentration range, and the measurement is still semi-quantitative with errors up to ±50%. The H2/H2O ratios are quite variable in volcanic gases ranging from less than 10-5 up to 10-1, and the ratio is largely controlled by temperature and pressure condition of the

  20. 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.

  1. 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.

  2. Treatment of advanced Parkinson’s disease

    PubMed Central

    Giugni, Juan C.; Okun, Michael S.

    2014-01-01

    Purpose of the review Later stage Parkinson’s disease (PD), sometimes referred to as advanced disease, has been characterized by motor complication, as well as by the potential emergence non-levodopa responsive motor and non-motor symptoms. The management of advanced stage PD can be complex. This review summarizes the currently available treatment strategies for addressing advanced PD. Recent findings We will discuss the latest pharmacological strategies (e.g. inhibitors of dopamine-metabolizing enzymes, dopamine agonists and extended release dopamine formulations) for addressing motor dysfunction. We will summarize the risks and benefits of current invasive treatments. Finally, we will address the current evidence supporting the treatment of non-motor symptoms in the advanced PD patient. We will conclude by detailing the potential non-pharmacological and multidisciplinary approaches for advanced stage PD. Summary The optimization of levodopa is in most cases the most powerful therapeutic option available, however medication optimization requires an advanced understanding of PD. Failure of conventional pharmacotherapy, should precipitate a discussion of the potential risks and benefits of more invasive treatments. Currently, there are no comparative studies of invasive treatment. Among the invasive treatments, deep brain stimulation has the largest amount of existing evidence, but also has the highest individual per patient risk. Non-motor symptoms will affect quality of life more than the motor PD symptoms, and these non-motor symptoms should be aggressively treated. Many advanced PD patients will likely benefit from multi- and interdisciplinary PD teams with multiple professionals collaborating to develop a collective and tailored strategy for an individual patient. PMID:24978634

  3. Advances and Challenges in Treatment of Locally Advanced Rectal Cancer

    PubMed Central

    Smith, J. Joshua; Garcia-Aguilar, Julio

    2015-01-01

    Dramatic improvements in the outcomes of patients with rectal cancer have occurred over the past 30 years. Advances in surgical pathology, refinements in surgical techniques and instrumentation, new imaging modalities, and the widespread use of neoadjuvant therapy have all contributed to these improvements. Several questions emerge as we learn of the benefits or lack thereof for components of the current multimodality treatment in subgroups of patients with nonmetastatic locally advanced rectal cancer (LARC). What is the optimal surgical technique for distal rectal cancers? Do all patients need postoperative chemotherapy? Do all patients need radiation? Do all patients need surgery, or is a nonoperative, organ-preserving approach warranted in selected patients? Answering these questions will lead to more precise treatment regimens, based on patient and tumor characteristics, that will improve outcomes while preserving quality of life. However, the idea of shifting the treatment paradigm (chemoradiotherapy, total mesorectal excision, and adjuvant therapy) currently applied to all patients with LARC to a more individually tailored approach is controversial. The paradigm shift toward organ preservation in highly selected patients whose tumors demonstrate clinical complete response to neoadjuvant treatment is also controversial. Herein, we highlight many of the advances and resultant controversies that are likely to dominate the research agenda for LARC in the modern era. PMID:25918296

  4. [Advancement in the treatment against prostate cancer].

    PubMed

    Shinohara, Nobuo; Abe, Takashige; Maruyama, Satoru

    2016-01-01

    With the advancement of basic science and medical technology, the treatment against prostate cancer (PC) has dramatically changed. Although the introduction of robotic radical prostatectomy and particle therapies in patients with early stage PC is of much note, the issues on the over-treatment and treatment cost should be heeded. From these points, active surveillance has been an important strategy in these patients. In patients with metastatic hormone-sensitive PC, especially high volume metastases, androgen deprivation therapy (ADT) with docetaxel has been reported to prolong overall survival compared with ADT alone. Lastly, several novel therapeutic agents have been investigated and shown to be favorable outcomes in patients with castration resistant PC. This review focuses on the recent advancement in the treatment against PCs. PMID:26793875

  5. USE OF PLUME DISPERSION MODELLING FOR VIABLE AEROSOLS FROM AN ACTIVATED SLUDGE SEWAGE TREATMENT PLANT

    EPA Science Inventory

    Predictions of the emissions of airborne total viable particle (TVP) concentrations from sewage are of concern due to possible adverse human health effects. Two types of modelling approaches were explored: dispersion modelling such as the Gaussian plume dispersion model and stati...

  6. Advances in the Treatment of Neuropathic Pain.

    PubMed

    Xu, Li; Zhang, Yuguan; Huang, Yuguang

    2016-01-01

    Neuropathic pain is pain that arises as a direct consequence of a lesion or diseases affecting the somatosensory system. Treatments for neuropathic pain include pharmacological, nonpharmacological, and interventional therapies. Currently recommended first-line pharmacological treatments include antidepressants and anticonvulsants (gabapentin and pregabalin). However, in some cases, pharmacological therapy alone fails to give adequate control of the chronic pain. New techniques have been invented and have been proved effective on neuropathic pain, such as behavioral, cognitive, integrative, and physical therapies. In this review, we focused on the advances in the treatment of central neuropathic pain, diabetic peripheral neuropathy, postherpetic neuralgia, and cancer pain. PMID:26900067

  7. 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).

  8. 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.

  9. The porphyrias: advances in diagnosis and treatment

    PubMed Central

    Balwani, Manisha

    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. PMID:22791288

  10. [Primary treatment of advanced Hodgkin's disease].

    PubMed

    Illés, Arpád; Udvardy, Miklós; Molnár, Zsuzsa

    2005-01-30

    Primary treatment of advanced Hodgkin's disease. Hodgkin's disease is one of the few malignant diseases that can be cured even in an advanced stage in the majority of cases. By employing a polychemotherapy containing anthracyclines, a long remission and recovery can be achieved in 60-70% of the patients. At present the standard treatment is ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) scheme for the following reasons: besides good treatment results early side effects are more favourable; sterility and secondary acute leukemia present themselves less often than by employing regimens containing alkylating agents. Unfortunately, some of the patients do not react properly to the treatment and about one third of the patients who are in remission following primary treatment will relapse at a later stage. The main goal is now to further improve treatment (recovery) results without an increase, or even a decrease of early or late side effects. Awareness of prognostic factors should lead to the employment of a less intensive but not toxic therapy in patients with good prognosis to prevent overtreatment, while in cases with bad prognosis a more effective regimen is needed (even for the price of expected complications). The latest meta-analysis on the subject has shown that--similarly to sequential high dose therapy--the addition of radiotherapy to an effective chemotherapy does not seem to prolong the survival of patients. Despite the excellent therapeutic results achieved by the many new "intensive" chemotherapies, there is unfortunately no optimal therapy or protocol available today. The multicentre analysis to confirm these results and to compare them with standard scheme is still under way. It is to be hoped that risk adapted management for advanced stage Hodgkin's disease will also be available soon. PMID:15773586

  11. Treatment of advanced medullary thyroid cancer.

    PubMed

    Smit, Johannes

    2013-03-14

    Therapy decisions in advanced medullary thyroid carcinoma should be guided by a critical appraisal of the natural disease course (slowly progressive vs. aggressive) and benefits and side effects of therapy. Therapy goals should be distinguished between curative and palliative. Local treatments are mainly palliative and may add to quality of life. The advent of novel systemic therapies opens promising perspectives but its place in the therapeutic arsenal must be further determined. PMID:23514632

  12. Advanced thyroid cancers: new era of treatment.

    PubMed

    Mohammed, Amrallah A; El-Shentenawy, Ayman

    2014-07-01

    Since chemotherapy has been shown to be unsuccessful in case of advanced thyroid carcinomas, the research for new therapies is fundamental. Clinical trials of many tyrosine kinase inhibitors as well as anti-angiogenic inhibitors suggest that patients with thyroid cancer could have an advantage with new target therapy. Recently, Food and Drug Administration approved two targeted therapies, vandetanib and cabozantinib for the treatment of metastatic thyroid carcinomas with acceptable outcome. We summarized the results and the toxic effects associated with these treatments reported in clinical trials. Future trials should aim at combinations of targeted agents with or without other treatment modalities to obtain a more effective result in thyroid carcinoma treatment. PMID:24908065

  13. Advances in the Psychosocial Treatment of Addiction

    PubMed Central

    Dallery, Jesse

    2012-01-01

    Synopsis The authors present an overview of empirically supported psychosocial interventions for individuals with substance use disorders (SUDs), including recent advances in the field. They also identify barriers to the adoption of evidence-based psychosocial treatments in community-based systems of care, and the promise of leveraging technology (computers, web, mobile phone, and emerging technologies) to markedly enhance the reach of these treatments. Technology-based interventions may provide “on-demand,” ubiquitous access to therapeutic support in diverse settings. A brief discussion of important next steps in developing, refining, and disseminating technology-delivered psychosocial interventions concludes the review. PMID:22640767

  14. New advances in targeted gastric cancer treatment.

    PubMed

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

    2016-08-14

    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

  15. 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

  16. Radiation treatment for breast cancer. Recent advances.

    PubMed Central

    Chow, Edward

    2002-01-01

    OBJECTIVE: To review recent advances in radiation therapy in treatment of breast cancer. QUALITY OF EVIDENCE: MEDLINE and CANCERLIT were searched using the MeSH words breast cancer, ductal carcinoma in situ, sentinel lymph node biopsy, and postmastectomy radiation. Randomized studies have shown the efficacy of radiation treatment for ductal carcinoma in situ (DCIS) and for invasive breast cancer. MAIN MESSAGE: Lumpectomy followed by radiation is effective treatment for DCIS. In early breast cancer, shorter radiation schedules are as efficacious for local control and short-term cosmetic results as traditional fractionation regimens. Sentinel lymph node biopsy is done in specialized cancer centres; regional radiation is recommended for patients with four or more positive axillary lymph nodes. Postmastectomy radiation has been shown to have survival benefits for high-risk premenopausal patients. Systemic metastases from breast cancer usually respond satisfactorily to radiation. CONCLUSION: Radiation therapy continues to have an important role in treatment of breast cancer. There have been great advances in radiation therapy in the last decade, but they have raised controversy. Further studies are needed to address the controversies. PMID:12113193

  17. Chronic hepatitis B: Advances in treatment

    PubMed Central

    Santantonio, Teresa Antonia; Fasano, Massimo

    2014-01-01

    Treatment of chronic hepatitis B (CHB) has markedly improved in the last 15 years due to the availability of direct antivirals which greatly increase therapeutic options. Currently, there are two classes of agents licensed for CHB treatment: standard or pegylated interferon alpha (IFN or Peg-IFN) and five nucleoside/nucleotide analogues (NAs). Long-term treatment with NAs is the treatment option most often used in the majority of CHB patients. Entecavir and tenofovir, the most potent NAs with high barrier to resistance, are recommended as first-line monotherapy by all major treatment guidelines and can lead to long-lasting virological suppression, resulting in histological improvement or reversal of advanced fibrosis and reduction in disease progression and liver-related complications. In this review, we focus on current treatment strategies of chronic hepatitis B and discuss the most recent efficacy and safety data from clinical trials and real life clinical practice. Recent findings of response-guided approaches are also discussed. PMID:24868322

  18. Myeloma today: Disease definitions and treatment advances.

    PubMed

    Rajkumar, S Vincent

    2016-01-01

    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 three 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, panobinostat, daratumumab, elotuzumab, and ixazomib have been approved for the treatment of the disease. 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

  19. Multimodal treatment strategies for advanced hilar cholangiocarcinoma.

    PubMed

    Weiss, Matthew J; Cosgrove, David; Herman, Joseph M; Rastegar, Neda; Kamel, Ihab; Pawlik, Timothy M

    2014-08-01

    Cholangiocarcinoma (CCA) is the second most common primary malignancy of the liver arising from malignant transformation and growth of biliary ductal epithelium. Approximately 50-70 % of CCAs arise at the hilar plate of the biliary tree, which are termed hilar cholangiocarcinoma (HC). Various staging systems are currently employed to classify HCs and determine resectability. Depending on the pre-operative staging, the mainstays of treatment include surgery, chemotherapy, radiation therapy, and photodynamic therapy. Surgical resection offers the only chance for cure of HC and achieving an R0 resection has demonstrated improved overall survival. However, obtaining longitudinal and radial surgical margins that are free of tumor can be difficult and frequently requires extensive resections, particularly for advanced HCs. Pre-operative interventions may be necessary to prepare patients for major hepatic resections, including endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, and portal vein embolization. Multimodal therapy that combines chemotherapy with external beam radiation, stereotactic body radiation therapy, bile duct brachytherapy, and/or photodynamic therapy are all possible strategies for advanced HC prior to resection. Orthotopic liver transplantation is another therapeutic option that can achieve complete extirpation of locally advanced HC in judiciously selected patients following standardized neoadjuvant protocols. PMID:24962146

  20. Plume radiation

    NASA Astrophysics Data System (ADS)

    Dirscherl, R.

    1993-06-01

    The electromagnetic radiation originating from the exhaust plume of tactical missile motors is of outstanding importance for military system designers. Both missile- and countermeasure engineer rely on the knowledge of plume radiation properties, be it for guidance/interference control or for passive detection of adversary missiles. To allow access to plume radiation properties, they are characterized with respect to the radiation producing mechanisms like afterburning, its chemical constituents, and reactions as well as particle radiation. A classification of plume spectral emissivity regions is given due to the constraints imposed by available sensor technology and atmospheric propagation windows. Additionally assessment methods are presented that allow a common and general grouping of rocket motor properties into various categories. These methods describe state of the art experimental evaluation techniques as well as calculation codes that are most commonly used by developers of NATO countries. Dominant aspects influencing plume radiation are discussed and a standardized test technique is proposed for the assessment of plume radiation properties that include prediction procedures. These recommendations on terminology and assessment methods should be common to all employers of plume radiation. Special emphasis is put on the omnipresent need for self-protection by the passive detection of plume radiation in the ultraviolet (UV) and infrared (IR) spectral band.

  1. Treatment of advanced-stage Hodgkin lymphoma.

    PubMed

    Vassilakopoulos, Theodoros P; Johnson, Peter W M

    2016-07-01

    There is now good evidence that the escalated BEACOPP regimen (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone) is more effective in controlling advanced-stage Hodgkin lymphoma (HL) than the widely used ABVD regimen (adriamycin, bleomycin, vinblastine, dacarbazine), but the extra efficacy comes at the expense of both short- and long-term toxicity, and there is debate as to whether overall survival is affected. Baseline prognostic factors have proven of limited utility for determining which patients require more intensive therapy and recent studies have sought to use interim fluoro-deoxyglucose positron emission tomography (FDG-PET) evaluation as a means to guide the modulation of treatment, both upwards and downwards in intensity. These suggest that if treatment starts with ABVD then patients remaining PET-positive after 2 months can be salvaged with escalated BEACOPP in around 65% of cases, but those becoming PET-negative may still experience recurrences in 15%-20%, an event that is more common in those with more advanced disease at presentation. There are early data to suggest that starting with escalated BEACOPP may reduce the rate of recurrence after a negative interim PET to less than 10%. This may be an attractive approach for those with very high-risk features at presentation, but risks overtreating many patients if applied nonselectively. New regimens incorporating antibody-drug conjugates may shift the balance of efficacy and toxicity once again, and further studies are underway to evaluate this. PMID:27496308

  2. Advances in systemic treatment for nasopharyngeal carcinoma.

    PubMed

    Tan, Wan-Ling; Tan, Eng-Huat; Lim, Darren Wan-Teck; Ng, Quan-Sing; Tan, Daniel Shao-Weng; Jain, Amit; Ang, Mei-Kim

    2016-04-01

    Nasopharyngeal carcinoma (NPC) is a unique disease endemic in Asia. It is etiologically linked to the Epstein-Barr virus and is both radio- and chemo-sensitive. While radiotherapy (RT) remains the primary treatment modality with high cure rates for early stage disease, systemic treatment forms an important integral component in the treatment of NPC, both in the non-metastatic as well as palliative setting. Presently, standard therapy in locally advanced NPC comprises conventional cytotoxic chemotherapy administered concurrently during RT. The role of induction chemotherapy and adjuvant chemotherapy remain to be well-defined. Further research strategies in non-metastatic disease will require better identification of patients with high risk disease, and determining the optimal sequence and combination of chemotherapeutic regimens. In metastatic disease, whilst chemotherapy remains the mainstay of care, resistance inevitably develops. Development of molecularly targeted therapies has not yielded much success to date, and further research has been focused on development of EBV-targeted strategies such as vaccination or administration of cytotoxic T-cells directed towards EBV, as well as evaluation of immune checkpoint inhibition approaches. PMID:27121881

  3. Recent advances in the treatment of hyperammonemia.

    PubMed

    Matoori, Simon; Leroux, Jean-Christophe

    2015-08-01

    Ammonia is a neurotoxic agent that is primarily generated in the intestine and detoxified in the liver. Toxic increases in systemic ammonia levels predominantly result from an inherited or acquired impairment in hepatic detoxification and lead to potentially life-threatening neuropsychiatric symptoms. Inborn deficiencies in ammonia detoxification mainly affect the urea cycle, an endogenous metabolic removal system in the liver. Hepatic encephalopathy, on the other hand, is a hyperammonemia-related complication secondary to acquired liver function impairment. A range of therapeutic options is available to target either ammonia generation and absorption or ammonia removal. Therapies for hepatic encephalopathy decrease intestinal ammonia production and uptake. Treatments for urea cycle disorders eliminate ammoniagenic amino acids through metabolic transformation, preventing ammonia generation. Therapeutic approaches removing ammonia activate the urea cycle or the second essential endogenous ammonia detoxification system, glutamine synthesis. Recent advances in treating hyperammonemia include using synergistic combination treatments, broadening the indication of orphan drugs, and developing novel approaches to regenerate functional liver tissue. This manuscript reviews the various pharmacological treatments of hyperammonemia and focuses on biopharmaceutical and drug delivery issues. PMID:25895618

  4. 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

  5. Low altitude plume impingement handbook

    NASA Technical Reports Server (NTRS)

    Smith, Sheldon D.

    1991-01-01

    Plume Impingement modeling is required whenever an object immersed in a rocket exhaust plume must survive or remain undamaged within specified limits, due to thermal and pressure environments induced by the plume. At high altitudes inviscid plume models, Monte Carlo techniques along with the Plume Impingement Program can be used to predict reasonably accurate environments since there are usually no strong flowfield/body interactions or atmospheric effects. However, at low altitudes there is plume-atmospheric mixing and potential large flowfield perturbations due to plume-structure interaction. If the impinged surface is large relative to the flowfield and the flowfield is supersonic, the shock near the surface can stand off the surface several exit radii. This results in an effective total pressure that is higher than that which exists in the free plume at the surface. Additionally, in two phase plumes, there can be strong particle-gas interaction in the flowfield immediately ahead of the surface. To date there have been three levels of sophistication that have been used for low altitude plume induced environment predictions. Level 1 calculations rely on empirical characterizations of the flowfield and relatively simple impingement modeling. An example of this technique is described by Piesik. A Level 2 approach consists of characterizing the viscous plume using the SPF/2 code or RAMP2/LAMP and using the Plume Impingement Program to predict the environments. A Level 3 analysis would consist of using a Navier-Stokes code such as the FDNS code to model the flowfield and structure during a single calculation. To date, Level 1 and Level 2 type analyses have been primarily used to perform environment calculations. The recent advances in CFD modeling and computer resources allow Level 2 type analysis to be used for final design studies. Following some background on low altitude impingement, Level 1, 2, and 3 type analysis will be described.

  6. Treatment of advanced thymoma and thymic carcinoma.

    PubMed

    Rajan, Arun; Giaccone, Giuseppe

    2008-12-01

    Although thymic epithelial tumors are rare, they are relatively common among neoplasms of the anterior superior mediastinum. They usually exhibit indolent behavior, but do have the capacity to invade surrounding structures and metastasize to distant sites. Thymic carcinomas are rare, but are highly aggressive tumors that are associated with a poor prognosis. The mainstay of therapy is complete surgical resection. Locally advanced thymoma and thymic carcinoma require a multimodality treatment approach with a combination of surgery, chemotherapy, and radiation therapy to decrease the chances of recurrence and improve survival. The risk of disease recurrence lasts for a number of years after completion of primary therapy. A majority of cases of recurrent disease present as pleural recurrences. Once again, surgical resection of recurrent disease represents the cornerstone of successful therapy and is critical to long-term survival. In recent years, a better understanding of the biologic basis of thymic epithelial tumors has led to the emergence of targeted therapy directed against this malignancy. PMID:19381821

  7. Some Advanced Kidney Cancer Patients May Postpone Treatment

    MedlinePlus

    ... advanced kidney cancer that has spread require immediate, aggressive treatment, a small new study suggests. "A subset ... them the inconvenience and debilitating side effects of aggressive treatments for about a year, and in some ...

  8. 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).

  9. 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.

  10. ADVANCED OXIDATION PROCESSES (AOP'S FOR THE TREATMENT OF CCL CHEMICALS

    EPA Science Inventory

    Research on treatment of Contaminant Candidate List (CCL) chemicals is being conducted. Specific groups of contaminants on the CCL will be evaluated using numerous advanced oxidation processes (AOPs). Initially, these CCL contaminants will be evaluated in groups based on chemical...

  11. [Treatment strategies for advanced prostate cancer].

    PubMed

    Küronya, Zsófia; Bíró, Krisztina; Géczi, Lajos; Németh, Hajnalka

    2015-09-01

    There has been dramatic improvement in the diagnosis and treatment of prostate cancer recently. The treatment of localized disease became more successful with the application of new, sophisticated techniques available for urologic surgeons and radiotherapists. Nevertheless a significant proportion of patients relapses after the initial local treatment or is diagnosed with metastatic disease at the beginning. In the past five years, six new drugs became registered for the treatment of metastatic, castration-resistant prostate cancer, such as sipuleucel-T, cabazitaxel, abiraterone, enzalutamide, the α-emitting radionuclide alpharadin and the receptor activator of nuclear factor kappa-B (RANK) ligand inhibitor denosumab. The availability of these new treatment options raises numerous questions. In this review we present the standard of care of metastatic prostate cancer by disease stage (hormone naive/ hormone sensitive metastatic prostate cancer, non-metastatic castration-resistant prostate cancer, oligometastatic/multimetastatic castration-resistant prostate cancer) and the emerging treatment modalities presently assessed in clinical trials. We would also like to give advice on debatable aspects of the management of metastatic prostate cancer. PMID:26339912

  12. Advances in the treatment of testicular cancer.

    PubMed

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

    2015-06-01

    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

  13. Entry inhibitors: New advances in HCV treatment

    PubMed Central

    Qian, Xi-Jing; Zhu, Yong-Zhe; Zhao, Ping; Qi, Zhong-Tian

    2016-01-01

    Hepatitis C virus (HCV) infection affects approximately 3% of the world's population and causes chronic liver diseases, including liver fibrosis, cirrhosis, and hepatocellular carcinoma. Although current antiviral therapy comprising direct-acting antivirals (DAAs) can achieve a quite satisfying sustained virological response (SVR) rate, it is still limited by viral resistance, long treatment duration, combined adverse reactions, and high costs. Moreover, the currently marketed antivirals fail to prevent graft reinfections in HCV patients who receive liver transplantations, probably due to the cell-to-cell transmission of the virus, which is also one of the main reasons behind treatment failure. HCV entry is a highly orchestrated process involving initial attachment and binding, post-binding interactions with host cell factors, internalization, and fusion between the virion and the host cell membrane. Together, these processes provide multiple novel and promising targets for antiviral therapy. Most entry inhibitors target host cell components with high genetic barriers and eliminate viral infection from the very beginning of the viral life cycle. In future, the addition of entry inhibitors to a combination of treatment regimens might optimize and widen the prevention and treatment of HCV infection. This review summarizes the molecular mechanisms and prospects of the current preclinical and clinical development of antiviral agents targeting HCV entry. PMID:26733381

  14. Advances in pharmacological treatment of migraine.

    PubMed

    Diener, H C; Limmroth, V

    2001-10-01

    Migraine is a paroxysmal disorder with attacks of headache, nausea, vomiting, photo- and phonophobia and malaise. This review summarises new treatment options both for the therapy of the acute attack as well as for migraine prophylaxis. Analgesics like aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) are effective in treating migraine attacks. Few controlled trials were performed for the use of ergotamine or dihydroergotamine. These trials indicate inferior efficacy compared with serotonin (5-HT(1B/D)) agonists (triptans). The triptans (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan and zolmitriptan), are highly effective. They improve headache as well as nausea, photo- and phonophobia. The different triptans show only minor differences in efficacy, headache recurrence and adverse effects. The knowledge of their different pharmacological profile allows a more specific treatment of the individual migraine characteristics. Migraine prophylaxis is recommended, when more than three attacks occur per month, if attacks do not respond to acute treatment or if side effects of acute treatment are severe. Substances with proven efficacy include the beta-blockers metoprolol and propranolol, the calcium channel blocker flunarizine, several 5-HT antagonists and amitriptyline. Recently anti-epileptic drugs (valproic acid, gabapentin, topiramate) were evaluated for the prophylaxis of migraine. The use of botulinum toxin is under investigation. PMID:11772289

  15. Entry inhibitors: New advances in HCV treatment.

    PubMed

    Qian, Xi-Jing; Zhu, Yong-Zhe; Zhao, Ping; Qi, Zhong-Tian

    2016-01-01

    Hepatitis C virus (HCV) infection affects approximately 3% of the world's population and causes chronic liver diseases, including liver fibrosis, cirrhosis, and hepatocellular carcinoma. Although current antiviral therapy comprising direct-acting antivirals (DAAs) can achieve a quite satisfying sustained virological response (SVR) rate, it is still limited by viral resistance, long treatment duration, combined adverse reactions, and high costs. Moreover, the currently marketed antivirals fail to prevent graft reinfections in HCV patients who receive liver transplantations, probably due to the cell-to-cell transmission of the virus, which is also one of the main reasons behind treatment failure. HCV entry is a highly orchestrated process involving initial attachment and binding, post-binding interactions with host cell factors, internalization, and fusion between the virion and the host cell membrane. Together, these processes provide multiple novel and promising targets for antiviral therapy. Most entry inhibitors target host cell components with high genetic barriers and eliminate viral infection from the very beginning of the viral life cycle. In future, the addition of entry inhibitors to a combination of treatment regimens might optimize and widen the prevention and treatment of HCV infection. This review summarizes the molecular mechanisms and prospects of the current preclinical and clinical development of antiviral agents targeting HCV entry. PMID:26733381

  16. New treatment options for advanced pancreatic cancer.

    PubMed

    Middleton, Gary; Ghaneh, Paula; Costello, Eithne; Greenhalf, William; Neoptolemos, John P

    2008-10-01

    Pancreatic cancer has a very high mortality rate and affects approximately 230,000 individuals worldwide. Gemcitabine has become established as the standard therapy for advanced pancreatic cancer; however, the survival advantage is small. Adjuvant chemotherapy using either 5-fluorouracil or gemcitabine is now established in pancreatic cancer as an alternative therapy. Combinations of gemcitabine with either platin agents or capecitabine may be advantageous. Anti-EGFR and anti-VEGF agents have been unsuccessful but multiple tyrosine kinase inhibitors are under investigation. Of the increasing number of immunological agents, the GV1001 antitelomerase vaccine holds some interest. Targeted agents against important mitogenic pathways, including MEK/ERK, Src, PI3K/Akt, mTOR, Hedgehog and NF-kappaB, as well as agents targeting histone deacetylase, poly(ADP-ribose) polymerase, heat shock protein 90 and other agents such as beta-lapachone, hold considerable interest for further development. However, the probability of individual success is low. PMID:19072345

  17. Recent treatment advances and novel therapeutic approaches in epilepsy

    PubMed Central

    Serrano, Enrique

    2015-01-01

    The purpose of this article is to review recent advances in the treatment of epilepsy. It includes five antiepileptic drugs that have been recently added to the pharmacologic armamentarium and surgical techniques that have been developed in the last few years. Finally, we review ongoing research that may have a potential role in future treatments of epilepsy. PMID:26097734

  18. [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. PMID:26932894

  19. 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. PMID:26683495

  20. Advances in the cognitive behavioural treatment of obsessive compulsive disorder.

    PubMed

    Shafran, Roz; Radomsky, Adam S; Coughtrey, A E; Rachman, S

    2013-01-01

    The aim of this paper is to highlight key advances in the cognitive-behavioural treatment of obsessive compulsive disorder over the course of Professor Lars Göran Öst's illustrious career. The paper will focus on three specific areas of interest: the treatment of obsessions, compulsive checking, and the fear of contamination. It will also highlight recent advances concerning the broader need to ensure that treatment is acceptable. An increase in acceptability could result in improvements in completion rates so that more patients benefit from the recent improvements in the science and therapy for this disabling disorder. PMID:23758093

  1. 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. PMID:26022170

  2. Recent advances in treatment for Benign Prostatic Hyperplasia

    PubMed Central

    van Rij, Simon; Gilling, Peter

    2015-01-01

    Clinical benign prostatic hyperplasia (BPH), often identified as a worsening ability of a male to pass urine, is a significant problem for men in our society. In 2015, the use of personalised medicine is tailoring treatment to individual patient needs and to genetic characteristics. Technological advances in surgical treatment are changing the way BPH is treated and are resulting in less morbidity. The future of BPH treatments is exciting, and a number of novel techniques are currently under clinical trial. PMID:26918132

  3. Recent advances in treatment for Benign Prostatic Hyperplasia.

    PubMed

    van Rij, Simon; Gilling, Peter

    2015-01-01

    Clinical benign prostatic hyperplasia (BPH), often identified as a worsening ability of a male to pass urine, is a significant problem for men in our society. In 2015, the use of personalised medicine is tailoring treatment to individual patient needs and to genetic characteristics. Technological advances in surgical treatment are changing the way BPH is treated and are resulting in less morbidity. The future of BPH treatments is exciting, and a number of novel techniques are currently under clinical trial. PMID:26918132

  4. 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.

  5. 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. PMID:26443596

  6. Treatment for Advanced and Recurrent Endometrial Carcinoma: Combined Modalities

    PubMed Central

    Rauh-Hain, J. Alejandro

    2010-01-01

    Women with recurrent or advanced endometrial cancer constitute a heterogeneous group of patients. Depending on previous treatment, women with recurrent endometrial cancer may be appropriate candidates for surgery, radiation therapy, hormonal therapy, or chemotherapy. Women with advanced stage disease at presentation may also be appropriate candidates for systemic and local therapies. We review the treatment options available to treat recurrent and locally advanced endometrial cancer. Treatment choice depends largely on the localization of disease, the patient’s performance status and previous treatment history, as well the tumor’s hormonal receptor status. Radiation therapy is appropriate for isolated vaginal recurrences in patients with no previous history of radiation therapy. Patients with recurrent low-grade tumors overexpressing estrogen and progesterone receptors may be treated with progestin therapy. Systemic therapy is appropriate for patients with disseminate recurrences or advanced stage disease at presentation, or for those with receptor-negative tumors. We review all these different treatment strategies available to patients with advanced or recurrent endometrial cancer. PMID:20660059

  7. [Advances in the treatment of secondary osteoporosis].

    PubMed

    Galindo Zavala, R; Núñez Cuadros, E; Díaz Cordovés-Rego, G; Urda Cardona, A L

    2014-12-01

    Osteoporosis is being increasingly recognised in paediatric practice as a consequence of the increasing life expectancy of children who suffer from chronic diseases and other factors. There are many non-pharmacological measures that can improve children' bone health, for example, avoiding inflammatory activity and osteotoxic treatments; increasing sun exposure and weight-bearing exercise, and maintaining an adequate nutritional status. Vitamin D and calcium supplements have been proposed as a measure to increase bone mass, but their effect and therapeutic indications are not completely clear. On the other hand, bisphosphonates are currently the only pharmacological alternative for the patients with infantile secondary osteoporosis. However, more studies are required on the therapeutic indications, posology, and long term secondary effects of biphosphonates. The aim of this article is to analyze the scientific evidence of the effectiveness of the therapeutic alternatives for childhood secondary osteoporosis and their safety in children. PMID:25441207

  8. Recent advances in treatment of heart failure

    PubMed Central

    Kitai, Takeshi; Tang, WH Wilson

    2015-01-01

    With the total cases and economic burden of heart failure continuing to rise, there is an overwhelming need for novel therapies. Several drugs for heart failure have succeeded in preclinical and early-phase clinical trials, but most of them failed to show the real benefit in pivotal clinical trials. Meanwhile, the US Food and Drug Administration recently approved two promising new drugs to treat heart failure: ivabradine and sacubitril/valsartan. Furthermore, some of the newer agents in testing offer the potential for significant progress in addition to these drugs. Patiromer and zirconium cyclosilicate are attractive agents that are expected to prevent hyperkalemia during renin-angiotensin-aldosterone system inhibition, and serelaxin and urodilatin are promising drugs in the treatment of acute heart failure. Future clinical trials with more appropriate study designs, optimal clinical endpoints, and proper patient selection are mandatory to assess the true efficacy of these attractive compounds in clinical practice. PMID:26918130

  9. [Reactive arthritis: advances in diagnosis and treatment].

    PubMed

    Palazzi, C; Olivieri, I; Salvarani, C; D'Amico, E; Alleva, G; Vitullo, P; Petricca, A

    2002-01-01

    Reactive Arthritis (ReA) is an aseptic synovitis developing after a primary infection distant from the joint, mainly localized in the gastrointestinal (Enteroarthritis) or genitourinary tract (Uroarthritis). Because of either the asymmetric joint involvement, the possibility of involvement of the spine and enthesis, and the HLA-B27 association ReA is considered one of the spondylarthropathies. Recently, bacterial components or viable bacteria were found in joints during ReA. For this reason, the limits between ReA itself and infectious arthritis are now less definite. Generally accepted diagnostic and classification criteria are still lacking but the improvement in techniques for detection of bacteria increase the possibility to identify the triggering agents. Several studies have examined the role of antimicrobial drugs in ameliorating the natural course of ReA, with some positive results for Uroarthritis only. However, more conventional treatments based on NSAIDs, sulfasalazine and steroids are effective in many cases. PMID:12105678

  10. Advances in the treatment of menopausal symptoms.

    PubMed

    Pinkerton, JoAnn V; Stovall, Dale W; Kightlinger, Rebecca S

    2009-07-01

    Vasomotor symptoms and vaginal atrophy are both common menopausal symptoms. Hormone therapy is currently the only FDA-approved treatment for hot flashes. Current recommendations are to use the lowest dose of hormone therapy for the shortest period that will allow treatment goals to be met. Although the reanalysis of the WHI in 2007 by Roussow et al. provided evidence of coronary heart safety for users of hormone therapy under the age of 60 years and within 10 years of the onset of menopause, not all women desire or are candidates for hormone therapy. In this review we present an evidence-based discussion considering the effectiveness of hormonal and nonhormonal therapies for the relief of vasomotor symptoms and vaginal atrophy. Concern exists regarding systemic absorption of vaginal estrogen and possible adverse effects on the breast and uterus. Selective estrogen receptor modulators and estrogen agonists offer benefits through targeted estrogen agonist/antagonistic effects and are being evaluated with and without estrogen for symptomatic menopausal women. Centrally acting nonhormonal therapies that are effective for the relief of vasomotor symptoms include various antidepressants, gabapentin and clonidine. A limited number of clinical trials have been conducted with nonprescription remedies, including paced respiration, yoga, acupuncture, exercise, homeopathy and magnet therapy, and some, but not all of these, have been found to be more effective than placebo. Dietary herbal supplements, such as soy and black cohosh, have demonstrated mixed and inconclusive results in placebo-controlled trials. Potential therapies for vasomotor symptoms and vaginal atrophy require randomized, placebo-controlled trials of sufficient duration to establish efficacy and safety. Agents under investigation for vasomotor symptoms relief include neuroactive agents, such as gabapentin and desvenlafaxine; an estrogen receptor-beta-targeted herbal therapy, MF-101; and the selective estrogen

  11. Photochemical grid model performance with varying horizontal grid resolution and sub-grid plume treatment for the Martins Creek near-field SO2 study

    NASA Astrophysics Data System (ADS)

    Baker, Kirk R.; Hawkins, Andy; Kelly, James T.

    2014-12-01

    Near source modeling is needed to assess primary and secondary pollutant impacts from single sources and single source complexes. Source-receptor relationships need to be resolved from tens of meters to tens of kilometers. Dispersion models are typically applied for near-source primary pollutant impacts but lack complex photochemistry. Photochemical models provide a realistic chemical environment but are typically applied using grid cell sizes that may be larger than the distance between sources and receptors. It is important to understand the impacts of grid resolution and sub-grid plume treatments on photochemical modeling of near-source primary pollution gradients. Here, the CAMx photochemical grid model is applied using multiple grid resolutions and sub-grid plume treatment for SO2 and compared with a receptor mesonet largely impacted by nearby sources approximately 3-17 km away in a complex terrain environment. Measurements are compared with model estimates of SO2 at 4- and 1-km resolution, both with and without sub-grid plume treatment and inclusion of finer two-way grid nests. Annual average estimated SO2 mixing ratios are highest nearest the sources and decrease as distance from the sources increase. In general, CAMx estimates of SO2 do not compare well with the near-source observations when paired in space and time. Given the proximity of these sources and receptors, accuracy in wind vector estimation is critical for applications that pair pollutant predictions and observations in time and space. In typical permit applications, predictions and observations are not paired in time and space and the entire distributions of each are directly compared. Using this approach, model estimates using 1-km grid resolution best match the distribution of observations and are most comparable to similar studies that used dispersion and Lagrangian modeling systems. Model-estimated SO2 increases as grid cell size decreases from 4 km to 250 m. However, it is notable that the

  12. Advance end-of-life treatment planning. A research review.

    PubMed

    Miles, S H; Koepp, R; Weber, E P

    1996-05-27

    The year 1996 marks the fifth anniversary of the federal Patient Self-Determination Act. The Patient Self-Determination Act required hospitals, nursing homes, and health plans to ask whether patients have advance directives and to incorporate them into the medical record. A "living will" is an advance directive by which a person tells caregivers the circumstances in which life-sustaining treatment is to be provided or forgone if the patient is unable to communicate. A "durable power of attorney for health care" enables one to designate a person to speak on his or her behalf if the author loses decision-making capacity. "Advance planning" is the process of reflection, discussion, and communication of treatment preferences for end-of-life care that precedes and may lead to an advance directive. PMID:8638992

  13. Advances in the Treatment of Malaria

    PubMed Central

    Castelli, Francesco; Tomasoni, Lina Rachele; Matteelli, Alberto

    2012-01-01

    Malaria still claims a heavy toll of deaths and disabilities even at the beginning of the third millennium. The inappropriate sequential use of drug monotherapy in the past has facilitated the spread of drug-resistant P. falciparum, and to a lesser extend P. vivax, strains in most of the malaria endemic areas, rendering most anti-malarial ineffective. In the last decade, a new combination strategy based on artemisinin derivatives (ACT) has become the standard of treatment for most P. falciparum malaria infections. This strategy could prevent the selection of resistant strains by rapidly decreasing the parasitic burden (by the artemisinin derivative, mostly artesunate) and exposing the residual parasite to effective concentrations of the partner drug. The widespread use of this strategy is somehow constrained by cost and by the inappropriate use of artemisinin, with possible impact on resistance, as already sporadically observed in South East Asia. Parenteral artesunate has now become the standard of care for severe malaria, even if quinine still retains its value in case artesunate is not immediately available. The appropriateness of pre-referral use of suppository artesunate is under close monitoring, while waiting for an effective anti-malarial vaccine to be made available. PMID:23170193

  14. Treatment of advanced thyroid cancer: role of molecularly targeted therapies.

    PubMed

    Covell, Lorinda L; Ganti, Apar Kishor

    2015-09-01

    Advanced thyroid cancer is not amenable to therapy with conventional cytotoxic chemotherapy. However, newer advances in the understanding of the molecular pathogenesis of different subtypes of thyroid cancer have provided new opportunities for the evaluation of molecularly targeted therapies. This has led to multiple clinical trials using various multi-kinase inhibitors and the subsequent US FDA approval of sorafenib for differentiated thyroid cancer and vandetanib and cabozantinib for medullary thyroid carcinoma. This review provides a summary of the current literature for the treatment of advanced thyroid carcinoma and future directions in this disease. PMID:26335853

  15. 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

  16. Recent advances in the treatment of colon cancer.

    PubMed

    Xu, R; Zhou, B; Fung, P C W; Li, X

    2006-08-01

    Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Although surgical resection is still the only treatment capable of curing colon cancer, adjuvant therapy continues to play an important role in preventing recurrence and metastasis. In recent years remarkable progress has been made in the treatment of colon cancer. This review discusses recent advances in adjuvant therapy for colon cancer, including chemotherapy, immunotherapy, antiangiogenic therapy and apoptosis induction. In the meantime, molecular therapy is also elucidated in the above methods. All these new advances will provide new promises for patients of colon cancer. PMID:16691539

  17. Dust Plumes off Libya

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Two-toned dust plumes blew northward off the coast of Libya on October 26, 2007, as the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA's Terra satellite took this picture. While plumes in the west are beige, reminiscent of the Sahara's sands, the plumes in the east are distinctly darker. The differences in color can be traced to the plumes's varied origins.

  18. 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. PMID:27261813

  19. Surgical treatment: Myomectomy and hysterectomy; Endoscopy: A major advancement.

    PubMed

    Thubert, Thibault; Foulot, Hervé; Vinchant, Marie; Santulli, Pietro; Marzouk, Paul; Borghese, Bruno; Chapron, Charles

    2016-07-01

    Uterine fibroids affect 25% of women worldwide. Symptomatic women can be treated by either medical or surgical treatment. Development of endoscopic surgery has widely changed the management of myoma. Currently, although laparoscopic or laparoscopic robot-assisted myomectomies or hysterectomies are common, there has been no consensual guideline concerning the surgical techniques, operative route, and usefulness of preoperative treatment. Hysteroscopy management is a major advancement avoiding invasive surgery. This study deals with a literature review concerning surgical management of fibroids. PMID:27400649

  20. Advances in Treatment Integrity Research: Multidisciplinary Perspectives on the Conceptualization, Measurement, and Enhancement of Treatment Integrity

    ERIC Educational Resources Information Center

    Schulte, Ann C.; Easton, Julia E.; Parker, Justin

    2009-01-01

    Documenting treatment integrity is an important issue in research and practice in any discipline concerned with prevention and intervention. However, consensus concerning the dimensions of treatment integrity and how they should be measured has yet to emerge. Advances from three areas in which significant treatment integrity work has taken…

  1. 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. PMID:24804662

  2. 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

  3. 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…

  4. Agonist treatment in opioid use: advances and controversy.

    PubMed

    Viswanath, Biju; Chand, Prabhat; Benegal, Vivek; Murthy, Pratima

    2012-06-01

    Opioid dependence is a chronic relapsing condition which requires comprehensive care; pharmacological agents form the mainstay of its long term treatment. The two most popular approaches are the harm reduction method using agonists and the complete abstinence method using antagonists. Currently, particularly from the harm minimization perspective and the low feasibility of an abstinence based approach, there is an increasing trend toward agonist treatment. The use of buprenorphine has gained popularity in view of its safety profile and the availability of the buprenorphine-naloxone combination has made it popular as a take-home treatment. This review outlines the pharmacological advances and controversies in this area. PMID:22813654

  5. SERA - An Advanced Treatment Planning System for Neutron Therapy

    SciTech Connect

    C. A. Wemple; C. L. Albright; D. W. Nigg; D. W. Wessol; F. J. Wheeler; G. J. Harkin; M. B. Rossmeirer; M. T. Cohen; M. W. Frandsen

    1999-06-01

    The technology for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT) has advanced significantly over the past few years. Because of the more complex nature of the problem, the computational methods that work well for treatment planning in photon radiotherapy are not applicable to BNCT. The necessary methods have, however, been developed and have been successfully employed both for research applications as well as human trials. Computational geometry for BNCT applications can be constructed directly from tomographic medical imagery and computed radiation dose distributions can be readily displayed in formats that are familiar to the radiotherapy community. The SERA system represents a significant advance in several areas for treatment planning. However further improvements in speed and results presentation are still needed for routine clinical applications, particularly when optimizations of dose pattern is required.

  6. [Treatment strategy for advanced prostate cancer with bone metastases].

    PubMed

    Sugimoto, Mikio; Kakehi, Yoshiyuki

    2006-08-01

    The introduction of PSA screening has led to confirming a shift towards an earlier pathological stage in the diagnosis of prostate cancer. Consequently, the proportion of detecting early stage prostate cancer has clearly been increasing. On the other hand, progressive cancers in the form of distant metastases and locally advanced ones that have been confirmed at the initial diagnosis exhibit a constant rate. In addition, there have been a lot of cases where hormonal resistance was acquired during hormonal therapy which resulted in advanced metastases of the prostate. Prostate cancer has a tendency to be metastatic to bones. Combining the fact that the survival period of patients undergoing treatment is prolonged after metastases, the length of suffering caused by complications, such as ostealgia, pathological fracture and myelopathy, becomes an issue in which QOL and ADL of the patient are sacrificed for a long time. As for treatment of prostate cancer with metastases, a palliative treatment is common in the clinical scene. However, we can extend a life prognosis with use of radiotherapy and surgical treatment in addition to the palliative treatment at an appropriate time. It appears that a combination of new chemotherapy and hormonal therapy will be promising. In the future, we believe that the appearance of new anticancer drugs, endocrine therapies, bisphosphonates and strontium treatment could be used as a part of the treatment strategy for prostate cancer with bone metastases. PMID:16912523

  7. Virus Reduction during Advanced Bardenpho and Conventional Wastewater Treatment Processes.

    PubMed

    Schmitz, Bradley W; Kitajima, Masaaki; Campillo, Maria E; Gerba, Charles P; Pepper, Ian L

    2016-09-01

    The present study investigated wastewater treatment for the removal of 11 different virus types (pepper mild mottle virus; Aichi virus; genogroup I, II, and IV noroviruses; enterovirus; sapovirus; group-A rotavirus; adenovirus; and JC and BK polyomaviruses) by two wastewater treatment facilities utilizing advanced Bardenpho technology and compared the results with conventional treatment processes. To our knowledge, this is the first study comparing full-scale treatment processes that all received sewage influent from the same region. The incidence of viruses in wastewater was assessed with respect to absolute abundance, occurrence, and reduction in monthly samples collected throughout a 12 month period in southern Arizona. Samples were concentrated via an electronegative filter method and quantified using TaqMan-based quantitative polymerase chain reaction (qPCR). Results suggest that Plant D, utilizing an advanced Bardenpho process as secondary treatment, effectively reduced pathogenic viruses better than facilities using conventional processes. However, the absence of cell-culture assays did not allow an accurate assessment of infective viruses. On the basis of these data, the Aichi virus is suggested as a conservative viral marker for adequate wastewater treatment, as it most often showed the best correlation coefficients to viral pathogens, was always detected at higher concentrations, and may overestimate the potential virus risk. PMID:27447291

  8. Burn wound healing and treatment: review and advancements.

    PubMed

    Rowan, Matthew P; Cancio, Leopoldo C; Elster, Eric A; Burmeister, David M; Rose, Lloyd F; Natesan, Shanmugasundaram; Chan, Rodney K; Christy, Robert J; Chung, Kevin K

    2015-01-01

    Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent. However, for the intensivist, challenges often exist that complicate patient support and stabilization. Furthermore, burn wounds are complex and can present unique difficulties that require late intervention or life-long rehabilitation. In addition to improvements in patient stabilization and care, research in burn wound care has yielded advancements that will continue to improve functional recovery. This article reviews recent advancements in the care of burn patients with a focus on the pathophysiology and treatment of burn wounds. PMID:26067660

  9. Locally Advanced Gastroesophageal Junction Tumor: A Treatment Dilemma

    PubMed Central

    Ashraf, Noman; Hoffe, Sarah

    2015-01-01

    Over the last several decades, the incidence of adenocarcinoma of the gastroesophageal junction (GEJ) has been increasing in developed countries. Although complete surgical resection remains the cornerstone of treatment for resectable disease, long-term outcomes are poor and recurrence rates are high with surgery alone in patients presenting with locally advanced disease. Multimodal therapy has been shown to improve survival; however, the optimal therapeutic approach remains controversial, and practices vary across the world. Preoperative chemoradiotherapy is generally used in the U.S., whereas perioperative chemotherapy without radiation is favored in most European countries. In this review, we discuss why the treatment of locally advanced GEJ tumors remains controversial, examine the evidence for various multimodal approaches, discuss their respective pros and cons, evaluate the role of radiation therapy, highlight some ongoing and planned clinical trials, and suggest areas that need further research. PMID:25561508

  10. Food allergy: recent advances in pathophysiology and treatment

    PubMed Central

    Sampson, Hugh A

    2009-01-01

    Food allergies are adverse immune reactions to food proteins that affect up to 6% of children and 3-4% of adults. A wide range of symptoms can occur depending on whether IgE or non-IgE mediated mechanism are involved. Many factors influence the development of oral tolerance, including route of exposure, genetics, age of the host, and allergen factors. Advances have been made in the understanding of how these factors interact in the pathophysiology of food allergy. Currently, the mainstay of treatment for food allergies is avoidance and ready access to emergency medications. However, with the improved understanding of tolerance and advances in characterization of food allergens, several therapeutic strategies have been developed and are currently being investigated as potential treatments and/or cures for food allergy. PMID:20224666

  11. Locally advanced gastroesophageal junction tumor: a treatment dilemma.

    PubMed

    Ashraf, Noman; Hoffe, Sarah; Kim, Richard

    2015-02-01

    Over the last several decades, the incidence of adenocarcinoma of the gastroesophageal junction (GEJ) has been increasing in developed countries. Although complete surgical resection remains the cornerstone of treatment for resectable disease, long-term outcomes are poor and recurrence rates are high with surgery alone in patients presenting with locally advanced disease. Multimodal therapy has been shown to improve survival; however, the optimal therapeutic approach remains controversial, and practices vary across the world. Preoperative chemoradiotherapy is generally used in the U.S., whereas perioperative chemotherapy without radiation is favored in most European countries. In this review, we discuss why the treatment of locally advanced GEJ tumors remains controversial, examine the evidence for various multimodal approaches, discuss their respective pros and cons, evaluate the role of radiation therapy, highlight some ongoing and planned clinical trials, and suggest areas that need further research. PMID:25561508

  12. 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.

  13. 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

  14. Intelligent Nanoparticles for Advanced Drug Delivery in Cancer Treatment

    PubMed Central

    Spencer, David S.; Puranik, Amey S.; Peppas, Nicholas A.

    2015-01-01

    Treatment of cancer using nanoparticle-based approaches relies on the rational design of carriers with respect to size, charge, and surface properties. Polymer-based nanomaterials, inorganic materials such as gold, iron oxide, and silica as well as carbon based materials such as carbon nanotubes and graphene are being explored extensively for cancer therapy. The challenges associated with the delivery of these nanoparticles depend greatly on the type of cancer and stage of development. This review highlights design considerations to develop nanoparticle-based approaches for overcoming physiological hurdles in cancer treatment, as well as emerging research in engineering advanced delivery systems for the treatment of primary, metastatic, and multidrug resistant cancers. A growing understanding of cancer biology will continue to foster development of intelligent nanoparticle-based therapeutics that take into account diverse physiological contexts of changing disease states to improve treatment outcomes. PMID:25621200

  15. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment.

    PubMed

    Zhu, Linlin; Qin, Jinyu; Wang, Jin; Guo, Tianjiao; Wang, Zijing; Yang, Jinlin

    2016-01-01

    Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist's experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC). PMID:26884753

  16. Treatment strategies in early and advanced Parkinson disease.

    PubMed

    Ossig, Christiana; Reichmann, Heinz

    2015-02-01

    The initiation of therapy in Parkinson disease (PD), altering the medication, adding new substances, and switching to alternative therapies throughout the disease is always a matter of debate. In the past, experts in PD have propagated different medication strategies. Even though there is no new medical treatment on the horizon, much has changed in consideration of the known treatments in the early and advanced therapy for PD. Therapeutic regimens have to be adapted and adjusted on a regular basis to accomplish the best medical care for the predominant symptom of the individual patient with PD. PMID:25432721

  17. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment

    PubMed Central

    Zhu, Linlin; Qin, Jinyu; Wang, Jin; Guo, Tianjiao; Wang, Zijing; Yang, Jinlin

    2016-01-01

    Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist's experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC). PMID:26884753

  18. 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

  19. Current perspectives in the treatment of advanced prostate cancer.

    PubMed

    Valdespino, Victor; Tsagozis, Panagiotis; Pisa, Pavel

    2007-01-01

    Prostate cancer (PC) continues to be an important world health problem for men. Patients with locally confined PC are treated with either radiotherapy or surgery. However, treatment of more advanced stages of the disease is problematic. Initially, androgen deprivation offers a period of clinical stability, which is however invariably followed by progression to non-responsiveness to hormonal manipulation. Current management of patients with androgen-independent prostate cancer (AIPC) displays modest response rates and achieves only short-term benefit. Recently, knowledge in the complex pathophysiology of advanced PC has led to the identification of mechanisms and target molecules permitting the introduction of new therapies. Consequently, many investigational treatments are ongoing for AIPC in Phase-II and Phase-III trials aiming at the combination of chemotherapeutic regimens along with immunotherapy targeting PC-associated antigens. Other attractive options are gene therapy, as well as the targeting of survival signaling, differentiation, and apoptosis of the malignant PC cells. Further treatment modalities are directed against the tumor microenvironment, bone metastasis, or both. Collectively, the aforementioned efforts introduce a new era in the management of advanced PC. Novel pharmaceutical compounds and innovative approaches, integrated into the concept of individualized therapy will hopefully, during the next decade, improve the outcome and survival for hundreds of thousands of men worldwide. PMID:17873302

  20. Advances in the treatment of polyarticular juvenile idiopathic arthritis

    PubMed Central

    Webb, Kate; Wedderburn, Lucy R.

    2015-01-01

    Purpose of review To review recent advances in the management strategies of polyarticular course juvenile idiopathic arthritis (JIA) and identify unanswered questions and avenues for further research. Recent findings There is evidence for an early, aggressive, treat-to-target approach for polyarticular JIA. Clinical disease activity criteria have been recently defined and validated, including criteria for inactive disease and the juvenile arthritis disease activity score (JADAS). There is a need for evidence-based, defined disease targets and biomarkers for prediction of response, including targets for remission induction, and guidelines on drug withdrawal. Recent treatment consensus plans and guidelines are discussed and compared, including the 2015 NHS England clinical policy statement, the 2014 Childhood Arthritis and Rheumatology Research Alliance (CARRA) treatment plans and the 2011 American College of Rheumatology (ACR) guidelines. Evidence for new agents such as tocilizumab, rituximab, golimumab, ustekinumab, certolizumab and tofacitinib is promising: the recent clinical trials are summarized here. Stratification of individual patient treatment remains a goal, and predictive biomarkers have been shown to predict success in the withdrawal of methotrexate therapy. Summary There are promising advances in the treatment approaches, disease activity criteria, clinical guidelines, pharmaceutical choices and individually stratified therapy choices for polyarticular JIA. PMID:26147756

  1. Technological Advances In The Surgical Treatment Of Movement Disorders

    PubMed Central

    Gross, Robert E.; McDougal, Margaret E.

    2013-01-01

    Technological innovations have driven the advancement of the surgical treatment of movement disorders, from the invention of the stereotactic frame to the adaptation of deep brain stimulation (DBS). Along these lines, this review will describe recent advances in getting neuromodulation modalities, including DBS, to the target; and in the delivery of therapy at the target. Recent radiological advances are altering the way that DBS leads are targeted and inserted, by refining the ability to visualize the subcortical targets using high-field strength MRI and other innovations such as diffusion tensor imaging, and the development of novel targeting devices enabling purely anatomical implantations without the need for neurophysiological monitoring. New portable CT scanners also are facilitating lead implantation without monitoring as well as improving radiological verification of DBS lead location. Advances in neurophysiological mapping include efforts to develop automatic target verification algorithms, and probabilistic maps to guide target selection. The delivery of therapy at the target is being improved by the development of the next generation of internal pulse generators (IPGs). These include constant current devices that mitigate the variability introduced by impedance changes of the stimulated tissue, and in the near future, devices that deliver novel stimulation patterns with improved efficiency. Closed-loop adaptive IPGs are being tested, which may tailor stimulation to ongoing changes in the nervous system reflected in Œbiomarkers1 continuously recorded by the devices. Finer grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via Œcurrent steering1 algorithms. Finally, even thermocoagulation - essentially replaced by DBS - is being advanced by new Œminimally-invasive1 approaches that may improve this therapy for selected patients in whom it may be preferred. Functional neurosurgery has a history of

  2. Recent advances in the treatment of advanced renal cell carcinoma: towards multidisciplinary personalized care.

    PubMed

    Bex, Axel; Gore, Martin; Mulders, Peter; Sternberg, Cora N

    2012-11-01

    What's known on the subject? and What does the study add? With recent improvements in the prognosis for patients with metastatic renal cell carcinoma (mRCC), focus is now shifting towards maximising clinical benefit from targeted therapies. Factors other than efficacy data are increasingly being considered when selecting a treatment strategy, with a view towards optimising clinical outcomes. This review examines the development and efficacy of targeted agents for the management of mRCC and discusses the potential factors, including resistance mechanisms, sequential therapy, prognostic and predictive markers of response, and adverse event management, that may contribute to successful individually tallored treatment of patients with this disease. • Targeted agents have substantially improved outcomes for patients with metastatic renal cell carcinoma (mRCC). • Treatment focus is now shifting towards achieving a continuum of care such that long-term benefit and extended survival may be achieved through the optimal use of targeted agents. • To achieve this goal, a number of factors which impact on treatment selection and outcomes need to be considered when treating patients with mRCC, such as the optimal sequence of targeted therapies (and the related issue of resistance mechanisms). • Recent advances are also likely to impact on the future treatment of mRCC. Examples include the identification of predictive biomarkers as well as a consideration of patient risk profiles or the safety profile of the selected targeted agent. In addition, attention is focusing on re-defining the role of surgery for the treatment of RCC in the context of targeted therapies. • This review examines the recent and future advances that offer the potential for personalizing treatment by selecting the most appropriate treatment for each patient with a view towards optimizing clinical outcomes. PMID:22624610

  3. 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. PMID:26416539

  4. 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

  5. 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

  6. Development of an advanced water treatment system for wastewater reuse.

    PubMed

    Chung, H; Ku, B; Gregory, J

    2008-09-01

    The aim of this research was to develop an optimal reuse system applying various types of advanced oxidation processes such as titanium dioxide (TiO2), ozone (O3) and electro-coagulation/oxidation methods. This system is suitable for improving the treatment efficiency of difficult wastewaters, and for the efficient reuse of wastewater. The connecting systems were divided into various types to investigate the stability and treatment efficiency according to the kinds of waste load. Different treatment sequences were examined taking into consideration the characteristics and economical efficiency. In the case of electro-coagulation/oxidation + ozone system, the mean treatment efficiency in terms of BOD5, CODCr and SS removal was 98.7%. The effluent concentration was 50.2 mg l(-1), 38.3 mg l(-1), 30.4 mg l(-1), respectively. In considering the economical efficiency and commercial use, around an eighth of the treatment expenses and around a fifth of the maintenance expenses could be saved compared with existing water treatment systems. The initial construction expenses could be reduced by a third to a fifth. Therefore, if a proper implementation of this research is carried out in relation to site conditions and the purpose of the water reuse, the water reuse rate will be higher and water resources can be protected. PMID:18844120

  7. Turbulent Plumes in Nature

    NASA Astrophysics Data System (ADS)

    Woods, Andrew W.

    2010-01-01

    This review describes a range of natural processes leading to the formation of turbulent buoyant plumes, largely relating to volcanic processes, in which there are localized, intense releases of energy. Phenomena include volcanic eruption columns, bubble plumes in lakes, hydrothermal plumes, and plumes beneath the ice in polar oceans. We assess how the dynamics is affected by heat transfer, particle fallout and recycling, and Earth's rotation, as well as explore some of the mixing of the ambient fluid produced by plumes in a confined geometry.

  8. Advance treatment directives for people with severe mental illness

    PubMed Central

    Campbell, Leslie Anne; Kisely, Steve R

    2014-01-01

    Background An advance directive is a document specifying a person’s preferences for treatment, should he or she lose capacity to make such decisions in the future. They have been used in end-of-life settings to direct care but should be well suited to the mental health setting. Objectives To examine the effects of advance treatment directives for people with severe mental illness. Search methods We searched the Cochrane Schizophrenia Group’s Register (February 2008), the Cochrane Library (Issue 1 2008), BIOSIS (1985 to February 2008), CINAHL (1982 to February 2008), EMBASE (1980 to February 2008), MEDLINE (1966 to February 2008), PsycINFO (1872 to February 2008), as well as SCISEARCH and Google - Internet search engine (February 2008). We inspected relevant references and contacted first authors of included studies. We updated this search on 17 May 2012 and added the results to the awaiting classification section of the review. Selection criteria We included all randomised controlled trials (RCTs), involving adults with severe mental illness, comparing any form of advance directive with standard care for health service and clinical outcomes. Data collection and analysis We extracted data independently. For homogenous dichotomous data we calculated fixed-effect relative risk (RR) and 95% confidence intervals (CI) on an intention-to-treat basis. For continuous data, we calculated weighted mean differences (WMD) and their 95% confidence interval again using a fixed-effect model. Main results We were able to include two trials involving 321 people with severe mental illnesses. There was no significant difference in hospital admission (n=160, 1 RCT, RR 0.69 0.5 to 1.0), or number of psychiatric outpatient attendances between participants given advanced treatment directives or usual care. Similarly, no significant differences were found for compliance with treatment, self harm or number of arrests. Participants given advanced treatment directives needed less use of

  9. 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.

  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. Treatment results in advanced stage Hodgkin's lymphoma: A retrospective study

    PubMed Central

    Jain, H; Sengar, M; Nair, R; Menon, H; Laskar, S; Shet, T; Gujral, S; Sridhar, E

    2015-01-01

    Background: Hodgkin's lymphoma displays distinct epidemiological attributes in Asian population thus making it relevant to study whether there are any differences in treatment outcomes too when treated with current standard of care. Aim: To evaluate the treatment outcomes of de-novo advanced stage HL in adults. Materials and Methods: This retrospective study included de-novo advanced stage HL patients (≥15 years) registered at our center from January 2004 to December 2007. Treatment outcomes were measured in terms of response rates, overall survival (OS) and progression-free survival (PFS). Overall and PFS were calculated with Kaplan-Meier methodology and Cox-proportional hazards model was used for multivariate analysis to identify prognostic factors. Results: There were 125 patients (males 77%) who received minimum one cycle of chemotherapy with median age of 32 years (Range 15-65 years). Stage IV disease was seen in (46 patients) 37%; 75% (94 patients) patients had B symptoms. International prognostic score (IPS) ≤4 was seen in 95/112 (85%) patients. ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy was given to 94%. Radiation to residual/bulky sites was given to 36% (45 patients). Response data was available for 112 patients; complete response in 76%; partial response in 10 % and progressive disease in 3 patients. Nineteen deaths (progressive disease-7, toxicity-8, unrelated cause-4) were observed. At median follow-up of 28 months, estimated 5-year OS and PFS were 60% and 58%, respectively. On multivariate analysis, IPS and response to treatment were significant factors for both OS and PFS. Conclusions: The treatment outcomes in this study are comparable with the published literature with limited follow-up data. PMID:25766339

  12. Outcome of nonsurgical treatment for locally advanced thymic tumors

    PubMed Central

    Wang, Chang-Lu; Gao, Lan-Ting; Lv, Chang-Xing; Zhu, Lei

    2016-01-01

    Background Surgical resection remains the mainstay of treatment for patients with early-staged thymic tumors, while chemotherapy is most commonly used in stage IV cases. As for locally advanced thymic tumors, especially those unsuitable for surgery, the optimal therapy is still controversial. Thus, we conducted this retrospective study by comparing three nonsurgical treatment modalities to find some clues. Methods Three treatment modalities were used in 42 patients from October 2000 to December 2010, including radiotherapy (RT) alone, sequential chemoradiation (SCRT) and concurrent chemoradiation (CCRT). Objective response rate (ORR), overall survival (OS) and toxicity of the three regimens were compared accordingly. Results The ORR in all 42 patients was 61.9%, and 5-year OS was 46%. The ORR of RT, SCRT and CCRT were 43.8%, 50% and 87.5%, respectively (RT vs. SCRT, P=0.692; RT vs. CCRT, P=0.009; SCRT vs. CCRT, P=0.051). The 5-year OS of RT, SCRT and CCRT were 30%, 50% and 61.9%, respectively. (RT vs. SCRT, P=0.230; RT vs. CCRT, P=0.011; SCRT vs. CCRT, P=0.282). Eleven patients developed neutropenia of grade 3–4, with 7 in CCRT group and 4 in SCRT, respectively. Nine patients experienced esophagitis of grade 3 with 2 in RT, 3 in SCRT and 4 in CCRT. There were also two cases of grade 3 radiation induced pneumonitis in CCRT group. No life-threatening side effects were noted. Conclusions When used to treat locally advanced thymic tumors unsuitable for surgery, CCRT performed more favorably than RT alone or SCRT in both tumor response and long time survival, but probably with the increasing risk of pulmonary damage. CCRT may offer the best chance of disease control in the management of locally advanced disease. PMID:27114838

  13. Advances in the Management of Treatment-Resistant Depression

    PubMed Central

    Holtzheimer, Paul E.

    2015-01-01

    Treatment-resistant depression (TRD) is a prevalent, disabling, and costly condition affecting 1%–4% of the U.S. population. Current approaches to managing TRD include medication augmentation (with lithium, thyroid hormone, buspirone, atypical antipsychotics, or various antidepressant medications), psychotherapy, and ECT. Advances in understanding the neurobiology of mood regulation and depression have led to a number of new potential approaches to managing TRD, including medications with novel mechanisms of action and focal brain stimulation techniques. This review will define and discuss the epidemiology of TRD, review the current approaches to its management, and then provide an overview of several developing interventions. PMID:25960694

  14. 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

  15. 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. PMID:27625747

  16. Mandibular advancement splints for the treatment of sleep apnea syndrome.

    PubMed

    Sutherland, K; Cistulli, P

    2011-01-01

    Oral devices, in particular Mandibular Advancement Splints (MAS), which hold the mandible in a protruded position during sleep, are increasingly used for the treatment of Obstructive Sleep Apnoea (OSA). These devices can be effective in treating OSA across a range of severity. Complete resolution of OSA (Apnoea-Hypopnoea Index [AHI] reduced <5/hr) with use of an MAS occurs in around 40% of patients. Overall two thirds of patients experience some clinical benefit (≥50% AHI reduction AHI) however others will not objectively respond to this form of treatment, despite improvement in symptoms. Although MAS are less efficacious in reducing polysomnographic indices of OSA than the standard treatment, Continuous Positive Airway Pressure (CPAP), improvements in health outcomes appear to be comparable. Therefore, the superiority of CPAP in improving oxygen desaturations and reducing AHI may be extenuated by its low compliance, resulting in both treatments having similar effectiveness in clinical practice. MAS are now recommended as a first line treatment for mild to moderate OSA, as well as in more severe patients who are unable to tolerate or refuse CPAP. Success with MAS treatment has been associated with factors such as female gender, younger age, supine-dependent OSA, lower BMI, smaller neck circumference and craniofacial factors, however a reliable, validated method for prediction in the clinical setting has yet to be established. MAS are well tolerated, however short-term side effects are common although generally minor and transient. Long-term dental changes are for the most part subclinical, but can be problematic for a minority of patients. MAS are a dental-based treatment for a medical sleep disorder and, as such, an interdisciplinary care model is considered important for the attainment of optimal patient outcomes. PMID:21956677

  17. 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

  18. The X-625 Groundwater Treatment Facility: A field-scale test of trichloroethylene dechlorination using iron filings for the X-120/X-749 groundwater plume

    SciTech Connect

    Liang, L.; West, O.R.; Korte, N.E.

    1997-09-01

    The dehalogenation of chlorinated solvents by zero-valence iron has recently become the subject of intensive research and development as a potentially cost-effective, passive treatment for contaminated groundwater through reactive barriers. Because of its successful application in the laboratory and other field sites, the X-625 Groundwater Treatment Facility (GTF) was constructed to evaluate reactive barrier technology for remediating trichloroethylene (TCE)-contaminated groundwater at the Portsmouth Gaseous Diffusion Plant (PORTS). The X-625 GTF was built to fulfill the following technical objectives: (1) to test reactive barrier materials (e.g., iron filings) under realistic groundwater conditions for long term applications, (2) to obtain rates at which TCE degrades and to determine by-products for the reactive barrier materials tested, and (3) to clean up the TCE-contaminated water in the X-120 plume. The X-625 is providing important field-scale and long-term for the evaluation and design of reactive barriers at PORTS. The X-625 GTS is a unique facility not only because it is where site remediation is being performed, but it is also where research scientists and process engineers can test other promising reactive barrier materials. In addition, the data collected from X-625 GTF can be used to evaluate the technical and economic feasibility of replacing the activated carbon units in the pump-and-treat facilities at PORTS.

  19. Advanced Nanobiomaterials: Vaccines, Diagnosis and Treatment of Infectious Diseases.

    PubMed

    Torres-Sangiao, Eva; Holban, Alina Maria; Gestal, Monica Cartelle

    2016-01-01

    The use of nanoparticles has contributed to many advances due to their important properties such as, size, shape or biocompatibility. The use of nanotechnology in medicine has great potential, especially in medical microbiology. Promising data show the possibility of shaping immune responses and fighting severe infections using synthetic materials. Different studies have suggested that the addition of synthetic nanoparticles in vaccines and immunotherapy will have a great impact on public health. On the other hand, antibiotic resistance is one of the major concerns worldwide; a recent report of the World Health Organization (WHO) states that antibiotic resistance could cause 300 million deaths by 2050. Nanomedicine offers an innovative tool for combating the high rates of resistance that we are fighting nowadays, by the development of both alternative therapeutic and prophylaxis approaches and also novel diagnosis methods. Early detection of infectious diseases is the key to a successful treatment and the new developed applications based on nanotechnology offer an increased sensibility and efficiency of the diagnosis. The aim of this review is to reveal and discuss the main advances made on the science of nanomaterials for the prevention, diagnosis and treatment of infectious diseases. Highlighting innovative approaches utilized to: (i) increasing the efficiency of vaccines; (ii) obtaining shuttle systems that require lower antibiotic concentrations; (iii) developing coating devices that inhibit microbial colonization and biofilm formation. PMID:27376260

  20. Latest advances and research in stroke treatment 2007.

    PubMed

    Montaner, Joan

    2007-04-01

    The 32nd International Stroke Conference, held February 7-9, 2007, in San Francisco, California, U.S.A., was an excellent forum to bring together advances in stroke treatment. Very challenging new steps in the process of developing drugs for stroke from basic science to clinical trials, such as testing the in vitro efficacy in human tissue of a candidate drug, or its in vivo PET distribution in ischemic brain, were proposed. This report focuses on new therapeutic stroke targets addressed in the meeting, together with the trends in neurovascular research presented at the oral and poster sessions. Some of the results obtained by researchers in several stroke fields such as thrombolysis, new drugs or devices and nonpharmacological approaches for stroke treatment tested in humans will also be covered. From the basic research, promising strategies found in new drugs and targets, and endothelial progenitor cells, cellular therapies and angiogenesis will be discussed. Also covered in this review are a selection of advances introduced in secondary prevention and in cerebral hemorrhage. PMID:17520097

  1. [Treatment outcome of peptide vaccination for advanced colorectal cancer].

    PubMed

    Sugiura, Fumiaki; Inoue, Keisuke; Kogita, Akihiro; Yoshioka, Yasumasa; Hida, Jinichi; Okuno, Kiyotaka; Sukegawa, Yasushi

    2013-11-01

    Complementary DNA( cDNA) microarray technology coupled with laser microdissection has been used to identify human leukocyte antigen (HLA)-A24-restricted epitope peptides as potential targets for cancer vaccination in colorectal cancer patients. These antigenic peptides were derived from 2 different cancer-testis antigens, ring finger protein 43 (RNF43) and translocase of outer mitochondrial membrane 34( TOMM34). We conducted a clinical trial of colorectal cancer-specific peptide( RNF43, TOMM34) vaccines with uracil/tegafur( UFT)+Leucovorin( LV) for the treatment of advanced or recurrent colorectal cancer. The vaccinations were well tolerated without any serious adverse events. There were long-term survivors in the group showing cytotoxic T lymphocyte (CTL) responses against both RNF43 and TOMM34, as well as in the group showing CTL responses against either RNF43 or TOMM34. A new study has been planned to obtain more immunological responses. We started a clinical trial of vaccines against multiple peptides (RNF43, TOMM34, forkhead box protein M1 [FOXM1], maternal embryonic leucine zipper kinase [MELK], holliday junction recognition protein[HJURP], vascular endothelial growth factor receptor 1[VEGFR1], and VEGFR2) for the treatment of advanced or recurrent colorectal cancer. PMID:24393856

  2. Advances in endoscopic diagnosis and treatment of Barrett's esophagus.

    PubMed

    Gaddam, Srinivas; Sharma, Prateek

    2010-12-01

    Barrett's esophagus (BE) is defined as abnormal specialized columnar metaplasia with intestinalization in place of the normal squamous esophageal epithelium. Gastroesophageal reflux disease is a known risk factor for BE; nonetheless BE is also detected in asymptomatic individuals. Other risk factors for BE include smoking, male gender, age over 50 and obesity. Patients diagnosed with BE (without dysplasia) are recommended to undergo endoscopic surveillance every 3-5 years. Advances in imaging techniques (such as narrow band imaging, autofluorescence imaging and confocal laser endomicroscopy) have the potential to improve the detection of dysplasia and early cancer, thus making surveillance a more cost-effective endeavor. Patients with high grade dysplasia (HGD) and early cancer have a high rate of progression to invasive adenocarcinoma and traditionally these patients were treated with esophagectomy. The rapid advancement of endoscopic therapeutic techniques along with a low risk of complications have made endoscopic therapy an acceptable alternative to an esophagectomy in patients with HGD and early cancer. Several endoscopic treatment techniques such as endoscopic mucosal resection, multipolar electrocoagulation, photodynamic therapy, argon plasma coagulation, cryotherapy, and radiofrequency ablation have been studied for endoscopic treatment. PMID:21091894

  3. Advances in the topical treatment of diabetic foot ulcers.

    PubMed

    Papanas, N; Eleftheriadou, I; Tentolouris, N; Maltezos, E

    2012-05-01

    The diabetic foot remains a major cause of morbidity worldwide. Even though considerable progress has been achieved over the past years, there is still an urgent need for improvement. While established therapeutic modalities (revascularization, casting and debridement) remain the mainstay of management, there is, therefore, continuous development of new treatment options. This review provides an outlook of advances in topical treatment, including bioengineered skin substitutes (such as Dermagraft, Apligraf, HYAFF, OASIS and Graftjacket), extracellular matrix proteins (such as Hyalofill and E-matrix), as well as miscellaneous further therapeutic adjuncts. Although promising, new therapies should not, for the time being, constitute the basis of management, since clinical experience has not yet confirmed their effectiveness in hard-to-heal diabetic foot ulcers. Furthermore, their cost-effectiveness merits further investigation. Instead, they should only be considered in combination with established treatments or be attempted when these have not been successful. Moreover, we should not be oblivious to the fact that established and emerging treatments need to be practised in the setting of multidisciplinary foot clinics to reduce the number of amputations. PMID:22429013

  4. 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. PMID:26304901

  5. ANALYSIS ON EFFLUENT WATER QUALITY AND ELECTRICITY CONSUMPTION AFTER INTRODUCING ADVANCED SEWAGE TREATMENT

    NASA Astrophysics Data System (ADS)

    Shiojiri, Yasuo; Maekawa, Shunich

    We analyze effluent water quality and electricity consumption after in troducing advanced treatment in sewage treatment plant. We define 'advanced treatment ratio' as volume of treated water through advanced treatment processes divided by total volume of treated water in plant. Advanced treatment ratio represents degree of introducing advanced treatment. We build two types of equation. One represents relation between effluent water quality and advanced treatment ratio, the other between electricity consumption and advanced treatment ratio. Each equation is fitted by least squares on 808 samples: 8 fiscal years operation data of 101 plants working in Kanagawa, Tokyo, Saitama and Chiba areas, and coefficient of advanced treatment ratio is estimated. The result is as follows. (1) After introducing advanced treatment aimed at nitrogen removal, T-N in effluent water decreases by 51.3% and electricity consum ption increases by 52.2%. (2) After introducing advanced treatment aimed at phosphorus removal, T-P in effluent water decreases by 27.8%. Using the above result, we try prioritizing 71 plants in Tokyo Bay watershed about raising advanced treatment ratio, so that, in total, pollutant in effluent water decreases with minimized increase of electricity consumption.

  6. Recent advances in the surgical treatment of hepatocellular carcinoma.

    PubMed

    Morise, Zenichi; Kawabe, Norihiko; Tomishige, Hirokazu; Nagata, Hidetoshi; Kawase, Jin; Arakawa, Satoshi; Yoshida, Rie; Isetani, Masashi

    2014-10-21

    Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. The treatment of HCC is complex and complicated by the severity of associated chronic liver disease, the stage of HCC, and the clinical condition of the patient. Liver resection (LR) is one of the most efficient treatments for patients with HCC, with an expected 5-year survival of 38%-61% depending on the stage of the disease. Improved liver function assessment, increased understanding of segmental liver anatomy from advanced imaging studies, and surgical technical progress are important factors that have led to reduced mortality in patients with HCC. The indication for LR may be expanded due to emerging evidences from laparoscopic hepatectomies and combined treatments with newly developed chemotherapies. Liver transplantation (LT) is considered as an ideal treatment for removal of existing tumors and the injured/preneoplastic underlying liver tissue with impaired liver function and the risk of multicentric carcinogenesis that results from chronically injured liver. However, LT is restricted to patients with minimal risk of tumor recurrence under immunosuppression. The expansion of criteria for LT in HCC patients is still under trial and discussion. Limited availability of grafts, as well as the risk and the cost of transplantation have led to considerable interest in expansion of the donor pool, living donor-related transplantation, and combined treatment involving LR and LT. This highlight presents evidence concerning recent studies evaluating LR and LT in HCC patients. In addition, alternative therapies for the treatment of early stage tumors and the management of patients on transplant waiting lists are discussed. PMID:25339825

  7. Recent advances in the surgical treatment of hepatocellular carcinoma

    PubMed Central

    Morise, Zenichi; Kawabe, Norihiko; Tomishige, Hirokazu; Nagata, Hidetoshi; Kawase, Jin; Arakawa, Satoshi; Yoshida, Rie; Isetani, Masashi

    2014-01-01

    Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. The treatment of HCC is complex and complicated by the severity of associated chronic liver disease, the stage of HCC, and the clinical condition of the patient. Liver resection (LR) is one of the most efficient treatments for patients with HCC, with an expected 5-year survival of 38%-61% depending on the stage of the disease. Improved liver function assessment, increased understanding of segmental liver anatomy from advanced imaging studies, and surgical technical progress are important factors that have led to reduced mortality in patients with HCC. The indication for LR may be expanded due to emerging evidences from laparoscopic hepatectomies and combined treatments with newly developed chemotherapies. Liver transplantation (LT) is considered as an ideal treatment for removal of existing tumors and the injured/preneoplastic underlying liver tissue with impaired liver function and the risk of multicentric carcinogenesis that results from chronically injured liver. However, LT is restricted to patients with minimal risk of tumor recurrence under immunosuppression. The expansion of criteria for LT in HCC patients is still under trial and discussion. Limited availability of grafts, as well as the risk and the cost of transplantation have led to considerable interest in expansion of the donor pool, living donor-related transplantation, and combined treatment involving LR and LT. This highlight presents evidence concerning recent studies evaluating LR and LT in HCC patients. In addition, alternative therapies for the treatment of early stage tumors and the management of patients on transplant waiting lists are discussed. PMID:25339825

  8. Advances in the treatment of nonalcoholic fatty liver disease

    PubMed Central

    Mehta, Sanjeev R.

    2010-01-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the Western world, and its prevalence is predicted to rise in the future in parallel with rising levels of obesity and type 2 diabetes mellitus. It is commonly associated with insulin resistance. Many patients have coexisting obesity, hypertension, dyslipidaemia or hyperglycaemia, and are at increased risk of developing cardiovascular disease. Although patients with simple steatosis have a good prognosis, a significant percentage will develop nonalcoholic steatohepatitis which may progress to cirrhosis, end-stage liver failure and hepatocellular carcinoma. Despite promising results from several pilot studies and small to medium randomized controlled trials, there is currently no pharmacological agent that is licensed for the treatment of NAFLD. At present the mainstay of treatment for all patients is lifestyle modification using a combination of diet, exercise and behavioural therapy. With recent advances in the understanding of the pathogenesis of NAFLD, the goal of treatment has shifted from simply trying to clear fat from the liver and prevent progressive liver damage to addressing and treating the metabolic risk factors for the condition. To reduce liver-related and cardiovascular morbidity and mortality, all patients with NAFLD should be invited to enrol in adequately powered, randomized controlled studies testing novel therapies, many of which are targeted at reducing insulin resistance or preventing progressive liver disease. Coexisting obesity, hypertension, dyslipidaemia or hyperglycaemia should be treated aggressively. Orlistat, bariatric surgery, angiotensin receptor blockers, statins, fibrates, metformin and thiazolidinediones should all be considered, but treatments should be carefully tailored to meet the specific requirements of each patient. The efficacy and safety of any new treatment, as well as its cost-effectiveness, will need to be carefully evaluated

  9. 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

  10. 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

  11. Advances in Medications and Tailoring Treatment for Alcohol Use Disorder

    PubMed Central

    Seneviratne, Chamindi; Johnson, Bankole A.

    2015-01-01

    Alcohol use disorder (AUD) is a chronic heritable brain disorder with a variable clinical presentation. This variability, or heterogeneity, in clinical presentation suggests complex interactions between environmental and biological factors, resulting in several underlying pathophysiological mechanisms in the development and progression of AUD. Classifying AUD into subgroups of common clinical or pathological characteristics would ease the complexity of teasing apart underlying molecular mechanisms. Genetic association analyses have revealed several polymorphisms—small differences in DNA—that increase a person’s vulnerability to develop AUD and other alcohol-related intermediate characteristics, such as severity of drinking, age of AUD onset, or measures of craving. They also have identified polymorphisms associated with reduced drinking. Researchers have begun utilizing these genetic polymorphisms to identify alcoholics who might respond best to various treatments, thereby enhancing the effectiveness of currently tested medications for treating AUD. This review compares the efficacy of medications tested for treatment of AUD with and without incorporating genetics. It then discusses advances in pre-clinical genetic and genomic studies that potentially could be adapted to clinical trials to improve treatment efficacy. Although a pharmacogenetic approach is promising, it is relatively new and will need to overcome many challenges, including inadequate scientific knowledge and social and logistic constraints, to be utilized in clinical practice. PMID:26259086

  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. 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.

  14. 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

  15. 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)

  16. Clinical utility of nivolumab in the treatment of advanced melanoma

    PubMed Central

    Asmar, Ramsey; Yang, Jessica; Carvajal, Richard D

    2016-01-01

    Melanomas are highly immunogenic tumors that evade the immune system by exploiting innate checkpoint pathways, rendering effector T-cells anergic. The immunotherapeutic approach of checkpoint inhibition can restore and invigorate endogenous antitumor T-cell responses and has become an important treatment option for patients with advanced melanoma. The CTLA-4 inhibitor ipilimumab and the PD-1 inhibitors nivolumab and pembrolizumab have been shown to induce durable responses and improve overall survival in metastatic, refractory melanoma. Optimization and validation of pretreatment biomarkers to predict response to these agents is a crucial area of ongoing research. Combination immunotherapy has recently demonstrated superior response rates compared to monotherapy; further investigation is needed to refine combinatorial strategies. PMID:27013881

  17. Development of Advanced Casing Treatments for Flow Control

    NASA Technical Reports Server (NTRS)

    Keith, Theo G., Jr.; Tsung, Fu-Lin

    2001-01-01

    Under the Base R&T and Ultra Efficient Engine Technology programs, the NASA-Goddard Space Flight Center Compressor Branch is investigating flow control strategies required to increase the loading and efficiency of core compressors while maintaining current levels of operability. Flow-control strategies being studied include advanced casing treatments, wall jet injection, and blade-tip injection for compressor stability enhancement, directed jets for surface boundary layer control, and vortex-generating devices. The use of computational fluid dynamics (CFD) simulations to assess the effectiveness of flow-control devices and to guide their design is a key element in this research. CFD simulations serve to screen potential flow-control concepts at a lower cost than executing physical experiments in turbomachinery facilities. CFD simulations also provide guidance in designing physical experiments for those flow control concepts, which appear promising.

  18. Quality of life and the treatment of advanced lung cancer.

    PubMed

    Plunkett, Tim A; Chrystal, Kathryn F; Harper, Peter G

    2003-07-01

    Lung cancer is the leading cause of cancer deaths worldwide, with the majority of patients presenting with advanced disease. Despite the introduction of newer therapeutic agents and modest survival improvement, the overall prognosis for these patients is poor. The goals of therapy should therefore include improvement in quality of life (QOL), palliation of symptoms, and prolongation of survival. Quality of life has now become recognized as an important outcome measure for cancer therapy. Quality-of-life endpoints are being increasingly incorporated into clinical trials of newer agents to further define meaningful response. The assessment of QOL involves comprehensive measurement tools that address the physical, social, functional, and emotional well-being of the patient. Such measurements should be easy to use, meaningful, and relevant to the patients and clinician. Although these measures assess the longitudinal impact of treatment on QOL, pretreatment QOL scores may also be an important prognostic factor for survival in patients with lung carcinoma. This article reviews QOL measures and the data for QOL benefits from therapy in patients with advanced small-cell and non-small-cell lung cancer. PMID:14596700

  19. 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.

  20. 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

  1. Advances in the treatment of chronic myeloid leukemia.

    PubMed

    Eiring, Anna M; Khorashad, Jamshid S; Morley, Kimberly; Deininger, Michael W

    2011-01-01

    Although imatinib is firmly established as an effective therapy for newly diagnosed patients with chronic myeloid leukemia (CML), the field continues to advance on several fronts. In this minireview we cover recent results of second generation tyrosine kinase inhibitors in newly diagnosed patients, investigate the state of strategies to discontinue therapy and report on new small molecule inhibitors to tackle resistant disease, focusing on agents that target the T315I mutant of BCR-ABL. As a result of these advances, standard of care in frontline therapy has started to gravitate toward dasatinib and nilotinib, although more observation is needed to fully support this. Stopping therapy altogether remains a matter of clinical trials, and more must be learned about the mechanisms underlying the persistence of leukemic cells with treatment. However, there is good news for patients with the T315I mutation, as effective drugs such as ponatinib are on their way to regulatory approval. Despite these promising data, accelerated or blastic phase disease remains a challenge, possibly due to BCR-ABL-independent resistance. PMID:21867560

  2. Advances in endoscopic retrograde cholangiopancreatography for the treatment of cholangiocarcinoma

    PubMed Central

    Uppal, Dushant S; Wang, Andrew Y

    2015-01-01

    Cholangiocarcinoma (CCA) is a malignancy of the bile ducts that carries high morbidity and mortality. Patients with CCA typically present with obstructive jaundice, and associated complications of CCA include cholangitis and biliary sepsis. Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable treatment modality for patients with CCA, as it enables internal drainage of blocked bile ducts and hepatic segments by using plastic or metal stents. While there remains debate as to if bilateral (or multi-segmental) hepatic drainage is required and/or superior to unilateral drainage, the underlying tenant of draining any persistently opacified bile ducts is paramount to good ERCP practice and good clinical outcomes. Endoscopic therapy for malignant biliary strictures from CCA has advanced to include ablative therapies via ERCP-directed photodynamic therapy (PDT) or radiofrequency ablation (RFA). While ERCP techniques cannot cure CCA, advancements in the field of ERCP have enabled us to improve upon the quality of life of patients with inoperable and incurable disease. ERCP-directed PDT has been used in lieu of brachytherapy to provide neoadjuvant local tumor control in patients with CCA who are awaiting liver transplantation. Lastly, mounting evidence suggests that palliative ERCP-directed PDT, and probably ERCP-directed RFA as well, offer a survival advantage to patients with this difficult-to-treat malignancy. PMID:26140095

  3. 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

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

    PubMed

    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

  5. 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

  6. 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...

  7. COOLING TOWER PLUME MODEL

    EPA Science Inventory

    A review of recently reported cooling tower plume models yields none that is universally accepted. The entrainment and drag mechanisms and the effect of moisture on the plume trajectory are phenomena which are treated differently by various investigators. In order to better under...

  8. 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

  9. Nanocarriers for respiratory diseases treatment: recent advances and current challenges.

    PubMed

    Trapani, Adriana; Gioia, Sante Di; Castellani, Stefano; Carbone, Annalucia; Cavallaro, Gennara; Trapani, Giuseppe; Conese, Massimo

    2014-01-01

    Pulmonary delivery of locally-acting drugs encapsulated in nanocarriers provides several advantages for the treatment of respiratory diseases such as asthma, chronic obstructive pulmonary diseases, cystic fibrosis, tuberculosis and lung cancer. These advantages include, among others, sustained drug delivery to the lungs, reduced therapeutic dose and improved patient compliance. The aim of this review is to give an updated overview on recent advances recorded in the last few years in this field as well as on the major challenges still existing and that remain to be overcome before any clinical application. After an outline on the cellular and extracellular barriers affecting drug delivery to the airways both in physiological and pathological conditions, the significant developments recorded using inhaled polymeric- and lipid-based nanocarriers for drug and gene delivery to the lung are presented. In this discussion, the major challenges existing in the field are evidenced including the understanding of the factors governing the mucus penetration capability of these nanocarriers and the identification of new technologies for delivering drugs to specific regions or cell types of the lungs. In this regard, the recognition of receptor expressed only at lung level may facilitate drug targeting to this organ and it should improve the therapeutic efficacy of nanocarrier-based treatments for respiratory diseases. PMID:24678708

  10. Surgical advances in the treatment of neuromuscular scoliosis

    PubMed Central

    Canavese, Federico; Rousset, Marie; Le Gledic, Benoit; Samba, Antoine; Dimeglio, Alain

    2014-01-01

    Neuromuscular disorders are a group of diseases affecting the neuro-musculo-skeletal system. Children with neuromuscular disorders frequently develop progressive spinal deformities with cardio-respiratory compromise in the most severe cases. The incidence of neuromuscular scoliosis is variable, inversely correlated with ambulatory abilities and with a reported risk ranging from 80% to 100% in non-ambulatory patients. As surgical and peri-operative techniques have improved, more severely affected children with complex neuromuscular deformities and considerable co-morbidities are now believed to be candidates for extensive surgery for spinal deformity. This article aimed to provide a comprehensive review of how neuromuscular spinal deformities can affect normal spine balance and how these deformities can be treated with segmental instrumentation and sub-laminar devices. Older concepts have been integrated with newer scientific data to provide the reader with a basis for better understanding of how treatment of neuromuscular scoliosis has evolved over the past few decades. Recent advances, as well as challenges that remain to be overcome, in the surgical treatment of neuromuscular curves with sub-laminar devices and in the management of post-operative infections are outlined. PMID:24829875

  11. 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. PMID:26517790

  12. Stealth Plumes on Io

    NASA Technical Reports Server (NTRS)

    Johnson, T. V.; Matson, Dennis L.; Blaney, Diana L.; Veeder, Glenn J.; Davies, Ashley

    1995-01-01

    We suggest that Io's eruptive activity may include a class of previously undetected SO2 geysers. The thermodynamic models for the eruptive plumes discovered by Voyager 'involve low to moderate entropy SO2 eruptions. The resulting plumes are a mixture of solid and gas which emerge from the vent and follow essentially ballistic trajectories. We show that intrusion of silicate magma into buried SO2 deposits can create the required conditions for high entropy eruptions which proceed entirely in the vapor phase. These purely gaseous plumes would have been invisible to Voyager's instruments. Hence, we call them "stealth" plumes. Such eruptions could explain the "patchy" SO2 atmosphere inferred from recent UV and micro-wave spectral observations. The magma intrusion rate required to support the required gas production for these plumes is a negligible fraction of estimated global magma intrusion rates.

  13. 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. PMID:26492355

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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.

  19. Export of reactive nitrogen from coal-fired power plants in the U.S.: Estimates from a plume-in-grid modeling study - article no. D04308

    SciTech Connect

    Vijayaraghavan, K.; Zhang, Y.; Seigneur, C.; Karamchandani, P.; Snell, H.E.

    2009-02-15

    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 SO{sub 2} 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.

  20. 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

  1. Recent advances in the treatment of organophosphorous poisonings.

    PubMed

    Balali-Mood, Mahdi; Saber, Hamidreza

    2012-06-01

    Organophosphorous compounds have been employed as pesticides and chemical warfare nerve agents. Toxicity of organophosphorous compounds is a result of excessive cholinergic stimulation through inhibition of acetyl cholinesterase. Clinical manifestations include cholinergic syndromes, central nervous system and cardiovascular disorders. Organophosphorous pesticide poisonings are common in developing worlds including Iran and Sri Lanka. Nerve agents were used during the Iraq-Iran war in 1983-1988 and in a terrorist attack in Japan in 1994-1995. Following decontamination, depending on the severity of intoxication the administration of atropine to counteract muscarinic over-stimulation, and an oxime to reactivate acetyl cholinesterase are indicated. Supportive and intensive care therapy including diazepam to control convulsions and mechanical respiration may be required. Recent investigations have revealed that intravenous infusion of sodium bicarbonate to produce mild to moderate alkalinization is effective. Gacyclidine; an antiglutamatergic compound, was also proved to be beneficial in conjunction with atropine, pralidoxime, and diazepam in nerve agent poisoning. Intravenous magnesium sulfate decreased hospitalization duration and improved outcomes in patients with organophosphorous poisoning. Bio-scavengers including fresh frozen plasma or albumin have recently been suggested as a useful therapy through clearing of free organophosphates. Hemofiltration and antioxidants are also suggested for organophosphorous poisoning. Recombinant bacterial phosphotriesterases and hydrolases that are able to transfer organophosphorous-degrading enzymes are very promising in delayed treatment of organophosphorous poisoning. Recently, encapsulation of drugs or enzymes in nanocarriers has also been proposed. Given the signs and symptoms of organophosphorous poisoning, health professionals should remain updated about the recent advances in treatment of organophosphorous poisoning

  2. Treatment of advanced Hodgkin's lymphoma: standard and experimental approaches.

    PubMed

    Engert, A; Wolf, J; Diehl, V

    1999-07-01

    The introduction of polychemotherapy and improved radiation techniques has transformed Hodgkin's lymphoma from an incurable disease to a malignancy with one of the highest cure rates. Milestones were the development of the MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) and ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) regimens. Radiotherapy is commonly used, although its precise role has not been defined for patients with advanced-stage disease. More recently, dose-intensified schedules such as Stanford V (doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, and prednisone) were shown to be effective in this group of patients. In particular, the BEACOPP regimen (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), in both standard and escalated doses, has produced impressive results in a randomized three-arm study when compared with COPP (cyclophosphamide, vincristine, procarbazine, and prednisone)/ABVD. The significantly higher rates of complete remission (CR) and freedom from treatment failure (FFTF) suggest that the new BEACOPP regimen improves efficacy, but definitive conclusions require further years of follow-up evaluation. Interestingly, BEACOPP abrogates the impact of the newly described seven-factor prognostic scoring system that was reported for patients treated with MOPP/ABVD or similar regimens. The prognostic index includes factors such as serum albumin, hemoglobin, male sex, stage IV disease, age more than 45 years, white blood cell count, and lymphocyte count. Whereas patients with Hodgkin's lymphoma have a good prognosis on first diagnosis, those with relapsed or refractory disease face a poor outcome. PMID:10462328

  3. Advances in the treatment of children with phonological disorders

    PubMed Central

    Ceron, Marizete Ilha; Pagliarin, Karina Carlesso; Keske-Soares, Márcia

    2013-01-01

    Summary Introduction: Treatment of phonological disorders considering extra-linguistic and linguistic variables are important to ensure that the alteration is resolved promptly and in the best manner as possible. Aim: To analyze therapeutic advances (phonetic inventory, phonological system, and distinctive features) in children with phonological disorders by considering the therapeutic approach used, the severity of the phonological disorder, age, and the number of therapeutic sessions. Methods: We conducted a case series study of 94 children aged 3 years, 9 months through 8 years, 5 months. The children were divided into groups based on the therapeutic approach used (Modified Cycles, Maximal Oppositions, ABAB-Withdrawal, and Multiple Probes), the severity of their phonological disorder, age, and the number of therapy sessions with each individual. Phonetic inventory, the phonological system, and the number of altered distinctive features were analyzed. Results: The greater the number of therapy sessions, the greater the number of sounds acquired. The number of sounds present in the phonetic inventory and phonological system increased and the severity of the phonological disorder decreased with all of the therapeutic approaches studied. There was also a reduction in the incidence of altered distinctive features. Conclusion: There was a favorable evolution in phonetic inventory and phonological system acquisitions as well as a reduction in the number of altered distinctive features for all 3 therapeutic models regardless of the severity of the phonological disorder, age, or number of sessions. PMID:25992012

  4. 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.

  5. 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. PMID:10817989

  6. 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...

  7. 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

  8. 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!

  9. Electrification of volcanic plumes

    NASA Astrophysics Data System (ADS)

    Mather, T. A.; Harrison, R. G.

    2006-07-01

    Volcanic lightning, perhaps the most spectacular consequence of the electrification of volcanic plumes, has been implicated in the origin of life on Earth, and may also exist in other planetary atmospheres. Recent years have seen volcanic lightning detection used as part of a portfolio of developing techniques to monitor volcanic eruptions. Remote sensing measurement techniques have been used to monitor volcanic lightning, but surface observations of the atmospheric electric Potential Gradient (PG) and the charge carried on volcanic ash also show that many volcanic plumes, whilst not sufficiently electrified to produce lightning, have detectable electrification exceeding that of their surrounding environment. Electrification has only been observed associated with ash-rich explosive plumes, but there is little evidence that the composition of the ash is critical to its occurrence. Different conceptual theories for charge generation and separation in volcanic plumes have been developed to explain the disparate observations obtained, but the ash fragmentation mechanism appears to be a key parameter. It is unclear which mechanisms or combinations of electrification mechanisms dominate in different circumstances. Electrostatic forces play an important role in modulating the dry fall-out of ash from a volcanic plume. Beyond the local electrification of plumes, the higher stratospheric particle concentrations following a large explosive eruption may affect the global atmospheric electrical circuit. It is possible that this might present another, if minor, way by which large volcanic eruptions affect global climate. The direct hazard of volcanic lightning to communities is generally low compared to other aspects of volcanic activity.

  10. 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; treatment of bonus and advanced royalty. (a) Bonus....

  11. 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.

  12. Electrification of volcanic plumes

    NASA Astrophysics Data System (ADS)

    Mather, T. A.; Harrison, R. G.

    We present a review of our current understanding of the electrification of volcanic plumes on Earth and discuss the possible implications both in terms of the volcanic monitoring, early Earth evolution and planetary exploration. Volcanic lightning is perhaps the most spectacular consequence of the electrification of volcanic plumes. Recent years have seen volcanic lightning detection used as part of a portfolio of developing techniques to monitor volcanic eruptions. Remote sensing measurement techniques have been used to monitor volcanic lightning, but surface observations of the atmospheric electric Potential Gradient (PG) and the charge carried on volcanic ash also show that many volcanic plumes, whilst not sufficiently electrified to produce lightning, have detectable electrification exceeding that of their surrounding environment. Electrification has only been observed associated with ash-rich explosive plumes, but there is little evidence that the composition of the ash is critical to its occurrence. Different conceptual theories for charge generation and separation in volcanic plumes have been developed to explain the disparate observations obtained, but the ash fragmentation mechanism appears to be a key parameter. It is unclear which mechanisms or combinations of electrification mechanisms dominate in different circumstances. Electrostatic forces play an important role in modulating the dry fall-out of ash from a volcanic plume. Beyond the local electrification of plumes, the higher stratospheric particle concentrations following a large explosive eruption may affect the global atmospheric electrical circuit. It is possible that this might present another, if minor, way by which large volcanic eruptions affect global climate. Volcanic lightning has been implicated in a number of ways in the origin of life on Earth, and may also exist in other planetary atmospheres where measurements of its occurrence might give clues about the nature of volcanism on other

  13. Preoperative treatment with radiochemotherapy for locally advanced gastroesophageal junction cancer and unresectable locally advanced gastric cancer

    PubMed Central

    Ratosa, Ivica; Oblak, Irena; Anderluh, Franc; Velenik, Vaneja; But-Hadzic, Jasna; Ermenc, Ajra Secerov; Jeromen, Ana

    2015-01-01

    Background. To purpose of the study was to analyze the results of preoperative radiochemotherapy in patients with unresectable gastric or locoregionally advanced gastroesophageal junction (GEJ) cancer treated at a single institution. Patients and methods. Between 1/2004 and 6/2012, 90 patients with locoregionally advanced GEJ or unresectable gastric cancer were treated with preoperative radiochemotherapy at the Institute of Oncology Ljubljana. Planned treatment schedule consisted of induction chemotherapy with 5-fluorouracil and cisplatin, followed by concomitant radiochemotherapy four weeks later. Three-dimensional conformal external beam radiotherapy was delivered by dual energy (6 and 15 MV) linear accelerator in 25 daily fractions of 1.8 Gy in 5 weeks with two additional cycles of chemotherapy repeated every 28 days. Surgery was performed 4–6 weeks after completing radiochemotherapy. Following the surgery, multidisciplinary advisory team reassessed patients for the need of adjuvant chemotherapy. The primary endpoints were histopathological R0 resection rate and pathological response rate. The secondary endpoints were toxicity of preoperative radiochemotherapy and survival. Results. Treatment with preoperative radiochemotherapy was completed according to the protocol in 84 of 90 patients (93.3%). Twenty patients (22.2%) did not undergo the surgery because of the disease progression, serious comorbidity, poor performance status or still unresectable tumour. In 13 patients (14.4%) only exploration was performed because the tumour was assessed as unresectable or diffuse peritoneal carcinomatosis was established. Fifty-seven patients (63.4%) underwent surgery with the aim of complete removal of the tumour. Radical resection was achieved in 50 (55.6%) patients and the remaining seven (7.8%) patients underwent non-radical surgery (R1 in five and R2 in two patients). In this group of patients (n = 57), pathological complete response of tumour was achieved in five

  14. 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. PMID:24684187

  15. Complete analysis of steady and transient missile aerodynamic/propulsive/plume flowfield interactions

    NASA Astrophysics Data System (ADS)

    York, B. J.; Sinha, N.; Dash, S. M.; Hosangadi, A.; Kenzakowski, D. C.; Lee, R. A.

    1992-07-01

    The analysis of steady and transient aerodynamic/propulsive/plume flowfield interactions utilizing several state-of-the-art computer codes (PARCH, CRAFT, and SCHAFT) is discussed. These codes have been extended to include advanced turbulence models, generalized thermochemistry, and multiphase nonequilibrium capabilities. Several specialized versions of these codes have been developed for specific applications. This paper presents a brief overview of these codes followed by selected cases demonstrating steady and transient analyses of conventional as well as advanced missile systems. Areas requiring upgrades include turbulence modeling in a highly compressible environment and the treatment of particulates in general. Recent progress in these areas are highlighted.

  16. 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...

  17. [Neoadjuvant radiochemotherapy in the treatment of locally advanced rectal tumors].

    PubMed

    Rápolti, Edit; Szigeti, András; Farkas, Róbert; Bellyei, Szabolcs; Boronkai, Arpád; Papp, András; Gömöri, Eva; Horváth, Ors Péter; Mangel, László

    2009-12-01

    We investigated the response rate and side effects of simultaneous, neoadjuvant radiochemotherapy (RCT) in locally advanced rectal cancer. Between 2005 and 2007, we treated 112 patients in stage II-III rectal carcinoma at the Institute of Oncotherapy, University of Pécs. For staging abdomino-pelvic CT (112) and transrectal US (49) or pelvic MR (10), or PET-CT (1) was performed. Radiation therapy was delivered with 3D CRT-based technique using belly-board with 18 MV photon energy, while patients in prone position. A total dose of 45 Gy (single dose 1.8 Gy) was delivered to the tumor and the pelvic lymph nodes. 5-FU and Ca-folinate was administered concomitantly in the 1st and 5th week of radiotherapy. Four weeks after delivering neoadjuvant RCT the patients' control CT was evaluated according to RECIST criteria. RCT was followed by surgery in 6-9 weeks. We graded the histology using the Mandard regression score system. Side effects were registered using CTCAE v 3.0. Grade 1, 2 or 3 acute gastrointestinal toxicity occurred in 12%, grade 3 hematological toxicity in 9.5% of the patients. The response rate determined by using control CT was 64.85%. According to the Mandard regression score, TRG1 occurred in 15%, TRG2 in 30.4%, TRG3 in 28%, TRG4 in 24% and TRG5 in 2.6% of the cases. Radical surgery was performed in 89 cases, 72 with R0 resection. By assessing the histological samples we found downstaging in 46% of the T and 34.5% of the N stage. We have no information on increased postoperative complications. We followed 86 patients after neoadjuvant therapy. Until March 2009 there was no progression in 48 of our patients. In 13 cases local relapse occurred, and in 25 cases the disease progressed because of distant metastasis, although local control was maintained. 10 patients had local relapse and distant metastases. 17 patients passed away. As a conclusion, neoadjuvant RCT of Stage II-III patients is an effective and well tolerated treatment, allowing for high R0

  18. 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

  19. 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

  20. The Impact of Advanced Technologies on Treatment Deviations in Radiation Treatment Delivery

    SciTech Connect

    Marks, Lawrence B. Light, Kim L.; Hubbs, Jessica L.; Georgas, Debra L.; Jones, Ellen L.; Wright, Melanie C.; Willett, Christopher G.; Yin Fangfang

    2007-12-01

    Purpose: To assess the impact of new technologies on deviation rates in radiation therapy (RT). Methods and Materials: Treatment delivery deviations in RT were prospectively monitored during a time of technology upgrade. In January 2003, our department had three accelerators, none with 'modern' technologies (e.g., without multileaf collimators [MLC]). In 2003 to 2004, we upgraded to five new accelerators, four with MLC, and associated advanced capabilities. The deviation rates among patients treated on 'high-technology' versus 'low-technology' machines (defined as those with vs. without MLC) were compared over time using the two-tailed Fisher's exact test. Results: In 2003, there was no significant difference between the deviation rate in the 'high-technology' versus 'low-technology' groups (0.16% vs. 0.11%, p = 0.45). In 2005 to 2006, the deviation rate for the 'high-technology' groups was lower than the 'low-technology' (0.083% vs. 0.21%, p = 0.009). This difference was caused by a decline in deviations on the 'high-technology' machines over time (p = 0.053), as well as an unexpected trend toward an increase in deviations over time on the 'low-technology' machines (p = 0.15). Conclusions: Advances in RT delivery systems appear to reduce the rate of treatment deviations. Deviation rates on 'high-technology' machines with MLC decline over time, suggesting a learning curve after the introduction of new technologies. Associated with the adoption of 'high-technology' was an unexpected increase in the deviation rate with 'low-technology' approaches, which may reflect an over-reliance on tools inherent to 'high-technology' machines. With the introduction of new technologies, continued diligence is needed to ensure that staff remain proficient with 'low-technology' approaches.

  1. Collapse in Thermal Plumes

    NASA Astrophysics Data System (ADS)

    Pears, M. I.; Lithgow-Bertelloni, C. R.; Dobson, D. P.; Davies, R.

    2013-12-01

    Collapsing thermal plumes have been investigated through experimental and numerical simulations. Collapsing plumes are an uncommon fluid dynamical phenomenon, usually seen when the buoyancy source is turned off. A series of fluid dynamical experiments were conducted on thermal plumes at a variety of temperature and viscosity contrasts, in a 26.5 cm^3 cubic tank heated by a constant temperature heater 2 cm in diameter and no-slip bottom and top surfaces. Working fluids included Lyle's Golden Syrup and ADM's Liquidose 436 syrup, which have strongly-temperature dependent viscosity and high Pr number (10^3-10^7 at experimental conditions). Visualisation included white light shadowgraphs and PIV of the central plane. Temperature contrasts ranged from 3-60°C, and two differing forms of collapse were identified. At very low temperature differences 'no rise' collapse was discovered, where the plumes stagnate in the lower third of the tank before collapsing. At temperature differences between 10-23°C normal evolution occurred until 'lens shape' collapse developed between midway and two-thirds of the distance from the base. The lens shape originated in the top of the conduit and was present throughout collapse. At temperatures above ΔT=23°C the plumes follow the expected growth and shape and flatten out at the top of the tank. Thermal collapse remains difficult to explain given experimental conditions (continuous heating). Instead it is possible that small density differences arising from crystallization at ambient temperatures changes plume buoyancy-inducing collapse. We show results on the evolution of the refractive index of the syrup through time to ascertain this possibility. Preliminary numerical results using Fluidity will be presented to explore a greater parameter range of viscosity contrasts and tank aspect ratios.

  2. 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.

  3. Recent advancement or less invasive treatment of percutaneous nephrolithotomy.

    PubMed

    Kim, Bum Soo

    2015-09-01

    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

  4. 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

  5. Io Pele plume

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Voyager 1 took this narrow-angle camera image on 5 March 1979 from a distance of 450,000 kilometers. At this geometry, the camera looks straight down through a volcanic plume at one of Io's most active volcanos, Pele. The large heart-shaped feature is the region where Pele's plume falls to the surface. At the center of the 'heart' is the small dark fissure that is the source of the eruption. The Voyager Project is managed by the Jet Propulsion Laboratory for NASA's Office of Space Science.

  6. Evidence for mantle plumes?

    PubMed

    Anderson, Don L; Natland, James H

    2007-11-22

    Geophysical hotspots have been attributed to partially molten asthenosphere, fertile blobs, small-scale convection and upwellings driven by core heat. Most are short-lived or too close together to be deeply seated, and do not have anomalous heat flow or temperature; many are related to tectonic features. Bourdon et al. investigate the dynamics of mantle plumes from uranium-series geochemistry and interpret their results as evidence for thermal plumes. Here we show why alternative mechanisms of upwelling and melting should be considered. PMID:18033248

  7. 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

  8. Modeling the Effects of Aircraft Emissions on Atmospheric Photochemistry Using Layered Plume Dynamics

    NASA Astrophysics Data System (ADS)

    Cameron, M. A.; Jacobson, M. Z.; Naiman, A. D.; Lele, S. K.

    2012-12-01

    Aviation is an expanding industry, experiencing continued growth and playing an increasingly noticed role in upper tropospheric/lower stratospheric composition. Nitrogen oxides and other gas-phase emissions from aircraft react to affect ozone photochemistry. This research investigates the effects of treating aircraft gas-phase chemistry within an expanding layered plume versus at the grid scale. SMVGEAR II, a sparse-matrix, vectorized Gear-type solver for ordinary differential equations, is used to solve chemical equations at both the grid scale and subgrid scale. A Subgrid Plume Model (SPM) is used to advance the expanding plume, accounting for wind shear and diffusion. Simulations suggest that using a layered plume approach results in noticeably different final NOx concentrations, demonstrating the importance of these plume dynamics in predicting the effects of aircraft on ozone concentrations. Results showing the effects of a layered plume, single plume, and no plume on ozone after several hours will be presented.

  9. [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. PMID:27078964

  10. 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.

  11. 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.

  12. 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...

  13. Advancing the Evidence Base of Rehabilitation Treatments: A Developmental Approach

    PubMed Central

    Whyte, John; Barrett, A.M.

    2013-01-01

    Translational research refers to the development of new scientific discoveries into evidence-based treatments for human diseases and conditions. This developmental process requires that a number of scientific, as well as social and psychological obstacles, be overcome during a sequence of research stages that address different goals. Rehabilitation, like other biomedical disciplines, requires this kind of developmental process. For a variety of reasons, however, development of rehabilitation treatments is less linear than the familiar phases of pharmaceutical research. In addition, research on treatments intended to address impairments (body structure/function, in terms of the International Classification of Functioning, Disability and Health), faces the challenge of determining the likely impact of an impairment-level treatment on the multifaceted activities and aspects of participation that are the typical goals of rehabilitation treatments. This article describes the application of treatment theory and enablement theory to the development of new impairment-based treatments, and examines similarities and differences between the developmental sequence needed for rehabilitation treatment research versus pharmaceutical research in other areas of medicine. PMID:22683206

  14. ADVANCED WASTE TREATMENT FOR HOUSING AND COMMUNITY DEVELOPMENTS

    EPA Science Inventory

    Treatment of wastewater from a subdivision in a physical-chemical treatment plant (screening, chemical coagulation, sedimentation, filtration, carbon adsorption, chlorination) was evaluated. The 190 cu m/day (50,000 gal/day) plant was housed in the shell of a standard house on a ...

  15. 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…

  16. COLD WEATHER PLUME STUDY

    EPA Science Inventory

    While many studies of power plant plume transport and transformation have been performed during the summer, few studies of these processes during the winter have been carried out. Accordingly, the U.S. Environmental Protection Agency and the Electric Power Research Institute join...

  17. Improving operational plume forecasts

    NASA Astrophysics Data System (ADS)

    Balcerak, Ernie

    2012-04-01

    Forecasting how plumes of particles, such as radioactive particles from a nuclear disaster, will be transported and dispersed in the atmosphere is an important but computationally challenging task. During the Fukushima nuclear disaster in Japan, operational plume forecasts were produced each day, but as the emissions continued, previous emissions were not included in the simulations used for forecasts because it became impractical to rerun the simulations each day from the beginning of the accident. Draxler and Rolph examine whether it is possible to improve plume simulation speed and flexibility as conditions and input data change. The authors use a method known as a transfer coefficient matrix approach that allows them to simulate many radionuclides using only a few generic species for the computation. Their simulations work faster by dividing the computation into separate independent segments in such a way that the most computationally time consuming pieces of the calculation need to be done only once. This makes it possible to provide real-time operational plume forecasts by continuously updating the previous simulations as new data become available. They tested their method using data from the Fukushima incident to show that it performed well. (Journal of Geophysical Research-Atmospheres, doi:10.1029/2011JD017205, 2012)

  18. 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.

  19. 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.

  20. 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.

  1. Profile of olaparib in the treatment of advanced ovarian cancer

    PubMed Central

    Chase, Dana M; Patel, Shreya; Shields, Kristin

    2016-01-01

    Olaparib is a poly(ADP-ribose) polymerase inhibitor that received accelerated approval from the US Food and Drug Administration as monotherapy for patients with germline BRCA mutations and ovarian cancer treated with three or more prior lines of chemotherapy. This article summarizes the mechanism of poly(ADP-ribose) polymerase inhibition, therapeutic profile and uses of olaparib, and current and ongoing literature pertaining to olaparib in advanced ovarian cancer. PMID:27186080

  2. Advances in HIV treatment and prevention: should treatment optimism lead to prevention pessimism?

    PubMed

    Lert, F

    2000-12-01

    Advances in HIV treatment have changed the natural history of HIV disease and improved the life of infected people. But, paradoxically, the transformation of a lethal disease into a chronic condition has lead many people to pessimism regarding the future of HIV prevention. Post-exposure prophylaxis and prophylaxis of vertical transmission have added new tools, although they do not change the main features of HIV prevention which still relies on safer drug use and safer sex. The role assigned to HIV testing started to change in some countries where it had not been encouraged; however the impact of these changes appears still very limited, except for prevention of vertical transmission. Recent developments should be placed in the whole historical perspective of HIV infection: after the early period of dramatic favourable changes (around 1990), positive changes in attitudes and behaviour have slowed down or even stabilized. Proofs of 'relapse' are, however, still tenuous. The impact of therapeutic changes is combined with the normalization process of HIV infection issues. In the general population, HIV infection seems a more remote personal and social concern and the perception of risk has decreased. The changes in the social context of prevention are more diverse. On one hand, some social norms renewed during the HIV era may have long-lasting effects. The acknowledgement of social and human rights of homosexuals and drug users, stimulated by the AIDS movement, has entered a long-term process and may continue to support preventive behaviours. On the other hand, the exceptionalist alliance which supported and stimulated the HIV policies is weakening. This process might be accelerated by improved therapeutic perspectives. The main challenge is the success of the integration of HIV prevention in broader public health policies (including prevention of STI transmission, family planning, health promotion, etc.) without losing advances in prevention strategies gained in the

  3. 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. PMID:23664475

  4. 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.

  5. 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.

  6. Radiofrequency thermal treatment with chemoradiotherapy for advanced rectal cancer

    PubMed Central

    SHOJI, HISANORI; MOTEGI, MASAHIKO; OSAWA, KIYOTAKA; OKONOGI, NORIYUKI; OKAZAKI, ATSUSHI; ANDOU, YOSHITAKA; ASAO, TAKAYUKI; KUWANO, HIROYUKI; TAKAHASHI, TAKEO; OGOSHI, KYOJI

    2016-01-01

    We previously reported that patients with a clinical complete response (CR) following radiofrequency thermal treatment exhibit significantly increased body temperature compared with other groups, whereas patients with a clinical partial response or stable disease depended on the absence or presence of output limiting symptoms. The aim of this study was to evaluate the correlation among treatment response, Hidaka radiofrequency (RF) output classification (HROC: termed by us) and changes in body temperature. From December 2011 to January 2014, 51 consecutive rectal cancer cases were included in this study. All patients underwent 5 RF thermal treatments with concurrent chemoradiation. Patients were classified into three groups based on HROC: with ≤9, 10–16, and ≥17 points, calculated as the sum total points of five treatments. Thirty-three patients received surgery 8 weeks after treatment, and among them, 32 resected specimens were evaluated for histological response. Eighteen patients did not undergo surgery, five because of progressive disease (PD) and 13 refused because of permanent colostomy. We demonstrated that good local control (ypCR + CR + CRPD) was observed in 32.7% of cases in this study. Pathological complete response (ypCR) was observed in 15.7% of the total 51 patients and in 24.2% of the 33 patients who underwent surgery. All ypCR cases had ≥10 points in the HROC, but there were no patients with ypCR among those with ≤9 points in the HROC. Standardization of RF thermal treatment was performed safely, and two types of patients were identified: those without or with increased temperatures, who consequently showed no or some benefit, respectively, for similar RF output thermal treatment. We propose that the HROC is beneficial for evaluating the efficacy of RF thermal treatment with chemoradiation for rectal cancer, and the thermoregulation control mechanism in individual patients may be pivotal in predicting the response to RF thermal treatment

  7. Advanced Vulvar Cancers: What are the Best Options for Treatment?

    PubMed

    Soderini, Alejandro; Aragona, Alejandro; Reed, Nicholas

    2016-10-01

    The treatment of patients with vulvar cancer remains challenging for gynecologic oncologists. Up to 30 % of the cases are diagnosed in a clinical condition of irresectability, and some kind of strategy has to be taken into account beyond surgery. In this regard, a common and standard definition is critical to maximize oncological results and minimize complications after treatments. Each patient treatment must be tailored individually according to their clinical and biological features and to the setting in which they are dealing with. PMID:27586378

  8. 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

  9. Advances in Nanotechnology for the Treatment of Osteoporosis.

    PubMed

    Barry, Mikayla; Pearce, Hannah; Cross, Lauren; Tatullo, Marco; Gaharwar, Akhilesh K

    2016-06-01

    Osteoporosis is a degenerative bone disease commonly related to aging. With an increase in life expectancies worldwide, the prevalence of the disease is expected to rise. Current clinical therapeutic treatments are not able to offer long-term solutions to counter the bone mass loss and the increased risk of fractures, which are the primary characteristics of the disease. However, the combination of bioactive nanomaterials within a biomaterial scaffold shows promise for the development of a localized, long-term treatment for those affected by osteoporosis. This review summarizes the unique characteristics of engineered nanoparticles that render them applicable for bone regeneration and recaps the current body of knowledge on nanomaterials with potential for osteoporosis treatment and bone regeneration. Specifically, we highlight new developments that are shaping this emerging field and evaluate applications of recently developed nanomaterials for osteoporosis treatment. Finally, we will identify promising new research directions in nanotechnology for bone regeneration. PMID:27048473

  10. Risk assessment for organic trace compounds in wastewater: comparison of conventional and advanced treatment.

    PubMed

    Schwätter, F; Hannich, C B; Nöthe, T; Oehlmann, J; Fahlenkamp, H

    2007-01-01

    The elimination of organic trace compounds in municipal wastewater was analysed at three German wastewater treatment plants. Additionally, the effects of advanced treatment, membrane filtration, adsorption and oxidation processes were investigated. To assess the ecotoxicity of effluents, a number of tools were used: substance-specific evaluation, case studies for combined effects and risk assessment on the basis of cumulative parameters. The results of the research projects revealed that aquatic environmental risks can be reduced significantly using advanced treatment technologies for wastewater treatment plants. PMID:17881832

  11. 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.

  12. 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

  13. Checkpoint Blockade for the Treatment of Advanced Melanoma.

    PubMed

    Callahan, Margaret K; Flaherty, Catherine R; Postow, Michael A

    2016-01-01

    Immunotherapy with immune checkpoint inhibition has been improving the outcomes of patients with many different types of malignancies. Immune checkpoint inhibition has been most extensively studied in patients with advanced melanoma and there are three FDA approved antibodies already widely used in clinical practice (ipilimumab, nivolumab, and pembrolizumab). In this chapter, we review the mechanistic basis behind the development of immune checkpoint blocking antibodies. We then discuss specifics regarding each agent, unique clinical considerations in treating patients with this approach, and future directions, including combination strategies. This chapter is focused on melanoma, but the principles related to this immunotherapy approach are applicable to patients with many types of malignancies. PMID:26601865

  14. 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. PMID:25329026

  15. Advances in prenatal diagnosis and treatment of congenital diaphragmatic hernia.

    PubMed

    Shue, Eveline H; Miniati, Doug; Lee, Hanmin

    2012-06-01

    Congenital diaphragmatic hernia (CDH) is a common birth anomaly. Absence or presence of liver herniation and determination of lung-to-head ratio are the most accurate predictors of prognosis for fetuses with CDH. Though open fetal CDH repair has been abandoned, fetal endoscopic balloon tracheal occlusion promotes lung growth in fetuses with severe CDH. Although significant improvements in lung function have not yet been shown in humans, reversible or dynamic tracheal occlusion is promising for select fetuses with severe CDH. This article reviews advances in prenatal diagnosis of CDH, the experimental basis for tracheal occlusion, and its translation into human clinical trials. PMID:22682380

  16. Radiofrequency thermal treatment with chemoradiotherapy for advanced rectal cancer.

    PubMed

    Shoji, Hisanori; Motegi, Masahiko; Osawa, Kiyotaka; Okonogi, Noriyuki; Okazaki, Atsushi; Andou, Yoshitaka; Asao, Takayuki; Kuwano, Hiroyuki; Takahashi, Takeo; Ogoshi, Kyoji

    2016-05-01

    We previously reported that patients with a clinical complete response (CR) following radiofrequency thermal treatment exhibit significantly increased body temperature compared with other groups, whereas patients with a clinical partial response or stable disease depended on the absence or presence of output limiting symptoms. The aim of this study was to evaluate the correlation among treatment response, Hidaka radiofrequency (RF) output classification (HROC: termed by us) and changes in body temperature. From December 2011 to January 2014, 51 consecutive rectal cancer cases were included in this study. All patients underwent 5 RF thermal treatments with concurrent chemoradiation. Patients were classified into three groups based on HROC: with ≤9, 10-16, and ≥17 points, calculated as the sum total points of five treatments. Thirty-three patients received surgery 8 weeks after treatment, and among them, 32 resected specimens were evaluated for histological response. Eighteen patients did not undergo surgery, five because of progressive disease (PD) and 13 refused because of permanent colostomy. We demonstrated that good local control (ypCR + CR + CRPD) was observed in 32.7% of cases in this study. Pathological complete response (ypCR) was observed in 15.7% of the total 51 patients and in 24.2% of the 33 patients who underwent surgery. All ypCR cases had ≥10 points in the HROC, but there were no patients with ypCR among those with ≤9 points in the HROC. Standardization of RF thermal treatment was performed safely, and two types of patients were identified: those without or with increased temperatures, who consequently showed no or some benefit, respectively, for similar RF output thermal treatment. We propose that the HROC is beneficial for evaluating the efficacy of RF thermal treatment with chemoradiation for rectal cancer, and the thermoregulation control mechanism in individual patients may be pivotal in predicting the response to RF

  17. Advances in Diagnosis and Treatments for Immune Thrombocytopenia

    PubMed Central

    Nomura, Shosaku

    2016-01-01

    Immune thrombocytopenia (ITP) is an acquired hemorrhagic condition characterized by the accelerated clearance of platelets caused by antiplatelet autoantibodies. A platelet count in peripheral blood <100 × 109/L is the most important criterion for the diagnosis of ITP. However, the platelet count is not the sole diagnostic criterion, and the diagnosis of ITP is dependent on additional findings. ITP can be classified into three types, namely, acute, subchronic, and persistent, based on disease duration. Conventional therapy includes corticosteroids, intravenous immunoglobulin, splenectomy, and watch-and-wait. Second-line treatments for ITP include immunosuppressive therapy [eg, anti-CD20 (rituximab)], with international guidelines, including rituximab as a second-line option. The most recently licensed drugs for ITP are the thrombopoietin receptor agonists (TRAs), such as romiplostim and eltrombopag. TRAs are associated with increased platelet counts and reductions in the number of bleeding events. TRAs are usually considered safe, effective treatments for patients with chronic ITP at risk of bleeding after failure of first-line therapies. Due to the high costs of TRAs, however, it is unclear if patients prefer these agents. In addition, some new agents are under development now. This manuscript summarizes the pathophysiology, diagnosis, and treatment of ITP. The goal of all treatment strategies for ITP is to achieve a platelet count that is associated with adequate hemostasis, rather than a normal platelet count. The decision to treat should be based on the bleeding severity, bleeding risk, activity level, likely side effects of treatment, and patient preferences. PMID:27441004

  18. 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.

  19. Advances in the treatment of newly diagnosed glioblastoma.

    PubMed

    Theeler, Brett J; Gilbert, Mark R

    2015-01-01

    Glioblastoma is a refractory malignancy with limited treatment options at tumor recurrence. Only a small proportion of patients survive 2 years or longer with the current standard of care. Gene expression profiling can segregate newly diagnosed patients into groups with different prognoses, and these biomarkers are being incorporated into a new generation of personalized clinical trials. Using the experience from recently completed large scale, multi-faceted, randomized glioblastoma clinical trials, a new clinical trial paradigm is being established to move promising therapies forward into the newly diagnosed treatment setting. Upcoming trials using the immune check-point inhibitors are an example of this changing paradigm and these and other immunotherapies have potential as promising new treatment modalities for newly diagnosed GB patients. PMID:26646075

  20. Advances in the treatment of portal hypertension in cirrhosis.

    PubMed

    Kimer, N; Wiese, S; Mo, S; Møller, S; Bendtsen, F

    2016-08-01

    Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension. PMID:26982499

  1. 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.

  2. 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

  3. Recent advances in the treatment of orthostatic hypotension.

    PubMed

    Robertson, D; Davis, T L

    1995-04-01

    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. PMID:7746370

  4. Advances in the surgical treatment of breast cancer.

    PubMed

    Xing, Lei; He, Qiang; Wang, Yuan-Yuan; Li, Hong-Yuan; Ren, Guo-Sheng

    2016-06-01

    Breast cancer has become the top malignant neoplasm in Chinese women with an increasing risk of morbidity and mortality. As a crucial part of comprehensive treatment of breast cancer, breast surgical technique is ceaselessly ameliorating and enriching its features. With the purpose of achieving minimal surgical intervention and satisfactory cosmetic results, the trend of mammary surgery is focusing on minimally invasive treatment and aesthetics in the 21st century. This article gives an overview of the most representative surgical procedures, such as breast conservative surgery, sentinel lymph node dissection, oncoplastic technique and breast reconstructive surgery. PMID:27265302

  5. 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

  6. Recent advances in the surgical treatment of benign prostatic hyperplasia

    PubMed Central

    Rocco, Bernardo; Ferreira, Rafael Coelho; Spinelli, Matteo; Cozzi, Gabriele; Dell’Orto, Paolo; Patel, Vipul; Rocco, Francesco

    2011-01-01

    TURP for many years has been considered the gold standard for surgical treatment of BPH. Symptoms relief, improvement in Maximum flow rate and reduction of post void residual urine have been reported in several experiences. Notwithstanding a satisfactory efficacy, concerns have been reported in terms of safety outcomes:intracapsular perforation, TUR syndrome, bleeding with a higher risk of transfusion particularly in larger prostates have been extensivelyreported in the literature. In the recent years the use of new forms of energy and devices suchas bipolar resector, Ho: YAG and potassium-titanyl-phosphate laserare challenging the role of traditional TURP for BPH surgical treatment. In 1999 TURP represented the 81% of surgical treatment for BPHversus 39% of 2005. Is this a marketing driven change or is there areal advantage in new technologies? We analyzed guidelines and higher evidence studies to evaluate therole of the most relevant new surgical approaches compared to TURPfor the treatment of BPH. In case of prostates of very large size the challenge is ongoing, withminimally invasive laparoscopic approach and most recently roboticapproach. We will evaluate the most recent literature on thisemerging field. PMID:22164196

  7. Advanced Mixed Waste Treatment Project (AMWTP) Final Environmental Impact Statement

    SciTech Connect

    1999-02-12

    The AMWTP Final EIS assesses the potential environmental impacts associated with alternatives related to the construction and operation of a proposed waste treatment facility at the INEEL. The alternatives analyzed were: the No Action Alternative, the Proposed Action, the Non-Thermal Treatment Alternative, and the Treatment and Storage Alternative. The Proposed Action is the Preferred Alternative. Under the Proposed Action/Preferred Alternative, the AMWTP facility would treat transuranic waste, alpha-contaminated low-level mixed waste, and low-level mixed waste in preparation for disposal. After treatment, transuranic waste would be disposed of at the Waste Isolation Pilot Plant in New Mexico. Low-level mixed waste would be disposed of at an approved disposal facility depending on decisions to be based on DOE's Final Waste Management Programmatic Environmental Impact Statement. Evaluation of impacts on land use, socioeconomics, cultural resources, aesthetic and scenic resources, geology, air resources, water resources, ecological resources, noise, traffic and transportation, occupational and public health and safety, INEEL services, and environmental justice were included in the assessment.

  8. 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…

  9. 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.

  10. In search of plumes: a GPR odyssey in Brazil

    SciTech Connect

    Ulrych, T.J.; Lima, O.A.L. de; Sampaio, E.E.S.

    1994-12-31

    Ground penetrating radar (GPR) and geoelectrical surveys have been combined to outline underground contaminant plumes of industrial origin within a petrochemical center in Bahia, Brazil. Such plumes are invading the upper phreatic layers of a regional aquifer system which is being exploited for supplying cities and villages in the region, for industrial activities and even for the population of Salvador, the third largest city in Brazil. Three case studies are presented: two are related to conductive plumes localized beneath a metallurgical plant and an effluent treatment plant and another, a DNAPL plume below a dirt petrochemical unit. Resistivity soundings and transverse profiling were useful for a gross delineation of the aquifer structure and the extent of the contamination. GPR processed sections were employed for refining the subsurface stratigraphy and petrophysics as well as for a more precise mapping of the plume boundaries.

  11. Evaluation of flocculation and dissolved air flotation as an advanced wastewater treatment.

    PubMed

    Pinto Filho, A C; Brandão, C C

    2001-01-01

    A bench scale study was carried out in order to evaluate the applicability of dissolved air flotation (DAF) as an advanced treatment for effluents from three different domestic wastewater treatment processes, namely: (i) a tertiary activated sludge plant; (ii) an upflow sludge blanket anaerobic reactor (UASB); and (iii) a high-rate stabilization pond. PMID:11394283

  12. 26 CFR 1.612-3 - Depletion; treatment of bonus and advanced royalty.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 7 2013-04-01 2013-04-01 false Depletion; treatment of bonus and advanced... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.612-3 Depletion; treatment... the payee as a cost depletion deduction in respect of the bonus an amount equal to that proportion...

  13. 26 CFR 1.612-3 - Depletion; treatment of bonus and advanced royalty.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 7 2014-04-01 2013-04-01 true Depletion; treatment of bonus and advanced... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.612-3 Depletion; treatment... the payee as a cost depletion deduction in respect of the bonus an amount equal to that proportion...

  14. 26 CFR 1.612-3 - Depletion; treatment of bonus and advanced royalty.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 7 2012-04-01 2012-04-01 false Depletion; treatment of bonus and advanced... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.612-3 Depletion; treatment... the payee as a cost depletion deduction in respect of the bonus an amount equal to that proportion...

  15. Recent advances in the pathogenesis and treatment of osteoporosis.

    PubMed

    Curtis, Elizabeth M; Moon, Rebecca J; Dennison, Elaine M; Harvey, Nicholas C; Cooper, Cyrus

    2016-08-01

    Over recent decades, the perception of osteoporosis has changed from that of an inevitable consequence of ageing, to that of a well characterised and treatable chronic non-communicable disease, with major impacts on individuals, healthcare systems and societies. Characterisation of its pathophysiology from the hierarchical structure of bone and the role of its cell population, development of effective strategies for the identification of those most appropriate for treatment, and an increasing armamentarium of efficacious pharmacological therapies, have underpinned this evolution. Despite this marked progress, individuals who experience a fragility fracture remain under-treated in many areas of the world, and there is substantial need for investment both in secondary and primary prevention globally. In this brief article, we give an overview of the pathogenesis of osteoporosis, and summarise current and future approaches to its assessment and -treatment. PMID:27481382

  16. New active drugs for the treatment of advanced colorectal cancer

    PubMed Central

    Zaniboni, Alberto

    2015-01-01

    Newer active drugs have been recently added to the pharmacological armamentarium for the treatment of metastatic colorectal cancer. Aflibercept, a recombinant fusion protein composed of the extracellular domains of human vascular endothelial growth factor receptors (VEGFR) 1 and 2 and the Fc portion of human immunoglobulin G1 (IgG1), is an attractive second-line option in combination with folfiri for patients who have failed folfox +/- bevacizumab. Ramucirumab, a human IgG1 monoclonal antibody that targets VEGFR-2, provided similar results in the same setting. Tas-102, an oral fluoropyrimidine, and regorafenib, a multi-tyrosine kinase inhibitor, are both able to control the disease in a considerable proportion of patients when all other available treatments have failed. These new therapeutic options along with the emerging concept that previous therapies may also be reitroduced or rechallenged after regorafenib and Tas-102 failure are bringing new hope for thousands of patients and their families. PMID:26730280

  17. New active drugs for the treatment of advanced colorectal cancer.

    PubMed

    Zaniboni, Alberto

    2015-12-27

    Newer active drugs have been recently added to the pharmacological armamentarium for the treatment of metastatic colorectal cancer. Aflibercept, a recombinant fusion protein composed of the extracellular domains of human vascular endothelial growth factor receptors (VEGFR) 1 and 2 and the Fc portion of human immunoglobulin G1 (IgG1), is an attractive second-line option in combination with folfiri for patients who have failed folfox +/- bevacizumab. Ramucirumab, a human IgG1 monoclonal antibody that targets VEGFR-2, provided similar results in the same setting. Tas-102, an oral fluoropyrimidine, and regorafenib, a multi-tyrosine kinase inhibitor, are both able to control the disease in a considerable proportion of patients when all other available treatments have failed. These new therapeutic options along with the emerging concept that previous therapies may also be reitroduced or rechallenged after regorafenib and Tas-102 failure are bringing new hope for thousands of patients and their families. PMID:26730280

  18. Symptomatic treatment of multiple sclerosis using cannabinoids: recent advances.

    PubMed

    Smith, Paul F

    2007-09-01

    Recent years have seen a dramatic increase in the number of clinical trials investigating the potential efficacy of medicinal cannabinoids for the symptomatic treatment of chronic pain and spasticity in multiple sclerosis (MS). A number of different cannabinoids have been used, including: delta9-tetrahydrocannabinol (THC) itself; the synthetic delta9-THC, dronabinol; a 1:1 ratio of delta9-THC:cannabidiol (Sativex); and the synthetic delta9-THC metabolites CT-3 and nabilone. Other Cannabis extracts have also been tested. While 2-3 years ago there was little consensus in the literature, now the majority of studies are beginning to suggest that cannabinoids are useful in the treatment of MS in at least a subset of individuals. Their adverse side-effect profile has generally been mild compared with other drugs used for pain and spasticity; nonetheless, there is still concern about potential long-term side effects, particularly psychiatric side effects and effects on fetal development. PMID:17868014

  19. 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

  20. 3D root canal modeling for advanced endodontic treatment

    NASA Astrophysics Data System (ADS)

    Hong, Shane Y.; Dong, Janet

    2002-06-01

    More than 14 million teeth receive endodontic (root canal) treatment annually. Before a clinician's inspection and diagnosis, destructive access preparation by removing teeth crown and dentin is usually needed. This paper presents a non-invasive method for accessing internal tooth geometry by building 3-D tooth model from 2-D radiographic and endoscopic images to be used for an automatic prescription system of computer-aided treatment procedure planning, and for the root canal preparation by an intelligent micro drilling machine with on-line monitoring. It covers the techniques specific for dental application in the radiographic images acquirement, image enhancement, image segmentation and feature recognition, distance measurement and calibration, merging 2D image into 3D mathematical model representation and display. Included also are the methods to form references for irregular teeth geometry and to do accurately measurement with self-calibration.

  1. Advances in the treatment of gastroenteropancreatic neuroendocrine tumors

    PubMed Central

    Kunz, Pamela L; Fisher, George A

    2010-01-01

    Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a rare and heterogeneous class of neoplasms. While surgical resection is the mainstay of treatment, non-surgical therapies play a role in the setting of unresectable and metastatic disease. The goals of medical therapy are directed both at alleviating symptoms of peptide release and shrinking tumor mass. Biotherapies such as somatostatin analogs and interferon can decrease the secretion of peptides and inhibit their end-organ effects. A second objective for treatment of unresectable GEP-NETs is limiting tumor growth. Options for limiting tumor growth include somatostatin analogs, systemic chemotherapy, locoregional therapies, ionizing radiation, external beam radiation, and newer targeted agents. In particular, angiogenesis inhibitors, tyrosine kinase inhibitors, and mTOR inhibitors have shown early promising results. The rarity of these tumors, their resistance to standard chemotherapy, and the excellent performance status of most of these patients, make a strong argument for consideration of novel therapeutic trials. PMID:21694850

  2. Chemical plume source localization.

    PubMed

    Pang, Shuo; Farrell, Jay A

    2006-10-01

    This paper addresses the problem of estimating a likelihood map for the location of the source of a chemical plume using an autonomous vehicle as a sensor probe in a fluid flow. The fluid flow is assumed to have a high Reynolds number. Therefore, the dispersion of the chemical is dominated by turbulence, resulting in an intermittent chemical signal. The vehicle is capable of detecting above-threshold chemical concentration and sensing the fluid flow velocity at the vehicle location. This paper reviews instances of biological plume tracing and reviews previous strategies for a vehicle-based plume tracing. The main contribution is a new source-likelihood mapping approach based on Bayesian inference methods. Using this Bayesian methodology, the source-likelihood map is propagated through time and updated in response to both detection and nondetection events. Examples are included that use data from in-water testing to compare the mapping approach derived herein with the map derived using a previously existing technique. PMID:17036813

  3. 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. PMID:27252259

  4. 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

  5. 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. PMID:25782187

  6. 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

  7. 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. PMID:27171673

  8. Mantle cell lymphoma: biological insights and treatment advances.

    PubMed

    Leonard, John P; Williams, Michael E; Goy, Andre; Grant, Steven; Pfreundschuh, Michael; Rosen, Steve T; Sweetenham, John W

    2009-08-01

    Mantle cell lymphoma (MCL) exhibits considerable molecular heterogeneity and complexity, and is regarded as one of the most challenging lymphomas to treat. With increased understanding of the pathobiology of MCL, it is proposed that MCL is the result of 3 major converging factors, namely, deregulated cell cycle pathways, defects in DNA damage responses, and dysregulation of cell survival pathways. In the present era of targeted therapies, these biologic insights have resulted in the identification of several novel rational targets for therapeutic intervention in MCL that are undergoing active clinical testing. To date, there is no standard of care in MCL. Several approaches including conventional anthracycline-based therapies and intensive high-dose strategies with and without stem cell transplantation have failed to produce durable remissions for most patients. Moreover, considering the heterogeneity of MCL, it is increasingly being recognized that risk-adapted therapy might be a relevant therapeutic approach in this disease. At the first and second Global Workshops on Mantle Cell Lymphoma, questions addressing advances in the pathobiology of MCL, optimization of existing therapies, assessment of current data with novel therapeutic strategies, and the identification of molecular or phenotypic risk factors for utilization in risk-adapted therapies were discussed and will be summarized herein. PMID:19717376

  9. 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. PMID:23099312

  10. New advances in the treatment of Clostridium difficile infection (CDI)

    PubMed Central

    Hedge, Dennis D; Strain, Joe D; Heins, Jodi R; Farver, Debra K

    2008-01-01

    Clostridium difficile infections (CDI) have increased in frequency throughout the world. In addition to an increase in frequency, recent CDI epidemics have been linked to a hypervirulent C. difficile strain resulting in greater severity of disease. Although most mild to moderate cases of CDI continue to respond to metronidazole or vancomycin, refractory and recurrent cases of CDI may require alternative therapies. This review provides a brief overview of CDI and summarizes studies involving alternative antibiotics, toxin binders, probiotics, and immunological therapies that can be considered for treatment of acute and recurrent CDI in severe and refractory situations. PMID:19209277

  11. 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. PMID:26966785

  12. 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.

  13. 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. PMID:22500691

  14. 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

  15. Advances in the treatment of varicella-zoster virus infections.

    PubMed

    Andrei, G; Snoeck, R

    2013-01-01

    Varicella-zoster virus (VZV) causes two distinct diseases, varicella (chickenpox) and shingles (herpes zoster). Chickenpox occurs subsequent to primary infection, while herpes zoster (usually associated with aging and immunosuppression) appears as a consequence of reactivation of latent virus. The major complication of shingles is postherpetic neuralgia. Vaccination strategies to prevent varicella or shingles and the current status of antivirals against VZV will be discussed in this chapter. Varivax®, a live-attenuated vaccine, is available for pediatric varicella. Zostavax® is used to boost VZV-specific cell-mediated immunity in adults older than 50 years, which results in a decrease in the burden of herpes zoster and pain related to postherpetic neuralgia. Regardless of the availability of a vaccine, new antiviral agents are necessary for treatment of VZV infections. Current drugs approved for therapy of VZV infections include nucleoside analogues that target the viral DNA polymerase and depend on the viral thymidine kinase for their activation. Novel anti-VZV drugs have recently been evaluated in clinical trials, including the bicyclic nucleoside analogue FV-100, the helicase-primase inhibitor ASP2151, and valomaciclovir (prodrug of the acyclic guanosine derivative H2G). Different candidate VZV drugs have been described in recent years. New anti-VZV drugs should be as safe as and more effective than current gold standards for the treatment of VZV, that is, acyclovir and its prodrug valacyclovir. PMID:23886000

  16. Recent advances in the treatment of premature ejaculation

    PubMed Central

    Linton, Kate D; Wylie, Kevan R

    2010-01-01

    Premature ejaculation (PE) is the most common sexual problem affecting men. It can affect men at all ages and has a serious impact on the quality of life for men and their partners. Currently there are no pharmaceutical agents approved for use in the UK, and so all drugs used for this condition are off label. Behavioral therapy has been used to treat PE, but the results are not durable once therapy has been concluded. Several topical therapies have been used including severance-secret (SS) cream, lignocaine spray, lidocaine-prilocaine cream and lidocaine-prilocaine spray (TEMPE). There has been recent interest in the selective serotonin reuptake inhibitors (SSRIs) for the treatment of PE, due to the fact that one of their common side effects is delayed ejaculation. Currently used SSRIs have several non-sexual side effects and long half lives, therefore there has been interest in developing a short acting, efficacious SSRI that can be used on-demand for PE. Dapoxetine has been recently evaluated for the treatment of PE by several groups, and results so far appear promising. PMID:20368901

  17. Advances in immunotherapy for treatment of lung cancer

    PubMed Central

    Bustamante Alvarez, Jean G.; González-Cao, María; Karachaliou, Niki; Santarpia, Mariacarmela; Viteri, Santiago; Teixidó, Cristina; Rosell, Rafael

    2015-01-01

    Different approaches for treating lung cancer have been developed over time, including chemotherapy, radiotherapy and targeted therapies against activating mutations. Lately, better understanding of the role of the immunological system in tumor control has opened multiple doors to implement different strategies to enhance immune response against cancer cells. It is known that tumor cells elude immune response by several mechanisms. The development of monoclonal antibodies against the checkpoint inhibitor programmed cell death protein 1 (PD-1) and its ligand (PD-L1), on T cells, has led to high activity in cancer patients with long lasting responses. Nivolumab, an anti PD-1 inhibitor, has been recently approved for the treatment of squamous cell lung cancer patients, given the survival advantage demonstrated in a phase III trial. Pembrolizumab, another anti PD-1 antibody, has received FDA breakthrough therapy designation for treatment of non-small cell lung cancer (NSCLC), supported by data from a phase I trial. Clinical trials with anti PD-1/PD-L1 antibodies in NSCLC have demonstrated very good tolerability and activity, with response rates around 20% and a median duration of response of 18 months. PMID:26487966

  18. 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.

  19. 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

    2016-05-01

    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. Wavefront 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 is relatively simple.

  20. 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.

  1. Advances in mechanistic understanding and treatment approaches to Tourette syndrome.

    PubMed

    Shprecher, David R; Kious, Brent M; Himle, Michael H

    2015-11-01

    Tourette syndrome (TS) is a childhood onset neurodevelopmental disorder characterized by semi-involuntary, repetitive movements and sounds (motor and phonic tics). Transient tics in childhood are common, and their persistence in TS may be due to failure of maturation of frontal-subcortical circuits mediated by genetic predisposition and environmental factors. Tic improvement by young adult years is common, but its mechanism and predictive factors are unclear. Though tics can often be managed with nonmedical therapies, pharmacotherapy is often used for refractory, severe, or injurious tics but is complicated by side effects and incomplete benefit. This review summarizes the current understanding of TS pathophysiology, current and future treatment options, and recommendations for future research. PMID:26645901

  2. Talimogene Laherparepvec for the Treatment of Advanced Melanoma.

    PubMed

    Ott, Patrick A; Hodi, F Stephen

    2016-07-01

    Talimogene laherparepvec (T-VEC) is a first-in-class oncolytic virus that mediates local and systemic antitumor activity by direct cancer cell lysis and an "in situ vaccine" effect. Based on an increased durable response rate compared with granulocyte macrophage-colony stimulating factor in a randomized phase III trial, it was approved by the FDA for the treatment of melanoma metastatic to skin or lymph nodes. The drug is currently in clinical trials as monotherapy and in combination with immune-checkpoint inhibitors and radiotherapy in melanoma and other cancers. The mechanism of action, toxicity, and efficacy as well as its role in current clinical practice and potential future applications are reviewed. Clin Cancer Res; 22(13); 3127-31. ©2016 AACR. PMID:27146699

  3. Advances in the treatment of virus-induced asthma.

    PubMed

    Tay, Hock; Wark, Peter A B; Bartlett, Nathan W

    2016-06-01

    Viral exacerbations continue to represent the major burden in terms of morbidity, mortality and health care costs associated with asthma. Those at greatest risk for acute asthma are those with more severe airways disease and poor asthma control. It is this group with established asthma in whom acute exacerbations triggered by virus infections remain a serious cause of increased morbidity. A range of novel therapies are emerging to treat asthma and in particular target this group with poor disease control, and in most cases their efficacy is now being judged by their ability to reduce the frequency of acute exacerbations. Critical for the development of new treatment approaches is an improved understanding of virus-host interaction in the context of the asthmatic airway. This requires research into the virology of the disease in physiological models in conjunction with detailed phenotypic characterisation of asthma patients to identify targets amenable to therapeutic intervention. PMID:27088397

  4. Enteroviral encephalitis in children: clinical features, pathophysiology, and treatment advances

    PubMed Central

    Jain, Shikha; Patel, Bhupeswari; Bhatt, Girish Chandra

    2014-01-01

    Enteroviruses (EVs) have emerged as one of the important etiological agents as a causative organism for encephalitis, especially in children and adults. After the first report of EV encephalitis cases in 1950s, there have been increasing reports of regular outbreaks of EV encephalitis worldwide. Enteroviruses are RNA viruses of the family Picornaviridae that consists of more than 100 serotypes, which are characterized by a single positive-strand genomic RNA. The clinical features are pleomorphic and can be accompanied by mucocutaneous manifestations or isolated encephalitis only. The incidence of encephalitis in EV infection is reported to be about 3% and is associated with high mortality and morbidity. A number of newer therapeutic agents have been used in EV encephalitis with variable results. This review will focus on clinical features, pathophysiology, and newer treatment modality in EV encephalitis. PMID:25175874

  5. Advances in Surgical Treatment of Congenital Airway Disease.

    PubMed

    Ragalie, William S; Mitchell, Michael E

    2016-01-01

    Tracheobronchomalacia (TBM) is frequently present in infants and children with congenital heart disease (CHD). Infants with CHD and TBM appear to do worse than those without TBM. The principle of operative intervention for TBM is to improve function of the airway and clinical status. When indicated, conventional surgical options include tracheostomy, aortopexy, tracheoplasty, and anterior tracheal suspension. There is no consensus on the optimal treatment of severe tracheobonchomalacia, which can be associated with a mortality rate as high as 80%. Congenital tracheal stenosis is also frequently associated with CHD (vascular rings, atrioventricular canal defects, and septal defects) and may require concomitant repair. Repair of tracheal stenosis is often associated with distal TBM. This article addresses new techniques that can be performed in corrective surgery for both TBM and congenital tracheal stenosis. PMID:27568138

  6. 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

  7. 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. PMID:22477036

  8. Neoadjuvant Treatment Strategies for Locally Advanced Rectal Cancer.

    PubMed

    Gollins, S; Sebag-Montefiore, D

    2016-02-01

    Improved surgical technique plus selective preoperative radiotherapy have decreased rectal cancer pelvic local recurrence from, historically, 25% down to about 5-10%. However, this improvement has not reduced distant metastatic relapse, which is the main cause of death and a key issue in rectal cancer management. The current standard is local pelvic treatment (surgery ± preoperative radiotherapy) followed by adjuvant chemotherapy, depending on resection histology. For circumferential resection margin (CRM)-threatened cancer on baseline magnetic resonance imaging, downstaging long-course preoperative chemoradiation (LCPCRT) is generally used. However, for non-CRM-threatened disease, varying approaches are currently adopted in the UK, including straight to surgery, short-course preoperative radiotherapy and LCPCRT. Clinical trials are investigating intensification of concurrent chemoradiation. There is also increasing interest in investigating preoperative neoadjuvant chemotherapy (NAC) as a way of exposing micro-metastatic disease to full-dose systemic chemotherapy as early as possible and potentially reducing metastatic relapse. Phase II trials suggest that this strategy is feasible, with promising histological response and low rates of tumour progression during NAC. Phase III trials are needed to determine the benefit of NAC when added to standard therapy and also to determine if it can be used instead of neoadjuvant radiotherapy-based schedules. Although several measures of neoadjuvant treatment response assessment based on imaging or pathology are promising predictive biomarkers for long-term survival, none has been validated in prospective phase III studies. The phase III setting will enable this, also providing translational opportunities to examine molecular predictors of response and survival. PMID:26645661

  9. 77 FR 62270 - Proposed Revision Treatment of Non-Safety Systems for Passive Advanced Light Water Reactors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... COMMISSION Proposed Revision Treatment of Non-Safety Systems for Passive Advanced Light Water Reactors AGENCY... Treatment of Non-Safety Systems (RTNSS) for Passive Advanced Light Water Reactors.'' The current SRP does not contain guidance on the proposed RTNSS for Passive Advance Light Water Reactors. DATES:...

  10. 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

  11. 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.

  12. Advances in the Understanding and Treatment of Head Injury

    PubMed Central

    Evans, Joseph P.

    1966-01-01

    The author describes his personal involvement in head injury prevention and management over the past 40 years. He reviews the evolution of knowledge concerning the role of increased intracranial pressure, and considers the importance of cerebral vasoparalysis in the production of signs and symptoms following head injury, and the development of methods of recording intracranial pressure continuously, over hours and days. The development of an experimental compression model has led to a fuller understanding of edema of the brain and has provided a means of studying, by light and electron microscopy, the histological changes that result from edema. More recently, analyses of biochemical changes and disturbed membrane function have opened up a new avenue of potential treatment. Moreover, it is now clear that cerebral vascular dilatation and abrupt pressure increase can be produced in the monkey, in over 50% of cases, by lesions in the dorsomedial nucleus of the hypothalamus. Similar lesions may occur in the human and this suggests other therapeutic approaches. There is, then, a genuine hope of a breakthrough in the management of head injuries. ImagesFig. 1Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 16Fig. 21 PMID:5928533

  13. Psychiatric advances in the understanding and treatment of alcohol dependence.

    PubMed

    Madden, J S

    1984-01-01

    Several psychiatric topics have been under recent investigation. Cerebral impairment is now known to occur in over half of alcoholic patients. Its improvement with abstinence and its interference with the considerable intellectual and volitional requirements needed by controlled drinking programmes point to abstinence as the necessary drinking goal when brain damage is suspected. A hereditary element to alcohol dependence has been suggested by several adoption and twin studies, but the many contradictions between research results emphasise that any genetic contribution is overshadowed by socio-cultural factors. Depression and anxiety are frequent accompaniments of alcoholism but are shown by investigations usually as results rather than causes of excessive drinking. The onset of depression with suicidal ideas secondary to alcoholism has been sensitively described, and attention drawn to its identification, potential risk, and prevention. Long-term drug treatments are little used at present, but several developments are feasible. They include an effective long-acting chemical deterrent; drugs to protect against organic damage; sobering agents; immunotherapy; chemical reversal of the neuroadaptive changes responsible for physical dependence; drugs to counteract dysphoria and craving produced by alcohol; pharmacological modification of reflex behaviour; and drugs for the abstinence syndrome and for mood disturbance that are not themselves liable to misuse of dependence. Finally, it is suggested that the syndrome of pathological intoxication is a fictitious state that should be discarded from the descriptive literature. PMID:6398077

  14. Recent Advances in Treatment Approaches of Mucopolysaccharidosis VI.

    PubMed

    Giugliani, Roberto; Carvalho, Clarissa Gutiérrez; Herber, Silvani; de Camargo Pinto, Louise Lapagesse

    2011-06-01

    Mucopolysaccharidosis VI is caused by accumulation of the glycosaminoglycan dermatan sulfate in all tissues due to decreased activity of the enzyme arylsulfatase B. Patients exhibit multisystemic signs and symptoms in a chronic and progressive manner, especially with changes in the skeleton, cardiopulmonary system, cornea, skin, liver, spleen and meninges. Patients usually have normal intelligence. In the past, treatment of mucopolysaccharidoses was limited to palliative medical care. The outcome for affected patients improved with the introduction of new technologies as hematopoietic stem cell transplantation, relegated to specific situations after enzyme replacement therapy (ERT) became available. The specific ERT for MPS VI, galsulfase (Naglazyme®, Biomarin Pharmaceutical) was approved in 2005 by FDA and in 2006 by EMEA, and three clinical studies including 56 patients have evaluated the efficacy and safety. Long-term follow up data with patients treated up to 5 years showed that ERT is well tolerated and associated with sustained improvements in the patients' clinical condition. Intrathecal ERT may be considered in situations of high neurosurgical risk but still it is experimental in humans, as is intra-articular ERT. It is possible that the full impact of this therapy will only be demonstrated when patients are identified and treated soon after birth, as it was shown that early introduction of ERT produced immune tolerance and improved enzyme effectiveness in the cat model. New insights on the pathophysiology of MPS disorders are leading to alternative therapeutic approaches, as gene therapy, inflammatory response modulators and substrate reduction therapy. PMID:21506914

  15. Recent advances in diagnosis and treatment of primary aldosteronism.

    PubMed

    Veglio, F; Morello, F; Rabbia, F; Leotta, G; Mulatero, P

    2003-08-01

    Primary aldosteronism is the most common form of secondary hypertension. The use of aldosterone/plasma renin activity ratio (ARR) as a screening test has elevated its prevalence up to 10% of hypertensive patients. Idiopathic bilateral adrenal hyperplasia and aldosterone-producing adrenal adenoma are the leading causes of primary aldosteronism. Most patients with this conditions are normokalemic and clinically undistinguishable from essential hypertensives. However, they suffer from anticipated and more severe target organ damage than other hypertensives. Thus, being primary aldosteronism a common, specifically treatable and sometimes surgically cured form of hypertension, a prompt diagnosis is necessary and cannot be overlooked. The measurement of ambulatory ARR represents the screening test and should be performed in the majority of hypertensive patients. ARR higher than a set cutoff suggests the need of a confirmatory test for primary aldosteronism, such as intravenous saline load or fludrocortisone suppression test. If inability to suppress aldosterone is demonstrated, the disease is confirmed. The subtype evaluation is based on adrenal imaging (CT scan) and selective adrenal venous sampling. The latter is the gold standard for the diagnosis of a lateralized aldosterone secretion, as typically observed in aldosterone-producing adenomas. Microadenomas are frequently overlooked by adrenal image. If lateralization is confirmed, unilateral adrenalectomy is the reasonable therapeutic option, leading to a significant reduction of blood pressure, if not normotension. If bilateral aldosterone excess is demonstrated, an aldosterone receptor antagonist should be administered. This article reviews and discusses the new data about prevalence, diagnosis and treatment of primary aldosteronism. PMID:14605590

  16. Recent advances in diagnosis and treatment of pheochromocytoma.

    PubMed

    Veglio, F; Morello, F; Morra Di Cella, S; Del Colle, S; Rabbia, F; Mulatero, P

    2003-08-01

    Pheochromocytomas are rare tumours of catecholamine-producing chromaffin cells leading to hypertension and symptoms of catecholamine excess. They can be benign or malignant, sporadic or familial tumours. Genetic syndromes associated with pheochromocytoma are MEN II, VHL disease and neurofibromatosis type 1. Usually, pheochromocytomas occur in the adrenal medulla. Clinical manifestations include hypertension (which can be intermittent, stable or in the form of hypertensive peaks) and symptoms related to catecholamine excess such as headache, palpitations and tachycardia, pallor, anxiety and nervousness, nausea, vomiting, weight loss. This clinical syndrome can be mimicked by various hyperkinetic and hyperadrenergic states. When pheochromocytoma is suspected, the first diagnostic step is represented by the measurement of catecholamines and their metabolites (metanephrines) in urine and plasma. Chro-mogranin A measurement can be useful. The clonidine suppression test may be helpful in ruling out other conditions that may elevate catecholamines and metanephrines. Localiza-tion and staging of pheochromocytoma is based on MRI, which is more sensitive than CT scan, and (131)I-MIBG scintiscan. The best therapeutic option for pheochromocytoma is surgery with a laparoscopic approach. An appropriate pre-, intra- and postoperative medical management of the patient is mandatory. In the absence of optimal medical treatment, intraoperative mortality reaches 50%. PMID:14605591

  17. 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.

  18. Advancing Recovery: Implementing Evidence-Based Treatment for Substance Use Disorders at the Systems Level

    PubMed Central

    Schmidt, Laura A.; Rieckmann, Traci; Abraham, Amanda; Molfenter, Todd; Capoccia, Victor; Roman, Paul; Gustafson, David H.; McCarty, Dennis

    2012-01-01

    Objective: A multisite evaluation examined the process and outcomes of Advancing Recovery, a Robert Wood Johnson Foundation initiative to overcome barriers to implementing evidence-based treatments within alcohol and drug treatment systems. Method: We report findings from a 3-year, mixed-method study of how treatment systems promoted two evidence-based practices: medication-assisted treatment and continuing care management. We compared outcomes and implementation strategies across 12 state/county agencies responsible for alcohol and drug treatment and their selected treatment centers. Each partnership received 2 years of financial and technical support to increase adoption of evidence-based treatments. Results: Partnerships flexibly applied the Advancing Recovery model to promote the adoption of evidence-based treatments. Most sites achieved a measurable increase in the numbers of patients served with evidence-based practices, up from a baseline of virtually no use. Rates of adopting medication-based treatments were higher than those for continuing care management. Partnerships used a menu of top-down and bottom-up strategies that varied in specifics across sites but shared a general process of incremental testing and piecemeal adaptation. Conclusions: Supported partnerships between providers and policymakers can achieve wider adoption of evidence-based treatment practices. Systems change unfolds through a trial-and-error process of adaptation and political learning that is unique to each treatment system. This leads to considerable state and local variation in implementation strategies and outcomes. PMID:22456246

  19. 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.

  20. Isotropic treatment of EMF effects in advanced photomasks

    NASA Astrophysics Data System (ADS)

    Tirapu Azpiroz, Jaione; Rosenbluth, Alan E.; Graur, Ioana; Burr, Geoffrey W.; Villares, Gustavo

    2009-10-01

    Classical methods for modeling electromagnetic scattering from the topography of lithographic reticles must place a high premium on fast computation, and toward that end they apply pre-stored perturbations (e.g. the so-called boundary layers) to feature edges in order to approximate the impact of finite-thickness mask films. Though approximate, these methods involve E&M calculations with vector fields, and so employ edge-field corrections that are different for edges oriented parallel or perpendicular to the vector field. As a result these methods entail a requirement for two separate aerial image simulations using orthogonal source polarizations in order to represent unpolarized illumination. This imposes a minimum 2X runtime penalty relative to baseline thin-mask (TMA) simulations, since the known method for combining the effect of both polarizations into one single set of imaging TCCs applies only to thin-mask calculations. More severe performance penalties are common in so-called sparse imaging methodologies when topographic effects are included, since the separated treatment of feature edges and the internal area of the features can increase the number of memory lookups required. In this paper an isotropic field perturbation approach is evaluated, in which an isotropic edge field correction, common to all edge orientations, mimics the effect of the true parallel and perpendicular edge field perturbations when the mask is illuminated with unpolarized light, as well as in certain cases of polarized illumination. The isofield is not an ad hoc empirical correction but rather an accurate approximation in the limit of modest departures from scalar TMA. More specifically, we show that the isofield model accounts for vector imaging effects with full accuracy in the TMA terms, and in an approximate way in the electromagnetic edge-field terms that becomes accurate when the polarization dependence of the TMA terms is small. We will show with comparison to more rigorous

  1. 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

  2. Life-Cycle Assessment of Advanced Nutrient Removal Technologies for Wastewater Treatment.

    PubMed

    Rahman, Sheikh M; Eckelman, Matthew J; Onnis-Hayden, Annalisa; Gu, April Z

    2016-03-15

    Advanced nutrient removal processes, while improving the water quality of the receiving water body, can also produce indirect environmental and health impacts associated with increases in usage of energy, chemicals, and other material resources. The present study evaluated three levels of treatment for nutrient removal (N and P) using 27 representative treatment process configurations. Impacts were assessed across multiple environmental and health impacts using life-cycle assessment (LCA) following the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) impact-assessment method. Results show that advanced technologies that achieve high-level nutrient removal significantly decreased local eutrophication potential, while chemicals and electricity use for these advanced treatments, particularly multistage enhanced tertiary processes and reverse osmosis, simultaneously increased eutrophication indirectly and contributed to other potential environmental and health impacts including human and ecotoxicity, global warming potential, ozone depletion, and acidification. Average eutrophication potential can be reduced by about 70% when Level 2 (TN = 3 mg/L; TP = 0.1 mg/L) treatments are employed instead of Level 1 (TN = 8 mg/L; TP = 1 mg/L), but the implementation of more advanced tertiary processes for Level 3 (TN = 1 mg/L; TP = 0.01 mg/L) treatment may only lead to an additional 15% net reduction in life-cycle eutrophication potential. PMID:26871301

  3. The Milan photooxidant plume

    NASA Astrophysics Data System (ADS)

    PréVôT, André S. H.; Staehelin, Johannes; Kok, Gregory L.; Schillawski, Richard D.; Neininger, Bruno; Staffelbach, Thomas; Neftel, Albrecht; Wernli, Heini; Dommen, Josef

    1997-10-01

    In Switzerland, measurement campaigns including aircraft measurements were carried out in the summers of 1992 and 1993 as part of the Pollution and Meteorology (POLLUMET) study. Ozone (O3) concentrations, up to 185 ppb, with a large spatial variability were found south of the Alps in the afternoon. Comparison to measurements north of the Alps shows that these concentration levels are extraordinarily high for central Europe. Backward trajectories reveal that the highest O3 levels were found 4-5 hours downwind of Milan, Italy. The measurements suggest a reactive organic gas (ROG) sensitive O3 production regime 1-3 hours downwind in the plume, and a NOx (sum of nitrogen oxide (NO) and nitrogen dioxide (NO2)) limitation in air masses not affected by the Milan plume. Air masses originating north of Milan are probably close to the transition zone between the two photochemical regimes. This was found by using measurements of total odd nitrogen (NOy,), NO, NO2, formaldehyde (HCHO), and hydrogen peroxide (H2O2) yielding indicators for ROG and NOx sensitive O3 production. The slope of ozone versus NOz (=NOy-NOx: photochemical products of NOx) were markedly higher in NOx limited conditions (ΔO3/ΔNOz=13.6) than in air masses close to the transition zone (ΔO3/ΔNOz=4.2).

  4. Nuclear rocket plume studies

    NASA Astrophysics Data System (ADS)

    Hastings, Daniel

    1993-05-01

    A description and detailed computational analysis of a vortex cleaning system designed to remove radioactive material from the plumes of nuclear rockets is included. The proposed system is designed to remove both particulates and radioactive gaseous material from the plume. A two part computational model is used to examine the system's ability to remove particulates, and the results indicate that under some conditions, the system can remove over 99% of the particles in the flow. Two critical parameters which govern the effectiveness of the system are identified and the information necessary to estimate cleaning efficiencies for particles of known sizes and densities is provided. A simple steady analytical solution is also developed to examine the system's ability to remove gaseous radioactive material. This analysis, while inconclusive, suggests that the swirl rates necessary to achieve useful efficiencies are too high to be achieved in any practical manner. Therefore, this system is probably not suitable for use, with gaseous radioactive material. It was concluded that the system can cause negligible specific impulse losses, though there may be a substantial mass penalty associated with its use.

  5. 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. PMID:24645541

  6. 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.

  7. 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.

  8. 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. PMID:20368458

  9. Atmospheric chemistry in volcanic plumes

    PubMed Central

    von Glasow, Roland

    2010-01-01

    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. PMID:20368458

  10. 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

  11. Ipilimumab Combined with Nivolumab: A Standard of Care for the Treatment of Advanced Melanoma?

    PubMed

    Carlino, Matteo S; Long, Georgina V

    2016-08-15

    Ipilimumab, an inhibitor of CTLA-4 on T cells, was the first drug to improve overall survival in patients with advanced melanoma. Subsequently, inhibitors of PD-1, including nivolumab and pembrolizumab, were shown to be superior to ipilimumab with a more favorable safety profile. The combination of ipilimumab and nivolumab is associated with a further improvement in response rate and progression-free survival; however, the combination is associated with an increased rate of immune-related toxicities. In 2015, the FDA approved the combination for the treatment of BRAF wild-type advanced melanoma. This review examines the preclinical rationale for the combination of ipilimumab and nivolumab as well as the efficacy and toxicity data from clinical trials in patients with advanced melanoma. Finally, alternative treatment options are discussed with a focus on patient selection. Clin Cancer Res; 22(16); 3992-8. ©2016 AACR. PMID:27340279

  12. Formation, Dynamics, and Impact of Plasmaspheric Plumes

    NASA Astrophysics Data System (ADS)

    Goldstein, Jerry; Borovsky, Joseph; Foster, John; Carpenter, Donald

    2007-06-01

    Workshop on Plasmaspheric Drainage Plumes, Taos, New Mexico, 9-13 October 2006 Plasmaspheric plumes result from erosion of the plasmasphere. The Institute of Geophysics and Planetary Physics (IGPP) Workshop on Plasmaspheric Drainage Plumes was convened in Taos, N. M., on 9-13 October 2006 to examine outstanding questions about the formation and dynamics of plumes, and the impact of plumes on the near-Earth space environment (geospace). A second workshop on plasmaspheric drainage plumes is planned for late 2007.

  13. The effect of advanced treatment on chlorine decay in metallic pipes

    EPA Science Inventory

    Experiments were run to measure what effect advanced treatment might have on the kinetics of chlorine decay in water distribution systems. A recirculating loop of 6-inch diameter unlined ductile iron pipe was used to simulate turbulent flow conditions in a pipe with significant c...

  14. THE REMOVAL OF METALS AND VIRUSES IN ADVANCED WASTEWATER TREATMENT SEQUENCES

    EPA Science Inventory

    An extensive study of metals and virus removals by advanced wastewater treatment processes was conducted in Dallas, Texas from June 1972 through December 1973. Processes applied to a biologically nitrified effluent included chemical coagulation with alum and/or lime, high-pH lime...

  15. 26 CFR 1.612-3 - Depletion; treatment of bonus and advanced royalty.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 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;...

  16. Advanced stimulation technology program helps zero in the optimum frac treatment

    SciTech Connect

    Saunders, B.

    1995-08-01

    The Gas Research Institute (GRI) has initiated the Advanced Stimulation Technology (AST) program to ensure that successful stimulation technologies developed in previous GRI programs are available to the petroleum industry and are used regularly. The AST program focuses on benefits analysis, real-time fracture treatment evaluation, and understanding critical concepts in fracture stimulation.

  17. ESTIMATING SURFACE CONCENTRATIONS FROM AN ELEVATED, BUOYANT PLUME IN A LIMITED-MIXED CONVECTIVE BOUNDARY LAYER

    EPA Science Inventory

    In the past decade, recent advances have suggested that convective scaling can be used to parameterize diffusion from a plume in the convective boundary layer (CBL). New methods such as convective scaling need to be explored because the traditionally used Gaussian plume model doe...

  18. Percutaneous microwave ablation combined with simultaneous transarterial chemoembolization for the treatment of advanced intrahepatic cholangiocarcinoma

    PubMed Central

    Yang, Guo-Wei; Zhao, Qing; Qian, Sheng; Zhu, Liang; Qu, Xu-Dong; Zhang, Wei; Yan, Zhi-Ping; Cheng, Jie-Min; Liu, Qing-Xin; Liu, Rong; Wang, Jian-Hua

    2015-01-01

    Aim To retrospectively evaluate the safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) combined with simultaneous transarterial chemoembolization (TACE) in the treatment of patients with advanced intrahepatic cholangiocarcinoma (ICC). Methods All patients treated with ultrasound-guided percutaneous MWA combined with simultaneous TACE for advanced ICC at our institution were included. Posttreatment contrast-enhanced computed tomography and/or magnetic resonance imaging were retrieved and reviewed for tumor response to the treatment. Routine laboratory studies, including hematology and liver function tests were collected and analyzed. Procedure-related complications were reviewed and survival rates were analyzed. Results From January 2011 to December 2014, a total of 26 advanced ICC patients were treated at our single institute with ultrasound-guided percutaneous MWA combined with simultaneous TACE. There were 15 males and eleven females with an average age of 57.9±10.4 years (range, 43–75 years). Of 26 patients, 20 (76.9%) patients were newly diagnosed advanced ICC without any treatment, and six (23.1%) were recurrent and treated with surgical resection of the original tumor. The complete ablation rate was 92.3% (36/39 lesions) for advanced ICC. There were no major complications observed. There was no death directly from the treatment. Median progression-free survival and overall survival were 6.2 and 19.5 months, respectively. The 6-, 12-, and 24-month survival rates were 88.5%, 69.2%, and 61.5%, respectively. Conclusion The study suggests that ultrasound-guided percutaneous MWA combined with simultaneous TACE therapy can be performed safely in all patients with advanced ICC. The complete ablation rate was high and there was no major complication. The overall 24-month survival was 61.5%. PMID:26060410

  19. 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

  20. Scanning thermal plumes

    NASA Technical Reports Server (NTRS)

    Scarpace, F. L.; Madding, R. P.; Green, T., III

    1975-01-01

    Over a three-year period 800 thermal line scans of power plant plumes were made by an airborne scanner, with ground truth measured concurrently at the plants. Computations using centered finite differences in the thermal scanning imagery show a lower bound in the horizontal temperature gradient in excess of 1.6 C/m. Gradients persist to 3 m below the surface. Vector plots of the velocity of thermal fronts are constructed by tracing the front motion in successive thermal images. A procedure is outlined for the two-point ground calibration of a thermal scanner from an equation describing the scanner signal and the voltage for two known temperatures. The modulation transfer function is then calculated by input of a thermal step function and application of digital time analysis techniques using Fast Fourier Transforms to the voltage output. Field calibration tests are discussed. Data accuracy is limited by the level of ground truth effort chosen.

  1. 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.

  2. 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

  3. New and emerging targeted treatments in advanced non-small-cell lung cancer.

    PubMed

    Hirsch, Fred R; Suda, Kenichi; Wiens, Jacinta; Bunn, Paul A

    2016-09-01

    Targeted therapies are substantially changing the management of lung cancers. These treatments include drugs that target driver mutations, those that target presumed important molecules in cancer cell proliferation and survival, and those that inhibit immune checkpoint molecules. This area of research progresses day by day, with novel target discoveries, novel drug development, and use of novel combination treatments. Researchers and clinicians have also extensively investigated the predictive biomarkers and the molecular mechanisms underlying inherent or acquired resistance to these targeted therapies. We review recent progress in the development of targeted treatments for patients with advanced non-small-cell lung cancer, especially focusing on data from published clinical trials. PMID:27598681

  4. 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

  5. Current approaches to the treatment of advanced-stage Hodgkin's disease.

    PubMed Central

    Rusthoven, J J

    1986-01-01

    Combination chemotherapy (CT) has been the mainstay of treatment of advanced-stage Hodgkin's disease since the late 1960s. Although treatment with MOPP (nitrogen mustard, vincristine sulfate [Oncovin], procarbazine and prednisone) has resulted in long-term disease-free survival rates exceeding 50%, newer approaches have been studied to improve on this success rate and to reduce the toxic effects associated with MOPP. Prognostic factors have now been defined that identify patients who may require more aggressive treatment; they include age greater than 40 years, presence of B symptoms and more advanced (especially extranodal) disease. A small number of patients with pathological stage III disease may still be successfully treated with extensive radiotherapy (RT) alone. Among patients with advanced-stage disease, significantly better therapeutic results are being obtained with newer treatment approaches than with MOPP, particularly in patients with factors that predict a poor outcome. These newer approaches include combination CT plus RT, alternating cycles of two non-cross-resistant CT regimens and hybrid regimens, which combine agents from two different CT regimens in one cycle. The prognosis of patients who suffer relapse after combination CT remains poor, even with newer drug regimens. The newer treatment approaches may well lead to better cure rates and fewer short-term and long-term toxic effects. PMID:2427176

  6. Multicriteria assessment of advanced treatment technologies for micropollutants removal at large-scale applications.

    PubMed

    Bui, X T; Vo, T P T; Ngo, H H; Guo, W S; Nguyen, T T

    2016-09-01

    With the introduction and discharge of thousands of new micropollutants (MPs) every year, traditional water and wastewater treatment plants may be incapable of tackling them all. With their low concentrations and diversity in nature, MP removal encounters numerous challenges. Although some MPs are effectively eliminated via conventional treatment methods, most of them can easily escape and are retained in the discharged effluent. Therefore, advanced methods such as (i) adsorption, (ii) oxidation and advanced oxidation processes (O3 and O3-based advanced oxidation processes, UV/H2O2), (iii) membrane processes, and (iv) membrane bioreactors, become an inevitable approach. Despite the unsurprisingly vast number of papers on MP treatment available at present, most of these studies were carried out at a laboratory scale while only a few pilot- and full-scale studies have experimented. Nevertheless, an in-depth assessment of real-world MP treatment methods is extremely crucial for practitioners. To date, no paper has been dedicated to look at this issue. Therefore, this paper aims to review these large-scale treatment methods. First, the paper goes through the regulations and standards which deal with MPs in water courses. It will then assess these methods in various case-studies with reference to different criteria towards serving as a reference for further practical applications. PMID:27198651

  7. Non-platinum-based chemotherapy for treatment of advanced gastric cancer: 5-fluorouracil, taxanes, and irinotecan.

    PubMed

    Kang, Byung Woog; Kim, Jong Gwang; Kwon, Oh-Kyoung; Chung, Ho Young; Yu, Wansik

    2014-05-14

    Despite numerous advances in treatment options, advanced gastric cancer (AGC) remains a major public health issue and the leading cause of cancer-related deaths. Cisplatin is one of the most effective broad-spectrum anticancer drugs for AGC and a doublet combination regimen of either cisplatin-based or 5-fluorouracil (5FU)-based chemotherapy is generally used for treatment of patients with AGC. However, there is still no consensus on the best regimen for treating AGC. Recently, various new chemotherapeutic agents, including oral 5FU, taxanes, and irinotecan, have been identified as improving the outcomes for AGC when used as a single agent or in combination with non-platinum chemotherapy. Nonetheless, it is still unclear whether non-platinum-based chemotherapy is a viable treatment option for patients with AGC. Accordingly, this review focuses on the efficacy and tolerability of non-platinum-based chemotherapy for patients with AGC. PMID:24833869

  8. [Advanced malignant soft tissue tumors: plastic reconstructive options for palliative treatment].

    PubMed

    Vogt, P M; Jokuszies, A

    2010-12-01

    Plastic and reconstructive procedures for the oncological treatment of malignant tumors in the head and neck region, trunk and extremities are primarily curative. Less is known about the treatment options of plastic surgery in patients with locally advanced or incurable tumors. Therefore superficial, mostly exulcerated and superinfected tumors are treated with a palliative approach. A plethora of symptoms drastically restricts the quality of life in patients with advanced cancer. Pain, oozing of blood and bacterial superinfection with fetidness compromise the patient's general condition, self-esteem and activity. Many patients suffer from increasing isolation. A stage-adapted and plastic-reconstructive approach aiming at reducing the tumor mass and closing ulcerating wounds provides a considerable benefit especially in these patients. In this article a variety of treatment options regarding palliative resections and plastic reconstructive procedures and the disease alleviating benefits for patients with incurable tumors are presented. PMID:19949764

  9. The place of subfascial endoscopic perforator vein surgery (SEPS) in advanced chronic venous insufficiency treatment

    PubMed Central

    Kurpiewski, Waldemar; Kowalczyk, Marek; Szynkarczuk, Rafał; Łuba, Magdalena; Żurada, Anna; Grabysa, Radosław

    2011-01-01

    In spite of medical science development and initiation of new technologies in minimally invasive surgery, treatment of advanced chronic venous insufficiency at the 5th and 6th degree of CEAP classification is still a great clinical challenge. In case of no satisfactory results of non-surgical treatment of recurrent venous ulcers, scientists search for alternative therapeutic methods which could be more effective and lasting. Subfascial endoscopic perforator vein surgery (SEPS) as a method of reducing venous pressure in the superficial venous system could provide healing of the recurrent venous ulcer. In this study we present a review of contemporary opinions about the place and significance of subfascial endoscopic perforator vein surgery as a treatment of advanced chronic venous insufficiency. PMID:23255980

  10. Non-platinum-based chemotherapy for treatment of advanced gastric cancer: 5-fluorouracil, taxanes, and irinotecan

    PubMed Central

    Kang, Byung Woog; Kim, Jong Gwang; Kwon, Oh-Kyoung; Chung, Ho Young; Yu, Wansik

    2014-01-01

    Despite numerous advances in treatment options, advanced gastric cancer (AGC) remains a major public health issue and the leading cause of cancer-related deaths. Cisplatin is one of the most effective broad-spectrum anticancer drugs for AGC and a doublet combination regimen of either cisplatin-based or 5-fluorouracil (5FU)-based chemotherapy is generally used for treatment of patients with AGC. However, there is still no consensus on the best regimen for treating AGC. Recently, various new chemotherapeutic agents, including oral 5FU, taxanes, and irinotecan, have been identified as improving the outcomes for AGC when used as a single agent or in combination with non-platinum chemotherapy. Nonetheless, it is still unclear whether non-platinum-based chemotherapy is a viable treatment option for patients with AGC. Accordingly, this review focuses on the efficacy and tolerability of non-platinum-based chemotherapy for patients with AGC. PMID:24833869

  11. 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.

  12. 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

  13. Treatment of advanced head and neck carcinoma with synchronous irradiation and methotrexate

    SciTech Connect

    Pointon, R.C.; Askill, C.S.; Hunter, R.D.; Wilkinson, P.M.

    1981-01-01

    Thirty-four patients with advanced head and neck cancer were treated by synchronous radiotherapy and methotrexate (MTX) (100 mg/m2). Complete resolution of disease was obtained in 18 patients, the median remission of patients being 17 months. In general, treatment was well tolerated, although mucosal reaction was prolonged in 50% of patients. Drug-induced hematological toxicity was observed in six patients (18%) and one patient died. As a result of these findings, a random clinical trial to compare X-ray therapy with X-ray therapy and MTX in advanced head and neck cancer has been commenced.

  14. Advances in the diagnosis and treatment of acute and chronic leukemia in Mexico.

    PubMed

    Ruiz-Argüelles, Guillermo José

    2016-04-01

    In the last 60 years, there have been substantial advances regarding the diagnosis and treatment of patients with acute and chronic leukemia in Mexico. Immunologic and molecular classifications of these diseases have improved both diagnosis and therapeutic capabilities. Although the pace of diagnostic and therapeutic advances has been slower compared with developed countries, Mexico is at the forefront among developing countries. Supporting research in these fields is expected to enhance the generation of new knowledge and improve the care of patients suffering from these diseases. PMID:27557388

  15. Hele-Shaw Experiments on Plume Stretching and Folding

    NASA Astrophysics Data System (ADS)

    Foster, M.; Mays, D. C.; Neupauer, R. M.

    2013-12-01

    Fluid mixing in laminar flow is important in a number of practical applications, including remediation of contaminated groundwater. Recent modeling studies have shown that mixing can be accelerated and amplified by imposing a flow that generates stretching and folding of an injected plume of treatment solution. Stretching and folding, in turn, results from engineered injection and extraction of clean water through an array of wells surrounding the treatment solution. This poster describes a series of experiments whose goal is to demonstrate plume stretching and folding in a Hele-Shaw apparatus. An initial plume of treatment solution is injected into the center of the Hele-Shaw apparatus, which is assumed to represent a zone of contaminated groundwater, with four wells spaced evenly around the treatment solution. In order to spread the treatment solution into the groundwater, the four wells perform a series of infusions and withdrawals that push and pull apart the plume of treatment solution. With the proper steps, it will be shown that the plume can be stretched and folded to greatly increase the reactive interface area between the treatment solution and the contaminated groundwater. Consideration is given to two qualitative differences with respect to previous modeling studies. First, constant volume is required by the no-flow boundary used at the edge of the Hele-Shaw cell; any pump that is withdrawing water must have a complementary pump adding water at the same rate. Second, in these experiments, mixing results from a physical process, namely Taylor dispersion, eliminating the uncertainty resulting from the need to assume dispersion mechanisms in numerical models. Therefore, these experiments further elucidate the benefits and challenges of imposing plume stretching and folding in systems (like aquifers) where dispersion is unavoidable, providing new insight into the required logistics of using this approach in groundwater treatment.

  16. Orbital Maneuvering Vehicle (OMV) plume and plume effects study

    NASA Technical Reports Server (NTRS)

    Smith, Sheldon D.

    1991-01-01

    The objective was to characterize the Orbital Maneuvering Vehicle (OMV) propulsion and attitude control system engine exhaust plumes and predict the resultant plume impingement pressure, heat loads, forces, and moments. Detailed description is provided of the OMV gaseous nitrogen (GN2) thruster exhaust plume flow field characteristics calculated with the RAMP2 snd SFPGEN computer codes. Brief descriptions are included of the two models, GN2 thruster characteristics and RAMP2 input data files. The RAMP2 flow field could be recalculated by other organizations using the information presented. The GN2 flow field can be readily used by other organizations who are interested in GN2 plume induced environments which require local flow field properties which can be supplied using the SFPGEN GN2 model.

  17. Rapid sequence treatment of advanced squamous cell carcinoma of the upper aerodigestive tract: A pilot study

    SciTech Connect

    Moloy, P.J.; Moran, E.M.; Azawi, S. )

    1991-01-01

    A review of the literature suggested that prolonged treatment time may lessen the probability of cure for patients with advanced squamous cell carcinoma of the upper aerodigestive tract. To shorten treatment time, rapid sequence treatment (RST) was devised in which chemotherapy, surgery, and irradation were administered in a total treatment time of 8 weeks. Twelve patients were treated and followed 3 years or longer. Medical complications were minor. Osteonecrosis occurred in each of the first five patients and was the only major complication of the protocol. Surgical techniques were modified, and no additional patient developed osteonecrosis. No patient developed local or regional recurrence. Two patients developed distant metastases and three other patients developed second primaries. Absolute survival was 50%. Rapid sequence treatment is an aggressive and potentially hazardous protocol that yielded encouraging results in this pilot study.

  18. 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

    ... solicitation for public comment published in the Federal Register on October 12, 2012 (77 FR 62270), on the... 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...

  19. EPA (ENVIRONMENTAL PROTECTION AGENCY) MODEL DEVELOPMENT FOR STABLE PLUME IMPINGEMENT ON ELEVATED TERRAIN OBSTACLES

    EPA Science Inventory

    The U.S. Environmental Protection Agency's Complex Terrain Model Development program is designed as a series of progressively advanced model development efforts accompanied by requisite field studies to provide data for model evaluation. Plume impingement studies have been perfor...

  20. 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...

  1. 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

    2016-01-01

    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. PMID:27438260

  2. Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness

    PubMed Central

    Swanson, Jeffrey W.; Swartz, Marvin S.; Elbogen, Eric B.; Van Dorn, Richard A.; Ferron, Joelle; Wagner, H. Ryan; McCauley, Barbara J.; Kim, Mimi

    2013-01-01

    Objective Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. Method A total of 469 patients with severe mental illness were randomly assigned to a facilitated psychiatric advance directive session or a control group that received written information about psychiatric advance directives and referral to resources in the public mental health system. Completion of an advance directive, its structure and content, and its short-term effects on working alliance and treatment satisfaction were recorded. Results Sixty-one percent of participants in the facilitated session completed an advance directive or authorized a proxy decision maker, compared with only 3% of control group participants. Psychiatrists rated the advance directives as highly consistent with standards of community practice. Most participants used the advance directive to refuse some medications and to express preferences for admission to specific hospitals and not others, although none used an advance directive to refuse all treatment. At 1-month follow-up, participants in the facilitated session had a greater working alliance with their clinicians and were more likely than those in the control group to report receiving the mental health services they believed they needed. Conclusions The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients’ treatment preferences. Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings. PMID:17074946

  3. Successful treatment of advanced malignant fibrous histiocytoma of the right forearm with apatinib: a case report

    PubMed Central

    Ji, Guanghui; Hong, Liu; Yang, Ping

    2016-01-01

    Malignant fibrous histiocytoma (MFH) is the most common soft-tissue sarcoma in late adult life. Unfortunately, advanced MFH has a poor prognosis due to a lack of effective drugs. We present here a case of advanced MFH with partial response to apatinib, a new potent oral small-molecule tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor 2 (VEGFR-2). To the best of our knowledge, this is the first case report using apatinib for MFH. Quantitative polymerase chain reaction analysis revealed high expression of VEGFR-2 mRNA, suggesting that apatinib leads to clinical response by inhibiting VEGFR-2 tyrosine kinase activity and the crucial role of VEGFR-2 for MFH. Apatinib could be a new option for the treatment of MFH. Further studies are needed to optimize the treatment. PMID:26917971

  4. Advances in the treatment of acute graft-versus-host disease

    PubMed Central

    Qian, Liren; Wu, Zhengcheng; Shen, Jianliang

    2013-01-01

    Allogeneic hematopoietic stem cell transplantation (HSCT) has been widely used for the treatment of hematologic malignant and non-malignant hematologic diseases and other diseases. However, acute graft-versus-host disease (GVHD) is a life-threatening complication of allogeneic transplantation. Acute GVHD may occur in 30% of transplant recipients, which is a syndrome of erythematous skin eruption, cholestatic liver disease and intestinal dysfunction, resulting from the activation of donor T lymphocytes by host antigen-presenting cells, resulting in an immune-mediated inflammatory response. Recent scientific advances in the understanding of the pathogenesis involved in the development of acute GVHD and clinical investigation have provided more effective therapeutic strategies for acute GVHD. This review focuses on major scientific and clinical advances in the treatment of acute GVHD. PMID:23802653

  5. Epidemiological overview, advances in diagnosis, prevention, treatment and management of epithelial ovarian cancer in Mexico.

    PubMed

    Gallardo-Rincón, Dolores; Espinosa-Romero, Raquel; Muñoz, Wendy Rosemary; Mendoza-Martínez, Roberto; Villar-Álvarez, Susana Del; Oñate-Ocaña, Luis; Isla-Ortiz, David; Márquez-Manríquez, Juan Pablo; Apodaca-Cruz, Ángel; Meneses-García, Abelardo

    2016-04-01

    The epithelial ovarian cancer (EOC) has been underdiagnosed because it does not have a specific clinical presentation, and the signs and symptoms are similar to the irritable bowel syndrome and pelvic inflammatory disease. EOC is less common than breast and cervical cancer, but it is more lethal. On the whole, EOC has an early dissemination to peritoneal cavity, which delays a timely diagnosis and increases the rate of advanced diagnosed disease. The diagnosis usually surprises the women and the primary care physician. Therefore, it is necessary to count on prevention and early diagnosis programs. EOC has 80% response to surgical treatment, but nearly 70% of the patients may relapse in five years. The objectives of this document are presenting a summary of the EOC epidemiology and comment about advancements in prevention, diagnosis, and treatment of this cancer. That will raise awareness about the importance of this disease. PMID:27557390

  6. Advances in the diagnosis and treatment of non-small cell lung cancer.

    PubMed

    Pillai, Rathi N; Ramalingam, Suresh S

    2014-03-01

    The diagnostic and therapeutic landscape of non-small cell lung cancer (NSCLC) has changed dramatically in the past 50 years since the Surgeon General's report on smoking and lung cancer. Early detection is now a reality for lung cancer. The use of low-dose computed tomography scans for early detection decreases mortality and is beginning to be used in routine clinical practice. Technological advances such as positron emission tomography and endobronchial ultrasound have improved the accuracy of NSCLC staging. The cure rate for early-stage NSCLC has improved as a result of multimodality treatment approaches. The role of systemic therapy has also expanded to earlier stages of the disease. In recent years, the initial steps toward personalized medicine by utilization of targeted treatments based on tumor genotype have been undertaken. Emerging technological advances and greater insights into tumor biology are poised to greatly reduce the burden of lung cancer in the years to come. PMID:24516099

  7. 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

  8. Could BEACOPP be the new standard for the treatment of advanced Hodgkin's lymphoma (HL)?

    PubMed

    Diehl, V; Behringer, K

    2006-11-01

    In 1992, the German Hodgkin Study Group (GHSG) developed the BEACOPP regimen for further improving the outcome of patients with advanced Hodgkin's lymphoma (HL). Since then, BEACOPP has been introduced in 3 different prospective randomized clinical trials of the GHSG to find an equilibrium between maximal efficacy and least toxicity with the BEACOPP principle for the treatment of advanced stage HL. In the HD9 trial of the GHSG, with 1,186 patients, after a median observation time (mot) of 7 years, the rates for freedom from treatment failure (FFTF) are 85 percent, and for overall survival (OS) 90 percent for dose-escalated BEACOPP, and for COPP/ABVD (C/ABVD comparable to ABVD) the rate for FFTF is 67 percent, and for OS it is 79 percent. These superior BEACOPP results are obtained inspite of a higher rate of secondary AML/MDS in the esc. BEACOPP arm. The number of toxic deaths during treatment, however, was lower for esc. BEACOPP (1.6 percent) than for C/ABVD (1.8 percent). The majority of patients were treated in outpatient setting, in a multicenter study with more than 400 centers, including 120 private doctors, in Germany and 9 other European countries. The reduce acute and longterm toxicity, the GHSG started in the consecutive studies HD12 and HD15 for advanced stage HL to de-escalate BEACOPP by reducing the number of escalated BEACOPP cycles and by applying the baseline-dose BEACOPP, a time-dense regimen, called BEACOPP-14. The excellent results obtained with the BEACOPP principle challenge the seemingly global consensus that ABVD is the gold standard treatment strategy for advanced stage HL. PMID:17118782

  9. 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

  10. 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

  11. 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. PMID:27072331

  12. Differential patient-caregiver opinions of treatment and care for advanced lung cancer patients.

    PubMed

    Zhang, Amy Y; Zyzanski, Stephen J; Siminoff, Laura A

    2010-04-01

    This study examined the differences of opinion between cancer patients and caregivers with regard to treatment and care decisions. 184 advanced lung cancer patients and 171 primary caregivers were recruited as a convenience sample from hospitals in Cleveland, Ohio. A telephone interview was conducted to collect data using a semi-structured questionnaire. Nonparametric tests and regression analysis were performed. The findings showed that patients and caregivers reported significant disagreement on three main issues: trade-off between treatment side effects and benefits; reporting treatment side effects to physicians, and hospice care. Caregivers were more concerned about patient's quality of life and more willing to discuss hospice issues than were patients (p < or = 01). Perceived family disagreement is associated with depression in both patients and caregivers (p < or = 01; R(2)=8%). The study provided empirical evidence for patient-caregiver disagreement about treatment and care decisions and its significant adverse impact on both patients and caregivers. PMID:20137849

  13. Advances in Applying Treatment Integrity Research for Dissemination and Implementation Science: Introduction to Special Issue

    PubMed Central

    Southam-Gerow, Michael A.; McLeod, Bryce D.

    2013-01-01

    This special series focuses upon the ways in which research on treatment integrity, a multidimensional construct including assessment of the content and quality of a psychosocial treatment delivered to a client as well as relational elements, can inform dissemination and implementation science. The five articles for this special series illustrate how treatment integrity concepts and methods can be applied across different levels of the mental health service system to advance dissemination and implementation science. In this introductory article, we provide an overview of treatment integrity research and describe three broad conceptual models that are relevant to the articles in the series. We conclude with a brief description of each of the five articles in the series. PMID:23970819

  14. Predictive and preventive strategies to advance the treatments of cardiovascular and cerebrovascular diseases: the Ukrainian context

    PubMed Central

    2012-01-01

    Despite great efforts in treatments of cardiovascular diseases, the field requires innovative strategies because of high rates of morbidity, mortality and disability, indicating evident deficits in predictive vascular diagnosis and individualized treatment approaches. Talking about the vascular system, currently, physicians are not provided with integrated medical approaches to diagnose and treat vascular diseases. Only an individual global approach to the analysis of all segments in the vascular system of a patient allows finding the optimal way for vascular disease treatment. As for the existing methodology, there is a dominance of static methods such as X-ray contrast angiography and magnetic resonance imaging in angiomode. Taking into account the world experience, this article deals with innovative strategies, aiming at predictive diagnosis in vascular system, personalization of the biomedical treatment approaches, and targeted prevention of individual patient cohorts. Clinical examples illustrate the advances in corresponding healthcare sectors. Recommendations are provided to promote the field. PMID:23083430

  15. 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. PMID:27326977

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

    PubMed

    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

  17. 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

  18. Immunological Treatment Options for Locoregionally Advanced Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Mirandola, Leonardo; Bernardini, Giovanni; Cunha, Nicholas D’; Tijani, Lukman; Nguyen, Diane; Cordero, Joehassin; Jenkins, Marjorie R.; Cobos, Everardo; Kast, W. Martin; Chiriva-Internati, Maurizio

    2014-01-01

    Patients with squamous cell carcinoma of the head and neck (HNSCC) are usually treated by a multimodal approach with surgery and/or radiochemotherapy as the mainstay of local–regional treatment in cases with advanced disease. Both chemotherapy and radiation therapy have the disadvantage of causing severe side effects, while the clinical outcome of patients diagnosed with HNSCC has remained essentially unchanged over the last decade. The potential of immunotherapy is still largely unexplored. Here the authors review the current status of the art and discuss the future challenges in HNSCC treatment and prevention. PMID:22251006

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

    PubMed

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

    2015-04-01

    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. PMID:25636058

  20. 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. PMID:24965093

  1. Advanced treatment of biologically pretreated coking wastewater by a bipolar three-dimensional electrode reactor.

    PubMed

    Zhang, Chunhui; Lin, Hui; Chen, Jun; Zhang, Wenwen

    2013-01-01

    Electrochemical oxidation is a promising technology for the treatment ofbio-refractory wastewater. In this research, advanced treatment of coking wastewater which had previously undergone A/O (anaerobic-aerobic biological) treatment was investigated over Ti/RuO2 x IrO2 anode, stainless steel cathode and coke powder particle electrodes which were packed into the electrodes in a bipolar three-dimensional electrode reactor (BTDR). The results showed that the removal efficiency of COD and ammonia nitrogen increased with applied current density. The main influencing factors of BTDR were evaluated by an orthogonal test, including reaction time, plate distance, current density, plate amounts and aeration flow rate. With reaction time of 60 min, plate distance of 1.0 cm, current density of 20 mA/cm2 and plate amounts of four pairs, most of the contaminants in coking wastewater can be remediated by BTDR, which can then meet the discharge limit for coking wastewater in China. For organic pollutants, 12 kinds of organic pollutants can be completely removed, and the removal efficiencies of 11 kinds of organic pollutants are between 13.3 and 70.3% by advanced treatment with BTDR. We conclude that there is great potential for BTDR in engineering applications as a final treatment for coking wastewater. PMID:24350493

  2. 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. PMID:26173890

  3. Advanced oropharyngeal squamous cell carcinoma: Pathogenesis, treatment, and novel therapeutic approaches

    PubMed Central

    Swiecicki, Paul L; Malloy, Kelly M; Worden, Francis P

    2016-01-01

    Oropharyngeal cancer accounts for approximately 2.8% of newly cancer cases. Although classically a tobacco related disease, most cases today are related to infection with human papilloma virus (HPV) and present with locally advanced tumors. HPV related tumors have been recognized as a molecularly distinct entity with higher response rates to therapy, lower rates of relapse, and improved overall survival. Treatment of oropharyngeal cancer entails a multi-disciplinary approach with concomitant chemoradiation. The role of induction chemotherapy in locally advanced tumors continues to be controversial however large studies have demonstrated no difference in survival or time to treatment failure. Surgical approaches may be employed with low volume oropharyngeal cancers and with development new endoscopic tools, more tumors are able to be resected via an endoscopic approach. Given advances in the understanding of HPV related oropharyngeal cancer, ongoing research is looking at ways to minimize toxicities via de-intensification of therapy. Unfortunately, some patients develop recurrent or metastatic disease. Novel therapeutics are currently being investigated for this patient population including immunotherapeutics. This review discusses the current understanding of the pathogenesis of oropharyngeal cancer and treatment. We also discuss emerging areas of research as it pertains to de-intensification as well novel therapeutics for the management of metastatic disease. PMID:26862488

  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. 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. PMID:24873715

  6. Recent advances in the understanding and treatment of anxiety disorders. Resilience: determinants, measurement, and treatment responsiveness.

    PubMed

    Connor, Kathryn M; Zhang, Wei

    2006-10-01

    In human terms, resilience is an ability to cope with stress and varies with context, time, age, gender, and cultural origin. Resilience shifts the focus of psychological investigation onto increasing the positive rather than reducing the negative. Inquiry into resilience has evolved from descriptions of resilient qualities, to discovery of the process to attain resilience, to uncovering the motivation to reintegrate in a resilient manner. Much of the research on resilience has focused on children in settings such as family violence, extreme poverty, war, and natural disasters. A coherent pattern of characteristics associated with successful adaptation has emerged. Salient characteristics include commitment, dynamism, humor in the face of adversity, patience, optimism, faith, and altruism. As such, resilience may represent an important target of treatment in anxiety, depression, and stress reactions. Resilience can be quantified, but available measures need to be validated transculturally. There exist many possible determinants of resilience, including neurobiologic, genetic, temperament, and environmental influences. Resilience is modifiable on individual and cultural levels. Posttraumatic stress disorder is an example of a serious disorder associated with impaired stress coping that can improve with treatment. PMID:17008825

  7. Evaluation of water quality functions of conventional and advanced soil-based onsite wastewater treatment systems.

    PubMed

    Cooper, Jennifer A; Loomis, George W; Kalen, David V; Amador, Jose A

    2015-05-01

    Shallow narrow drainfields are assumed to provide better wastewater renovation than conventional drainfields and are used for protection of surface and ground water. To test this assumption, we evaluated the water quality functions of two advanced onsite wastewater treatment system (OWTS) drainfields-shallow narrow (SND) and Geomat (GEO)-and a conventional pipe and stone (P&S) drainfield over 12 mo using replicated ( = 3) intact soil mesocosms. The SND and GEO mesocosms received effluent from a single-pass sand filter, whereas the P&S received septic tank effluent. Between 97.1 and 100% of 5-d biochemical oxygen demand (BOD), fecal coliform bacteria, and total phosphorus (P) were removed in all drainfield types. Total nitrogen (N) removal averaged 12.0% for P&S, 4.8% for SND, and 5.4% for GEO. A mass balance analysis accounted for 95.1% (SND), 94.1% (GEO), and 87.6% (P&S) of N inputs. When the whole treatment train (excluding the septic tank) is considered, advanced systems, including sand filter pretreatment and SND or GEO soil-based treatment, removed 99.8 to 99.9% of BOD, 100% of fecal coliform bacteria and P, and 26.0 to 27.0% of N. In contrast, the conventional system removed 99.4% of BOD and 100% of fecal coliform bacteria and P but only 12.0% of N. All drainfield types performed similarly for most water quality functions despite differences in placement within the soil profile. However, inclusion of the pretreatment step in advanced system treatment trains results in better N removal than in conventional treatment systems despite higher drainfield N removal rates in the latter. PMID:26024275

  8. 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

  9. Evaluation of Water Quality Renovation by Advanced Soil-Based Wastewater Treatment Systems

    NASA Astrophysics Data System (ADS)

    Cooper, J.; Loomis, G.; Kalen, D.; Boving, T.; Morales, I.; DeLuca, J.; Amador, J.

    2013-12-01

    25% of US households utilize onsite wastewater treatment systems (OWTS) for wastewater management. Advanced technologies were designed to overcome the inadequate wastewater treatment by conventional OWTS in critical shallow water table areas, such as coastal zones, in order to protect ground water quality. In addition to the septic tank and soil drainfield that comprise a conventional OWTS, advanced systems claim improved water renovation with the addition of sand filtration, timed dosing controls, and shallow placement of the infiltrative zone. We determined water quality renovation functions under current water table and temperature conditions, in anticipation of an experiment to measure OWTS response to a climate change scenario of 30-cm increase in water table elevation and 4C temperature increase. Replicate (n=3) intact soil mesocosms were used to evaluate the effectiveness of drainfields with a conventional wastewater delivery (pipe-and-stone) compared to two types of pressurized, shallow narrow drainfield. Results under steady state conditions indicate complete removal of fecal coliform bacteria, phosphorus and BOD by all soil-based systems. By contrast, removal of total nitrogen inputs was 16% in conventional and 11% for both advanced drainfields. Effluent waters maintained a steady state pH between 3.2 - 3.7 for all technologies. Average DO readings were 2.9mg/L for conventional drainfield effluent and 4.6mg/L for advanced, showing the expected oxygen uptake with shallow placement of the infiltrative zone. The conventional OWTS is outperforming the advanced with respect to nitrogen removal, but renovating wastewater equivalently for all other contaminants of concern. The results of this study are expected to facilitate development of future OWTS regulation and planning guidelines, particularly in coastal zones and in the face of a changing climate.

  10. THE STRUCTURE AND ORIGIN OF SOLAR PLUMES: NETWORK PLUMES

    SciTech Connect

    Gabriel, A.; Tison, E.; Bely-Dubau, F.; Wilhelm, K.

    2009-07-20

    This study is based upon plumes seen close to the solar limb within coronal holes in the emission from ions formed in the temperature region of 1 MK, in particular, the band of Fe IX 171 A from EIT on the Solar and Heliospheric Observatory. It is shown, using geometric arguments, that two distinct classes of structure contribute to apparently similar plume observations. Quasi-cylindrical structures are anchored in discrete regions of the solar surface (beam plumes), and faint extended structures require integration along the line of sight (LOS) in order to reproduce the observed brightness. This second category, sometimes called 'curtains', are ubiquitous within the polar holes and are usually more abundant than the beam plumes, which depend more on the enhanced magnetic structures detected at their footpoints. It is here proposed that both phenomena are based on plasma structures in which emerging magnetic loops interact with ambient monopolar fields, involving reconnection. The important difference is in terms of physical scale. It is proposed that curtains are composed of a large number of microplumes, distributed along the LOS. The supergranule network provides the required spatial structure. It is shown by modeling that the observations can be reproduced if microplumes are concentrated within some 5 Mm of the cell boundaries. For this reason, we propose to call this second population 'network plumes'. The processes involved could represent a major contribution to the heating mechanism of the solar corona.

  11. Performance of an overland flow system for advanced treatment of wastewater plant effluent.

    PubMed

    Taebi, Amir; Droste, Ronald L

    2008-09-01

    Overland flow (OF) systems were evaluated and compared for advanced treatment of municipal and industrial effluents, including nutrients and nondegradable chemical oxygen demand (COD) removal. Three pilot plants were constructed at the Shahin Shahr Wastewater Treatment Plant (WWTP), Isfahan, Iran. Each pilot was assigned a specific wastewater and all were simultaneously operated for 8 months. Treatment of primary effluent, activated sludge secondary effluent, and lagoon effluent of textile wastewater was investigated at application rates (ARs) of 0.15, 0.25, and 0.35 m(3)m(-1)h(-1). During 5 months of stable operation after a 3-month acclimation period, mean removals of total 5-day biochemical oxygen demand (TBOD(5)), total COD (TCOD), total suspended solids (TSS), total nitrogen (TN), total phosphorus (TP) and turbidity were 74.5%, 54.8%, 66.2%, 39.4%, 35.8%, and 67.7% for primary effluent; 52.9%, 52.9%, 66.5%, 44.4%, 39.8%, and 50.1% for activated sludge effluent; 65.7%, 58.7%, 70.3%, 41.7%, 41.3%, and 54.9% for textile wastewater lagoon effluent, respectively. The model of Smith and Schroeder, 1985. Field studies of the overland flow process for the treatment of raw and primary treated municipal wastewater. Journal of Water Pollution Control Federation 57, 785-794] was satisfactory for TBOD(5). For all treatment parameters a standard first-order removal model was inadequate to represent the data but a modified first-order model provided a satisfactory fit to the data. Based on the results of this study, it can be concluded that an OF system as advanced treatment had the ability to meet effluent discharge permit limits and was an economical replacement for stabilization ponds and mechanical treatment options. PMID:17499907

  12. Could BEACOPP be the new standard for the treatment of advanced Hodgkin's lymphoma?

    PubMed

    Diehl, V; Behringer, K

    2006-01-01

    In 1992, the German Hodgkin Study Group (GHSG) developed the BEACOPP regimen for further improving the outcome of patients with advanced Hodgkin's lymphoma (HL). Since then, BEACOPP has been introduced in 3 different prospective randomized clinical trials of the GHSG to find an equilibrium between maximal efficacy and least toxicity with the BEACOPP principle for the treatment of advanced stage HL. In the HD9 trial of the GHSG, with 1,186 patients, after a median observation time of 7 years, the rates for FFTF are 85 percent and for overall survival 90 percent for dose-escalated BEACOPP, and for COPP/ABVD (C/ABVD comparable to ABVD) the rate for FFTF is 67 percent and for overall survival it is 79 percent. These superior BEACOPP results are obtained inspite of a higher rate of secondary AML/MDS in the escalated BEACOPP arm. The number of toxic deaths during treatment, however, was lower for escalated BEACOPP (1.6 percent) than for C/ABVD (1.8 percent). The majority of patients were treated in an outpatient setting, in a multicenter study with more than 400 centers, including 120 private doctors, located in Germany and 9 other European countries. To reduce acute and long-term toxicity, the GHSG started in the consecutive studies HD12 and HD15 for advanced stage HL to de-escalate BEACOPP by reducing the number of escalated BEACOPP cycles and by applying the baseline dose BEACOPP, a time dense regimen, called BEACOPP-14. The excellent results obtained with the BEACOPP principle challenge the seemingly global consensus that ABVD is the gold standard treatment strategy for advanced stage HL. PMID:16777701

  13. 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

  14. Recent evidence, advances, and current practices in surgical treatment of lung cancer.

    PubMed

    Suda, Kenichi; Sato, Katsuaki; Mizuuchi, Hiroshi; Kobayashi, Yoshihisa; Shimoji, Masaki; Tomizawa, Kenji; Takemoto, Toshiki; Iwasaki, Takuya; Sakaguchi, Masahiro; Mitsudomi, Tetsuya

    2014-11-01

    In the last 10-15 years, strategies and modalities of lung cancer treatment have changed dramatically. Meanwhile, the treatment objectives, the lung cancers themselves, have also changed, probably owing to early detection by computed tomography and aging of the population. In particular, the proportions of smaller lung cancers, lung adenocarcinomas with ground-glass opacity, and lung cancers in older patients are increasing. Along with these changes, surgeons have innovated and evaluated novel procedures for pulmonary resection. These include the application of minimally invasive surgical techniques, such as video-assisted thoracoscopic surgery (VATS) and robotic surgery, and sub-lobar resection, such as wedge resection and segmentectomy, for small peripheral lung cancers. Currently, VATS has gained wide acceptance and several institutions in Japan have started using robotic surgery for lung cancers. Two important clinical trials of sub-lobar resection for small peripheral lung cancers are now underway in Japan. In addition, surgery itself is of growing importance in lung cancer treatment. In particular, recent evidence supports the use of surgery in strictly selected patients with locally advanced disease, lung cancers with N2 lymph node metastases, small cell lung cancers, recurrent oligo-metastasis after pulmonary resection, or relapsed tumors after drug treatment. Surgical treatment also provides abundant tumor samples for molecular analysis, which can be used for drug selection in the adjuvant setting or after disease relapse. In the era of personalized treatment, surgery is still one of the most important treatment modalities to combat lung cancer. PMID:25453375

  15. 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. PMID:20939575

  16. Bevacizumab in the pre-operative treatment of locally advanced rectal cancer: A systematic review

    PubMed Central

    Fornaro, Lorenzo; Caparello, Chiara; Vivaldi, Caterina; Rotella, Virginia; Musettini, Gianna; Falcone, Alfredo; Baldini, Editta; Masi, Gianluca

    2014-01-01

    Despite advances in the management of patients with locally advanced, non-metastatic rectal adenocarcinoma (LARC), prognosis remains largely unsatisfactory due to a high rate of distant relapse. In fact, currently available neoadjuvant protocols, represented by fluoropyrimidine-based chemo-radiotherapy (CT-RT) or short-course RT, together with improved surgical techniques, have largely reduced the risk of local relapse, with limited impact on distant recurrence. Available results of phase III trials with additional cytotoxic agents combined with standard CT-RT are disappointing, as no significant reduction in the risk of recurrence has been demonstrated. In order to improve the control of micrometastatic disease, integrating targeted agents into neoadjuvant treatment protocols thus offers a rational approach. In particular, the antiangiogenic agent bevacizumab has demonstrated synergistic activity with both CT and RT in pre-clinical and clinical models, and thus may represent a suitable companion in the neoadjuvant treatment of LARC. Preliminary results of phase I-II clinical studies are promising and suggest potential clinical parameters and molecular predictive biomarkers useful for patient selection: treatment personalization is indeed the key in order to maximize the benefit while reducing the risk of more complex neoadjuvant treatment schedules. PMID:24876730

  17. 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

    2015-06-01

    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.

  18. 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

  19. 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

  20. 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

  1. MEK inhibitors and their potential in the treatment of advanced melanoma: the advantages of combination therapy

    PubMed Central

    Tran, Khiem A; Cheng, Michelle Y; Mitra, Anupam; Ogawa, Hiromi; Shi, Vivian Y; Olney, Laura P; Kloxin, April M; Maverakis, Emanual

    2016-01-01

    The treatment of melanoma has improved markedly over the last several years with the advent of more targeted therapies. Unfortunately, complex compensation mechanisms, such as those of the mitogen-activated protein kinase (MAPK) pathway, have limited the clinical benefit of these treatments. Recently, a better understanding of melanoma resistance mechanisms has given way to intelligently designed multidrug regimes. Herein, we review the extensive pathways of BRAF inhibitor (vemurafenib and dabrafenib) resistance. We also review the advantages of dual therapy, including the addition of an MEK inhibitor (cobimetinib or trametinib), which has proven to increase progression-free survival when compared to BRAF inhibitor monotherapy. Finally, this review touches on future treatment strategies that are being developed for advanced melanoma, including the possibility of triple therapy with immune checkpoint inhibitors and the work on optimizing sequential therapy. PMID:26730180

  2. 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. PMID:25711844

  3. 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

  4. Non-small cell lung cancer: current treatment and future advances

    PubMed Central

    Zappa, Cecilia

    2016-01-01

    Lung cancer has a poor prognosis; over half of people diagnosed with lung cancer die within one year of diagnosis and the 5-year survival is less than 18%. Non-small cell lung cancer (NSCLC) accounts for the majority of all lung cancer cases. Risk factors for developing NSCLC have been identified, with cigarette smoking being a major factor along with other environmental and genetic risk factors. Depending on the staging of lung cancer, patients are eligible for certain treatments ranging from surgery to radiation to chemotherapy as well as targeted therapy. With the advancement of genetics and biomarkers testing, specific mutations have been identified to better target treatment for individual patients. This review discusses current treatments including surgery, chemotherapy, radiotherapy, and immunotherapy as well as how biomarker testing has helped improve survival in patients with NSCLC. PMID:27413711

  5. Treatment of advanced thyroid cancer with targeted therapies: ten years of experience.

    PubMed

    Viola, David; Valerio, Laura; Molinaro, Eleonora; Agate, Laura; Bottici, Valeria; Biagini, Agnese; Lorusso, Loredana; Cappagli, Virginia; Pieruzzi, Letizia; Giani, Carlotta; Sabini, Elena; Passannati, Paolo; Puleo, Luciana; Matrone, Antonio; Pontillo-Contillo, Benedetta; Battaglia, Valentina; Mazzeo, Salvatore; Vitti, Paolo; Elisei, Rossella

    2016-04-01

    Thyroid cancer is rare, but it is the most frequent endocrine malignancy. Its prognosis is generally favorable, especially in cases of well-differentiated thyroid cancers (DTCs), such as papillary and follicular cancers, which have survival rates of approximately 95% at 40 years. However, 15-20% of cases became radioiodine refractory (RAI-R), and until now, no other treatments have been effective. The same problems are found in cases of poorly differentiated (PDTC) and anaplastic (ATC) thyroid cancers and in at least 30% of medullary thyroid cancer (MTC) cases, which are very aggressive and not sensitive to radioiodine. Tyrosine kinase inhibitors (TKIs) represent a new approach to the treatment of advanced cases of RAI-R DTC, MTC, PDTC, and, possibly, ATC. In the past 10 years, several TKIs have been tested for the treatment of advanced, progressive, and RAI-R thyroid tumors, and some of them have been recently approved for use in clinical practice: sorafenib and lenvatinib for DTC and PDTC and vandetanib and cabozantinib for MTC. The objective of this review is to present the current status of the treatment of advanced thyroid cancer with the use of innovative targeted therapies by describing both the benefits and the limits of their use based on the experiences reported so far. A comprehensive analysis and description of the molecular basis of these therapies, as well as new therapeutic perspectives, are reported. Some practical suggestions are given for both the choice of patients to be treated and their management, with particular regard to the potential side effects. PMID:27207700

  6. Staging laparoscopy improves treatment decision-making for advanced gastric cancer

    PubMed Central

    Hu, Yan-Feng; Deng, Zhen-Wei; Liu, Hao; Mou, Ting-Yu; Chen, Tao; Lu, Xin; Wang, Da; Yu, Jiang; Li, Guo-Xin

    2016-01-01

    AIM: To evaluate the clinical value of staging laparoscopy in treatment decision-making for advanced gastric cancer (GC). METHODS: Clinical data of 582 patients with advanced GC were retrospectively analyzed. All patients underwent staging laparoscopy. The strength of agreement between computed tomography (CT) stage, endoscopic ultrasound (EUS) stage, laparoscopic stage, and final stage were determined by weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted. A χ2 test was used to analyze the correlation between peritoneal metastasis or positive cytology and clinical characteristics. RESULTS: Among the 582 patients, the distributions of pathological T classifications were T2/3 (153, 26.3%), T4a (262, 45.0%), and T4b (167, 28.7%). Treatment plans for 211 (36.3%) patients were changed after staging laparoscopy was performed. Two (10.5%) of 19 patients in M1 regained the opportunity for potential radical resection by staging laparoscopy. Unnecessary laparotomy was avoided in 71 (12.2%) patients. The strength of agreement between preoperative T stage and final T stage was in almost perfect agreement (Kw = 0.838; 95% confidence interval (CI): 0.803-0.872; P < 0.05) for staging laparoscopy; compared with CT and EUS, which was in fair agreement. The strength of agreement between preoperative M stage and final M stage was in almost perfect agreement (Kw = 0.990; 95% CI: 0.977-1.000; P < 0.05) for staging laparoscopy; compared with CT, which was in slight agreement. Multivariate analysis revealed that tumor size (≥ 40 mm), depth of tumor invasion (T4b), and Borrmann type (III or IV) were significantly correlated with either peritoneal metastasis or positive cytology. The best performance in diagnosing P-positive was obtained when two or three risk factors existed. CONCLUSION: Staging laparoscopy can improve treatment decision-making for advanced GC and decrease unnecessary exploratory laparotomy. PMID:26855545

  7. 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.

  8. Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer.

    PubMed

    Jordens, Christopher F C; Morrell, Bronwen; Harnett, Paul; Hobbs, Kim; Mason, Catherine; Kerridge, Ian H

    2010-11-01

    Post-treatment surveillance of advanced ovarian cancer involves regular testing of asymptomatic patients using the CA125 test. This practice is based on a rationale that is not supported by evidence from clinical trials. This paper aims to stimulate critical reflection concerning the effect of investigative tests on clinical decisions and interactions, and the experience of illness, particularly in the context of advanced malignant disease. Drawing on the idea of the "medical gaze", and building on previous health communication research, we present an analysis of in-depth interviews and psychometric tests collected in a prospective study of 20 Australian women with advanced ovarian cancer conducted between 2006 and 2009. We describe the demands placed on patients by the use of the CA125 test, some hazards it creates for decision-making, and some of the test's subjective benefits. It is widely believed that the CA125 test generates anxiety among patients, and the proposed solution is to educate women more about the test. We found no evidence that anxiety was a problem requiring a response over and above existing services. We conclude that the current debate is simplistic and limited. Focussing on patient anxiety does not account for other important effects of post-treatment surveillance, and educating patients about the test is unlikely to mitigate anxiety because testing is part of a wider process by which patients become aware of a disease that--once it has relapsed--will certainly kill them in the near future. PMID:20832155

  9. 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

  10. 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...

  11. Tomographic reconstruction of polar plumes

    NASA Astrophysics Data System (ADS)

    Auchère, F.; Guennou, C.; Barbey, N.

    2012-06-01

    We present a tomographic reconstruction of polar plumes as observed in the Extreme Ultraviolet in January 2010. Plumes are elusive structures visible in polar coronal holes that may play an important role in the acceleration of the solar wind. However, despite numerous observations, little is irrefutably known about them. Because of line of sight effects, even their geometry is subject to debate. Are they genuine cylindrical features of the corona or are they only chance alignments along the line of sight? Tomography provides a means to reconstruct the volume of an optically thin object from a set of observations taken from different vantage points. In the case of the Sun, these are typically obtained by using a solar rotation worth of images, which limits the ability to reconstruct short lived structures. We present here a tomographic inversion of the solar corona obtained using only 6 days of data. This is achieved by using simultaneously three space telescopes (EUVI/STEREO and SWAP/PROBA2) in a very specific orbital configuration. The result is the shortest possible tomographic snapshot of polar plumes. The 3D reconstruction shows both quasi-cylindrical plumes and a network pattern that can mimic them by line of sight superimpositions. This suggests that the controversy on plume geometry is due to the coexistence of both types of structures.

  12. 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

  13. Membrane bio-reactor for advanced textile wastewater treatment and reuse.

    PubMed

    Lubello, C; Gori, R

    2004-01-01

    Textile wastewater contains slowly- or non-biodegradable organic substances whose removal or transformation calls for advanced tertiary treatments downstream Activated Sludge Treatment Plants (ASTP). This work is focused on the treatment of textile industry wastewater using Membrane Bio-reactor (MBR) technology. An experimental activity was carried out at the Baciacavallo Wastewater Treatment Plant (WWTP) (Prato, Italy) to verify the efficiency of a pilot-scale MBR for the treatment of municipal wastewater, in which textile industry wastewater predominates. In the Baciacavallo WWTP the biological section is followed by a coagulation-flocculation treatment and ozonation. During the 5 months experimental period, the pilot-scale MBR proved to be very effective for wastewater reclamation. On average, removal efficiency of the pilot plant (93% for COD, 96% for ammonium and 99% for total suspended solids) was higher than the WWTP ones. Color was removed as in the WWTP. Anionic surf actants removal of pilot plant and WWTP were very similar (92.5 and 93.3% respectively), while the non-ionic surfactants removal was higher in the pilot plant (99.2 vs. 97.1). In conclusion the MBR technology demonstrated to be effective for textile wastewater reclamation, leading both to an improvement of pollutants removal and to a draw-plate simplification. PMID:15344781

  14. 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.

  15. Combination of Advanced Oxidation Processes and biological treatments for wastewater decontamination--a review.

    PubMed

    Oller, I; Malato, S; Sánchez-Pérez, J A

    2011-09-15

    Nowadays there is a continuously increasing worldwide concern for development of alternative water reuse technologies, mainly focused on agriculture and industry. In this context, Advanced Oxidation Processes (AOPs) are considered a highly competitive water treatment technology for the removal of those organic pollutants not treatable by conventional techniques due to their high chemical stability and/or low biodegradability. Although chemical oxidation for complete mineralization is usually expensive, its combination with a biological treatment is widely reported to reduce operating costs. This paper reviews recent research combining AOPs (as a pre-treatment or post-treatment stage) and bioremediation technologies for the decontamination of a wide range of synthetic and real industrial wastewater. Special emphasis is also placed on recent studies and large-scale combination schemes developed in Mediterranean countries for non-biodegradable wastewater treatment and reuse. The main conclusions arrived at from the overall assessment of the literature are that more work needs to be done on degradation kinetics and reactor modeling of the combined process, and also dynamics of the initial attack on primary contaminants and intermediate species generation. Furthermore, better economic models must be developed to estimate how the cost of this combined process varies with specific industrial wastewater characteristics, the overall decontamination efficiency and the relative cost of the AOP versus biological treatment. PMID:20956012

  16. [Advances on Extrocorporeal Photochemotherapy in the Treatment of Chronic Graft-Versus-Host Disease].

    PubMed

    Chen, Run-Zhe; Chen, Bao-An; Cheng, Jian

    2015-08-01

    Chronic graft-versus-host disease (cGVHD) is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT), which is also one of the major causes of patients' death following transplantation. Recently, extracorporeal photochemotherapy (ECP) has shown a considerable efficacy in cGVHD treatment, which is based on the infusion of autologous peripheral blood mononuclear cells collected by aphesis, incubated with the photoactivable drug 8-methoxypsoralen (8-MOP) and UV-A irradiation. The therapeutic effect of ECP is mainly achieved by the induction of cell apoptosis, influencing the function of dendritic cells and the induction of immune tolerance. ECP has many advantages in the treatment of cGVHD, such as no increasing the risk of infection in patients, unaffecting the graft-versus-leukemia effect, nearly no side effect and so on. Many medical centers have done a lot of research on the treatment of cGVHD in both children and adults by using ECP and achieved good results. CD19(+) CD21(-) B lymphocytes, serum BAFF and serum TNFα can be used to measure and early evaluate the efficacy of ECP treatment. The effect of ECP is associated with many factors, and certain complications may occur during the treatment. At present, the application of ECP treatment is limited by the unclear mechanisms, varying treatment cycles in different studies, and small number of patients in clinical research. In the near future, with deeper basic research, increasing the case number and standard clinical treatment, ECP will have a more extensive application prospects. This review focuses mainly on the clinical advances of ECP in the treatment of cGVHD. PMID:26314474

  17. Technical advances in endoscopic ultrasound-guided fiducial placement for the treatment of pancreatic cancer

    PubMed Central

    Chavalitdhamrong, Disaya; DiMaio, Christopher J.; Siersema, Peter D.; Wagh, Mihir S.

    2015-01-01

    Radiation therapy has an important role in the treatment of locally advanced or metastatic pancreatic cancer and can be used alone or in conjunction with surgery and/or systemic chemotherapy. Because of the challenge of delivering an accurate and optimal radiation dose, image-guided radiation therapy can be used to improve targeting. Fiducial markers can be placed in the tumor and used for localization in patients undergoing image-guided radiation therapy. The safety and feasibility of endoscopic ultrasound (EUS)-guided placement of fiducials has been assessed and reported for the management of pancreatic cancer. We herein review the technique, efficacy, and safety profile of EUS-guided fiducial placement. In addition, we highlight recent advances and technological upgrades in EUS-guided fiducial delivery systems for pancreatic cancer most relevant to practicing gastroenterologists and interventional endoscopists. PMID:26355267

  18. 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.

  19. HeartWare left ventricular assist device for the treatment of advanced heart failure.

    PubMed

    Hanke, Jasmin S; Rojas, Sebastian V; Avsar, Murat; Bara, Christoph; Ismail, Issam; Haverich, Axel; Schmitto, Jan D

    2016-01-01

    The importance of mechanical circulatory support in the therapy of advanced heart failure is steadily growing. The rapid developments in the field of mechanical support are characterized by continuous miniaturization and enhanced performance of the assist devices, providing increased pump durability and prolonged patient survival. The HeartWare left ventricular assist device system (HeartWare Inc., Framingham, MA, USA) is a mechanical ventricular assist device with over 8000 implantations worldwide. Compared with other available assist devices it is smaller in size and used in a broad range of patients. The possibility of minimally invasive procedures is one of the major benefits of the device - allowing implants and explants, as well as exchanges of the device with reduced surgical impact. We present here a review of the existing literature on the treatment of advanced heart failure using the HeartWare left ventricular assist device system. PMID:26597386

  20. Technical advances in endoscopic ultrasound-guided fiducial placement for the treatment of pancreatic cancer.

    PubMed

    Chavalitdhamrong, Disaya; DiMaio, Christopher J; Siersema, Peter D; Wagh, Mihir S

    2015-08-01

    Radiation therapy has an important role in the treatment of locally advanced or metastatic pancreatic cancer and can be used alone or in conjunction with surgery and/or systemic chemotherapy. Because of the challenge of delivering an accurate and optimal radiation dose, image-guided radiation therapy can be used to improve targeting. Fiducial markers can be placed in the tumor and used for localization in patients undergoing image-guided radiation therapy. The safety and feasibility of endoscopic ultrasound (EUS)-guided placement of fiducials has been assessed and reported for the management of pancreatic cancer. We herein review the technique, efficacy, and safety profile of EUS-guided fiducial placement. In addition, we highlight recent advances and technological upgrades in EUS-guided fiducial delivery systems for pancreatic cancer most relevant to practicing gastroenterologists and interventional endoscopists. PMID:26355267

  1. 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.

  2. 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

  3. Recent advances in the treatment of adult T-cell leukemia-lymphomas

    PubMed Central

    Utsunomiya, Atae; Choi, Ilseung; Chihara, Dai; Seto, Masao

    2015-01-01

    Recent advances in treatment for adult T-cell leukemia-lymphoma (ATL) are reviewed herein. It is currently possible to select a therapeutic strategy for ATL and predict prognosis by classification of patients by clinical subtypes and clinicopathological factors. Although the overall survival (OS) of patients with ATL has increased marginally because of advances in chemotherapy, further prolongation of survival might be difficult with conventional chemotherapy alone. Promising results have been reported for antiviral therapy using zidovudine and interferon-α, and, indeed, antiviral therapy is currently the standard treatment for patients with ATL in western countries. Remarkably, the 5-year OS rates are 100% for both the smoldering-type and chronic-type ATL. Recently, treatments for ATL have included allogeneic hematopoietic stem cell transplantation and molecular targeted therapies. Furthermore, the anti-CCR4 monoclonal antibody mogamulizumab has been shown to have marked cytotoxic effects on ATL cells, especially in the leukemic type of ATL. In the lymphoma type of ATL, the response rate may be improved by combining mogamulizumab with chemotherapy. It should be recognized that prevention of infection from carriers of human T-cell leukemia virus type-I and transfer of the virus from mother to infant are crucial issues for the eradication of ATL. PMID:25613789

  4. Advancements in Non-steroidal Antiandrogens as Potential Therapeutic Agents for the Treatment of Prostate Cancer.

    PubMed

    Kaur, Paranjeet; Khatik, Gopal L

    2016-01-01

    Prostate cancer (PCa) is a leading cause of death in men worldwide. The main reason for the progression of prostate cancer is identified as over activation of androgen receptor (AR) through androgens. Its development can be diagnosed by monitoring the prostate specific antigen (PSA). Treatment of PCa includes prostatectomy, radiotherapy, and chemotherapy, among them chemotherapy is normally employed in early and advanced prostate cancer. Chemotherapy mainly includes two classes of drugs which are steroidal and non-steroidal antiandrogens. The non-steroidal classes of compounds are preferred over steroidal because they are relatively safe, cost effective and diverse. Non-steroidal drugs are commonly used for the treatment of PCa, however these drugs are associated with serious side effects and acquired resistance. So researchers are working in the direction to develop better analogue which can address the issue related to resistant type of prostate cancer. This review discusses the advancement in the non-steroidal antiandrogens which offers a better potential in the treatment of prostate cancer. PMID:26776222

  5. Advanced sludge treatment affects extracellular polymeric substances to improve activated sludge dewatering.

    PubMed

    Neyens, Elisabeth; Baeyens, Jan; Dewil, Raf; De heyder, Bart

    2004-01-30

    The management of wastewater sludge, now often referred to as biosolids, accounts for a major portion of the cost of the wastewater treatment process and represents significant technical challenges. In many wastewater treatment facilities, the bottleneck of the sludge handling system is the dewatering operation. Advanced sludge treatment (AST) processes have been developed in order to improve sludge dewatering and to facilitate handling and ultimate disposal. The authors have extensively reported lab-scale, semi-pilot and pilot investigations on either thermal and thermochemical processes, or chemical oxidation using hydrogen peroxide. To understand the action of these advanced sludge technologies, the essential role played by extracellular polymeric substances (EPS) needs to be understood. EPS form a highly hydrated biofilm matrix, in which the micro-organisms are embedded. Hence they are of considerable importance in the removal of pollutants from wastewater, in bioflocculation, in settling and in dewatering of activated sludge. The present paper reviews the characteristics of EPS and the influence of thermochemical and oxidation mechanisms on degradation and flocculation of EPS. Experimental investigations on waste activated sludge are conducted by the authors to evaluate the various literature findings. From the experiments, it is concluded that AST methods enhance cake dewaterability in two ways: (i) they degrade EPS proteins and polysaccharides reducing the EPS water retention properties; and (ii) they promote flocculation which reduces the amount of fine flocs. PMID:15177096

  6. Selecting the best strategy of treatment in newly diagnosed advanced-stage ovarian cancer patients

    PubMed Central

    Minig, Lucas; Zorrero, Cristina; Iserte, Pablo Padilla; Poveda, Andres

    2015-01-01

    Although it is assumed that the combination of chemotherapy and radical surgery should be indicated in all newly diagnosed advanced-stage ovarian cancer patients, one of the main raised questions is how to select the best strategy of initial treatment in this group of patients, neoadjuvant chemotherapy followed by interval debulking surgery or primary debulking surgery followed by adjuvant chemotherapy. The selection criteria to offer one strategy over the other as well as a stepwise patient selection for initial treatment are described. Selecting the best strategy of treatment in newly diagnosed advanced stage ovarian cancer patients is a multifactorial and multidisciplinary decision. Several factors should be taken into consideration: (1) the disease factor, related to the extension and localization of the disease as well as tumor biology; (2) the patient factor, associated with patient age, poor performance status, and co-morbidities; and (3) institutional infrastructure factor, related to the lack of prolonged operative time, an appropriate surgical armamentarium, as well as well-equipped intensive care units with well-trained personnel. PMID:26713279

  7. Lidar sounding of volcanic plumes

    NASA Astrophysics Data System (ADS)

    Fiorani, Luca; Aiuppa, Alessandro; Angelini, Federico; Borelli, Rodolfo; Del Franco, Mario; Murra, Daniele; Pistilli, Marco; Puiu, Adriana; Santoro, Simone

    2013-10-01

    Accurate knowledge of gas composition in volcanic plumes has high scientific and societal value. On the one hand, it gives information on the geophysical processes taking place inside volcanos; on the other hand, it provides alert on possible eruptions. For this reasons, it has been suggested to monitor volcanic plumes by lidar. In particular, one of the aims of the FP7 ERC project BRIDGE is the measurement of CO2 concentration in volcanic gases by differential absorption lidar. This is a very challenging task due to the harsh environment, the narrowness and weakness of the CO2 absorption lines and the difficulty to procure a suitable laser source. This paper, after a review on remote sensing of volcanic plumes, reports on the current progress of the lidar system.

  8. 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

  9. 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

  10. 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).

  11. Scalable hardbody and plume optical signatures

    NASA Astrophysics Data System (ADS)

    Crow, Dennis R.; Hawes, Fred; Braunstein, Matthew; Coker, Charles F.; Smith, Thomas, Jr.

    2004-08-01

    The Fast Line-of-sight Imagery for Target and Exhaust Signatures (FLITES) is a High Performance Computing (HPC-CHSSI) and Missile Defense Agency (MDA) funded effort that provides a scalable program to compute highly resolved temporal, spatial, and spectral hardbody and plume optical signatures. Distributed processing capabilities are included to allow complex, high fidelity, solutions to be generated quickly generated. The distributed processing logic includes automated load balancing algorithms to facilitate scalability using large numbers of processors. To enhance exhaust plume optical signature capabilities, FLITES employs two different radiance transport algorithms. The first algorithm is the traditional Curtis-Godson bandmodel approach and is provided to support comparisons to historical results and high-frame rate production requirements. The second algorithm is the Quasi Bandmodel Line-by-line (QBL) approach, which uses randomly placed "cloned" spectral lines to yield highly resolved radiation spectra for increased accuracy while maintaining tractable runtimes. This capability will provide a significant advancement over the traditional SPURC/SIRRM radiance transport methodology.

  12. Docetaxel combined with intraperitoneal hyperthermic perfusion chemotherapy and hyperthermia in the treatment of advanced ovarian cancer

    PubMed Central

    ZHANG, TING; PAN, QIONG; XIAO, SONGSHU; LI, LIJIE; XUE, MIN

    2016-01-01

    Ovarian cancer is a clinical type of gynecological malignant tumor with poor prognosis and a high mortality rate. At present, the primary treatment method used is surgery, with chemotherapy as an ajdunctive therapy. Thus, new short-term treatments should be identified. The aim of the present study was to investigate the short-term curative effects and safety of docetaxel combined with intraperitoneal cisplatin chemotherapy and hyperthermia treatment of advanced ovarian cancer. A total of 112 cases of advanced (stage III–IV) ovarian cancer patients confirmed by clinical diagnosis between October 2014 and December 2015 were included in the study. The patients were randomly divided into the study and control groups (n=56 cases). The control group was treated with docetaxel and intraperitoneal cisplatin hyperthermic perfusion chemotherapy, while the study group was treated with docetaxel venous chemotherapy and intraperitoneal cisplatin cyclical hyperthermic perfusion chemotherapy with BR-TRG-1 body cavity hyperthermic perfusion treatment system. Clinical treatment results for short-term curative effects and adverse reactions were compared and analyzed 8 weeks after treatment. The total effective rate of the study and control groups were 87.5 and 62.5%, respectively, and the difference was statistically significant (P<0.05). The controlled rate of ascites, remission rate of tumor and descent rate of CA125 of patients in the study group were better than patients in the control group (P<0.05). The rate of adverse reactions of patients in the study group was 39.3%, and the grade of toxicity was from I to II, while the rate of adverse reactions of patients in the control group was 55.4%, and the grade of toxicity was from II to III. The difference between the two groups was statistically significant (P<0.05). In conclusion, applying the combination of docetaxel, intraperitoneal cisplatin hyperthermic perfusion chemotherapy and hyperthermia to treat advanced ovarian

  13. 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

  14. 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

  15. 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.

  16. 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

  17. Recent Advances in the Diagnosis and Treatment of Clostridium Difficile Infection

    PubMed Central

    Avila, Meera B.; Avila, Nathaniel P.; Dupont, Andrew W.

    2016-01-01

    Clostridium difficile infection (CDI) has become the most frequently reported health care-associated infection in the United States [1]. As the incidence of CDI rises, so too does the burden it produces on health care and society. In an attempt to decrease the burden of CDI and provide the best outcomes for patients affected by CDI, there have been many recent advancements in the understanding, diagnosis, and management of CDI. In this article, we review the current recommendations regarding CDI testing and treatment strategies. PMID:26918176

  18. 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.

  19. Treatment experience: locally advanced sarcomas with 15 MeV fast neutrons

    SciTech Connect

    Ornitz, R.; Herskovic, A.; Schell, M.; Fender, F.; Rogers, C.C.

    1980-06-01

    Experience with ten evaluable osseous sarcomas and ten evaluable advanced soft tissue sarcomas treated with neutrons of a mean neutron energy of 15 MeV are described. Neutron irradiation with or without conventional megavoltage radiotherapy is an effective modality in the treatment of these patients. No correlation between response rate and grade or whether fast neutrons alone or combined with megavoltage radiotherapy was noted. Those patients receiving a neutron dose of 2195 neutron plus gamma rads or greater all had a complete response.

  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; 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.

  1. 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

  2. Nanovectors for anti-cancer drug delivery in the treatment of advanced pancreatic adenocarcinoma.

    PubMed

    Hsueh, Chung-Tzu; Selim, Julie H; Tsai, James Y; Hsueh, Chung-Tsen

    2016-08-21

    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

  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

    1999-05-11

    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.

  4. Advances in the use of nanocarriers for cancer diagnosis and treatment.

    PubMed

    Vieira, Débora Braga; Gamarra, Lionel Fernel

    2016-03-01

    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

  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

    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.

  6. 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.

  7. 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

  8. Advances in targeted therapy for the treatment of patients with relapsed/refractory multiple myeloma.

    PubMed

    Le Ray, Emmanuelle; Jagannath, Sundar; Palumbo, Antonio

    2016-01-01

    The development of proteasome inhibitors (PIs) and immunomodulatory drugs has significantly improved outcomes for patients with relapsed/refractory multiple myeloma (RRMM); however, not all patients benefit from treatment with these agents and some patients can become drug refractory over time. Due to the largely incurable nature of multiple myeloma, the development of newer agents is ongoing and includes new oral PIs (ixazomib), immunotherapies (e.g., CD38- or SLAMF7-targeted antibodies), and small molecules. This review provides an overview of the advances in targeted therapy for patients with RRMM, including recently approved agents, with a focus on monotherapy and combined targeted therapies. PMID:26558304

  9. Advancing Alzheimer's disease diagnosis, treatment, and care: recommendations from the Ware Invitational Summit.

    PubMed

    Naylor, Mary D; Karlawish, Jason H; Arnold, Steven E; Khachaturian, Ara S; Khachaturian, Zaven S; Lee, Virginia M-Y; Baumgart, Matthew; Banerjee, Sube; Beck, Cornelia; Blennow, Kaj; Brookmeyer, Ron; Brunden, Kurt R; Buckwalter, Kathleen C; Comer, Meryl; Covinsky, Kenneth; Feinberg, Lynn Friss; Frisoni, Giovanni; Green, Colin; Guimaraes, Renato Maia; Gwyther, Lisa P; Hefti, Franz F; Hutton, Michael; Kawas, Claudia; Kent, David M; Kuller, Lewis; Langa, Kenneth M; Mahley, Robert W; Maslow, Katie; Masters, Colin L; Meier, Diane E; Neumann, Peter J; Paul, Steven M; Petersen, Ronald C; Sager, Mark A; Sano, Mary; Schenk, Dale; Soares, Holly; Sperling, Reisa A; Stahl, Sidney M; van Deerlin, Vivianna; Stern, Yaakov; Weir, David; Wolk, David A; Trojanowski, John Q

    2012-09-01

    To address the pending public health crisis due to Alzheimer's disease (AD) and related neurodegenerative disorders, the Marian S. Ware Alzheimer Program at the University of Pennsylvania held a meeting entitled "State of the Science Conference on the Advancement of Alzheimer's Diagnosis, Treatment and Care," on June 21-22, 2012. The meeting comprised four workgroups focusing on Biomarkers; Clinical Care and Health Services Research; Drug Development; and Health Economics, Policy, and Ethics. The workgroups shared, discussed, and compiled an integrated set of priorities, recommendations, and action plans, which are presented in this article. PMID:22959699

  10. 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.

  11. TREATMENT OF METAL-LADEN HAZARDOUS WASTES WITH ADVANCED CLEAN COAL TECHNOLOGY BY-PRODUCTS

    SciTech Connect

    James T. Cobb, Jr.; Ronald D. Neufeld; Jana Agostini

    1999-04-28

    This thirteenth quarterly report describes work done during the thirteenth 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.

  12. 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.

  13. Recent advances in the treatment of mantle cell lymphoma: a post-ASH 2009 discussion.

    PubMed

    Czuczman, Myron S; Leonard, John P; Williams, Michael E

    2010-04-01

    Mantle cell lymphoma (MCL) is a rare subtype of non-Hodgkin lymphoma characterized by CD5 expression and a t(11;14) cytogenetic translocation that results in overexpression of the cyclin D1 gene. Currently, there is no standard of care for the treatment of MCL, and patient prognosis is poor. Traditional treatments for MCLrely on conventional chemotherapy agents, including cyclophosphamide, doxorubicin, vincristine, and prednisone(CHOP). The addition of the immunotherapeutic agent rituximab to this regimen (CHOP-R) has helped to improve patient response to treatment. These treatments often provide good initial responses that are difficult to sustain. Therefore, a number of newer agents and combinations have been investigated to produce more durable benefit. Several of these advances were reported at the 51st American Society of Hematology (ASH)Annual Meeting and Exposition, held December 5-8, 2009 in New Orleans, Louisiana. In this clinical roundtable monograph, new strategies in the treatment of MCL are discussed. Some of the drug classes examined here are proteasome inhibitors, inhibitors of the protein mammalian target of rapamycin (mTOR), the unique alkylating agent bendamustine, and immunomodulatory agents. PMID:20552750

  14. 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.

  15. 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

  16. 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. PMID:25926073

  17. The primary treatment of advanced vocal cord cancer: laryngectomy or radiotherapy

    SciTech Connect

    van den Bogaert, W.; Ostyn, F.; van der Schueren, E.

    1983-03-01

    When different treatment modalities yield equal results in cancer treatment, the least mutilating is preferred. If results are different, however, the survival rate after treatment must be weighed against the quality of life. Considerable controversy exists concerning the primary treatment modality for advanced glottic cancer, with some authors defending surgery (with or without radiotherapy) and others defending radiotherapy as sole treatment, with laryngectomy reserved for local failures. From a group of 102 patients with T3 and T4 tumors, 65 were treated with a laryngectomy. Uncorrected survival at 5 years was 48%, local control was 75%. A group of 35 patients were treated with radiotherapy. Survival was 22% at 5 years, local control 23%, with rescue surgery 37%. These unfavorable results are related to the negative selection of patients for radiotherapy (inoperable, bad cooperation). In 14 patients who were operable but refused laryngectomy the final local control was 53%, with voice preservation in 34%; survival, however, remained low (27% at 5 years). Primary surgery seems to provide better chances for ultimate survival than radiotherapy alone. At the moment, it is not yet clear if a proportion of patients can be selected for whom a more conservative attitude can be allowed, with laryngectomy reserved for poor regression or recurrences after radiotherapy.

  18. 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

  19. [Treatment of advanced non-small-cell lung cancer with driver mutations].

    PubMed

    Tessmer, Antje; Kollmeier, Jens

    2015-03-01

    Advanced non-small-cell lung cancer is no longer one disease but the collective name for different diseases defined by clinical, histological, immunohistochemical and, to an increasing extent, molecular biomarkers. This article deals with the treatment options we gained by identifying so called driver mutations in a growing subset of these cancers. For patients whose tumors are characterized by a targetable molecular alteration such as an activating EGFR-Mutation, an ALK-translocation or a ROS1-rearrangement, we see prolonged survival and oral treatments with tyrosine kinase inhibitors demonstrate superiority to chemotherapy in terms of response (remission rate), progression free survival and quality of life. We provide a review of the literature and discuss the status quo of the diagnostic need and the therapeutic options in Germany and Europe. PMID:25734673

  20. Advances in research on and diagnosis and treatment of achondroplasia in China

    PubMed Central

    Wang, Yao; Liu, Zeying; Liu, Zhenxing; Zhao, Heng; Zhou, Xiaoyan; Cui, Yazhou; Han, Jinxiang

    2013-01-01

    Summary Achondroplasia is a rare autosomal dominant genetic disease. Research on achondroplasia in China, however, has received little emphasis. Around 80–90% of cases of neonatal achondroplasia result from mutations in fibroblast growth factor receptor 3 (FGFR3) according to polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). Recently, genetic research on achondroplasia in China made a major breakthrough by revealing two novel mutations located on the FGFR3 gene, thus helping to complete the pathological molecular map of achondroplasia. There are still, however, unknown aspects of the diagnosis and treatment of achondroplasia. This review will summarize advances in research on and the clinical diagnosis and treatment of achondroplasia in China. PMID:25343101

  1. 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. PMID:25218660

  2. Advances in intravesical therapy for the treatment of non-muscle invasive bladder cancer (Review).

    PubMed

    Weintraub, Michael D; Li, Qingdi Quentin; Agarwal, Piyush K

    2014-09-01

    The knowledge of tumor biology and the biomechanical properties of the urothelium have led to significant advances in the development of intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC). Targeted therapy improves the efficacy and decreases the side effects of antineoplastic agents. Nanoparticles that target antitumor agents to the urothelial cells have allowed for improved delivery of these agents to tumor cells. Gene therapy is another strategy that has allowed for a targeted induction of an antitumor response. Finally, engineering of the bacillus Calmette-Guérin (BCG) vaccine aimed to minimize the potential side effects associated with this treatment. These novel approaches hold promise for decreasing the rate of progression and recurrence of NMIBC. PMID:25054027

  3. [The impact of the VAC-treatment for locally advanced malignancy of the scalp].

    PubMed

    Schintler, M V; Prandl, E-C; Wittguber, G; Zink, B; Spendel, S; Hellbom, B; Scharnagl, E

    2004-05-01

    Locally advanced cutaneous malignancy of the scalp is a disease that requires an aggressive approach to resection and reconstruction. In cases where the pericranium is intact a split-thickness skin graft is a simple treatment, since direct closure often fails because due to the lack of elasticity of the scalp. If there is a loss of periosteum or a skull defect local or free flaps are necessary for sufficient coverage. Increasing geriatric and polymorbid patients with impaired wound healing require surgical treatment, considering pros and cons for general anaesthesia. A simple method of both, combining radicality of tumor resection with outer table bone and skin grafting as a two stage procedure, while minimizing perioperative risk using local anaesthesia and analgo-sedation, using the vacuum assisted closure device, is presented. PMID:15168314

  4. Current Advances in Polymer-Based Nanotheranostics for Cancer Treatment and Diagnosis

    PubMed Central

    2015-01-01

    Nanotheranostics is a relatively new, fast-growing field that combines the advantages of treatment and diagnosis via a single nanoscale carrier. The ability to bundle both therapeutic and diagnostic capabilities into one package offers exciting prospects for the development of novel nanomedicine. Nanotheranostics can deliver treatment while simultaneously monitoring therapy response in real-time, thereby decreasing the potential of over- or under-dosing patients. Polymer-based nanomaterials, in particular, have been used extensively as carriers for both therapeutic and bioimaging agents and thus hold great promise for the construction of multifunctional theranostic formulations. Herein, we review recent advances in polymer-based systems for nanotheranostics, with a particular focus on their applications in cancer research. We summarize the use of polymer nanomaterials for drug delivery, gene delivery, and photodynamic therapy, combined with imaging agents for magnetic resonance imaging, radionuclide imaging, and fluorescence imaging. PMID:25014486

  5. Available evidence and new biological perspectives on medical treatment of advanced thymic epithelial tumors.

    PubMed

    Serpico, D; Trama, A; Haspinger, E R; Agustoni, F; Botta, L; Berardi, R; Palmieri, G; Zucali, P; Gallucci, R; Broggini, M; Gatta, G; Pastorino, U; Pelosi, G; de Braud, F; Garassino, M C

    2015-05-01

    Thymic epithelial tumors (TETs) are rare primary mediastinal tumors arising from thymic epithelium. Their rarity and complexity hinder investigations of their causes and therapy development. Here, we summarize the existing knowledge regarding medical treatment of these tumors, and thoroughly review the known genetic aberrations associated with TETs and the present status of potential biological treatments. Epidermal growth factor receptor (EGFR), stem-cell factor receptor, insulin-like growth factor-1 receptor (IGF1R), and vascular endothelial growth factors (VEGF-A, VEGF-B, and VEGF-2) are overexpressed in TETs. EGFR overexpression in TETs is associated with higher stage, and IGF1R overexpression has poor prognostic value. Data indicate that anti-IGF1R monoclonal antibodies, and inhibitors of angiogenesis, somatostatin receptors, histone deacetylase, mammalian target of rapamycin, and cyclin-dependent kinases may be active against TETs. Continued investigations in this field could lead to advancement of targeted and biological therapies for TETs. PMID:25411417

  6. Advancement in the treatment of diminished ovarian reserve by traditional Chinese and Western medicine

    PubMed Central

    ZHANG, CHEN; XU, XIA

    2016-01-01

    Diminished ovarian reserve (DOR) refers to the decreased production of mature ova in ovarium and decreased quality of oocyte, leading to deficiency of the female sex hormone and decreased fertility. DOR can also develop into premature ovarian failure, which affects female life quality and constitutes an important cause of female infertility. A fast lifestyle, environmental deterioration and accumulated understanding of this disease, have led to an increase in the incidence of DOR. Therefore, reasonable and effective treatment for DOR is particularly important to improve ovarian function and female life quality as well as reduce infertility. This mini review provides recent updates regarding DOR and a summary of advancements in the treatment of DOR using Chinese and Western Medicine. PMID:27073418

  7. 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

  8. Advances in the diagnosis and treatment of tumor necrosis factor receptor-associated periodic syndrome.

    PubMed

    Aguado-Gil, L; Irarrazaval-Armendáriz, I; Pretel-Irazabal, M

    2013-09-01

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a rare autosomal dominant disease included in the group of autoinflammatory syndromes. It is characterized by recurrent episodes of fever and inflammation in different regions of the body. The main clinical manifestations are myalgia, migratory erythematous rash, periorbital edema, and abdominal pain. The diagnosis is reached using gene analysis and prognosis depends on the appearance of amyloidosis secondary to the recurrent episodes of inflammation. Tumor necrosis factor inhibitors and corticosteroids are the most widely used treatments. In recent years, significant advances have been made in the diagnosis and treatment of TRAPS, thanks to a better understanding of its pathogenesis. Dermatologists must be aware that the skin manifestations of TRAPS are particularly important, as they are often diagnostic. PMID:23891452

  9. Successful Treatment of Advanced Ovarian Cancer with Thermochemotherapy and Adjuvant Immune Therapy

    PubMed Central

    Kleef, R.; Kekic, S.; Ludwig, N.

    2012-01-01

    We report on a 4-year progression-free survival of a 54-year-old female first diagnosed in December 2007 with advanced bilateral ovarian cancer FIGO IIIc, disseminated peritoneal carcinosis and malignant diaphragm invasion. Treatment started in January 2008 with 6 cycles of Taxol 175 mg/m2/carboplatin AUC 5 in 3-week intervals. Twenty-four hours following each chemotherapy session, fever-range long-duration whole-body hyperthermia (WBH) was performed at the temperature plateau of 40°C body core temperature for 6 h. Three months after completion of chemotherapy, 4 more long-duration WBH procedures were performed in monthly intervals. Importantly, long-duration WBH was paralleled with intradermal vaccination of autologous dendritic cells. No other treatment was given to the patient. Four years following the first diagnosis, the patient is still in complete remission with no evidence of disease. PMID:22679425

  10. Sequence of treatment in locally advanced and metastatic renal cell carcinoma

    PubMed Central

    Fischer, Stefanie; Gillessen, Silke

    2015-01-01

    The spectrum of drugs that have shown activity in advanced or metastatic renal cell carcinoma (RCC) has led to a debate on the optimal sequence of treatments. There is agreement on recommending targeted agents as the standard of care in this disease. Uncertainty, however, remains on the best first-line drug choice. Physicians and patients may select sunitinib, bevacizumab in combination with interferon-alpha (IFN-α), pazopanib, or—in poor risk patients—temsirolimus. There are also a variety of therapies with proven efficacy on hand in the second-line setting: sorafenib, pazopanib, axitinib, and everolimus. While most randomized RCC trials assessed progression free survival (PFS) as primary endpoint, some agents were shown to improve median overall survival (OS), and given in sequence they have extended the life expectancy of RCC patients from 13 months in the cytokine era to over 30 months. Despite the progress made, there are sobering aspects to the oncologic success story in RCC, as the new treatments do not obtain an objective response or disease stabilization (SD) in all patients. There are also as yet no predictors to select patients who might benefit and those who are primary resistant to specific drugs, and ultimately almost all patients will experience disease progression. Bearing inevitable treatment failure in mind, availability of further drugs and switching therapy while the patient is in a condition to continue pharmacotherapy is essential. Of note, depending on the setting, only 33-59% of patients receive second-line treatment. In this review we present data on first-, second-, and third-line treatment in RCC, and discuss the difficulties in their interpretation in the context of treatment sequence. We summarize biological aspects and discuss mechanisms of resistance to anti-angiogenic therapy and their implications for treatment selection. PMID:26816832

  11. Dynamics of laser ablated colliding plumes

    SciTech Connect

    Gupta, Shyam L.; Pandey, Pramod K.; Thareja, Raj K.

    2013-01-15

    We report the dynamics of single and two collinearly colliding laser ablated plumes of ZnO studied using fast imaging and the spectroscopic measurements. Two dimensional imaging of expanding plume and temporal evolution of various species in interacting zones of plumes are used to calculate plume front velocity, electron temperature, and density of plasma. The two expanding plumes interact with each other at early stage of expansion ({approx}20 ns) resulting in an interaction zone that propagates further leading to the formation of stagnation layer at later times (>150 ns) at the lateral collision front of two plumes. Colliding plumes have larger concentration of higher ionic species, higher temperature, and increased electron density in the stagnation region. A one-to-one correlation between the imaging and optical emission spectroscopic observations in interaction zone of the colliding plumes is reported.

  12. 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.

  13. 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

  14. 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. PMID:25189846

  15. Transcatheter arterial chemoembolization with gemcitabine and oxaliplatin for the treatment of advanced biliary tract cancer

    PubMed Central

    Zhao, Qing; Qian, Sheng; Zhu, Liang; Qu, Xu-Dong; Zhang, Wei; Yan, Zhi-Ping; Cheng, Jie-Min; Liu, Qing-Xin; Liu, Rong; Wang, Jian-Hua

    2015-01-01

    Background The aim of this study was to determine the therapeutic efficacy and safety of transarterial chemoembolization (TACE) with gemcitabine and oxaliplatin in patients with advanced biliary tract cancer (BTC). Methods We retrospectively analyzed the outcomes for 65 patients with advanced BTC treated by TACE with gemcitabine 1,000 mg/m2 and oxaliplatin 100 mg/m2. Follow-up laboratory tests and computed tomography or magnetic resonance imaging were performed routinely to evaluate the response of the tumor to treatment. All patients were assessed for adverse effects. Results Of the 65 patients, 19 (29.2%) achieved a partial response, 36 (55.4%) showed stable disease, and ten (15.4%) showed progressive disease. The overall response rate was 29.2%. At the end of this study, five patients were still alive. The median overall survival was 12.0 months (95% confidence interval 8.5–15.5). There were no serious complications after TACE. Conclusion The disease control rate and overall survival in this retrospective study were consistent with those in previous reports. TACE with gemcitabine and oxaliplatin was well tolerated and highly effective in patients with advanced BTC. PMID:25792843

  16. [A Case Report of Advanced Gastric Cancer Demonstrating CR after Treatment with S-1 and Paclitaxel].

    PubMed

    Kudoh, Keisuke; Ogata, Kenichi; Ohchi, Tetsufumi; Ootao, Ryu; Koga, Yuki

    2015-11-01

    Here, we report a case of advanced gastric cancer that demonstrated CR after treatment with S-1 and paclitaxel. The patient was an 80-year-old woman with gastric cancer in whom upper gastrointestinal endoscopy (GIF) revealed a type 3 tumor in the cardia of the stomach that was pathologically diagnosed as a well-differentiated adenocarcinoma. Computed tomography showed no lymph node involvement or metastasis. Considering her advanced age and cardinal functional disorder, she was administered chemotherapy consisting of S-1 and paclitaxel. Depending on a state, a side effect, I changed a dose and inter-dose interval from head to foot and I treated it by foreign going to hospital and continued it. Gradual tumor reduction was observed on GIF (2011/1/25). CR was diagnosed without tumor disappearance, with accepted malignant findings on biopsy. The patient has now survived for 7 years 9 months after diagnosis. The present case demonstrates that combination therapy of S-1 and paclitaxel is safe and useful for patients with risk factors such as advanced age and underlying disease. PMID:26805267

  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. PMID:27271213

  18. 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.

  19. Plasma genetic and genomic abnormalities predict treatment response and clinical outcome in advanced prostate cancer.

    PubMed

    Xia, Shu; Kohli, Manish; Du, Meijun; Dittmar, Rachel L; Lee, Adam; Nandy, Debashis; Yuan, Tiezheng; Guo, Yongchen; Wang, Yuan; Tschannen, Michael R; Worthey, Elizabeth; Jacob, Howard; See, William; Kilari, Deepak; Wang, Xuexia; Hovey, Raymond L; Huang, Chiang-Ching; Wang, Liang

    2015-06-30

    Liquid biopsies, examinations of tumor components in body fluids, have shown promise for predicting clinical outcomes. To evaluate tumor-associated genomic and genetic variations in plasma cell-free DNA (cfDNA) and their associations with treatment response and overall survival, we applied whole genome and targeted sequencing to examine the plasma cfDNAs derived from 20 patients with advanced prostate cancer. Sequencing-based genomic abnormality analysis revealed locus-specific gains or losses that were common in prostate cancer, such as 8q gains, AR amplifications, PTEN losses and TMPRSS2-ERG fusions. To estimate tumor burden in cfDNA, we developed a Plasma Genomic Abnormality (PGA) score by summing the most significant copy number variations. Cox regression analysis showed that PGA scores were significantly associated with overall survival (p < 0.04). After androgen deprivation therapy or chemotherapy, targeted sequencing showed significant mutational profile changes in genes involved in androgen biosynthesis, AR activation, DNA repair, and chemotherapy resistance. These changes may reflect the dynamic evolution of heterozygous tumor populations in response to these treatments. These results strongly support the feasibility of using non-invasive liquid biopsies as potential tools to study biological mechanisms underlying therapy-specific resistance and to predict disease progression in advanced prostate cancer. PMID:25915538

  20. 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. PMID:17267104

  1. Treatment of Children with Advanced-Stage Lymphoblastic Lymphoma with Pegaspargase

    PubMed Central

    Yu-tong, Zhang; Li-hua, FENG; Xiao-dan, Zhong; Li-zhe, Wang; Jian, Chang

    2014-01-01

    Objective: To evaluate the feasibility of Pegaspargase instead of L-asparaginase to treat children with advanced-stage lymphoblastic lymphoma (LBL) on the Berlin-Frankfurt-Munster (BFM)-95 protocol. Methods: Fifty-four newly diagnosed patients with stage III or IV LBL and without any treatment were enrolled in this study. Pegaspargase took place of L-asparaginase in BFM-95. The complications and treatment responses of patients treated on the BFM-95 protocol and modified BFM-95 protocol were then evaluated respectively. Findings : For LBL patients treated with BFM-95 protocol or modified BFM-95 protocol, the complete response, event-free survival, overall survival were similar. Stage 4 myelosuppression was the most common complication in both groups. Besides that, among 31 patients receiving modified BFM-95 protocol, coagulation defects were the most common complication. In contrast, anaphylactic reaction was the most common complication in the other 23 patients receiving BFM-95 protocol. Conclusion: Modified BFM-95 protocol is available to children with advanced-stage LBL with an equal outcome and enhances its compliance and decreases the incidence of anaphylactic reaction, compared to BFM-95 protocol. Coagulation defects are the major complication and tolerable in modified one. PMID:25793049

  2. Novel Approaches to Treatment of Advanced Melanoma: A Review on Targeted Therapy and Immunotherapy.

    PubMed

    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

  3. Plasma genetic and genomic abnormalities predict treatment response and clinical outcome in advanced prostate cancer

    PubMed Central

    Du, Meijun; Dittmar, Rachel L.; Lee, Adam; Nandy, Debashis; Yuan, Tiezheng; Guo, Yongchen; Wang, Yuan; Tschannen, Michael R.; Worthey, Elizabeth; Jacob, Howard; See, William; Kilari, Deepak; Wang, Xuexia; Hovey, Raymond L.; Huang, Chiang-Ching; Wang, Liang

    2015-01-01

    Liquid biopsies, examinations of tumor components in body fluids, have shown promise for predicting clinical outcomes. To evaluate tumor-associated genomic and genetic variations in plasma cell-free DNA (cfDNA) and their associations with treatment response and overall survival, we applied whole genome and targeted sequencing to examine the plasma cfDNAs derived from 20 patients with advanced prostate cancer. Sequencing-based genomic abnormality analysis revealed locus-specific gains or losses that were common in prostate cancer, such as 8q gains, AR amplifications, PTEN losses and TMPRSS2-ERG fusions. To estimate tumor burden in cfDNA, we developed a Plasma Genomic Abnormality (PGA) score by summing the most significant copy number variations. Cox regression analysis showed that PGA scores were significantly associated with overall survival (p < 0.04). After androgen deprivation therapy or chemotherapy, targeted sequencing showed significant mutational profile changes in genes involved in androgen biosynthesis, AR activation, DNA repair, and chemotherapy resistance. These changes may reflect the dynamic evolution of heterozygous tumor populations in response to these treatments. These results strongly support the feasibility of using non-invasive liquid biopsies as potential tools to study biological mechanisms underlying therapy-specific resistance and to predict disease progression in advanced prostate cancer. PMID:25915538

  4. 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

  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. 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. PMID:26004052

  7. 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.

  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. ASRM plume deflector analysis program

    NASA Astrophysics Data System (ADS)

    Dawson, Michael C.; Douglas, Freddie, III; Orlin, Peter A.

    1992-07-01

    This paper presents analytical conclusions resulting from subscale solid rocket motor tests and flowfield modeling for a plume deflector. Loads, flow characteristics, and corresponding material behavior were predicted or observed and will be used in final design of the deflector. The efforts resulted in quantifiable size reductions and lower cost material selections, which will significantly reduce the deflector cost while meeting performance requirements.

  10. 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

  11. FDA Approval Summary: Temsirolimus as Treatment for Advanced Renal Cell Carcinoma

    PubMed Central

    Prowell, Tatiana M.; Ibrahim, Amna; Farrell, Ann T.; Justice, Robert; Mitchell, Shan Sun; Sridhara, Rajeshwari; Pazdur, Richard

    2010-01-01

    This report summarizes the U.S. Food and Drug Administration (FDA)'s approval of temsirolimus (Torisel®), on May 30, 2007, for the treatment of advanced renal cell carcinoma (RCC). Information provided includes regulatory history, study design, study results, and literature review. A multicenter, three-arm, randomized, open-label study was conducted in previously untreated patients with poor-prognosis, advanced RCC. The study objectives were to compare overall survival (OS), progression-free survival (PFS), objective response rate, and safety in patients receiving interferon (IFN)-α versus those receiving temsirolimus alone or in combination with IFN-α. In the second planned interim analysis of the intent-to-treat population (n = 626), there was a statistically significant longer OS time in the temsirolimus (25 mg) arm than in the IFN-α arm (median, 10.9 months versus 7.3 months; hazard ratio [HR], 0.73; p = .0078). The combination of temsirolimus (15 mg) and IFN-α did not lead to a significant difference in OS compared with IFN-α alone. There was also a statistically significant longer PFS time for the temsirolimus (25 mg) arm than for the IFN-α arm (median, 5.5 months versus 3.1 months; HR, 0.66, p = .0001). Common adverse reactions reported in patients receiving temsirolimus were rash, asthenia, and mucositis. Common laboratory abnormalities were anemia, hyperglycemia, hyperlipidemia, and hypertriglyceridemia. Serious but rare cases of interstitial lung disease, bowel perforation, and acute renal failure were observed. Temsirolimus has demonstrated superiority in terms of OS and PFS over IFN-α and provides an additional treatment option for patients with advanced RCC. PMID:20332142

  12. 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

  13. 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. PMID:12552984

  14. Recent Advances in Delivery of Drug-Nucleic Acid Combinations for Cancer Treatment

    PubMed Central

    Li, Jing; Wang, Yan; Zhu, Yu; Oupický, David

    2013-01-01

    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. PMID:23624358

  15. Advances in the treatment of relapsing—remitting multiple sclerosis — critical appraisal of fingolimod

    PubMed Central

    Gasperini, Claudio; Ruggieri, Serena; Mancinelli, Chiara Rosa; Pozzilli, Carlo

    2013-01-01

    Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, traditionally considered to be an autoimmune, demyelinating disease. Based on this understanding, initial therapeutic strategies were directed at immune modulation and inflammation control. At present, there are five licensed first-line disease-modifying drugs for MS in Europe, and two second-line treatments. Currently available MS therapies have shown significant efficacy throughout many trials, but they produce different side effects. Despite disease-modifying drugs being well known and safe, they require regular and frequent parenteral administration and are associated with limited long-term treatment adherence. Therefore, the development of new therapeutic strategies is warranted. Several oral compounds are in late stages of development for treating MS. fingolimod is an oral sphingosine-1-phosphate receptor modulator that has demonstrated superior efficacy compared with placebo and interferon β-1a in phase III studies. It has already been approved in the treatment of MS. This review focuses on advances in current and novel oral treatment approaches in MS. We summarily review the oral compounds in this study, focusing on the recent development, approval, and the clinical experience with fingolimod. PMID:23483794

  16. 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

  17. Retrospective evaluation of 5-fluorouracil-interferon-a aTreatment of advanced colorectal cancer patients.

    PubMed

    András, C; Csiki, Z; Gál, I; Takács, I; Antal, L; Szegedi, G

    2000-01-01

    The authors describe the retrospective analysis of treatment by 5-fluorouracil and interferon-a aof 34 patients with advanced colorectal cancer. An average of 4.6 treatment cycles (3 12) was applied. Complete remission was not observed; partial remission was observed in 8 patients; in 13 patients no change occurred and progression was detected in 14 cases. Remission rate was 22.8%, mean response time was 5.2 (3 12) months, mean progress-free survival 5.6 (0 22) months. Mean survival from the start of treatment was 11.9 (1 42) months and from the establishment of the diagnosis 26.1 (3 60) months. Severe life-threatening side-effects did not occur; other side-effects such as fever, nausea, diarrhea, leucopenia, and anemia responded to drugs. Treatment by 5-FU and interferon, in accordance with other authors findings, improved survival and well-being of patients but no breakthrough has been achieved. PMID:11033456

  18. Treatment of Advanced Tumours of Head and Neck with Fast Neutrons

    PubMed Central

    Catterall, Mary; Vonberg, D. D.

    1974-01-01

    Fast neutrons interact with matter in a different way from x and gamma rays. They have been used at Hammersmith Hospital for the past four years in the treatment of advanced tumours in several sites of the body, and the results of this treatment in the first 100 cases of tumours of the head and neck are described here. Altogether 62 patients who had been referred for fast neutron therapy because it was thought that no other treatment would be effective experienced complete regression of the tumours, and only two recurred. Tumours of the buccal cavity and salivary glands responded particularly well and the relief of pain and ulceration was striking. Side effects were not serious and did not differ from those seen with supervoltage radiation, apart from the reaction of the skin. Follow-up was short, however, owing to deaths from metastases, and out of 76 patients treated more than one year previously only 30 survived. Cases which have not metastasized must therefore be treated so that the effects on tumours and adjacent normal tissues can be observed for several years after treatment. The results obtained so far indicate that it is now justifiable to use neutrons in such cases. ImagesFIG. 2FIG. 3 PMID:4210570

  19. 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.

  20. Plasma plume MHD power generator and method

    DOEpatents

    Hammer, J.H.

    1993-08-10

    A method is described of generating power at a situs exposed to the solar wind which comprises creating at separate sources at the situs discrete plasma plumes extending in opposed directions, providing electrical communication between the plumes at their source and interposing a desired electrical load in the said electrical communication between the plumes.

  1. 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.

  2. 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.

  3. Types of thermal plumes in coastal waters

    NASA Technical Reports Server (NTRS)

    Green, T.; Madding, R.; Scarpace, F.

    1977-01-01

    A large number of thermal images of the surface temperatures of the thermal plumes associated with the once-through cooling of electric power plants show that four kinds of plume occur sufficiently often to be classified as distinct plume types. Each type has implications for both numerical models and measurement strategies.

  4. Moving Forward: Advances in the Treatment of Movement Disorders with Deep Brain Stimulation

    PubMed Central

    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. PMID:22084629

  5. Pathologic response to neoadjuvant treatment in locally advanced rectal cancer and impact on outcome

    PubMed Central

    Davis, Sidney; Mohebbi, Mohammadreza; Sugamaran, Bhuvana; Porter, Ian W.; Bell, Stephen; Warrier, Satish K.; Wale, Roger

    2016-01-01

    Background Downstaging and pathologic complete response (pCR) after chemoradiotherapy (CRT) may improve progression-free survival and overall survival (OS) after curative therapy of locally advanced adenocarcinoma of rectum. The purpose of this study is to evaluate the pathologic response subsequent to neoadjuvant chemoradiation in locally advanced rectal adenocarcinoma and any impact of response on oncological outcome [disease-free survival (DFS), OS]. Methods A total of 127 patients with histologically-proven rectal adenocarcinoma, locally advanced, were treated with preoperative radiotherapy and concurrent 5-fluorouracil (5 FU), and followed by curative surgery. Pathologic response to neoadjuvant treatment was evaluated by comparing pathologic TN (tumour and nodal) staging (yp) with pre-treatment clinical staging. DFS and OS were compared in patients with: pCR, partial pathologic response and no response to neoadjuvant therapy. Results 14.96% (19 patients) had a pCR, 58.27% [74] showed downstaging and 26.77% [34] had no change in staging. At follow-up (range, 4–9 years, median 6 years 2 months or 74 months), 17.32% [22] showed recurrence: 15.74% [20] distant metastasis, 1.57% [2] pelvic failure. 10.5% [2] of the patients with pCR showed distant metastasis, none showed local recurrence. In the downstaged group, nine developed distant failure and two had local recurrence (14.86%). Distant failure was seen in 26.47% [9] of those with no response to neoadjuvant treatment. DFS and OS rates for all groups were 82.67% and 88.97% respectively. Patients with pCR showed 89.47% DFS and 94.7% OS. In partial responders, DFS was 85.1% and OS was 90.5%. In non-responders, DFS and OS were 73.5% and 82.3% respectively. Patients with pCR had a significantly greater probability of DFS and OS than non-responders. Rectal cancer-related death was 11.02% [14]: one patient (5.26%) with pCR, 9.47% [7] in the downstaged group and 17.64% [6] of non-responders. Conclusions The majority

  6. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods

    PubMed Central

    Ahmed, Rafay; Oborski, Matthew J; Hwang, Misun; Lieberman, Frank S; Mountz, James M

    2014-01-01

    Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12–15 months for glioblastomas and 2–5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies, and importantly, for facilitating patient management, sparing patients from weeks or months of toxicity and ineffective treatment. This review will present an overview of epidemiology, molecular pathogenesis and current advances in diagnoses, and management of malignant gliomas. PMID:24711712

  7. 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. PMID:26540311

  8. 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. PMID:25150682

  9. Treatment of Locally Advanced Adenoid Cystic Carcinoma of the Trachea With Neutron Radiotherapy

    SciTech Connect

    Bittner, Nathan; Koh, W.-J.; Laramore, George E.; Patel, Shilpen; Mulligan, Michael S.; Douglas, James G.

    2008-10-01

    Purpose: To examine the efficacy of fast neutron radiotherapy in the treatment of locally advanced adenoid cystic carcinoma (ACC) of the trachea and to compare outcomes with and without high-dose-rate (HDR) endobronchial brachytherapy boost. Methods and Materials: Between 1989 and 2005, a total of 20 patients with ACC of the trachea were treated with fast neutron radiotherapy at University of Washington. Of these 20 patients, 19 were treated with curative intent. Neutron doses ranged from 10.7 to 19.95 Gy (median, 19.2 Gy). Six of these patients received an endobronchial brachytherapy boost using an HDR {sup 192}Ir source (3.5 Gy x 2 fractions). Median duration of follow-up was 46 months (range, 10-121 months). Results: The 5-year actuarial overall survival rate and median overall survival for the entire cohort were 89.4%, and 97 months, respectively. Overall survival was not statistically different among those patients receiving an endobronchial boost compared with those receiving neutron radiotherapy alone (100% vs. 68%, p = 0.36). The 5-year actuarial locoregional control rate for the entire cohort was 54.1%. The locoregional control rate was not statistically different among patients who received an endobronchial boost compared with those who received neutron radiotherapy alone (40% vs. 58%, p 0.94). There were no cases of Grade {>=}3 acute toxicity. There were 2 cases of Grade 3/4 chronic toxicity. Conclusions: Fast neutron radiotherapy is an effective treatment for locally advanced adenoid cystic carcinoma of the trachea, with acceptable treatment-related toxicity.

  10. Mandibular advancement devices: indications and predictors of treatment outcome. A review.

    PubMed

    Cuccia, A M; Caradonna, C

    2007-09-01

    Obstructive sleep apnea syndrome (OSAS) is a chronic sleep and respiratory disorder, which causes a partial or total obstruction of the air passage at the upper airway level. Mandibular advancement devices (MADs) have been used in the treatment of snoring, but may be a valid alternative to the continuous nasal positive airway pressure (CPAP) for certain OSAS cases. Therapy by means of MADs arises the interest of the scientific community and now there are many sleep-centres where dentists work as experts in sleep disorders. MADs are instruments of value because they are simple to use, reversible, portable and they generally have a low complication rate. They mechanically increase the oropharyngeal space by advancing the mandible and/or the tongue and reduce pharyngeal collapsibility. More than 60 different MADs are in use, with considerable variations in design. Several studies show that their systematic use produces an evident improvement in the global quality of life as well as in the symptoms of patients with OSAS, especially sleepiness. Even though significant progress has been made in proving the efficacy of MADs for OSAS, the ability to predict the treatment outcome and hence pre-select suitable candidates for this treatment still remains in its early stage. The first aim of this review is to supply to the clinician informations on the cephalometric and polysomnographic parameters that can be used to predict the efficacy of the outcome of MAD therapy in OSAS. Moreover, we examine the cases for which the use of a MAD is indicated. PMID:17938623

  11. War and peace? The oncologic and the palliative care perspective on personalized cancer treatment in a patient with advanced cancer.

    PubMed

    Masel, Eva K; Schur, Sophie; Posch, Doris; Weixler, Dietmar; Meran, Johannes G; Schmidinger, Manuela; Watzke, Herbert H

    2015-08-01

    Personalized cancer treatment utilizing targeted therapies in a tailored approach is based on tumor and/or patient-specific molecular profiles. Recent clinical trials continue to look for new potential targets in heavily pretreated patients or rare disease entities. Careful selection of patients who may derive benefit from such therapies constitutes a challenge. This case report presents an experimental personalized cancer treatment in an advanced cancer patient and provides a list of issues for discussion: How can we combine treatment goals and simultaneously meet the individual needs in advanced cancer reconciling both perspectives: oncology and palliative care? PMID:25986998

  12. Detection of Metallic Compounds in Rocket Plumes

    NASA Astrophysics Data System (ADS)

    Rogers, Chris; Dunn, Dr. Robert

    1998-04-01

    Recent experiments using metal mixed in hydroxyl-terminated polybutadiene (HTPB) fuel grains in small hybrid rocket indicates ion detectors may be effective in detection of metallic compounds in rocket plumes. We wanted to ascertain the extent to which the presence of metallic compounds in rocket plumes could be detected using ion probes and Gaussian rings. Charges that collide with or pass near the intruding probe are detected. Gaussian rings, short insulated cylindrical Gaussian surfaces, enclose the plume without intruding into the plume. Charges in the plume are detected by currents they induce in the cylinder.

  13. 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.

  14. Transition Flow Effects On Plume Radiation

    NASA Astrophysics Data System (ADS)

    Elgin, James B.

    1983-07-01

    A calculational comparison of a free molecular plume code (HAPAIR: High Altitude Plume-Atmosphere Interaction Radiation) and a Monte-Carlo Plume Code (TRAMP: Transitional and Rarefied Axisymmetric Monte-carlo Plume) is made for a selected sequence of cases going from a free molecular (Kn = 15) to a highl transitional (Kn = 0.07) flow regime. Results are presented which document the breakdown of free molecular flow assumptions in the transition regime and show the effect on the critical physical processes responsible for plume emission.

  15. 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

  16. 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

  17. Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer

    PubMed Central

    Hashemi-Meshkini, Amir; Keshavarz, Khosro; Gharibnaseri, Zahra; Kheirandish, Mehrnaz; Kebriaeezadeh, Abbas

    2013-01-01

    Introduction Exemestane was approved in 2005 for adjuvant treatment of breast cancer. In this study, we aimed to assess whether it is cost-effective in comparison to available alternatives. Material and methods To evaluate the efficacy of exemestane, a systematic review was conducted by searching electronic databases. The outcomes of interest were “clinical benefit”, “overall response” and “disease-free survival rate”. To evaluate the cost of treatments, costs of both domestic generic and imported brand medicines were taken into account, and the incremental cost-effectiveness ratio (ICER) was calculated for each comparison. Results Regarding primary breast cancer, based upon available evidence, exemestane could not be considered as a cost-effective medicine either in generic or brand form compared with placebo (ICER: 119,100 and 215,525), with tamoxifen after 2-3 years of therapy (ICER: 35,150 and 82,400) and with sequential treatment by tamoxifen and exemestane (dominated because of lower effectiveness and higher cost). In metastatic breast cancer, exemestane was not considered a cost-effective treatment compared with both anastrozole and megestrol acetate (dominated) and was highly cost-effective compared with tamoxifen (ICERs: 2,208 and 4,326 dollars per one more patient with an overall response for generic and brand medicines) although even in this case it was not cost-effective in terms of the 1-year survival rates (dominated). Conclusions Regarding current evidence and related costs in terms of Iranian pharmaceutical market prices, exemestane could not be considered a cost-effective treatment in primary and advanced breast cancer compared with available alternatives. However, more evidence is still needed for more certain decisions. PMID:23847669

  18. 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. PMID:26828795

  19. 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

  20. 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

  1. Recent advances on the development of wound dressings for diabetic foot ulcer treatment--a review.

    PubMed

    Moura, Liane I F; Dias, Ana M A; Carvalho, Eugénia; de Sousa, Hermínio C

    2013-07-01

    Diabetic foot ulcers (DFUs) are a chronic, non-healing complication of diabetes that lead to high hospital costs and, in extreme cases, to amputation. Diabetic neuropathy, peripheral vascular disease, abnormal cellular and cytokine/chemokine activity are among the main factors that hinder diabetic wound repair. DFUs represent a current and important challenge in the development of novel and efficient wound dressings. In general, an ideal wound dressing should provide a moist wound environment, offer protection from secondary infections, remove wound exudate and promote tissue regeneration. However, no existing dressing fulfills all the requirements associated with DFU treatment and the choice of the correct dressing depends on the wound type and stage, injury extension, patient condition and the tissues involved. Currently, there are different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production. Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances). This work reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to systems employing new polymeric biomaterials, and to the latest and innovative therapeutic strategies and delivery approaches. PMID:23542233

  2. Acute phase treatment of venous thromboembolism: advanced therapy. Systemic fibrinolysis and pharmacomechanical therapy.

    PubMed

    Konstantinides, Stavros V; Wärntges, Simone

    2015-06-01

    Venous thromboembolism, which encompasses deep-vein thrombosis and acute pulmonary embolism (PE), represents a major contributor to global disease burden worldwide. For patients who present with cardiogenic shock or persistent hypotension (acute high-risk PE), there is consensus that immediate reperfusion treatment applying systemic fibrinolysis or, in the case of a high bleeding risk, surgical or catheter-directed techniques, is indicated. On the other hand, for the large, heterogeneous group of patients presenting without overt haemodynamic instability, the indications for advanced therapy are less clear. The recently updated guidelines of the European Society of Cardiology emphasise the importance of clinical prediction rules in combination with imaging procedures (assessment of right ventricular function) and laboratory biomarkers (indicative of myocardial stress or injury) for distinguishing between an intermediate and a low risk for an adverse early outcome. In intermediate-high-risk PE defined by the presence of both right ventricular dysfunction on echocardiography (or computed tomography) and a positive troponin (or natriuretic peptide) test, the bleeding risks of full-dose fibrinolytic treatment have been shown to outweigh its potential clinical benefits unless clinical signs of haemodynamic decompensation appear (rescue fibrinolysis). Recently published trials suggest that catheter-directed, ultrasound-assisted, low-dose local fibrinolysis may provide an effective and particularly safe treatment option for some of these patients. PMID:25789580

  3. 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. PMID:16806395

  4. The role of pembrolizumab in the treatment of advanced non-small cell lung cancer

    PubMed Central

    Santabarbara, Giuseppe; Maione, Paolo; Rossi, Antonio; Palazzolo, Giovanni

    2016-01-01

    Lung cancer is the leading cause of death cancer related worldwide. The standard therapies have unmet medical needs both due to the limited activity and relevant toxicity of platinum-based chemotherapy and to the low frequency of specific alterations required to use targeted therapies. Immune checkpoint inhibition due to restoring the immune system’s capacity to eradicate tumors is undergoing in extensive investigation in non-small cell lung cancer (NSCLC) as a new treatment approach. Programmed cell death protein-1 (PD-1) and its ligand, programmed cell death-ligand 1 (PD-L1) have recently led to significantly and durable improvements in the clinical outcome of several kind of tumors including lung cancer. Pembrolizumab, approved by the U.S. FDA for the treatment of advanced NSCLC progressed after other therapies and with expression of PD-L1, has demonstrated durable response and prolonged overall survival (OS) especially in patients with high PD-L1 expression. Further investigation are needed to improve treatment outcomes through combination of immunotherapy or combined with other targeted therapies. PMID:27386489

  5. Recent advances in diagnosis and treatment of gliomas using chlorotoxin-based bioconjugates

    PubMed Central

    Cheng, Yongjun; Zhao, Jinhua; Qiao, Wenli; Chen, Kai

    2014-01-01

    Malignant gliomas, especially glioblastoma multiforme, are the most widely distributed and deadliest brain tumors because of their resistance to surgical and medical treatment. Research of glioma-specific bioconjugates for diagnosis and therapy developed rapidly during the past several years. Many studies have demonstrated that chlorotoxin (CTX) and Buthus martensii Karsch chlorotoxin (BmK CT) specifically inhibited glioma cells growth and metastasis, and accelerated tumor apoptosis. The bioconjugates of CTX or BmK CT with other molecules have played an increasing role in diagnostic imaging and treatment of gliomas. To date, CTX-based bioconjugates have achieved great success in phase I/II clinical trials about safety profiles. Here, we will provide a review on the important role of ion channels in the underlying mechanisms of gliomas invasive growth and how CTX suppresses gliomas proliferation and migration. We will summarize the recent advances in the applications of CTX bioconjugates for gliomas diagnosis and treatment. In addition, we will review recent studies on BmK CT bioconjugates and compare their efficacies with CTX derivatives. Finally, we will address advantages and challenges in the use of CTX or BmK CT bioconjugates as specific agents for theranostic applications in gliomas. PMID:25143859

  6. Analysis of clinical efficacy of CyberKnife® treatment for locally advanced pancreatic cancer

    PubMed Central

    Song, Yongchun; Yuan, Zhiyong; Li, Fengtong; Dong, Yang; Zhuang, Hongqing; Wang, Jingsheng; Chen, Huaming; Wang, Ping

    2015-01-01

    Objective To evaluate the efficacy and safety of CyberKnife® treatment for locally-advanced pancreatic cancer (LAPC). Methods The efficacy of CyberKnife® treatment was analyzed in 59 LAPC patients treated between October 2006 and September 2014. The median tumor volume was 27.1 mL (13.0–125.145 mL). The median prescribed dose was 45 Gy (35–50 Gy), delivered in 5 fractions (3–8 fractions). The overall survival (OS) rates and freedom from local progression (FFLP) rates were estimated using the Kaplan–Meier survival curve. Results The median follow-up for all patients was 10.9 months (3.2–48.7 months) and 15.6 months (3.9–37.6 months) among surviving patients. The median OS was 12.5 months, and the 1-year and 2-year survival rates were 53.9% and 35.1%, respectively. The 1-year FFLP rate was 90.8% based on the computed tomography (CT) evaluation. Grade 1–2 acute and late-stage gastrointestinal (GI) reactions were observed in 61% of the patients. One patient experienced grade 3 toxicity. Conclusion Excellent clinical efficacy was obtained after treatment of LAPC using CyberKnife®, with minimal toxicity. PMID:26109866

  7. Recent Advances on Multi-Parameter Flow Cytometry to Characterize Antimicrobial Treatments.

    PubMed

    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

  8. 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). PMID:23735488

  9. 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.

  10. 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

  11. Treatment of advanced squamous carcinoma of the maxillary sinus by irradiation

    SciTech Connect

    Frich, J.C. Jr.

    1982-08-01

    Between 1959 and 1972, there were 23 patients with advanced squamous carcinoma of the maxillary sinus treated by radiation therapy as the only modality. Eighteen of these patients had not shown evidence of metastasis and were locally extensive being classified as T/sub 3-4/N/sub 0/M/sub 0/. They received 60-75 Gy (6000-7500 rad) in 6 to 7 1/2 weeks using an anterior portal with opposed lateral wedge pairs to give a homogenous dose. No treatment was given to the neck. Of 10 patients with tumors presenting in the suprastructures, six are living 5 years with no evidence of disease (NED), one is dead of intercurrent disease, one died of metastatic disease with no evidence of tumor at the primary site, and two died of recurrent primary tumor. With suprastructure presentation, radiation therapy as a sole treatment was able to control the primary tumor in eight out of 10 patients. It is concluded that in extensive tumors of suprastructure, radiation may be the only modality required to control the primary tumor (80%). In the infrastructure, radiation has failed in 75% of the patients so that surgery may also be required as a planned part of treatment in order to control the primary tumor. Metastatic disease accounted for three of the 10 deaths as a result of tumor.

  12. 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

    2016-03-01

    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. PMID:26727278

  13. Compositional differentiation of Enceladus' plume

    NASA Astrophysics Data System (ADS)

    Khawaja, N.; Postberg, F.; Schmidt, J.

    2014-04-01

    The Cosmic Dust Analyser (CDA) on board the Cassini spacecraft sampled Enceladus' plume ice particles emanated directly from Enceladus' fractured south polar terrain (SPT), the so-called "Tiger Stripes", during two consecutive flybys (E17 and E18) in 2012. The spacecraft passed through the dense plume with a moderate velocity of ~7.5km/s, horizontally to the SPT with a closest approach (CA) at an altitude of ~75km almost directly over the south pole. In both flybys, spectra were recorded during a time interval of ~ ±3 minutes with respect to the closest approach achieving an average sampling rate of about 0.6 sec-1. We assume that the spacecraft passed through the plume during an interval of about ±60(sec) from the CA. Particles encountered before and after this period are predominately from the E-ring background in which Enceladus is embedded. Most CDA TOF-mass spectra are identified as one of three compositional types: (i) almost pure water (ii) organic rich and (iii) salt rich [2]. A Boxcar Analysis (BCA) is performed from a count database for compositional mapping of the plume along the space-craft trajectory. In BCA, counts of each spectrum type are integrated for a certain interval of time (box size). The integral of counts represents frequencies of compositional types in absolute abundances, which are converted later into proportions. This technique has been proven to be a suitable for inferring the compositional profiles from an earlier flyby (E5) [1]. The inferred compositional profiles show similar trends on E17 and E18. The abundances of different compositional types in the plume clearly differ from the Ering background and imply a compositional differentiation inside the plume. Following up the work of Schmidt et al, 2008 and Postberg et al, 2011 we can link different compositional types to different origins. The E17/E18 results are compared with the E5 flyby in 2008, which yielded the currently best compositional profile [2] but was executed at much

  14. 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.

  15. 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.

  16. Role of immunotherapy in the treatment of advanced non-small-cell lung cancer.

    PubMed

    Rijavec, Erika; Genova, Carlo; Alama, Angela; Barletta, Giulia; Sini, Claudio; Pronzato, Paolo; Coco, Simona; Dal Bello, Maria Giovanna; Savarino, Graziana; Truini, Anna; Boccardo, Francesco; Grossi, Francesco

    2014-01-01

    After several decades of modest results with nonspecific immune stimulants, immunotherapy has become an exciting approach in the treatment of cancer. Although non-small-cell lung cancer has not been considered an immunogenic disease for very long, a better understanding of tumor immunology and the identification of new targets have led to the development of many clinical trials of immune-based therapies for this neoplasm. Promising results from many clinical trials suggest that immunotherapy could be an effective strategy in the management of advanced non-small-cell lung cancer. Further studies are required to help clinicians in the selection of patients who are more likely to benefit from immunotherapy strategies by the identification of biomarkers and to understand when the combination of immunotherapy with other agents should be recommended. PMID:24328411

  17. Advances in the treatment of erectile dysfunction: what's new and upcoming?

    PubMed

    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

  18. The role of pharmacogenetics and advances in gene therapy in the treatment of diabetic retinopathy.

    PubMed

    Agarwal, Aniruddha; Ingham, Sally A; Harkins, Keegan A; Do, Diana V; Nguyen, Quan Dong

    2016-02-01

    Diabetic retinopathy (DR) and its complications such as diabetic macular edema continue to remain a major cause for legal blindness in the developed world. While the introduction of anti-tVEGF agents has significantly improved visual outcomes of patients with DR, unpredictable response, largely due to genetic polymorphisms, appears to be a challenge with this therapy. With advances in identification of various genetic biomarkers, novel therapeutic strategies consisting of gene transfer are being developed and tested for patients with DR. Application of pharmacogenetic principles appears to be a promising futuristic strategy to attenuate diabetes-mediated retinal vasculopathy. In this comprehensive review, data from recent studies in the field of pharmacogenomics for the treatment of DR have been provided. PMID:26807609

  19. 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

  20. 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.