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

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

  4. 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

  5. Advances in Alcoholism Treatment

    PubMed Central

    Huebner, Robert B.; Kantor, Lori Wolfgang

    2011-01-01

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

  6. Interpretation of the optical emission of argon in the plume of the Advanced Plasma Source

    NASA Astrophysics Data System (ADS)

    Harhausen, J.; Loffhagen, D.; Foest, R.

    2015-02-01

    The plume of the argon plasma of the Advanced Plasma Source employed for the deposition of optical coatings has been investigated by means of optical emission spectroscopy, Langmuir probe measurements as well as collisional radiative modeling using the measured electron energy probability function as the input. The emission of the ten argon lines considered is found to exhibit a cone-shaped spatial distribution. The emission on the axis of symmetry decreases exponentially with increasing distance from the source in good agreement with the results obtained by collisional radiative modeling and the radial extension of the Gaussian profile in the radial direction increases linearly along the axial direction. The analysis of the measured electron properties shows in particular that the electron pressure varies between about 2 Pa near the plasma source exit and 1 mPa at larger distances. The argon neutral density determined by collisional radiative modeling is found to be about 6 · 1011 cm-3 in the plasma plume in front of the source exit corresponding to a degree of ionization as high as 60%.

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

    USGS Publications Warehouse

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

    2005-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  9. Surgical treatment of advanced melanoma.

    PubMed

    Hussussian, Christopher J

    2010-01-01

    Primary surgical treatment should be considered for patients with metastatic melanoma. Because of the poor response of melanoma to chemotherapy or radiation therapy, surgery can be the best approach to quickly eliminate detectable disease and return the patient to normal activities. In properly selected patients, surgery can lead to significant palliation and prolongation of survival. This article reviews the principles of patient selection and the potential benefits of surgical management of melanoma metastatic to various sites. Novel adjuvant therapies are being developed to augment the benefits of surgical treatment of advanced melanoma in the future.

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  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. 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

  18. 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.

  19. 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.

  20. Sustainability assessment of advanced wastewater treatment technologies.

    PubMed

    Høibye, L; Clauson-Kaas, J; Wenzel, H; Larsen, H F; Jacobsen, B N; Dalgaard, O

    2008-01-01

    As a consequence of the EU Water Framework Directive more focus is now on discharges of hazardous substances from wastewater treatment plants and sewers. Thus, many municipalities in Denmark may have to adopt to future advanced treatment technologies. This paper describes a holistic assessment, which includes technical, economical and environmental aspects. The technical and economical assessment is performed on 5 advanced treatment technologies: sand filtration, ozone treatment, UV exclusively for disinfection of pathogenic microorganisms, membrane bioreactor (MBR) and UV in combination with advanced oxidation. The technical assessment is based on 12 hazardous substances comprising heavy metals, organic pollutants, endocrine disruptors as well as pathogenic microorganisms. The environmental assessment is performed by life cycle assessment (LCA) comprising 9 of the specific hazardous substances and three advanced treatment methods; sand filtration, ozone treatment and MBR. The technical and economic assessment showed that UV solely for disinfection purposes or ozone treatment is the most advantageous advanced treatment methods if the demands are restricted to pathogenic microorganisms. In terms of sustainability, sand filtration is the most advantageous method based on the technical and environmental assessment due to the low energy consumption and high efficiency with regards to removal of heavy metals.

  1. Discovery, interception, and treatment of a groundwater plume: Oak Ridge National Laboratory

    SciTech Connect

    Lee, R.; Ketelle, D.

    1996-06-01

    A radiological groundwater plume was discovered to be discharging into a surface stream and portions of the storm drain network at Oak Ridge National Laboratory (ORNL). A CERCLA removal action was initiated to address the discharges. The plume was found to be migrating 65 degrees oblique to the overall hydraulic gradient and was identified only after historic data were analyzed and field tests were performed under the working hypothesis of stratabound flow and transport. A detailed geologic and hydrologic analysis was performed that accurately predicted the 3-dimensional plume configuration from a single point datum where significantly elevated contaminant levels were found in a bedrock core hole. Subsequent sampling found that direct discharges of contamination existed in the stream only in the location of the predicted stratum. The affected storm drain outfall discharges were suspected to be the major contributors to {sup 90}Sr surface water risk from ORNL. Thus, the selected removal action focused on eliminating the known seepage to the storm drain network. Intercept system operations reduced the total surface water {sup 90}Sr flux by about 90%. Ongoing investigations seek to identify the source of the plume with the hope that the intercept system may eventually be deactivated. However, the efficiency of the system exceeded expectations and demonstrated that a good understanding of the hydrodynamics is a prerequisite to success. The relatively trouble free operation of the system also indicates that simple technologies can serve as effective measures to address immediate problems.

  2. 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).

  3. 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.

  4. [Multidisciplinary treatment of locally advanced rectal cancer].

    PubMed

    Faes, Seraina; Gié, Olivier; Demartines, Nicolas; Hahnloser, Dieter

    2016-06-15

    Treatment of patients with locally advanced rectal cancer remains challenging. Preoperative imaging with pelvic MRI allows to identify patients for multimodal treatment including induction chemothe- rapy or neoadjuvant radio-chemotherapy and an extended surgical resection. With multidisciplinary approach and an experienced team, excellent oncologic results may be achieved, as well as a good function and quality of life, even with preservation of the anus in the majority of patients. PMID:27487624

  5. 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

  6. The porphyrias: advances in diagnosis and treatment.

    PubMed

    Balwani, Manisha; Desnick, Robert J

    2012-11-29

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

  7. The porphyrias: advances in diagnosis and treatment.

    PubMed

    Balwani, Manisha; Desnick, Robert J

    2012-01-01

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

  8. Advanced Treatment for Basal Cell Carcinomas

    PubMed Central

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

    2014-01-01

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

  9. New advances in targeted gastric cancer treatment.

    PubMed

    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

  10. 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

  11. Recent advances in Essential Tremor: Surgical treatment.

    PubMed

    Picillo, Marina; Fasano, Alfonso

    2016-01-01

    While no real breakthrough in the medical treatment of Essential Tremor (ET) has recently emerged, surgical field is expanding exponentially. Purpose of this review is to examine the recent and future developments of the surgical treatments for ET. Technological advances are shaping the present and the future application of deep brain stimulation (DBS) in ET. New electrode configurations as well as new implantable pulse generators are now available. Application of closed-loop or adaptive stimulation in clinical practice will allow DBS to deliver stimulation in a truly physiological way to restore aberrant neurological circuits on demand, thus avoiding side effects, tolerance and also saving the battery life. Besides DBS and standard thalamotomy, novel surgical approaches for ET are on the horizon. The development of MRI-guided focused ultrasound technique has been the new frontier of deep brain lesional therapies. Although the benefit of motor cortex stimulation is yet to be defined, this minimally invasive approach remains intriguing. Although the advances of surgical treatments along the clinical and technological directions described in this review will certainly contribute to a successful management of ET patients, future studies need to consider critical issues such as the heterogeneity of ET and the development of tolerance. PMID:26382842

  12. Recent advances in Essential Tremor: Surgical treatment.

    PubMed

    Picillo, Marina; Fasano, Alfonso

    2016-01-01

    While no real breakthrough in the medical treatment of Essential Tremor (ET) has recently emerged, surgical field is expanding exponentially. Purpose of this review is to examine the recent and future developments of the surgical treatments for ET. Technological advances are shaping the present and the future application of deep brain stimulation (DBS) in ET. New electrode configurations as well as new implantable pulse generators are now available. Application of closed-loop or adaptive stimulation in clinical practice will allow DBS to deliver stimulation in a truly physiological way to restore aberrant neurological circuits on demand, thus avoiding side effects, tolerance and also saving the battery life. Besides DBS and standard thalamotomy, novel surgical approaches for ET are on the horizon. The development of MRI-guided focused ultrasound technique has been the new frontier of deep brain lesional therapies. Although the benefit of motor cortex stimulation is yet to be defined, this minimally invasive approach remains intriguing. Although the advances of surgical treatments along the clinical and technological directions described in this review will certainly contribute to a successful management of ET patients, future studies need to consider critical issues such as the heterogeneity of ET and the development of tolerance.

  13. 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

  14. Recent advances in treatment of aplastic anemia

    PubMed Central

    Shin, Seung Hwan; Lee, Sung Eun

    2014-01-01

    Recent advances in the treatment of aplastic anemia (AA) made most of patients to expect to achieve a long-term survival. Allogeneic stem cell transplantation (SCT) from HLA-matched sibling donor (MSD-SCT) is a preferred first-line treatment option for younger patients with severe or very severe AA, whereas immunosuppressive treatment (IST) is an alternative option for others. Horse anti-thymocyte globuline (ATG) with cyclosporin A (CsA) had been a standard IST regimen with acceptable response rate. Recently, horse ATG had been not available and replaced with rabbit ATG in most countries. Subsequently, recent comparative studies showed that the outcomes of patients who received rabbit ATG/CsA were similar or inferior compared to those who received horse ATG/CsA. Therefore, further studies to improve the outcomes of IST, including additional eltrombopag, are necessary. On the other hand, the upper age limit of patients who are able to receive MSD-SCT as first-line treatment is a current issue because of favorable outcomes of MSD-SCT of older patients using fludarabine-based conditioning. In addition, further studies to improve the outcomes of patients who receive allogeneic SCT from alternative donors are needed. In this review, current issues and the newly emerging trends that may improve their outcomes in near futures will be discussed focusing the management of patients with AA. PMID:25378968

  15. Tvashtar's Plume

    NASA Technical Reports Server (NTRS)

    2007-01-01

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

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

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

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

  16. Advances in 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

  17. Biogenic metals in advanced water treatment.

    PubMed

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

    2009-02-01

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

  18. 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

  19. 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).

  20. 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 ...

  1. 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.

  2. Advances in Adolescent Substance Abuse Treatment

    PubMed Central

    Botzet, Andria M.; Fahnhorst, Tamara

    2011-01-01

    Alcohol and other drug use among adolescents has been a public health problem for decades. Although some substance use may be developmentally routine, a concerning number of adolescents meet criteria for a substance use disorder and could greatly benefit from a quality treatment experience. However, parents and health care providers want evidence of the efficacy of adolescent-specific treatment programs. This review summarizes four factors surrounding the efficacy of current adolescent treatment programs: 1) adolescent-specific treatment services; 2) the variety of therapeutic modalities; 3) relapse and recovery rates; and 4) the need for evidence-based, quality assessments and research. Current adolescent treatment efforts are summarized, and the recent literature regarding the efficacy of adolescent treatment and recovery rates is discussed. PMID:21701838

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

    NASA Astrophysics Data System (ADS)

    Lee, D. S.; Lisk, I.

    2015-12-01

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

  4. 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

  5. ASSESSMENT OF PLUME DIVING

    EPA Science Inventory

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

  6. 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

  7. 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.

  8. The treatment of advanced juvenile nasopharyngeal angiofibroma.

    PubMed

    McGahan, R A; Durrance, F Y; Parke, R B; Easley, J D; Chou, J L

    1989-11-01

    Fifteen patients with juvenile nasopharyngeal angiofibroma (JNA) were treated in the Department of Radiation Oncology, Baylor College of Medicine between 1973 and 1986. All patients underwent radiographic evaluation including CT scanning, selective digital subtraction angiography, tomograms, or MRI. Patients referred for definitive irradiation exhibited extensive tumor involvement. Eleven of 15 patients had middle cranial fossa involvement; cavernous sinus extension was observed in six patients. Ten patients were treated with primary radiation therapy; five patients had surgical resection initially and were referred for radiation therapy upon local recurrence. Follow-up ranges from 1 1/2-13 years. Four of the 5 patients who received 3200 cGy in 200 cGy fractions demonstrated tumor recurrence within 2 years after irradiation. All recurrences were ultimately controlled by either further irradiation and/or resection. No tumor recurrence was encountered among the patients treated at the higher tumor doses (36-46 Gy). No severe complications have been observed. Radiation therapy utilizing carefully tailored fields is an appropriate therapeutic approach to patients with extensive disease or intracranial extension. A total dose of greater than 40 Gy may allow improved local control for advanced lesions.

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. [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

  15. Advances in nanomedicines for malaria treatment.

    PubMed

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

    2013-12-01

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

  16. Advances in nanomedicines for malaria treatment.

    PubMed

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

    2013-12-01

    Malaria is an infectious disease that mainly affects children and pregnant women from tropical countries. The mortality rate of people infected with malaria per year is enormous and became a public health concern. The main factor that has contributed to the success of malaria proliferation is the increased number of drug resistant parasites. To counteract this trend, research has been done in nanotechnology and nanomedicine, for the development of new biocompatible systems capable of incorporating drugs, lowering the resistance progress, contributing for diagnosis, control and treatment of malaria by target delivery. In this review, we discussed the main problems associated with the spread of malaria and the most recent developments in nanomedicine for anti-malarial drug delivery. PMID:24192063

  17. 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

  18. [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.

  19. Development of treatment strategies for advanced neuroblastoma.

    PubMed

    Hara, Junichi

    2012-06-01

    Neuroblastoma is the most common cancer in childhood. The majority of patients with neuroblastoma are assigned to the high-risk group based on age at diagnosis, stage, histology, MYCN status, and DNA ploidy. Their prognosis remains unsatisfactory; the 5-year event-free survival (EFS) rate is generally 40 %. During the past 20 years, much effort has been made to reinforce chemotherapy, including the introduction of high-dose chemotherapy with autologous stem cell rescue, resulting in a 5-year EFS rate of around 30 %. Subsequently, maintenance therapy aimed at eradicating residual tumors after induction and consolidation therapies was introduced, consisting of differentiation-inducing agents, retinoids, and immunotherapy using anti-GD2 antibodies combined with cytokines. However, such additional treatment provided benefit to only 10-20 % of patients, while the prognosis of about half the patients remains poor. Currently, novel targeted agents are under development. Among them, anaplastic lymphoma kinase (ALK) inhibitors and aurora kinase A inhibitors are promising. ALK somatic mutation or gene amplification predisposing neuroblastoma development occurs in up to 15 % of neuroblastomas. Crizotinib is a dual-specific inhibitor of ALK/Met and inhibits proliferation of neuroblastoma cells harboring R1275Q-mutated ALK or amplified wild-type ALK, but not cells harboring F1174L. Instead, cells with F1174L are sensitive to another small molecule ALK inhibitor, TAE684. Aurora kinase A plays a pivotal role in centrosome maturation and spindle formation during mitosis. MLN8237 (alisertib) is a small molecule inhibitor of aurora kinase A that is currently in early-phase clinical testing. Future treatment will be individually planned, adapting targeted agents based on personal biological tumor characteristics.

  20. Cellulite: advances in treatment: facts and controversies.

    PubMed

    Emanuele, Enzo

    2013-01-01

    Cellulite is traditionally considered a highly prevalent aesthetic condition in women. From a clinical standpoint, it is characterized by a cottage-cheese-like appearance of the skin, which can be most commonly found in certain areas of the body (eg, thighs, buttocks, and legs). Although cellulite is generally asymptomatic, the more severe stages can be accompanied by the appearance of painful nodules and increased local temperature, which are suggestive of an inflammatory reaction occurring in the dermis and in the underlying subcutaneous adipose tissue. Whether cellulite is a real disease or only a disturbing aesthetic issue is still a matter of controversy. This debate notwithstanding, it seems clear from market trends that there is considerable commercial interest in developing effective strategies aimed at reducing the cottage-cheese-like appearance of cellulite areas. Quite disturbingly, the majority of treatment attempts to date have been conducted in an empirical manner and without the application of rigorous scientific methodology. This is likely due--at least in part--to the lack of major, evidence-based pathophysiological insights into the nature of this condition. More stringent regulatory control is needed over commercial products aiming at improving the appearance of cellulite.

  1. Recent advancements in drug treatment of obesity.

    PubMed

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

    2012-10-01

    The prevalence of obesity is rising worldwide, with the U.K. having the highest prevalence in Europe. Obesity is associated with significant morbidity and has substantial healthcare implications, with current projections estimating that by 2030 obesity will cost the NHS approximately pounds 2 billion each year. Lifestyle modification remains the cornerstone of anti-obesity treatment, but drugs can be introduced as adjuncts to assist and maintain weight loss. Some 1.45 million obesity-related prescriptions were dispensed in 2009, highlighting the high demand for obesity pharmacotherapy. At present, the lipase inhibitor orlistat (Xenical) is the only UK-approved long-term medical therapy for obesity. Double-blind clinical trials have shown that orlistat significantly increases weight loss compared to placebo, but the array of adverse side effects associated with orlistat limits its tolerability. The need for more effective and better-tolerated anti-obesity medications is clear and six therapies have reached phase-III trials. PMID:23101148

  2. 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

  3. 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

  4. 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.

  5. [Advances in the research of treatment of hydrofluoric acid burn].

    PubMed

    Wang, Xin-gang; Zhang, Yuan-hai; Han, Chun-mao

    2013-08-01

    Hydrofluoric acid (HF) is one of the most common inorganic acids used widely in industrial circle. HF not only causes cutaneous burn, but also induces systemic toxicity by its unique injury mechanism. Accurate and timely diagnosis and treatment are critical after HF burns. To date, the strategies for treating HF burns have been developed, mainly including topical treatments and systematic support. However, there is no standard treatment strategy with wide acceptance in the world. This paper presents a comprehensive overview of the advances in the research of strategies for the treatment of HF burns.

  6. 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

  7. Plume head - trench interaction: impact on subduction dynamics

    NASA Astrophysics Data System (ADS)

    Betts, P. G.; Moresi, L. N.; Mason, W. G.; Willis, D.

    2013-12-01

    The geologic record provides numerous examples where plumes and their associated buoyancy swell have disrupted convergent plate margins. These interactions have produced a variety of responses in the overriding plate including transient episodes of arc amagmatism, transient episodes of crustal shortening followed by plume-related magmatism in the overriding plate. The latter observation implies the plume must have transitioned from the subducting plate to the overriding plate. We present several 3D Underworld numerical models of plume heads of variable dimension and buoyancy interacting with a subduction trench. The models indicate that plume heads impact enormously on trench geometry. Arcuate trenches are created as the trench retreats around the edges of the plume head, whereas trench advance occurs in front of the plume resulting in transient crustal shortening in the overriding plate. Stalling of subduction when the plume head impacts the trench causes slab windowing. The size of the slab window is dependent on the size and buoyancy of the plume. The creation of the slab window provides a potential conduit for plume migration to the overriding plate. Alternatively, the plume head may be transferred to the overriding plate as subduction is re-established behind the plume. Models with "strong" slabs, characterized by high yield strengths, display different behavior. Plume-heads are entrained in the slab and are subducted without the development of a slab window.

  8. Variability and Composition of Io's Pele Plume

    NASA Astrophysics Data System (ADS)

    Jessup, K. L.; Spencer, J.; Yelle, R.

    2004-11-01

    The Pele plume is one of the largest and most dynamic of the plumes on Io. While sulfur dioxide (SO2) gas was always assumed to be a constituent of this plume, spectral observations obtained in 1999 were the first to positively identify elemental sulfur (S2) (Spencer et al. 2000) within the Pele plume. The S2/SO2 ratio derived from this observation provided a critical component necessary for the constraint of the magma chemistry and vent conditions of the Pele plume (Zolotov and Fegley 1998). But, because the Pele plume has long been known to be variable in its eruptive behavior, it is not likely that the vent conditions are invariant. Consequently, additional observations were needed to constrain the extent of the variability of the plume's composition and gas abundances. To this end, in February 2003, March 2003 and January 2004 we obtained spectra of Pele with Hubble's Space Telescope Imaging Spectrograph (STIS) in transit of Jupiter, using the 0.1 arcsec slit, for the wavelength region extending from 2100-3100 Å. Contemporaneous with the spectral data we also obtained UV and visible-wavelength images of the plume in reflected sunlight with the Advanced Camera for Surveys (ACS) prior to Jupiter transit, in order to constrain plume dust abundance. The newly acquired STIS data show both the S2 and SO2 absorption signatures, and provide concrete evidence of temporal variability in the abundance of these gases. Likewise, the degree of dust scattering recorded in the ACS data varied as a function of the date of observation. We will present preliminary constraints on the composition and variability of the gas abundances of the Pele plume as recorded within the STIS data. We will also give a brief overview of the variability of the plume dust signatures relative to the gas signatures as a function of time.

  9. Recent Advances in the Treatment of Isosexual Precocious Puberty

    PubMed Central

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

    1991-01-01

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

  10. 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.

  11. 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…

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

    PubMed Central

    Digklia, Antonia; Wagner, Anna Dorothea

    2016-01-01

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

  13. Advances in developing alternative treatments for postharvest pest control

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  14. 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…

  15. Significance of Surgical Plume Obstruction During Laparoscopy

    PubMed Central

    da Silva, Rodrigo Donalisio; Sehrt, David; Molina, Wilson R.; Moss, Jake; Park, Sang Hyun

    2014-01-01

    With the advent of laparoscopic surgery, the need of optimal visualization and efficient instrumentation has created a need for better understanding of the characteristics of the surgical plume. Despite the technological advances of digital imaging and dissector technology (ultrasonic, radiofrequency electrical, and bipolar), the inconvenient and sometimes harmful generation of a surgical plume decreases visualization, often requiring the surgeon to remove the scope from the surgical field and remove the obstructing particles. If visualization is suboptimal or lost during bleeding, the outcome can be deadly. Therefore, we reviewed the available reports in the literature focused on the quantification of surgical plumes. PMID:25419108

  16. Advances in the treatment of central serous chorioretinopathy

    PubMed Central

    Abouammoh, Marwan A.

    2015-01-01

    Central serous chorioretinopathy is a disease that is partly understood. Novel advancements have led to further understanding of the disease, and have identified choroidal dysfunction as the principal element in CSCR development. New imaging tools have aided in better monitoring disease response to various treatment models. Enhanced depth imaging optical coherence tomography, in particular, has helped in observing choroidal thickness changes after various treatment models. To date, photodynamic therapy and focal laser remain the main stay of treatment. More understanding of disease pathophysiology in the future will help in determining the drug of choice and the best management option for such cases. PMID:26586979

  17. 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

  18. 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

  19. 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.

  20. [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

  1. Advances in the treatment of inherited coagulation disorders.

    PubMed

    Escobar, M A

    2013-09-01

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

  2. 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.

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

    PubMed

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

    2015-03-01

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

  4. 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

  5. Measurements and simulations of the visual effects of particulate plumes

    NASA Astrophysics Data System (ADS)

    Seigneur, Christian; Bergstrom, Robert W.; Johnson, Clark D.; Willard Richards, L.

    In this paper we present field measurements of the visual effects of particulate plumes from two power plants and a copper smelter. The measurements were conducted at downwind distances ranging from 7 to 34 km and for sun-observer angles ranging from 40 to 160°. The visual effects of the power plant plumes were relatively small due to atmospheric dispersion (Kincaid power plant plume in February 1981) or hazy background (Labadie power plant plume in August 1981). The plume from the San Manuel smelter was more visible because of the clean environment. The measurements of plume contrasts range from - 0.15 to + 0.15. Further development of the EPA plume visibility model to improve the treatment of multiple scattering of light and incorporate light absorption by carbonaceous aerosols is described. Teleradiometer measurements and model simulations are in reasonable agreement for cases in which experimental uncertainties are small. The model appears to underpredict forward scattering of light by plume particles.

  6. Treatment of advanced non-small cell lung cancer.

    PubMed

    De Petris, L; Crinò, L; Scagliotti, G V; Gridelli, C; Galetta, D; Metro, G; Novello, S; Maione, P; Colucci, G; de Marinis, F

    2006-03-01

    In the last decade the treatment of advanced-metastatic non-small cell lung cancer has substantially improved. If in the early 90s there was still concern about the real efficacy of chemotherapy over best suppotive care alone in the advanced setting, constant developments in clinical research have demonstrated the survival advantage of active anti-cancer drugs not only in the first-line setting, but, lately, even in patients with recurrent disease after failure of two previous chemotherapy lines. With the premises of high throughput technologies, translational research is aiming to characterize patients and tumors on a molecular basis. With pharmacogenomics it would then be possible to accurately predict patient outcome and tailor the treatment strategy according to the geno-phenotype of single patients.

  7. Warm autoimmune hemolytic anemia: advances in pathophysiology and treatment.

    PubMed

    Michel, M

    2014-04-01

    Autoimmune hemolytic anemia due to warm antibodies (wAIHA) accounts for approximately 70% to 80% of all AIHAs in adults. The pathogenesis of wAIHA is a complex multistep process, the last step of which being the abnormal production of auto-antibodies directed towards red blood cells' membrane antigens. The recent advances in the understanding of the underlying mechanisms leading to the breakdown of self-tolerance in wAIHA, mainly thanks to the study of animal models are discussed in this review. Treatment of wAIHA has long been empirical and mainly based on corticosteroids. In the last decade however, the efficacy of rituximab as second-line treatment has been demonstrated first in retrospective and more recently throughout prospective studies. Based on these advances, an algorithm for the management of primary adult's wAIHA is proposed in this review.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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

  13. 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

  14. Recent advances in tuberculosis: New drugs and treatment regimens.

    PubMed

    Sloan, Derek J; Davies, Geraint R; Khoo, Saye H

    2013-06-01

    The current treatment regimen against drug susceptible tuberculosis (DS-TB) was defined by the 1980s. Since then the emergence of the global HIV pandemic and the escalation of drug resistant (DR-) forms of TB have presented new challenges for therapeutic research. Priority goals include shortening DS-TB treatment, improving DR-TB treatment and making combined TB-HIV therapy easier. To help achieve these goals, a range of new drugs and treatment strategies are currently being evaluated. Phase IIb and III clinical trials are ongoing to assess combinations involving the high-dose rifamycins, the 8-methoxyquinolones, a diarylquinoline (bedaquiline) and the nitroimidazoles. Other compounds (e.g. novel oxazolidinones and ethylenediamines) are at earlier stages of clinical development. Overall, there are grounds for optimism that recent advances will contribute towards achievement of new treatment regimens in the foreseeable future. However, long-term investment, political commitment and scientific endeavour are crucial to ensure that progress is sustained and the benefits of recent advances reach those in the greatest need.

  15. Technological advances in the surgical treatment of movement disorders.

    PubMed

    Gross, Robert E; McDougal, Margaret E

    2013-08-01

    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 inserting 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 magnetic resonance imaging 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 computed tomography 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 biomarkers continuously recorded by the devices. Finer-grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via current steering algorithms. Finally, even thermocoagulation-essentially replaced by DBS-is being advanced by new minimally-invasive approaches that may improve this therapy for selected patients in whom it may be preferred. Functional

  16. Technological advances in the surgical treatment of movement disorders.

    PubMed

    Gross, Robert E; McDougal, Margaret E

    2013-08-01

    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 inserting 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 magnetic resonance imaging 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 computed tomography 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 biomarkers continuously recorded by the devices. Finer-grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via current steering algorithms. Finally, even thermocoagulation-essentially replaced by DBS-is being advanced by new minimally-invasive approaches that may improve this therapy for selected patients in whom it may be preferred. Functional

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

    PubMed Central

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

    2013-01-01

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

  18. 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

  19. Turbulent plumes in stellar convective envelopes.

    NASA Astrophysics Data System (ADS)

    Rieutord, M.; Zahn, J.-P.

    1995-04-01

    Recent numerical simulations of compressible convection in a stratified medium suggest that strong downwards directed flows may play an important role in stellar convective envelopes, both in the dynamics and in the energy transport. We transpose this idea to stellar convective envelopes by assuming that these plumes are turbulent plumes which may be described by Taylor's entrainment hypothesis, whose validity is well established in various geophysical conditions. We consider first the ideal case of turbulent plumes occurring in an isentropic atmosphere, and ignore all types of feedback. Thereafter we include the effect of the backflow generated by the plumes, and take into account the contribution of the radiative flux. The main result is that plumes originating from the upper layers of a star are able to reach the base of its convective envelope. Their number is necessarily limited because of their conical shape; the backflow further reduces their number to a maximum of about 1000. In these plumes the flux of kinetic energy is directed downwards, but it is less than the upwards directed enthalpy flux, so that the plumes always carry a net energy flux towards the surface. Our plume model is not applicable near the surface, where the departures from adiabaticity become important due to radiative leaking; therefore it cannot predict the depth of the convection zone, which is determined mainly by the transition from the radiative regime above to the nearly adiabatic conditions below. Neither does it permit to evaluate the extent of penetration, which strongly depends on the (unknown) number of plumes. We conclude that, to be complete, a phenomenological model of stellar convection must have a dual character: it should include both the advective transport through diving plumes, which is outlined in this paper, and the turbulent diffusion achieved by the interstitial medium. Only the latter process is apprehended by the familiar mixing-length treatment.

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

    PubMed

    Rojas Hernandez, Cristhiam M; Oo, Thein Hlaing

    2015-03-01

    Pernicious anemia (PA) is an entity initially described in 1849 as a condition that consisted of pallor, weakness, and progressive health decline. Since then several advances led to the conclusion that PA is an autoimmune disease characterized by the deficient absorption of dietary cobalamin. It is currently recognized as the most common cause of cobalamin deficiency worldwide. We hereby review the current understanding of the disease and its neurological, hematological, and biochemical manifestations with emphasis on the diagnostic approach, treatment, and monitoring strategies. We propose an algorithm for the diagnostic approach considering the current performance and limitations of the available diagnostic tools for evaluation of cobalamin status and the presence of autoimmune chronic atrophic gastritis (CAG). Patients with PA require lifelong treatment with cobalamin replacement therapy. The current widely available treatment can be provided through enteral or parenteral cobalamin supplements, with comparable efficacy and tolerability. PMID:25828519

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders

    PubMed Central

    Murawski, Nathen J.; Moore, Eileen M.; Thomas, Jennifer D.; Riley, Edward P.

    2015-01-01

    Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facial characteristics of exposure, and examination of the relation between face, brain, and behavior. Basic research also is pointing toward potential new interventions for FASD involving pharmacotherapies, nutritional therapies, and exercise interventions. Although researchers have assessed the majority of these treatments in animal models of FASD, a limited number of recent clinical studies exist. An assessment of this literature suggests that targeted interventions can improve some impairments resulting from developmental alcohol exposure. However, combining interventions may prove more efficacious. Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment. PMID:26259091

  6. NRL Satellite Volcanic Ash Plume Monitoring

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

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

  7. 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.

  8. 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

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

    PubMed Central

    Papadantonakis, Nikolaos; Advani, Anjali S.

    2016-01-01

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

  10. Neoadjuvant treatment for locally advanced rectal cancer: a systematic review.

    PubMed

    Uehara, Keisuke; Nagino, Masato

    2016-02-01

    We reviewed the history and the current status of neoadjuvant treatment for locally advanced rectal cancer (LARC) in Western countries and Japan. The introduction of total mesorectal excision (TME) and preoperative radiotherapy (RT) were treatment revolutions that resulted in improved local control after curative resection for rectal cancer. However, local relapses still occur, even in the era of TME, and remain a cause of recurrence worldwide. The high rate of distant metastasis after curative resection remains a problem. Furthermore, the introduction of newly developed cytotoxic agents into the LARC treatment strategy continues to be an ongoing challenge. Shifting part of an adjuvant chemotherapy (CTx) regimen to the preoperative period is a promising strategy. Currently, various novel methods, such as induction CTx, consolidation CTx, concomitant administration with RT, and neoadjuvant CTx without RT, have been attempted worldwide. Although some strategies have shown favorable short-term outcomes, the long-term efficacy of the treatments needs be evaluated. At the same time, we must investigate clinical and/or molecular biomarkers to predict the therapeutic effects of each treatment, which is the fastest route to providing ideal personalized therapy for patients with LARC.

  11. 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

  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. Microbial populations in contaminant plumes

    USGS Publications Warehouse

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

    2000-01-01

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

  14. Recent advancements of bortezomib in acute lymphocytic leukemia treatment.

    PubMed

    Du, Xiao-Li; Chen, Qi

    2013-01-01

    Although survival rates for acute lymphocytic leukemia (ALL), especially in children, have shown dramatic improvement over time, poor outcomes are still observed in patients who have refractory or relapsed disease after conventional chemotherapy. New therapeutic options are urgently needed. Bortezomib (Velcade, formerly PS-341) is the first proteasome inhibitor approved by the US FDA for the treatment of newly diagnosed multiple myeloma and relapsed/refractory multiple myeloma and mantle cell lymphoma. Although the mechanisms of bortezomib anticancer activity are still not completely understood, it is a new treatment option for patients with refractory or relapsed ALL, particularly when used in combination with conventional chemotherapy or targeted agents. This review summarizes recent advancements in the understanding of the bortezomib molecular mechanism of action in ALL. Understanding of the molecular approaches might help customize cancer chemotherapy for each individual patient, directing the field towards rational therapeutics.

  15. Advances in the diagnosis and treatment of sarcoidosis

    PubMed Central

    2014-01-01

    This manuscript outlines recent advances in the diagnosis and treatment of sarcoidosis. The diagnosis of sarcoidosis can occasionally be made on clinical grounds without a confirmatory biopsy when very specific clinical findings are present. Otherwise, the diagnosis requires histologic evidence of granulomatous inflammation, exclusion of alternative causes, and evidence of systemic disease. Because there is no available diagnostic test for sarcoidosis, the diagnosis is never completely secure. Instruments have been developed to establish the presence of sarcoidosis in a second organ and hence establish the systemic nature of the disease. Corticosteroids remain the drug of choice for the treatment of sarcoidosis. Additional sarcoidosis medications are most commonly used as corticosteroid-sparing agents. Recent clinical sarcoidosis drug trials have exposed important issues that may confound trial results, including selecting patients with active disease, identifying study drug effects in patients receiving concomitant corticosteroids, and establishing proper study endpoints. PMID:25374667

  16. 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)

  17. [Modern aspects of surgical treatment of locally advanced pelvic cancer].

    PubMed

    Solovyov, I A; Vasilchenko, M V; Lychev, A B; Ambartsumyan, S V; Alekseev, V V

    2015-09-01

    The aim of investigation is to improve surgical treatment of patients with locally advanced pelvic cancer. The basis of investigation is 186 patients with locally advanced pelvic cancer. The average age of patients is 65.2 ± 5.2 years (from 43.7 to 88.4 years). Among them are 112 women and 74 men. In the period from 2007 to 2015 they were carried out combined (101 patients) and expanded (85 patients) surgical intervention in the department of naval surgery of the Military medical academy after S.M.Kirov. Pelvic evisceration was performed in 63 cases. Both patients were performed isolated vascular hyperthermic chemical pelvic perfusion. Indications for plastic surgery of peritoneum pelvic were: total infralitoral pelvic evisceration (9 patients), dorsal infralitoral pelvic evisceration (11 cases) and expanded abdominoperineal rectum extirpation (34 patients). Plastic surgery with autogenouse tissues was performed to 43 patients, with reticulate explants--to 11 patients. The rate of postoperative complications was 40.2%. The rate of postoperative lethality was 8%. Expanded and combined operations of pelvic at patients with locally advanced cancer without absolute contra-indications can be performed irrespective of age. Plastic surgery of peritoneum pelvic after total and dorsal infralitoral pelvic evisceration and expanded abdominoperineal rectum extirpation indicated in all cases. The easiest method is plastic surgery with greater omentum or peritoneum pelvic. Plastic surgery with reticulate explants is performed when autoplastic is impossible. PMID:26827515

  18. 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

  19. Remembrance of conversations past: oral advance statements about medical treatment.

    PubMed Central

    Sommerville, A.

    1995-01-01

    Polls show increasing public interest in advance statements or directives about medical treatment ("living wills") but that few people, apart from Jehovah's Witnesses, carry such documents. Patients' firm, witnessed oral decisions are often sufficient to aid clinical decision making but should still be recorded in medical notes. Without documentation, dilemmas arise when others claim to know patients' views on the basis of past unrecorded conversations and demand withdrawal of treatment when patients are not terminally ill and cannot speak for themselves. Legal and ethical considerations oblige doctors to act in the best interests of an incapacitated patient; these considerations are now formally defined in draft legislation as including consideration of the patient's past wishes. The practicalities of ascertaining the strength and validity of such wishes from conversations reported second hand are complex. The paucity of legal and ethical guidance on reported oral advance statements makes debate imperative and renders the alternative of having designated surrogate decision makers increasingly attractive. Images p1664-a PMID:7795460

  20. Advances in the diagnosis, pathogenesis and treatment of CIDP.

    PubMed

    Dalakas, Marinos C

    2011-08-16

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic autoimmune neuropathy. Despite clinical challenges in diagnosis-owing in part to the existence of disease variants, and different views on how many electrophysiological abnormalities are needed to document demyelination-consensus criteria seem to have been reached for research or clinical practice. Current standard of care involves corticosteroids, intravenous immunoglobulin (IVIg) and/or plasmapheresis, which provide short-term benefits. Maintenance therapy with IVIg can induce sustained remission, increase quality of life and prevent further axonal loss, but caution is needed to avoid overtreatment. Commonly used immunosuppressive drugs offer minimal benefit, necessitating the development of new therapies for treatment-refractory patients. Advances in our understanding of the underlying immunopathology in CIDP have identified new targets for future therapeutic efforts, including T cells, B cells, and transmigration and transduction molecules. New biomarkers and scoring systems represent emerging tools with the potential to predict therapeutic responses and identify patients with active disease for enrollment into clinical trials. This Review highlights the recent advances in diagnosing CIDP, provides an update on the immunopathology including new target antigens, and discusses current treatments, ongoing challenges and future therapeutic directions.

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

    Glaucoma is the leading cause of irreversible blindness worldwide. The goal of this study was to describe our experience with the novel micropulse transscleral cyclophotocoagulation (MP-TSCPC; IRIDEX IQ810 Laser Systems, CA) in patients with advanced glaucoma. Patients with advanced glaucoma who underwent MP-TSCPC were included in our study. Laser settings were 2000 mW of 810 nm infrared diode laser set on micropulse delivery mode. The laser was delivered over 360° for 100-240 s. The duty cycle was 31.3 %, which translated to 0.5 ms of "on time" and 1.1 ms of "off time." Surgical success was defined as an intraocular pressure (IOP) of 6-21 mmHg or a reduction of IOP by 20 % at the last follow-up visit. Failure was defined as an inability to meet the criteria for success or a need for incisional glaucoma surgery. Nineteen patients underwent MP-TSCPC with mean follow-up of 60.3 days. Mean IOP dropped from 37.9 mmHg preoperatively to 22.7 mmHg at last follow-up, representing a 40.1 % decrease. The success rate for initial treatment was 73.7 % (n = 14). Three patients underwent a second treatment, increasing the overall success rate to 89.5 % (n = 17). Four patients gained one line of vision, and four patients lost one line of vision. The novel MP-TSCPC laser had a high rate of surgical success after a short follow-up period in patients with advanced glaucoma. Further long-term evaluation and comparison to the traditional transscleral cyclophotocoagulation are warranted. PMID:26714976

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. Advances in Risk Classification and Treatment Strategies for Neuroblastoma

    PubMed Central

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

    2015-01-01

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

  10. 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.

  11. 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.

  12. Geodynamic modeling of eclogite-bearing mantle plumes: Ascent dynamics, plume-plate-interaction and surface manifestations

    NASA Astrophysics Data System (ADS)

    Dannberg, Juliane; Sobolev, Stephan

    2014-05-01

    under which conditions thermo-chemical plumes ascend through the whole mantle and what structures they form in the upper mantle. Modeling shows that plumes with a buoyancy higher than some critical value directly advance to the base of the lithosphere, while plumes with slightly lower buoyancy pond in a depth of 300-400 km and form pools or a second layer of hot material. These structures become asymmetric and finger-like channels begin to form when the plume gets entrained by a quickly moving overlying plate. Our models also suggest that thermo-chemical plumes ascend in the mantle much slower compared to thermal plumes and have thicker plume tails. The conversion of plume excess temperatures to anomalies in seismic velocity shows that thermo-chemical low-buoyancy plumes can explain a variety of features observed by seismic tomography much better than purely thermal plumes.

  13. 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

  14. 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...

  15. 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.

  16. 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

  17. Assessment of the risk potential of pyrolysis products in plume produced during laser treatment under OR conditions

    NASA Astrophysics Data System (ADS)

    Albrecht, Hansjoerg; Waesche, Wolfgang; Mueller, Gerhard J.

    1995-01-01

    Aerosols, vapors, and gases in smoke produced during laser treatments of tissue can be a nuisance to the operating team and the patient and may be the source of potential health hazards. This paper provides information on distribution models as a link between aerosol and gaseous emission and immission to persons in the operating room. In vitro measurements according to this model were performed in an operating scenario. During vaporization of porcine liver with a CO2 laser (20 W cw) respirable fine dust was collected at several measuring points in a typical operating room. The fine dust concentration was acquired at three measuring points both as the mean value of 30 minutes and as six consecutive measurements of five minutes each. Since the maximum concentration was measured above the treated surface the operating surgeon is likely to aspirate most of the dust. Thus the immission concentration of volatile organic compounds (VOC) typically produced during vaporization was also determined at this measuring point. The measured values were compared to theoretically predicted developments of concentrations of dust and VOC. To estimate the potential health hazards the measured concentrations were related to threshold limits given by the European authorities.

  18. 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

  19. 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.

  20. 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

  1. Mars Methane Plume Tracer

    NASA Astrophysics Data System (ADS)

    Mischna, M. A.; Banfield, D.; Sykes, I.

    2014-07-01

    Putative releases of methane from the martian surface may be challenging to detect from orbit. Successful detections depend on the character of the plume itself (duration, magnitude, expanse), but also on the observing platform.

  2. 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...

  3. Neuropsychological resiliency after treatment for advanced stage neuroblastoma.

    PubMed

    Carpentieri, S C; Diller, L R

    2005-06-01

    The purpose of this study was to describe the neuropsychological functioning of survivors of advanced stage neuroblastoma. In all, 16 survivors, diagnosed at a median of 2.8 years, who had received intensive chemotherapy and surgical treatments, were identified; 11 had received myeloablative consolidation therapy, eight with total body irradiation (TBI). All patients were evaluated with a neuropsychological assessment battery at a median age of 8.8 years. Analyses included comparison of the performances of the TBI group vs the no-TBI group; determination of whether the proportion of individuals with impaired or superior performance on each measure exceeded normative expectations; and performance indexes reflecting patterns of performance. Results indicate no significant deleterious impact of TBI and/or presence or absence of myeloablative therapy on neurocognitive and neurobehavioral functioning. For this cohort, resilience to neuropsychological vulnerability was observed, which included the emergence of a profile of full-scale IQ, verbal IQ, and mathematical achievement well above average expectations. We concluded that the results document a lack of neuropsychological morbidity among this cohort of survivors of advanced stage neuroblastoma, regardless of the inclusion of TBI. Moreover, a striking pattern of excellent neurocognitive functioning with intact neurobehavioral functioning was observed.

  4. 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.

  5. 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

  6. 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

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

    PubMed

    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.

  8. 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.

  9. Advances in pathogenesis and treatment of systemic sclerosis.

    PubMed

    Denton, Christopher P

    2016-02-01

    Systemic sclerosis is the most severe disease within the scleroderma spectrum and is a major medical challenge with high mortality and morbidity. There have been advances in understanding of pathogenesis that reflect the interplay between immune-inflammatory processes and vasculopathy and fibrosis. It can be regarded as a disease of connective tissue repair and this leads to organ-based complications. However the aetiology and triggering events remain to be elucidated. Treatment is available for many aspects of the disease although the available therapies are not curative and some complications remain very challenging, especially non-lethal manifestations such as fatigue, calcinosis and anorectal dysfunction. Immunosuppression is now established as a beneficial approach but balancing risk and benefit is vital, especially for powerful approaches such as autologous stem cell transplantation.

  10. Advances in pathogenesis and treatment of systemic sclerosis.

    PubMed

    Denton, Christopher P

    2015-12-01

    Systemic sclerosis is the most severe disease within the scleroderma spectrum and is a major medical challenge with high mortality and morbidity. There have been advances in understanding of pathogenesis that reflect the interplay between immune-inflammatory processes and vasculopathy and fibrosis. It can be regarded as a disease of connective tissue repair and this leads to organ-based complications. However the aetiology and triggering events remain to be elucidated. Treatment is available for many aspects of the disease although the available therapies are not curative and some complications remain very challenging, especially non-lethal manifestations such as fatigue, calcinosis and anorectal dysfunction. Immunosuppression is now established as a beneficial approach but balancing risk and benefit is vital, especially for powerful approaches such as autologous stem cell transplantation.

  11. Advancements in stem cells treatment of skeletal muscle wasting

    PubMed Central

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

    2014-01-01

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

  12. 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

  13. 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

  14. 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

  15. 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!

  16. 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

  17. 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.

  18. Pembrolizumab for Treatment of Patients with Advanced or Unresectable Melanoma.

    PubMed

    Sullivan, Ryan J; Flaherty, Keith T

    2015-07-01

    From Coley's toxin to combination immune checkpoint inhibition, strategies to activate the immune system and generate anticancer immunity have been ongoing for well over a century. Over the past decade, the so-called immune checkpoint inhibitors, generally monoclonal antibodies that target key regulators of T-cell activation, emerged as the most effective immune-targeted agents. Pembrolizumab is the first anti-programmed death 1 (PD-1) antibody approved by the FDA for the treatment of metastatic melanoma. With responses seen in 25% to 40% of patients, depending on dose and setting (i.e., before or after ipilimumab), pembrolizumab specifically and anti-PD-1 antibodies generally are revolutionizing the treatment of melanoma. However, in the setting of other recent advances in the field, a number of practical issues are emerging that need to be addressed to optimize the care of patients with melanoma. First, the optimal sequencing of therapy (first-line immunotherapy over molecular targeted therapy, ipilimumab versus pembrolizumab as initial immune checkpoint inhibitor) is unknown and must be evaluated through randomized trials. Second, there is a strong rationale to combine immune checkpoint inhibitors (i.e., anti-PD-1 with ipilimumab) and to combine immune therapies with targeted therapy agents, so determining whether combination therapy is better than direct sequencing is another critical issue that needs to be addressed in carefully carried out studies.

  19. Advancing drug delivery systems for the treatment of multiple sclerosis.

    PubMed

    Tabansky, Inna; Messina, Mark D; Bangeranye, Catherine; Goldstein, Jeffrey; Blitz-Shabbir, Karen M; Machado, Suly; Jeganathan, Venkatesh; Wright, Paul; Najjar, Souhel; Cao, Yonghao; Sands, Warren; Keskin, Derin B; Stern, Joel N H

    2015-12-01

    Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. It is characterized by demyelination of neurons and loss of neuronal axons and oligodendrocytes. In MS, auto-reactive T cells and B cells cross the blood-brain barrier (BBB), causing perivenous demyelinating lesions that form multiple discrete inflammatory demyelinated plaques located primarily in the white matter. In chronic MS, cortical demyelination and progressive axonal transections develop. Treatment for MS can be stratified into disease-modifying therapies (DMTs) and symptomatic therapy. DMTs aim to decrease circulating immune cells or to prevent these cells from crossing the BBB and reduce the inflammatory response. There are currently 10 DMTs approved for the relapsing forms of MS; these vary with regard to their efficacy, route and frequency of administration, adverse effects, and toxicity profile. Better drug delivery systems are being developed in order to decrease adverse effects, increase drug efficacy, and increase patient compliance through the direct targeting of pathologic cells. Here, we address the uses and benefits of advanced drug delivery systems, including nanoparticles, microparticles, fusion antibodies, and liposomal formulations. By altering the properties of therapeutic particles and enhancing targeting, breakthrough drug delivery technologies potentially applicable to multiple disease treatments may rapidly emerge.

  20. 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.

  1. Advances in diagnosis and treatment of trigeminal neuralgia.

    PubMed

    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

  2. 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

  3. 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.

  4. 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

  5. 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

  6. Recent Advances in the Treatment of Organophosphorous Poisonings

    PubMed Central

    Balali-Mood, Mahdi; Saber, Hamidreza

    2012-01-01

    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

  7. 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.

  8. Dairy farm wastewater treatment by an advanced pond system.

    PubMed

    Craggs, R J; Tanner, C C; Sukias, J P S; Davies-Colley, R J

    2003-01-01

    Waste stabilisation ponds (WSPs) have been used for the treatment of dairy farm wastewater in New Zealand since the 1970s. The conventional two pond WSP systems provide efficient removal of wastewater BOD5 and total suspended solids, but effluent concentrations of other pollutants including nutrients and faecal bacteria are now considered unsuitable for discharge to waterways. Advanced Pond Systems (APS) provide a potential solution. A pilot dairy farm APS consisting of an Anaerobic pond (the first pond of the conventional WSP system) followed by three ponds: a High Rate Pond (HRP), an Algae Settling Pond (ASP) and a Maturation Pond (which all replace the conventional WSP system facultative pond) was evaluated over a two year period. Performance was compared to that of the existing conventional dairy farm WSP system. APS system effluent quality was considerably higher than that of the conventional WSP system with respective median effluent concentrations of BOD5: 34 and 108 g m(-3), TSS: 64 and 220 g m(-3), NH4-N: 8 and 29 g m(-3), DRP: 13 and 17 g m(-3), and E. coli: 146 and 16195 MPN/100 ml. APS systems show great promise for upgrading conventional dairy farm WSPs in New Zealand.

  9. 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

  10. Viral hemorrhagic fevers: advancing the level of treatment

    PubMed Central

    2012-01-01

    The management of viral hemorrhagic fevers (VHFs) has mainly focused on strict infection control measures, while standard clinical interventions that are provided to patients with other life-threatening conditions are rarely offered to patients with VHFs. Despite its complexity, a proper clinical case management of VHFs is neither futile nor is it lacking in scientific rationale. Given that patient outcomes improve when treatment is started as soon as possible, development and implementation of protocols to promptly identify and treat patients in the earliest phases of diseases are urgently needed. Different pharmacological options have been proposed to manage patients and, as for other life-threatening conditions, advanced life support has been proved effective to address multiorgan failure. In addition, high throughput screening of small molecular libraries has emerged as a novel promising way to find new candidates drugs for VHFs therapy and a relevant number of new molecules are currently under investigation. Here we discuss the current knowledge about VHF clinical management to propose a way to step up the approach to VHFs beyond the mere application of infection control measures. PMID:22458265

  11. Current Pharmacological Advances in the Treatment of Cardiac Arrest

    PubMed Central

    Papastylianou, Andry; Mentzelopoulos, S.

    2012-01-01

    Cardiac arrest is defined as the sudden cessation of spontaneous ventilation and circulation. Within 15 seconds of cardiac arrest, the patient loses consciousness, electroencephalogram becomes flat after 30 seconds, pupils dilate fully after 60 seconds, and cerebral damage takes place within 90–300 seconds. It is essential to act immediately as irreversible damage can occur in a short time. Cardiopulmonary resuscitation (CPR) is an attempt to restore spontaneous circulation through a broad range of interventions which are early defibrillation, high-quality and uninterrupted chest compressions, advanced airway interventions, and pharmacological interventions. Drugs should be considered only after initial shocks have been delivered (when indicated) and chest compressions and ventilation have been started. During cardiopulmonary resuscitation, no specific drug therapy has been shown to improve survival to hospital discharge after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This paper reviews current pharmacological treatment of cardiac arrest. There are three groups of drugs relevant to the management of cardiac arrest: vasopressors, antiarrhythmics, and other drugs such as sodium bicarbonate, calcium, magnesium, atropine, fibrinolytic drugs, and corticosteroids. PMID:22145080

  12. 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.

  13. Skylon Aerodynamics and SABRE Plumes

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

  14. Rocket plume burn hazard.

    PubMed

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

    1980-05-01

    By use of miniature rocket engines, the burn hazard posed by exposure to ejection seat rocket plume flames was determined in the anaesthetized rat. A reference chart is provided for predicting equivalent effects in human skin based on extrapolation of earlier direct measurements of heat input for rat and human burns. The chart is intended to be used in conjunction with thermocouple temperature measurements of the plume environment for design and modification of escape seat system to avoid thermal injury on ejection from multiplace aircraft. PMID:7387571

  15. Plumes Do Not Exist

    NASA Astrophysics Data System (ADS)

    Hamilton, W. B.; Anderson, D. L.; Foulger, G. R.; Winterer, E. L.

    Hypothetical plumes from the deep mantle are widely assumed to provide an abso- lute hotspot reference frame, inaugurate rifting, drive plates, and profoundly influence magmatic and tectonic evolution of oceans and continents. Many papers on local to global tectonics, magmatism, and geochemistry invoke plumes, and assign to the man- tle whatever properties, dynamics, and composition are needed to enable them. The fixed-plume concept arose from the Emperor-Hawaii seamount-and-island province, the 45 Ma inflection in which was assumed to record a 60-degree change in direction by the Pacific plate. Paleomagnetic latitudes and smooth Pacific spreading patterns show that such a change did not occur. Other Pacific chains once assumed to be syn- chronous with, and Euler-parallel to, Hawaii have proved to be neither. Thermal and physical properties of Hawaiian lithosphere falsify plume predictions. Rationales for fixed hotspots elsewhere also have become untenable as databases enlarged. Astheno- sphere is everywhere near solidus temperature, so buoyant melt does not require a local heat source but, rather, needs a thin roof or crack or tensional setting for egress. MORB and ocean-island basalt (OIB) broadly intergrade in composition, but MORB typically is richer in refractory elements and their radiogenic daughters, whereas OIB commonly is richer in fusible elements and their daughters. MORB and OIB contrasts are required by melt behavior and do not indicate unlike source reservoirs. MORB melts rise, with minimal reaction, through hot asthenosphere, whereas OIB melts re- act, and thereby lose substance, by crystallizing refractories and retaining and assim- ilating subordinate fusibles, with thick, cool lithosphere and crust. There is no need for hypotheses involving chaotic plume behavior or thousands of km of lateral flow of plume material, nor for postulates of SprimitiveT lower mantle contrary to cos- & cedil;mological and thermodynamic considerations. Plume

  16. 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.

  17. 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...

  18. 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.

  19. The Fluid Dynamics of Plumes

    NASA Astrophysics Data System (ADS)

    Hansen, U.

    Plumes form as instabilities from thermal boundary layers of convecting systems.The shape, the size and the temporal evolution of plumes is strongly influenced by the vis- cosity of the material. Employing a numerical scheme the evolution of plumes in fluids with strong temperature and temperature-pressure dependent viscosity has been stud- ied. The strong dependence of viscosity on temperature leads to a pulse-like evolution of the plumes.Pulses of hot material rise episodically through the pre-established low viscosity channels. In a later stage the plumes generate extended network-like struc- tures in the thermal boundary layers. Pressure dependence of the viscosity leads to a significant cooling of the plumes.Furthe a fragmentation of one plume into several smaller ones is commonly observed. While internal convection takes place within the plume head, only little entrainment of material is observed.

  20. Advances in the treatment of cognitive impairment in Parkinson's disease.

    PubMed

    Goldman, Jennifer G; Weintraub, Daniel

    2015-09-15

    Cognitive impairment in Parkinson's disease (PD) is a frequent complication, with significant interindividual variability in clinical symptoms, severity, timing, and neural substrates. Recent studies have focused not only on understanding PD dementia, but also mild cognitive impairment in PD, which may represent a prodromal stage for dementia. In recent years, there have been important advances regarding clinical characterizations, definitions, associated biomarkers, and risk factors for both mild cognitive impairment in PD and PD dementia. However, there is a paucity of effective therapies for cognitive impairment in PD, whether for mild symptoms or for moderate to severe dementia. At present, only rivastigmine is U.S. Food and Drug Administration approved for PD dementia, an indication received nearly a decade ago. Given the frequency of PD cognitive impairment and its substantial impact on both patients and families, the lack of available and effective treatments represents a striking gap in the field, especially when compared to the large number of available therapies for PD motor symptoms and complications. Improved symptomatic therapies, as well as potential disease-modifying agents, for PD cognitive impairment are needed. Most therapeutic trials for PD dementia and mild cognitive impairment in PD have focused on drugs developed for and tested in Alzheimer's disease, such as cholinesterase inhibitors and the N-methyl-D-aspartate receptor antagonist, memantine, though recent and ongoing trials examine the effects of pharmacological agents affecting other neurotransmitters, as well as nonpharmacological therapies, including mental and physical exercise and neurostimulation. This review summarizes the design and outcomes of trials for PD cognitive impairment published since 2013 and highlights future therapeutic research opportunities and challenges.

  1. 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.

  2. 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…

  3. 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.

  4. 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.

  5. 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

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

    PubMed

    Plakun, Eric M

    2015-09-01

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

  7. 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...

  8. Reducing the Human Burden of Breast Cancer: Advanced Radiation Therapy Yields Improved Treatment Outcomes.

    PubMed

    Currey, Adam D; Bergom, Carmen; Kelly, Tracy R; Wilson, J Frank

    2015-01-01

    Radiation therapy is an important modality in the treatment of patients with breast cancer. While its efficacy in the treatment of breast cancer was known shortly after the discovery of x-rays, significant advances in radiation delivery over the past 20 years have resulted in improved patient outcomes. With the development of improved systemic therapy, optimizing local control has become increasingly important and has been shown to improve survival. Better understanding of the magnitude of treatment benefit, as well as patient and biological factors that confer an increased recurrence risk, have allowed radiation oncologists to better tailor treatment decisions to individual patients. Furthermore, significant technological advances have occurred that have reduced the acute and long-term toxicity of radiation treatment. These advances continue to reduce the human burden of breast cancer. It is important for radiation oncologists and nonradiation oncologists to understand these advances, so that patients are appropriately educated about the risks and benefits of this important treatment modality.

  9. 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

  10. Modeling mercury in power plant plumes.

    PubMed

    Lohman, Kristen; Seigneur, Christian; Edgerton, Eric; Jansen, John

    2006-06-15

    Measurements of speciated mercury (Hg) downwind of coal-fired power plants suggest that the Hg(II)/(Hg0 + HgII) ratio (where HgII is divalent gaseous Hg and Hg0 is elemental Hg) decreases significantly between the point of emission and the downwind ground-level measurement site, but that the SO2/(Hg0 + HgII) ratio is conserved. We simulated nine power plant plume events with the Reactive & Optics Model of Emissions (ROME), a reactive plume model that includes a comprehensive treatment of plume dispersion, transformation, and deposition. The model simulations fail to reproduce such a depletion in HgII. A sensitivity study of the impact of the HgII dry deposition velocity shows that a difference in dry deposition alone cannot explain the disparity. Similarly, a sensitivity study of the impact of cloud chemistry on results shows that the effect of clouds on Hg chemistry has only minimal impact. Possible explanations include HgII reduction to Hg0 in the plume, rapid reduction of HgII to Hg0 on ground surfaces, and/or an overestimation of the HgII fraction in the power plant emissions. We propose that a chemical reaction not included in current models of atmospheric mercury reduces HgII to Hg0 in coal-fired power plant plumes. The incorporation of two possible reduction pathways for HgII (pseudo-first-order decay and reaction with SO2) shows better agreement between the model simulations and the ambient measurements. These potential HgII to Hg0 reactions need to be studied in the laboratory to investigate this hypothesis. Because the speciation of Hg has a significant effect on Hg deposition, models of the fate and transport of atmospheric Hg may need to be modified to account for the reduction of HgII in coal-fired power plant plumes if such a reaction is confirmed in further experimental investigations.

  11. 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

  12. 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

  13. Treatment of cellulite: Part II. Advances and controversies.

    PubMed

    Khan, Misbah H; Victor, Frank; Rao, Babar; Sadick, Neil S

    2010-03-01

    Treatments for localized adiposities range from topical creams to liposuction. Most treatments lack a substantial proof of efficacy. The unpredictable treatment outcome can be related to the fact that cellulite adipose tissue is physiologically and biochemically different from subcutaneous tissue found elsewhere in the body. Part II of this two-part series on cellulite reviews the various treatment options that are currently available for human adipose tissue including, but not limited to, cellulite. It also focuses on newer techniques that can be potentially useful in the future for the treatment of cellulite.

  14. 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.

  15. [Advances in the research of infiltration wetland wastewater treatment systems].

    PubMed

    Cui, Lihua; Zhu, Xizhen; Luo, Shiming

    2003-04-01

    As their high purification efficiency and relatively low capital investment and treatment cost, infiltration wetland wastewater treatment systems have been popular, and are being increasingly applied in many countries. In this paper, the bed structure and filtering media, nitrogen and phosphorus removal processes and purification mechanisms, performance, current design criteria, operation and regulation mechanisms, soil clogging problem and solutions, and combination of vertical-horizontal flow wetlands treatment system and its use in different types of wastewater treatment were introduced and summarized. Finally, the future research directions of this technique were also discussed.

  16. 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.

  17. 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.

  18. [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.

  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

    2016-08-01

    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.

  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

    2016-05-01

    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.

  1. 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

  2. Treatment of a Vadose Zone Plume Using Barometric Pumping: A Passive Soil Vapor Extraction Study at the Miscellaneous Chemicals Basin, Savannah River Site, S.C.

    NASA Astrophysics Data System (ADS)

    Bosze, S. L.; Riha, B.; Rossabi, J.; Hyde, K.

    2001-12-01

    A passive soil vapor extraction (PSVE) treatability study at the Miscellaneous Chemical Basin (MCB) of the Savannah River Site (SRS) has been progressing since September 1996. During this time more than 243 pounds of chlorinated organic contaminants (183 lbs of TCE and 61 lbs of PCE) have been removed by natural barometric pumping of wells fitted with BaroBall TM valves (low-pressure check valves). In addition, contour maps of the vadose zone contaminant gas plume made before the study and after 4.5 years of operation show a significant decrease in the extent of the gas plume and identify the source location. To date, over 86% of all PCE and 89% of all TCE have been removed from the system. By projecting the exponentially declining concentration curves it is estimated that 99% of all PCE and TCE will be removed from the system by 2007 and 2009 respectively. In addition, soil samples were collected in July 2001 at various depths within the previously defined plume source area. Analysis of VOC content in these samples confirms that barometric pumping has significantly remediated the contamination in the MCB area. Barometric pumping harnesses natural atmospheric fluctuations to move air in and out of the vadose zone. Barometric pressure fluctuations are transmitted through the vadose zone, however, these pressure waves are damped and delayed in phase to degrees dependent on the effective vertical permeability of the formation. As a result, there is a pressure differential between the atmospheric pressure at the surface and the soil gas pressure in the subsurface. By connecting these two zones with a vadose zone well, the differential pressure will cause gas flow either into or out of the well. If the soil gas in the subsurface contains VOC's (gas phase), than flow out of the well will remove contaminants from the subsurface without mechanical pumping. The Baroball uses a lightweight ball in a conical seat to allow gas flow in only one direction with little pressure

  3. 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

  4. 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

  5. Endoscopic Coblation for the treatment of advanced juvenile nasopharyngeal angiofibroma.

    PubMed

    Pierson, Brandon; Powitzky, Rosser; Digoy, G Paul

    2012-10-01

    We present 2 cases of advanced juvenile nasopharyngeal angiofibroma (JNA) to illustrate the advantages of endoscopic Coblation-assisted resection of intranasal extensions of these masses. Both patients-an 11-year-old boy and a 14-year-old boy-presented with a large, extensive mass (Radkowski stage IIIb and Fisch stage IVb in both cases). After embolization was performed on each patient, his JNA was partially ablated via an endoscopic approach with the Coblator II Surgery System with an EVac Xtra Plasma Wand in conjunction with an image-guided navigation system. Both patients experienced resolution of their nasal obstruction with removal of the intranasal extension of the tumor. Coblation allowed for a controlled debulking of the tumors with less blood loss and without the need for multiple instruments. To the best of our knowledge, our report is one of the first to describe image-guided endoscopic Coblation of advanced JNA tumors. Future studies in adequately sized populations are needed to determine the safety and effectiveness of Coblation-assisted endoscopic removal of both advanced and lower-stage JNAs.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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.

  13. Advanced pancreatic cancer - how to choose an adequate treatment option

    PubMed Central

    Korkeila, Eija A

    2015-01-01

    The prognosis of pancreatic adenocarcinoma is poor, making it one of the leading causes of cancer-related death. The 5-year overall survival rate remains below 5% and little progress is made during the past decade. Only about 10%-20% of patients are eligible for curative-intent surgery and the majority end up having recurring disease even after radical surgery and postoperative adjuvant chemotherapy. Chemotherapy in metastatic disease is palliative at best, aiming at disease and symptom control and prolongation of life. Treatment always causes side effects, the degree of which varies from patient to patient, depending on the patient’s general condition, concomitant morbidities as well as on the chosen treatment modality. Why is pancreatic cancer so resistant to treatment? How to best help the patient to reach the set treatment goals? PMID:26478662

  14. Upwelling relaxation and estuarine plumes

    NASA Astrophysics Data System (ADS)

    Rao, Shivanesh; Pringle, James; Austin, Jay

    2011-09-01

    After coastal upwelling, the water properties in the nearshore coastal region close to estuaries is determined by the race between the new estuarine plume traveling along the coast and the upwelled front (a marker for the old upwelled plume and the coastal pycnocline) returning to the coast under downwelling winds. Away from an estuary, downwelling winds can return the upwelled front to the coast bringing less dense water nearshore. Near the estuary, the estuarine plume can arrive along the coast and return less dense water to the nearshore region before the upwelled front returns to the coast. Where the plume brings less dense water to the coast first, the plume keeps the upwelled front from returning to the coast. In this region, only the plume and the anthropogenic input and larvae associated with the plume waters influence the nearshore after upwelling. We quantify the extent of the region where the plume is responsible for bringing less dense water to the nearshore and keeping the upwelled front from returning to the coast after upwelling. We successfully tested our predictions against numerical experiments and field observations of the Chesapeake plume near Duck, North Carolina. We argue that this alongshore region exists for other estuaries where the time-integrated upwelling and downwelling wind stresses are comparable.

  15. Structure of axisymmetric mantle plumes

    NASA Technical Reports Server (NTRS)

    Olson, Peter; Schubert, Gerald; Anderson, Charles

    1993-01-01

    The structure of axisymmetric subsolidus thermal plumes in the earth's lower mantle is inferred from calculations of axisymmetric thermal plumes in an infinite Prandtl number fluid with thermally activated viscosity. The velocity and temperature distribution is determined for axisymmetric convection above a heated disk in an incompressible fluid cylinder 2,400 km in height and 1,200 km in diameter. Several calculations of plumes with heat transport in the range 100-400 GW, similar to the advective heat transport at the Hawaiian hotspot, are presented. Hotspot formation by plumes originating at the base of the mantle requires both large viscosity variations and a minimum heat transport.

  16. 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.

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

    PubMed

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

    2016-01-01

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

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. Advances in the treatment of relapsing-remitting multiple sclerosis.

    PubMed

    Tanasescu, Radu; Ionete, Carolina; Chou, I-Jun; Constantinescu, Cris S

    2014-01-01

    This article reviews and discusses the approved and emerging therapies for multiple sclerosis (MS). MS is a chronic and disabling immune-mediated disease of the central nervous system (CNS) that affects mainly young adults. MS imposes a huge economic burden on healthcare systems and the society. Although the last 20 years have brought a continuous expansion in therapeutic options, there are still unmet needs in MS management. Available MS drugs have varying degrees of efficacy in reducing relapse risk. The long-term term effects of these treatments are incompletely known. New therapies, along with variations of currently available treatments, may prove more effective and tolerable than the available drugs. Treatments for MS differ with respect to the mode of administration, tolerability and likelihood of treatment adherence, side effects, and risk of major toxicity. The armamentarium of approved disease-modifying therapies in MS and those in development include: (1) the first approved, moderately effective, injectable interferon-β and glatiramer acetate; (2) oral drugs (fingolimod, laquinimod, teriflunomide, dimethyl fumarate); (3) monoclonal antibodies (rituximab, ocrelizumab, ofatumumab, daclizumab, alemtuzumab); and (4) immunosuppressive agents (e.g. mitoxantrone). The place of each drug in the therapeutic algorithm is dependent on its specific risk-benefit profile. Patients' clinical and paraclinical phenotypes and biomarker profile may help to elucidate disease subtypes and response to therapy in the future, thus allowing treatment individualization. PMID:24732658

  3. 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

  4. Recent advances in the treatment of orthostatic hypotension

    NASA Technical Reports Server (NTRS)

    Robertson, D.; Davis, T. L.

    1995-01-01

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

  5. Spotlight on pembrolizumab in the treatment of advanced melanoma.

    PubMed

    Rajakulendran, Thanashan; Adam, David N

    2015-01-01

    Metastatic melanoma is an aggressive cancer with a poor prognosis. Many approved therapies often do not achieve durable responses in patients. This underscores the need for novel therapeutic strategies. Recruiting a robust immune response is an important antineoplastic treatment strategy. Immune checkpoints offer a molecular target for modulating the immune response and a promising therapeutic target in metastatic melanoma. Here we discuss the recent approval of pembrolizumab by the US Food and Drug Administration for the treatment of metastatic melanoma and its impact on future management of the disease.

  6. 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…

  7. Current treatment of medulloblastoma: recent advances and future challenges.

    PubMed

    Rood, Brian R; Macdonald, Tobey J; Packer, Roger J

    2004-10-01

    Medulloblastoma (MB) is the most common malignant brain tumor of childhood, yet it makes up only 1% of adult brain tumors. MB is uniquely sensitive to chemotherapy and radiation, but successful surgical resection continues to be an important component of therapeutic success. Progress in the treatment of MB has occurred in multiple areas from improved neurosurgical techniques, refined dosing and delivery of radiation, and optimized chemotherapy. Tumors are currently risk-stratified as average risk or high risk depending on clinical factors such as age, extent of resection, and presence of metastases. Molecular biology is beginning to improve upon clinical prognostication and may soon provide the means to accurately predict response to therapy. Treatment for average-risk MB has achieved a level of success that allows efforts to be focused on the limitation of adverse treatment effects. Therapy for high-risk and relapsed MB has been positively affected by the advent of high-dose chemotherapy with stem cell rescue. In addition, molecular targets are being elucidated and new therapeutic agents are being tested for safety and efficacy. Treatment for this disease has evolved a great deal over the preceding decades, but a great deal of work remains to be done to effect reliable cures while reducing long-term sequelae of therapy.

  8. 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.

  9. Advances in the treatment of blunt thoracic aortic injuries.

    PubMed

    Challoumas, Dimitrios; Dimitrakakis, Georgios

    2015-08-01

    Blunt thoracic aortic injuries, even though rare in incidence, carry significant mortality rates and their management still remains challenging. There have been major shifts in diagnosing and treating these injuries in the last 5 decades, which proved to be beneficial in terms of mortality and complications. Endovascular repair has been increasingly used for definitive treatment and its outcomes appear to be at least equally safe and effective as those of open repair. We present a balanced review of the relevant literature regarding the most appropriate approach and definitive treatment of these pathological entities. Based on the studies analyzed, endovascular repair is increasingly being established as the choice of treatment, however, the conventional open surgical approach still remains a safe method for severe injuries; the mortality, complication rates and proven longterm results of the latter are continuously improving. Additionally, delayed repair, where appropriate, seems to be a safe option with very low mortality rates. Despite the encouraging short and midterm outcomes reported, endovascular treatment needs to be assessed in the longterm for more accurate conclusions to be drawn about its durability and safety.

  10. Advances in Diagnosis and Treatments for Immune Thrombocytopenia.

    PubMed

    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 × 10(9)/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

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. Abiraterone for the Treatment of Advanced Prostate Cancer.

    PubMed

    Forde, Patrick M; Antonarakis, Emmanuel S

    2012-09-01

    Until recently, treatment options for castration-resistant prostate cancer (CRPC) were limited to only the chemotherapeutic agent docetaxel which demonstrated a survival advantage over palliative chemotherapy. Abiraterone acetate (AA) is an orally available, potent irreversible inhibitor of the adrenal microsomal enzyme cytochrome P450-17 (CYP17). In a large phase III study of AA in docetaxel-pretreated patients, AA demonstrated excellent tolerance and a 4-month survival advantage over placebo, leading to the approval of AA for docetaxel-pretreated patients by the FDA in 2011. More recently, phase III data in docetaxel-naïve patients have become available, showing clear clinical benefits in this population as well, and it is likely that the label for AA will soon be expanded to include men with CRPC who have not yet received chemotherapy. This article summarizes clinical studies of AA in CRPC patients and discusses the emerging treatment paradigm in this rapidly evolving area.

  18. Funnel-and-gate for in situ groundwater plume containment

    SciTech Connect

    Smyth, D.J.A.; Cherry, J.A.; Jowett, R.J.

    1994-12-31

    At most CERCLA and RCRA sites and numerous other sites, plumes of groundwater contamination emanate from subsurface source zones, commonly DNAPL or LNAPL source zones, where considerable volumes of immiscible organic liquids persist below the water table. Pump-and-treat can provide an effective means of containing hydraulically the dissolved contaminants emanating from these sources; however, at many sites pump-and-treat will have to continue for many decades or longer because the source zones dissipate slowly. Projected long term costs of operation, maintenance, and water disposal or reinjection are therefore large. A new approach for source zone containment or plume control that is more passive than pump-and-treat and that offers considerable potential for long term cost savings has been developed at the University of Waterloo (UW) and is referred to as the fuel-and-gate system (patent pending). In this system low permeability vertical barriers are placed across plumes. Gaps in the barrier allow passage of the plume through the barrier. In the gaps, referred to as gates, a reactive medium is positioned or released so that the plume water is treated while passing through the gates. The reactive medium can be solid phase particles and/or liquid from a controlled release system. The goal is to cause the plume to meet water quality standards on the down gradient side of the funnel-and-gate system and to avoid pumping plume water to surface for treatment.

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

    PubMed

    Thomas, Inas H; DiMeglio, Linda A

    2016-02-01

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

  20. Advances in the treatment of cutaneous lupus erythematosus.

    PubMed

    Kuhn, A; Landmann, A; Wenzel, J

    2016-07-01

    Lupus erythematosus (LE) is a multifactorial autoimmune disease with clinical manifestations of differing severity which may present with skin manifestations as primary sign of the disease (cutaneous lupus erythematosus, CLE) or as part of a disease spectrum (systemic lupus erythematosus, SLE). To date, no drugs are approved specifically for the treatment of CLE and only single agents have been applied in randomized controlled trials. Therefore, topical and systemic agents are used "off-label", primarily based on open-label studies, case series, retrospective analyses, and expert opinions. In contrast, several agents, such as hydroxychloroquine, chloroquine, cyclophosphamide, azathioprine, and belimumab, are approved for the treatment of SLE. Recent approaches in the understanding of the molecular pathogenesis of LE enabled the development of further new agents, which target molecules such as interleukin 6 (IL-6) and interferon (IFN). Only single trials, however, applied these new agents in patients with cutaneous involvement of the disease and/or included endpoints which evaluated the efficacy of these agents on skin manifestations. This article provides an updated review on new and recent approaches in the treatment of CLE. PMID:27252259

  1. 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.

  2. 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.

  3. Targeted treatments in advanced renal cell carcinoma: focus on axitinib

    PubMed Central

    Verzoni, Elena; Grassi, Paolo; Testa, Isabella; Iacovelli, Roberto; Biondani, Pamela; Garanzini, Enrico; De Braud, Filippo; Procopio, Giuseppe

    2014-01-01

    Antiangiogenesis options have evolved rapidly in the last few years, with an increasing number of agents currently approved by the US Food and Drug Administration and European Medicines Agency. Angiogenesis inhibitors have been shown to be very effective for the treatment of metastatic renal cancer cell. Axitinib is a third-generation inhibitor of vascular endothelial growth factor receptor and is currently being developed for the treatment of various malignancies. The pharmacokinetic properties of axitinib may have a selective therapeutic effect, with minimal adverse reactions and enhanced safety. In a large Phase III study of previously treated patients with metastatic renal cell carcinoma, axitinib achieved a longer progression-free survival than sorafenib with an acceptable safety profile and good quality of life. This review focuses on the pharmacology, pharmacokinetics, and clinical activity of axitinib in the current treatment of renal cell carcinoma. The role of axitinib in the adjuvant and/or neoadjuvant setting needs to be evaluated in further clinical trials. PMID:24715765

  4. 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

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

    PubMed

    Thomas, Inas H; DiMeglio, Linda A

    2016-02-01

    Osteogenesis imperfecta (OI) is a rare disorder of type 1 collagen with 13 currently identified types attributable to inherited abnormalities in type 1 collagen amount, structure, or processing. The disease is characterized by an increased susceptibility to bony fracture. In addition to the skeletal phenotype, common additional extraskeletal manifestations include blue sclerae, dentinogenesis imperfecta, vascular fragility, and hearing loss. Medical management is focused on minimizing the morbidity of fractures, pain, and bone deformities by maximizing bone health. Along with optimizing Vitamin D status and calcium intake and physical/occupational therapy, individualized surgical treatment may be indicated. Pharmacological therapy with bisphosphonate medications is now routinely utilized for moderate to severe forms and appears to have a good safety profile and bone health benefits. New therapies with other anti-resorptives as well as anabolic agents and transforming growth factor (TGF)β antibodies are in development. Other potential treatment modalities could include gene therapy or mesenchymal cell transplant. In the future, treatment choices will be further individualized in order to reduce disease morbidity and mortality. PMID:26861807

  6. 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

  7. 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.

  8. 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

  9. 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

  10. Targeted treatment of advanced and metastaticbreast cancer with lapatinib

    PubMed Central

    Corkery, Brendan; O’Donovan, Norma; Crown, John

    2008-01-01

    Improved molecular understanding of breast cancer in recent years has led to the discovery of important drug targets such as HER-2 and EGFR. Lapatinib is a potent dual inhibitor of HER-2 and EGFR. Preclinical and phase I studies have shown activity with lapatinib in a number of cancers, including breast cancer, and the drug is well tolerated. The main known drug interactions are with paclitaxel and irinotecan. The most significant side-effects of lapatinib are diarrhea and adverse skin events. Rates of cardiotoxicity compare favorably with trastuzumab, a monoclonal antibody against HER-2. This paper focuses on lapatinib in advanced and metastatic breast cancer, which remains an important therapeutic challenge. Phase II and III studies show activity as monotherapy, and in combination with chemotherapy or hormonal agents. Results from these studies suggest that the main benefit from lapatinib is in the HER-2 positive breast cancer population. Combinations of lapatinib and trastuzumab are also being studied and show encouraging results, particularly in trastuzumab-refractory metastatic breast cancer. Lapatinib may have a specific role in treating HER-2 positive CNS metastases. The role of lapatinib as neoadjuvant therapy and in early breast cancer is also being evaluated. PMID:21127749

  11. Recent advances of sonodynamic therapy in cancer treatment

    PubMed Central

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

    2016-01-01

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

  12. Advance in the pathogenesis and treatment of Wilson disease

    PubMed Central

    2012-01-01

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

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. Advances in understanding and treatment of Tourette syndrome.

    PubMed

    McNaught, Kevin St P; Mink, Jonathan W

    2011-12-01

    Tourette syndrome is a hereditary, childhood-onset neurodevelopmental disorder that was first clearly described in France in 1885. This disorder is characterized by sudden, rapid, recurrent, nonrhythmic movements (motor tics) or sounds (vocal or phonic tics), often preceded by premonitory sensations or urges. Some individuals also have psychiatric comorbidities, notably attention-deficit hyperactivity disorder or obsessive-compulsive disorder. Tourette syndrome occurs worldwide, in all races and ethnicities, in both sexes and in children as well as in adults. Estimates of its prevalence in children vary, with rates of up to 1% being reported, but rates of 0.3-0.8% are thought to accurately reflect the occurrence of the disorder. Research has led to progress in many aspects of Tourette syndrome, although many questions and unmet needs remain. For example, except for rare cases, the genetic basis remains elusive. The anatomical and neuronal changes in the brain that underlie Tourette syndrome are also unclear, although the evidence increasingly implicates alterations in basal ganglia function. Treatment is often unnecessary for individuals with mild tics, but for those with moderate to severe forms of the syndrome, some drugs are available, albeit frequently ineffective. Behavioral and surgical therapies, in particular deep brain stimulation, are currently undergoing development and show promising results. This Review examines the history of Tourette syndrome and describes its clinical presentation. The article also provides an overview of the epidemiology and pathophysiology of this disorder. Current treatment strategies and potential future therapies are also discussed. PMID:22064610

  18. 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.

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

    PubMed

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

    2015-12-01

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

  20. 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:...

  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. Diagnosis, pathogenesis and treatment of myositis: recent advances

    PubMed Central

    Carstens, P-O; Schmidt, J

    2014-01-01

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

  3. Advances in the Treatment of Fragile X Syndrome

    PubMed Central

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

    2010-01-01

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

  4. 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

  5. Advances in the Understanding and Treatment of Male Urethritis.

    PubMed

    Bachmann, Laura H; Manhart, Lisa E; Martin, David H; Seña, Arlene C; Dimitrakoff, Jordan; Jensen, Jørgen Skov; Gaydos, Charlotte A

    2015-12-15

    Neisseria gonorrhoeae and Chlamydia trachomatis are well-documented urethral pathogens, and the literature supporting Mycoplasma genitalium as an etiology of urethritis is growing. Trichomonas vaginalis and viral pathogens (herpes simplex virus types 1 and 2 and adenovirus) can cause urethritis, particularly in specific subpopulations. New data are emerging regarding the potential role of bacterial vaginosis-associated bacteria in urethritis, although results are inconsistent regarding the pathogenic role of Ureaplasma urealyticum in men. Mycoplasma hominis and Ureaplasma parvum do not appear to be pathogens. Men with suspected urethritis should undergo evaluation to confirm urethral inflammation and etiologic cause. Although nucleic acid amplification testing would detect N. gonorrhoeae and C. trachomatis (or T. vaginalis if utilized), there is no US Food and Drug Administration-approved clinical test for M. genitalium available in the United States at this time. The varied etiologies of urethritis and lack of diagnostic options for some organisms present treatment challenges in the clinical setting.

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

    PubMed Central

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

    2016-01-01

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

  7. [Recent advances in the treatment of type 1 diabetes mellitus].

    PubMed

    Schloot, N C; Roden, M; Bornstein, S R; Brendel, M D

    2011-02-01

    INTERVENTIONAL APPROACHES TO BETA CELL PRESERVATION: In a pilot study, initial attempts at primary prevention by preserving islet beta cells have been successful with highly hydrolyzed milk formula in children who are at high genetic risk of diabetes. Attempts at secondary prevention by intranasal application in children with a high-risk HLA genotype and positive islet autoantibodies have been disappointing. But in tertiary prevention anti-inflammatory, antigen-directed and T-cell targeted treatment has been partially successful in slowing down the destruction of beta cells. BIOLOGICAL BETA CELL SUBSTITUTION: Transplantation of a vascularised pancreas or islet cells results in disease regression and the prevention of secondary/tertiary complications of diabetes. A principal aim is the avoidance of frequent, severe hypoglycaemic episodes resulting from markedly reduced awareness of hypoglycaemia or its counter-regulation.

  8. Novel targeted agents for the treatment of advanced breast cancer.

    PubMed

    de la Vega, Máximo; Díaz-Cantón, Enrique; Alvarez, Ricardo H

    2012-05-01

    The discovery of the molecular processes involved in cancer development has led to the design of an array of targeted agents. These agents, directed to specific proteins in the machinery of cancer cells, interfere with vital cascades involved in cell invasion, metastasis, apoptosis, cell-cycle control and angiogenesis. In breast cancer, the main pathways studied and targeted by drugs are the HER2 pathway, EGFR, VEGF, PI3K/Akt/mammalian target of rapamycin (PI3K-M-Tor), IGF/IGFR, poly(ADP ribose) polymerase 1, HDAC and many others. In this review, we present the most promising studies of these new targeted therapies and novel combination of targeted therapies with cytotoxic agents for the treatment of breast cancer patients. PMID:22571614

  9. Advances in the Understanding and Treatment of Male Urethritis.

    PubMed

    Bachmann, Laura H; Manhart, Lisa E; Martin, David H; Seña, Arlene C; Dimitrakoff, Jordan; Jensen, Jørgen Skov; Gaydos, Charlotte A

    2015-12-15

    Neisseria gonorrhoeae and Chlamydia trachomatis are well-documented urethral pathogens, and the literature supporting Mycoplasma genitalium as an etiology of urethritis is growing. Trichomonas vaginalis and viral pathogens (herpes simplex virus types 1 and 2 and adenovirus) can cause urethritis, particularly in specific subpopulations. New data are emerging regarding the potential role of bacterial vaginosis-associated bacteria in urethritis, although results are inconsistent regarding the pathogenic role of Ureaplasma urealyticum in men. Mycoplasma hominis and Ureaplasma parvum do not appear to be pathogens. Men with suspected urethritis should undergo evaluation to confirm urethral inflammation and etiologic cause. Although nucleic acid amplification testing would detect N. gonorrhoeae and C. trachomatis (or T. vaginalis if utilized), there is no US Food and Drug Administration-approved clinical test for M. genitalium available in the United States at this time. The varied etiologies of urethritis and lack of diagnostic options for some organisms present treatment challenges in the clinical setting. PMID:26602615

  10. 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

  11. Psoriasis. A review of recent advances in treatment.

    PubMed

    Farber, E M; Nall, L

    1984-10-01

    Current concepts in the treatment of psoriasis are reviewed, including: traditional modalities of dithranol (anthralin), tar, and corticosteroids alone or in combination with other agents; phototherapy and photochemotherapy; experimental studies with the aromatic retinoid etretinate and related analogues; dialysis; and the potential use of hyperthermia. Prudent administration of agents that are known to have serious side effects should be the concern of all clinicians. Many regimens that have beneficial short term results may have the potential for long term sequelae that may not only affect the patient but the offspring as well. Two of the most promising innovative concepts in the therapeutic armamentarium for psoriasis are psoriasis 'day care centres', and prevention and self-care. With the ever-increasing costs of medical care throughout the world, ways and means of reducing costs should be initiated by the clinician when considering a treatment programme. The clinician has the responsibility of determining whether the severity of the disease warrants ambulatory outpatient regimens or hospitalisation. If the patient would benefit from daily attention, then the psoriasis day care centre approach provides an appropriate clinical setting. However, in addition to administering appropriate medication, it is incumbent upon the clinician to educate patients regarding their disease and the triggering factors to prevent exacerbations. 'Disability prevention' means extending the services of clinicians and others to deal systematically with 2 areas involved in disease development; one is recognising the genetic component of psoriasis; the other, environmental triggering factors, e.g. infection, trauma to the skin, low humidity, and stress. Until recently, dermatology has focused on diseases and repairing the damage they cause. Now, the significance of genetic and environmental influences in multifactorial diseases like psoriasis has been realised, as has the importance of

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

    SciTech Connect

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

    2000-03-01

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

  13. Efficacy and compliance in treatment of sleep apnea with Herbst mandibular advancement splints (OHA version).

    PubMed

    Amoric, Michel

    2013-06-01

    The benefits of the Herbst thermoformed advancement splint in the treatment of obstructive breathing disorders during sleep have been assessed in numerous studies. Unfortunately, like all other mandibular advancement devices, patients fail to wear it regularly in the long-term. Injuries, discomfort or pain caused by errors in manufacture or adjustment are generally blamed for this. After a critical review of the literature, some solutions are proposed to improve production of the orthesis and patient management.

  14. 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.

  15. Treatment of petroleum refinery sourwater by advanced oxidation processes.

    PubMed

    Coelho, Alessandra; Castro, Antonio V; Dezotti, Márcia; Sant'Anna, G L

    2006-09-01

    The performance of several oxidation processes to remove organic pollutants from sourwater was investigated. Sourwater is a specific stream of petroleum refineries, which contains slowly biodegradable compounds and toxic substances that impair the industrial biological wastewater treatment system. Preliminary experiments were conducted, using the following processes: H2O2, H2O2/UV, UV, photocatalysis, ozonation, Fenton and photo-Fenton. All processes, except Fenton and photo-Fenton, did not lead to satisfactory results, reducing at most 35% of the sourwater dissolved organic carbon (DOC). Thus, further experiments were performed with these two techniques to evaluate process conditions and organic matter removal kinetics. Batch experiments revealed that the Fenton reaction is very fast and reaches, in a few minutes, an ultimate DOC removal of 13-27%, due to the formation of iron complexes. Radiation for an additional period of 60 min can increase DOC removal up to 87%. Experiments were also conducted in a continuous mode, operating one 0.4L Fenton stirred reactor and one 1.6L photo-Fenton reactor in series. DOC removals above 75% were reached, when the reaction system was operated with hydraulic retention times (HRT) higher than 85 min. An empirical mathematical model was proposed to represent the DOC removal kinetics, allowing predicting process performance quite satisfactorily.

  16. 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.

  17. 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

  18. Advancing Tobacco Dependence Treatment Services in the Eastern Mediterranean Region

    PubMed Central

    Hawari, Feras I.; Bader, Rasha K.

    2014-01-01

    Tobacco use negatively affects health and is a major risk factor for non-communicable diseases (NCDs). Today, tobacco use ranks third among risk factors in North Africa and the Middle East in terms of disease burden. Despite the established need for these services, tobacco dependence treatment (TDT) services are still inadequate in the Eastern Mediterranean region (EMR). Among the main challenges hindering their expansion is the current lack of training opportunities. The provision of training and capacity-building—a key enabler of TDT—offers an excellent catalyst to launch TDT services in the region. This review discusses the need for TDT training in the EMR and describes a model for providing regional evidence-based training in line with international standards. The King Hussein Cancer Center in Amman, Jordan, is the regional host for Global Bridges, a worldwide TDT initiative. Using this model, they have trained 1,500 professionals and advocates from the EMR over the past three years. PMID:25364544

  19. 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.

  20. 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.

  1. 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.

  2. Treatment of advanced head and neck cancer: multiple daily dose fractionated radiation therapy and sequential multimodal treatment approach.

    PubMed

    Nissenbaum, M; Browde, S; Bezwoda, W R; de Moor, N G; Derman, D P

    1984-01-01

    Fifty-eight patients with advanced head and neck cancer were entered into a randomised trial comparing chemotherapy (DDP + bleomycin) alone, multiple daily fractionated radiation therapy, and multimodality therapy consisting of chemotherapy plus multiple fractionated radiation therapy. Multimodal therapy gave a significantly higher response rate (69%) than either single-treatment modality. The use of a multiple daily dose fractionation allowed radiation therapy to be completed over 10 treatment days, and the addition of chemotherapy to the radiation treatment did not significantly increase toxicity. Patients receiving multimodal therapy also survived significantly longer (median 50 weeks) than those receiving single-modality therapy (median 24 weeks).

  3. Effects of advanced treatment systems on the removal of antibiotic resistance genes in wastewater treatment plants from Hangzhou, China.

    PubMed

    Chen, Hong; Zhang, Mingmei

    2013-08-01

    This study aimed at quantifying the concentration and removal of antibiotic resistance genes (ARGs) in three municipal wastewater treatment plants (WWTPs) employing different advanced treatment systems [biological aerated filter, constructed wetland, and ultraviolet (UV) disinfection]. The concentrations of tetM, tetO, tetQ, tetW, sulI, sulII, intI1, and 16S rDNA genes were examined in wastewater and biosolid samples. In municipal WWTPs, ARG reductions of 1-3 orders of magnitude were observed, and no difference was found among the three municipal WWTPs with different treatment processes (p > 0.05). In advanced treatment systems, 1-3 orders of magnitude of reductions in ARGs were observed in constructed wetlands, 0.6-1.2 orders of magnitude of reductions in ARGs were observed in the biological aerated filter, but no apparent decrease by UV disinfection was observed. A significant difference was found between constructed wetlands and biological filter (p < 0.05) and between constructed wetlands and UV disinfection (p < 0.05). In the constructed wetlands, significant correlations were observed in the removal of ARGs and 16S rDNA genes (R(2) = 0.391-0.866; p < 0.05). Constructed wetlands not only have the comparable ARG removal values with WWTP (p > 0.05) but also have the advantage in ARG relative abundance removal, and it should be given priority to be an advanced treatment system for further ARG attenuation from WWTP.

  4. [News and perspectives in the treatment of advanced gastric and colorectal cancers].

    PubMed

    Diciolla, A; Cristina, V; De Micheli, R; Digklia, A; Wagner, A D

    2015-05-20

    Colorectal and gastric cancers are the fourth and third leading causes of cancer death world-wide. Unfortunately, gastric cancer is usually diagnosed at an advanced stage after becoming metastatic in distant sites, so that palliative therapy is the mainstay of treatment. Major progress in the understanding of the biology, the development of valid biomarkers and molecular targeted drugs have improved the treatment options and prognosis of both cancers significantly in the last years. Here, we review the current standards of care for patients with advanced and metastatic colorectal and gastric cancer and outline the perspectives for the future.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  7. 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

  8. 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

  9. Treatment of Childhood Acute Lymphoblastic Leukemia: Prognostic Factors and Clinical Advances.

    PubMed

    Vrooman, Lynda M; Silverman, Lewis B

    2016-10-01

    While the majority of children and adolescents with newly diagnosed childhood acute lymphoblastic leukemia (ALL) will be cured, as many as 20 % of patients will experience relapse. On current treatment regimens, the intensity of upfront treatment is stratified based upon prognostic factors with the aim of improving cure rates (for those at the highest risk of relapse) and minimizing treatment-related morbidity (for lower-risk patients). Here we review advances in the understanding of prognostic factors and their application. We also highlight novel treatment approaches aimed at improving outcomes in childhood ALL.

  10. 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...

  11. Integrating first-line treatment options into clinical practice: what's new in advanced melanoma?

    PubMed

    Dummer, Reinhard; Schadendorf, Dirk; Ascierto, Paolo A; Larkin, James; Lebbé, Celeste; Hauschild, Axel

    2015-12-01

    Melanoma remains a serious form of skin cancer in Europe and worldwide. Localized, early-stage melanomas can usually be treated with surgical excision. However, the prognosis is poorer for patients with advanced disease. Before 2011, treatment for advanced melanoma included palliative surgery and/or radiotherapy, and chemotherapy with or without immunotherapy, such as interleukin-2. As none of these treatments had shown survival benefits in patients with advanced melanoma, European guidelines had recommended that patients be entered into clinical trials. The lack of approved first-line options and varying access to clinical trials meant that European clinicians relied on experimental regimens and chemotherapy-based treatments when no other options were available. Since 2011, ipilimumab, an immuno-oncology therapy, and vemurafenib and dabrafenib, targeted agents that inhibit mutant BRAF, have been approved by the European Medicines Agency for the treatment of advanced melanoma. More recently, the MEK inhibitor, trametinib, received European marketing authorization for use in patients with BRAF mutation-positive advanced melanoma. In 2014, the anti-PD-1 antibody nivolumab was approved as a first-line therapy in Japan. Whereas nivolumab and another anti-PD-1 antibody, pembrolizumab, were approved as second-line therapies in the USA, their recent approval in Europe are for first-line use based on new clinical trial data in this setting. Together these agents are changing clinical practice and making therapeutic decisions more complex. Here, we discuss current and emerging therapeutic options for the first-line treatment of advanced melanoma, and how these therapies can be optimized to provide the best possible outcomes for patients. PMID:26426764

  12. [Current status and future prospect of internal medicine treatment for advanced esophageal cancer].

    PubMed

    Wang, F; Fan, Q X

    2016-09-23

    Esophageal cancer (EC) is one of common malignant tumors, and the incidence and mortality of EC in China rank the first place in the world. Because of the occult onset, the early atypical symptoms, and the lack of effective early diagnostic methods, most of patients are diagnosed at an advanced stage of the disease and lost the chance of surgery. Comprehensive treatment including palliative medical treatment, molecular targeted therapy, immunotherapy and so on is appropriate for these patients. How to choose the chemotherapy regimen and formulate reasonable treatment plan has become a hot spot in clinical research. Molecular targeted drugs have become a new developmental direction in cancer treatment because of their high specificity and antitumor activity, but the effects on esophageal cancer remain controversial. With the development of immune check point blockade treatment, breakthrough has been made in tumor immunotherapy, which has become an important means in cancer comprehensive treatment and shown a good prospect of treatment.

  13. [Current status and future prospect of internal medicine treatment for advanced esophageal cancer].

    PubMed

    Wang, F; Fan, Q X

    2016-09-23

    Esophageal cancer (EC) is one of common malignant tumors, and the incidence and mortality of EC in China rank the first place in the world. Because of the occult onset, the early atypical symptoms, and the lack of effective early diagnostic methods, most of patients are diagnosed at an advanced stage of the disease and lost the chance of surgery. Comprehensive treatment including palliative medical treatment, molecular targeted therapy, immunotherapy and so on is appropriate for these patients. How to choose the chemotherapy regimen and formulate reasonable treatment plan has become a hot spot in clinical research. Molecular targeted drugs have become a new developmental direction in cancer treatment because of their high specificity and antitumor activity, but the effects on esophageal cancer remain controversial. With the development of immune check point blockade treatment, breakthrough has been made in tumor immunotherapy, which has become an important means in cancer comprehensive treatment and shown a good prospect of treatment. PMID:27647396

  14. Discuss the impact technological advances in equipment and materials have made on the delivery and outcome of endodontic treatment.

    PubMed

    Lababidi, Emad Aldin

    2013-12-01

    Recent advances in endodontic equipment and materials have considerably changed the manner in which endodontic treatment is delivered. Specific technological advances, including nickel-titanium instruments, ultrasonic instruments and the dental operating microscope have been associated with increased efficiency and efficacy of treatment and simplification of delivery. The effects of most of these changes have been tested via in vitro studies and case reports. Ongoing studies should constantly investigate what effects technological advances might have on the outcome of endodontic treatment.

  15. 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.

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

    PubMed

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

    2000-01-10

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

  17. 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.

  18. 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...

  19. 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

  20. Advanced treatment of landfill leachate by a new combination process in a full-scale plant.

    PubMed

    Li, Huo-Sheng; Zhou, Shao-Qi; Sun, Yan-Bo; Feng, Ping; Li, Jing-da

    2009-12-15

    Advanced treatment of mature landfill leachate from a municipal landfill located in southern China (Jiangmen) was carried out in a full-scale plant using a new process. The combined process has a sequencing batch reactor (SBR) serving as the primary treatment, with polyferric sulfate (PFS) coagulation coupled with a Fenton system as secondary treatment, and a pair of upflow biological aerated filters (UBAFs) in parallel as tertiary treatment. The overall removal efficiency of chemical oxygen demand (COD) in this process was 97.3%, with an effluent COD less than 100 mg/L. Up to 99% ammonia (N-NH3) removal efficiency was achieved in the SBR, with an effluent of less than 3 mg/L, which meets the discharge standard (< or =25 mg/L) with only primary treatment. The total phosphorus (TP) and suspended solids (SS) in the final effluent were reduced to less than 1 mg/L and 10 mg/L, respectively. The experience gained in the operation and maintenance will lead to a more stable performance of this combined process. An economic analysis shows that the overall operating cost of the advanced treatment was $2.70/m(3). This new combination process was proved to be highly compatible and efficient in a small-scale landfill leachate treatment plant and is recommended for small-scale landfill leachate treatment plants.

  1. 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

  2. The Structure and Origin of Solar Plumes: Network Plumes

    NASA Astrophysics Data System (ADS)

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

    2009-07-01

    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 Å 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.

  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. 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

  5. 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

  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. 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.

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

    PubMed

    Pesta, Wiesław; Kurpiewski, Waldemar; Kowalczyk, Marek; Szynkarczuk, Rafał; Luba, Magdalena; Zurada, Anna; Grabysa, Radosław

    2011-12-01

    In spite of medical science development and initiation of new technologies in minimally invasive surgery, treatment of advanced chronic venous insufficiency at the 5(th) and 6(th) 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.

  9. 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

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

    PubMed

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

    2016-01-01

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

  11. 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

  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. Developing treatment and control conditions in a clinical trial of massage therapy for advanced cancer.

    PubMed

    Smith, Marlaine; Kutner, Jean; Hemphill, Linnea; Yamashita, Traci; Felton, Susanne

    2007-01-01

    The purpose of this article is to describe the challenges faced by a research team in developing treatment and control conditions in a study of the efficacy of massage therapy for advanced cancer. Five design considerations were addressed related to developing a massage therapy protocol: (1) dosage, that is, the number, spacing and length of treatments; (2) type of massage therapy; (3) degree to which the protocol for the treatment is standardized; (4) qualifications of the persons providing the treatment; and (5) conditions under which the treatment is provided. Five criteria for structuring the control condition of the study are elaborated: (1) equivalency of contact; (2) similarity of form; (3) minimum adverse or negative effects; (4) expectancy of therapeutic benefit; and (5) minimum therapeutic benefit.

  14. 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.

  15. Treatment patterns in advanced melanoma: findings from a survey of European oncologists.

    PubMed

    Jones, C; Zhao, Z; Barber, B; Bagijn, M; Corrie, P; Saltman, D

    2015-11-01

    With the emergence of new therapies, established patterns of treating advanced melanoma are changing. The aim of this study was to understand how advanced melanoma is treated in clinical practice in Europe following the introduction of ipilimumab and vemurafenib. An online survey was conducted between August and November 2012 with 150 oncologists and dermatologists, from France, Germany, Italy, Spain and the U.K.; respondents reported treating the majority of patients with one or two lines of therapy. For BRAF mutant melanoma, the most frequently used first-line treatments were vemurafenib and dacarbazine. For BRAF wild-type melanoma, the most frequently used first-line treatment was dacarbazine. There was no single preferred agent for the second-line treatment of BRAF mutant or BRAF wild-type disease. Most sequencing from first- to second-line was from conventional dacarbazine to newer agents such as ipilimumab and vemurafenib. The treatment of advanced melanoma is rapidly evolving due to the introduction of new agents. This study presents an early insight into access to the new agents, ipilimumab and vemurafenib, and clinical practice in several European countries.

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

    PubMed

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

    2007-08-01

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

  17. 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...

  18. 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.

  19. Guideline adherence for the treatment of advanced schistosomiasis japonica in Hubei, China.

    PubMed

    Zhong, Fangying; Liu, Chenxi; Zhang, Xinping

    2014-12-01

    This study compared physicians' practices on three treatment procedures and hospitalization days with guideline recommendations to assess guideline adherence in the treatment of advanced schistosomiasis japonica. Descriptive statistics were used to estimate patients' characteristics and rate of guideline adherence. And chi-square tests were used to assess influences of severity of the disease on guideline adherence. The study found no one (0/173) adhered to adequate diagnosis, treatment regimens, and discharge criteria of guidelines completely. And 2.23% of patients in group 1 and 4.23% in group 2 were totally conforming to adequate diagnosis. 91.91% of patients were conforming to adequate treatment regimens among which group 1 and group 2 were 90.32 and 92.25%, respectively. And one (2.23%) patient in group 1 and zero (0%) in group 2 were conforming to discharge criteria of guidelines, and most of the patients left hospital without symptom checks (151/173), liver function and biochemical tests (169/173), and complication checks (91/173). Among 173 inpatients, rate of adequate hospitalization days was 36.42% (63/173). And chi-square test suggested no significant difference (P > 0.05) on guideline adherence in two groups, which implied both of critical and general patients' treatments should be stressed to comply with guidelines. There existed a large gap between guidelines and practices of the treatment of advanced schistosomiasis japonica.

  20. Critical evaluation of ramucirumab in the treatment of advanced gastric and gastroesophageal cancers.

    PubMed

    ElHalawani, Hesham; Abdel-Rahman, Omar

    2015-01-01

    Gastric (GC) and gastroesophageal junction (GEJ) cancers are two global health problems with a relatively high mortality, particularly in the advanced stage. Inhibition of angiogenesis is now contemplated as a classic treatment preference for myriad tumor types encompassing renal cell carcinoma, non-small cell lung cancer, colorectal cancer, glioblastoma, and ovarian cancer, among others. Bevacizumab and ramucirumab have been widely investigated in GC and GEJ cancer, with some controversy about their therapeutic role. Ramucirumab is a monoclonal antibody for vascular endothelial growth factor receptor-2, with demonstrated activity both as a monotherapy and as a part of combination strategy in the management of advanced GC/GEJ cancer. In this review article, we present a critical evaluation of the preclinical and clinical data underlying the use of this drug in this indication. Moreover, we provide a spotlight on the future perspectives in systemic therapy for advanced GC/GEJ cancer.

  1. Critical evaluation of ramucirumab in the treatment of advanced gastric and gastroesophageal cancers

    PubMed Central

    ElHalawani, Hesham; Abdel-Rahman, Omar

    2015-01-01

    Gastric (GC) and gastroesophageal junction (GEJ) cancers are two global health problems with a relatively high mortality, particularly in the advanced stage. Inhibition of angiogenesis is now contemplated as a classic treatment preference for myriad tumor types encompassing renal cell carcinoma, non-small cell lung cancer, colorectal cancer, glioblastoma, and ovarian cancer, among others. Bevacizumab and ramucirumab have been widely investigated in GC and GEJ cancer, with some controversy about their therapeutic role. Ramucirumab is a monoclonal antibody for vascular endothelial growth factor receptor-2, with demonstrated activity both as a monotherapy and as a part of combination strategy in the management of advanced GC/GEJ cancer. In this review article, we present a critical evaluation of the preclinical and clinical data underlying the use of this drug in this indication. Moreover, we provide a spotlight on the future perspectives in systemic therapy for advanced GC/GEJ cancer. PMID:26251608

  2. 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

  3. 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

  4. 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.

  5. 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

  6. Advanced Mixed Waste Treatment Project, Design, Construction and Start-up

    SciTech Connect

    Dobson, A.; Harrop, G.; Holmes, R.G.G.

    2006-07-01

    The Advanced Mixed Waste Treatment Project (AMWTP) was awarded to BNG America in December of 1996. In 2005, following discussions between the United States (US) Department of Energy (DOE) and the United Kingdom (UK) Department of Trade and Industry (DTi) the DOE purchased the facilities. DOE awarded Bechtel B and W Idaho (BBWI) a contract to operate the facilities for one year, commencing 1 May 2005. The hand-over of AMWTP included the facility to repackage and super-compact waste (Advanced Mixed Waste Treatment Facility) and the retrieval, characterization, storage and Transuranic Package Transporter (TRUPACT) loading facility. This poster updates the progress of AMWTP from the previous presentations to Waste Management (WM) [1 and 2] to completion of the transition to BBWI in May 2005. (authors)

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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

  13. [Our experience with the treatment of high perianal fistulas with the mucosal flap advancement technique].

    PubMed

    Marino, Giuseppe; Greco, Ettore; Gasparrini, Marcello; Romanzi, Aldo; Ottaviani, Maurizio; Nasi, Stefano; Pasquini, Giorgio

    2004-01-01

    The authors present their experience with the treatment of high transphincteric anal fistulas with the mucosal flap advancement technique. This technique, though by no means easy to perform, allows fistulas to be treated in a single surgical session in comparison to the technique in which setone is used or to the less well known transposition techniques, given the same long-term results in terms of continence and recurrence rate. After a brief overview of the problem, from the points of view of both aetiopathogenesis and classification, the principal surgical treatment techniques are described, presenting the results and complications observed in the authors' own case series. PMID:15038659

  14. Recent advances in laser therapy for the treatment of port wine stains

    NASA Astrophysics Data System (ADS)

    Lanigan, Sean W.

    2004-09-01

    The pulsed dye laser is the preferred laser for treating port wine stains. It is relatively effective with a low incidence of side effects. However, although considerable lightening of a port wine stain is likely to occur with treatment, complete clearance is achieved in the minority. There has been a number of therapeutic advances over the last few years in the laser treatment of port wine stains. These have come from modification of the original pulsed dye laser, use of other lasers and light sources and a greater understanding of laser - port wine interactions. All of these developments will be discussed in this review.

  15. 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

  16. 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

  17. 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

  18. 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

  19. Differential Patient-Caregiver Opinions of Treatment and Care For Advanced Lung Cancer Patients

    PubMed Central

    Zyzanski, Stephen J; Siminoff, Laura A

    2010-01-01

    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 clinics 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. Perceived family disagreement is associated with depression in both patients and caregivers. 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

  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.

  1. 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.

  2. 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

  3. 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.

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

    PubMed

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

    2013-01-01

    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

  5. 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

  6. 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.

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

    PubMed

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

    2009-05-30

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

  8. 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

  9. 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.

  10. Plume rise measurements at turbigo

    NASA Astrophysics Data System (ADS)

    Anfossi, D.

    The fourth C.E.C. campaign on remote sensing of air pollution, organized jointly by ENEL and the Commission of European Communities, was held at Turbigo (northern Italy) during September 1979. This paper presents analyses of plume measurements obtained during that campaign by the ENEL groundbased Lidar. The five stacks of Turbigo Power Plant have different heights and emission parameters and their plumes usually combine, so a model for multiple sources developed by D. Anfossi et al. (1978, Atmospheric Environment12, 1821-1826) was used to predict the plume rises. These predictions are compared with the observations. Measurements of σy and σz over the first 1000 m are compared with the curves derived from other observations in the Po Valley, using the no-lift balloon technique over the same range of downwind distance. Skewness and kurtosis distributions are shown, both along the vertical and the horizontal directions. In order to show the plume structure in more detail, we present two examples of Lidar-derived cross sections and the corresponding vertically and horizontally integrated concentration profiles.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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

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

    PubMed

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

    2013-12-01

    A series of experiments were conducted to study the occurrence and distribution of volatile organic compounds (VOCs) in conventional and advanced drinking water treatment processes of 3 water treatment plants in Lianyungang City. Results showed that 30 compounds of 3 classes were detected from 67 kinds of VOCs in all the samples collected. The concentrations of carbonyl compounds, halogenated hydrocarbons and benzenes detected were in the ranges of 0.04-61.27, 0.02-35.61 and 0.07-2.33 microg x L(-1) respectively. Comparing the changes of different VOCs in three drinking water treatment plants, conventional chlorination process could effectively remove benzenes but meanwhile produced trihalomethanes (THMs). Additional advanced treatment ozonation-biological activated carbon process could decrease the formation of THMs during pre-chlorination but produced new risky contaminants like carbonyl compounds. The changes of VOCs in tap water were also investigated. It was found that carbonyl compounds produced by ozonation could be further transformed to THMs with residual chlorine. However, the health risks of all detected compounds in tap water were at a low level, except that the carcinogenic risk of crotonaldehydes (9.3 x 10(-5)-2.2 x 10(-4)) was slightly higher than the US EPA threshold (10(-6)-10(-4)). PMID:24640902

  18. Variation and removal efficiency of assimilable organic carbon (AOC) in an advanced water treatment system.

    PubMed

    Lou, Jie-Chung; Chen, Bi-Hsiang; Chang, Ting-Wei; Yang, Hung-Wen; Han, Jia-Yun

    2011-07-01

    This study investigates the microorganism growth indicator and determines the assimilable organic carbon (AOC) content at the Cheng-Ching Lake Advanced Water Treatment Plant (CCLAWTP) in Kaohsiung, Taiwan. Notably, AOC is associated with the biological stability within the water distribution network and has garnered considerable attention in the environmental engineering field in recent years. Water samples were collected from the effluent of each unit in CCLAWTP once monthly during December 2008 to November 2009. Items of water quality related to carbon concentration levels, including AOC, total organic carbon, dissolved organic carbon, UV(254), and specific ultraviolent absorbance were analyzed. Analytical results demonstrate that the average AOC concentration in raw water was 83.61 μg/L and reduced in freshwater was controlled at an average of 50 μg/L after an advanced treatment system of roughly 54% of AOC was removed in compliance with treatment plant standards. If AOC concentrations in freshwater can be reduced, study results can provide a direction for improving water treatment capabilities. PMID:20835921

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

    PubMed

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

    2013-12-01

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

  20. 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

  1. 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

  2. Vismodegib: A smoothened inhibitor for the treatment of advanced basal cell carcinoma.

    PubMed

    Aditya, Suruchi; Rattan, Aditya

    2013-10-01

    Incidence of basal cell carcinoma (BCC), the most common skin cancer in humans, is rising. Surgery is the mainstay of treatment but there is no standard of care for locally advanced or metastatic disease. Hedgehog signaling proteins are critical for cell growth and differentiation during embryogenesis; Hh pathway is silenced in adults. Dysregulated or aberrant Hh signaling has been implicated in the pathogenesis of BCC. This hyperactive pathway can be inhibited by use of smoothened inhibitors such as vismodegib. Food and drug administration approved this oral, once-daily medication in 2012 to treat adults with metastatic BCC or locally advanced, recurrent BCC after surgery and also for patients with locally advanced BCC who are not candidates for surgery or radiation treatment. Clinical studies have shown it to be highly efficacious and the most common adverse effects include, muscle spasms, alopecia and dysgeusia. Use of targeted biologic modifiers, exemplified by Hh directed therapeutics offer a new hope to patients with high-surgical morbidity or inoperable tumors.

  3. Paclitaxel-based regimens as first-line treatment in advanced gastric cancer.

    PubMed

    Guo, Zengqing; Wang, Xiaojie; Lin, Rongbo; Chen, Ling; Fan, Nanfeng; Chen, Yu; Lin, Jinyuan; Yu, Jiami

    2015-02-01

    The aim of this study was to evaluate the efficacy and safety of paclitaxel-based regimens as first-line treatments in advanced gastric cancer. We reviewed 397 previously untreated patients with advanced gastric cancer, who non-randomly received one of three paclitaxel-based regimens: paclitaxel plus fluorouracil/leucovorin (PF), paclitaxel plus oxaliplatin (PO), and paclitaxel plus oxaliplatin plus fluorouracil/leucovorin (POF) between January 2003 and December 2010. The PF, PO, and POF response rates were 47.13, 52.08, and 63.78%, respectively. Overall survivals (OS) were 11.2, 11.7, and 11.7 months, respectively. Progression-free survivals (PFS) were 6.6, 7.2, and 7.1 months, respectively. Leucopenia was higher on the triplet regimen than the doublet regimens. The paclitaxel-based regimens appeared to be effective in patients with advanced gastric cancer. The triplet regimen produced a higher response rate than either doublet regimen with more side effects, while survivals were similar among all three treatments.

  4. 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

  5. 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.

  6. Clinical use of cabozantinib in the treatment of advanced kidney cancer: efficacy, safety, and patient selection

    PubMed Central

    Yu, Steven S; Quinn, David I; Dorff, Tanya B

    2016-01-01

    Clear cell (cc) renal cell carcinoma (RCC) is the most common type of cancer found in the kidney accounting for ~90% of all kidney cancers. In 2012, there were ~337,000 new cases of RCC diagnosed worldwide with an estimated 143,000 deaths, with the highest incidence and mortality in Western countries. Despite improvements in cancer control achieved with VEGF- and mTOR-targeted therapy for RCC, progression remains virtually universal and additional therapies are needed. The pivotal results of the METEOR trial led to cabozantinib’s designation as a breakthrough drug by the US Food and Drug Administration and its approval for treatment of advanced RCC in 2016. Subsequent data from the CABOSUN trial, where caboxantinib is compared with sunitinib, will provide information on the relative activity of cabozantinib as first-line therapy for ccRCC. We review the development of cabozantinib in advanced RCC and its role in the treatment landscape for advanced RCC. PMID:27713636

  7. Technological advances in the treatment of trauma: a review of promising practices.

    PubMed

    Paul, Lisa A; Hassija, Christina M; Clapp, Joshua D

    2012-11-01

    Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting. Technological innovations in this literature aim to expand availability of empirically based intervention, increase treatment adherence and acceptability, and overcome barriers commonly encountered with conventional trauma-focused treatment. Much of the current research on these technological developments consists of brief reviews and case studies of the separate therapy modalities. Although this work serves to document the appeal and utility of these innovations, it does not provide comprehensive information about the host of options available. To that end, the three general categories of technological advances in trauma therapy (i.e., videoconferencing, e-Health, virtual reality) are reviewed here, including information regarding their empirical support and suggestions for future research and clinical practice.

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

    PubMed

    Zappa, Cecilia; Mousa, Shaker A

    2016-06-01

    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

  9. 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

  10. 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

  11. 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

  12. Enhanced biodegradation of petrochemical wastewater using ozonation and BAC advanced treatment system.

    PubMed

    Lin, C K; Tsai, T Y; Liu, J C; Chen, M C

    2001-03-01

    The characteristics of degradation/conversion of bio-refractory and the growth of a biofilm are investigated in laboratory-scale pre-ozonation and lifted moving-bed biological activated carbon (BAC) advanced treatment processes treating phenol, benzoic acid, aminobenzoic acid and petrochemical industry wastewater which contains acrylonitrile butadiene styrene (ABS). The optimal reaction time and ozone dosage of pre-ozonation for bio-refractory conversion were determined to be 30 min and 100-200 mg O3/hr, respectively. After pre-ozonation of 30 min treatment, BOD5/COD ratio of influent and effluent increased apparently from 20 to 35%, approximately. However, the change of pH in pre-ozonation was inconspicuous. The optimal flow rate of influent and air were controlled at 1.6 l/h and 120-150 nl/min in lifted moving-bed BAC advanced treatment reactor. A COD removal efficiency of 85-95% and 70-90% may be maintained by using an organic loading of 3.2-6.3 kg COD/m3 day and 0.6-1.6 kg-COD/m3 day with an HRT of 6.0 h as secondary and advanced treatment system, respectively. The time required for the BAC bed is be regenerated by a thermal regeneration is prolonged 4-5 times more than that of GAC system. It can be estimated that the enhanced COD removal capability of the biofilm was not only due to the increase in the COD removal capability of acclimated bacteria, but also due to species succession of bacteria in bio-film ecosystem.

  13. [Phosphorus removal and mechanisms for advanced treatment of sewage by Spirogyra].

    PubMed

    Lei, Guo-Yuan; Ma, Jun

    2009-04-15

    The novel way of advanced treatment of municipal wastewater was proposed and characterized by purifying wastewater by Spirogyra. The characteristics of nitrogen and phosphorus removal by Spirogyra were studied aiming at nitrogen and phosphorus removal in advanced treatment of sewage. Under natural light, when Spirogyra's dosage (gross mass) was more than 3.05 g/L, total phosphorus concentration, NH4+-N concentration, TN concentration and permanganate index decreased to less than 0.09, 2.82, 4.31 and 16.86 mg/L respectively, with removal efficiencies of more than 96.84%, 88.60%, 85.49% and 24.56%. During the treatment of sewage, pH value increased, while both calcium cation and magnesium cation concentration decreased, and conductivity decreased. During the growth of Spirogyra, increasing pH value induced saline minerals precipitation, and the precipitated minerals adsorbed phosphate, which were considered as the main mechanisms of phosphorus removal. Furthermore, phosphorus removal by Spirogyra followed Langmuir adsorption isotherm model, and the saturated adsorption of Spirogyra (gross mass) for phosphorus was 3.159 mg/g under this test condition. The increasing pH value made ammonia evaporate during Spirogyra-growth, which might be the main mechanism of nitrogen removal. Under suitable Spirogyra's dosage and hydraulic retention time, the treated sewage might meet the demands of water supply for landscape impoundments on nitrogen and phosphorus concentrations. The better performance of Spirogyra removing nitrogen and phosphorus might provide a novel alternative way for advanced treatment of sewage.

  14. 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

  15. 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

  16. Impact of underweight after treatment on prognosis of advanced-stage ovarian cancer.

    PubMed

    Kim, Se Ik; Kim, Hee Seung; Kim, Tae Hun; Suh, Dong Hoon; Kim, Kidong; No, Jae Hong; Chung, Hyun Hoon; Kim, Yong Beom; Song, Yong Sang

    2014-01-01

    This study aimed to investigate the impact of underweight status on the prognosis of advanced-stage ovarian cancer. A total of 360 patients with stage III-IV epithelial ovarian cancer were enrolled and divided into three groups by body mass indexes (BMIs): underweight (BMI < 18.5 kg/m(2)); normal weight to overweight (18.5 kg/m(2) BMI < 27.5 kg/m(2)); obesity (BMI ≥ 27.5 kg/m(2)). Progression-free survival (PFS), overall survival (OS), CA-125, and neutrophil to lymphocyte ratio (NLR) as a marker reflecting host inflammation and immunity were compared among the three groups according to the three treatment times: at diagnosis; after surgery; and after treatment. Only underweight status after treatment was associated with poor OS in comparison with normal weight to overweight or obesity (mean value, 44.9 versus 78.8 or 67.4 months; P = 0.05); it was also an unfavorable factor for OS (adjusted HR, 2.29; 95% CI, 1.08-4.85). Furthermore, NLR was higher in patients with underweight than in those with obesity after treatment (median value, 2.15 versus 1.47; P = 0.03), in spite of no difference in CA-125 among the three groups at the three treatment times. In conclusion, underweight status after treatment may be a poor prognostic factor in patients with advanced-stage ovarian cancer, which accompanies increased host inflammation and decreased immunity.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. Cost-utility analysis of imatinib mesilate for the treatment of advanced stage chronic myeloid leukaemia.

    PubMed

    Gordois, A; Scuffham, P; Warren, E; Ward, S

    2003-08-18

    Imatinib mesilate (Glivec), Novartis Pharmaceuticals) is a novel therapy for the treatment of chronic myeloid leukaemia (CML). We evaluated the cost-effectiveness of imatinib (600 mg daily) when used for the treatment of patients in advanced stages of CML (accelerated phase and blast crisis) against conventional therapies of combination chemotherapy (DAT) and palliative care in hospital or at home. A Markov model simulated the transitions of hypothetical patient cohorts and outcomes were modelled for 5 years from the start of treatment. Costs were estimated from the perspective of the UK National Health Service. Over 5 years, a patient in accelerated phase will, on average, accrue an additional 2.09 QALYs with imatinib compared to conventional therapies, while patients in blast crisis will accrue an additional 0.58 quality-adjusted life-years (QALYs) with imatinib compared to conventional therapies. The costs per additional QALY gained from treatment with imatinib compared with conventional therapies were pound 29344 (accelerated phase) and pound 42239 (blast crisis). The results were particularly sensitive to the price of imatinib, improvements in quality of life, and the duration of haematological responses. We conclude that treatment of CML with imatinib confers considerably greater survival and quality of life than conventional treatments but at a cost. PMID:12915870

  3. 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.

  4. 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.

  5. Critical appraisal of pazopanib as treatment for patients with advanced metastatic renal cell carcinoma.

    PubMed

    Bukowski, Ronald M

    2011-01-01

    The management of renal cell carcinoma (RCC) has undergone significant changes during the past 10 years, with the treatment of metastatic RCC undergoing the most radical changes. These developments reflect an enhanced understanding of this tumor's underlying biology, which was then translated into the development of a new treatment paradigm. Current therapeutic approaches for the management of patients with metastatic RCC utilize knowledge of histology, molecular abnormalities, clinical prognostic factors, the natural history of this malignancy, and the treatment efficacy and toxicity of available agents. The treatment options available for patients with metastatic RCC have changed dramatically over the past 6 years. Interferon-α and interleukin-2 were the previous mainstays of therapy, but since December 2005, six new agents have been approved in the US for the treatment of advanced RCC. Three are multi-targeted tyrosine kinase inhibitors (TKI) including sunitinib, sorafenib, and pazopanib, two target the mammalian target of rapamycin (temsirolimus and everolimus), and one is a humanized monoclonal antibody (bevacizumab in combination with interferon-α). The current review focuses on the newest TKI available to treat patients with metastatic RCC, pazopanib. The development of this agent both preclinically and clinically is reviewed. The efficacy and safety data from the pivotal clinical trials are discussed, and the potential role of pazopanib in the treatment of patients with metastatic RCC in comparison to other treatment alternatives is critically appraised. This agent has a favorable overall risk benefit, and the available data demonstrate efficacy in patients with metastatic RCC who are either treatment-naïve or cytokine refractory. It therefore represents another alternative for treatment of metastatic RCC patients.

  6. [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

  7. 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.

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

    PubMed

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

    2015-12-26

    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.

  9. Treatment approaches in patients with advanced non-small cell lung cancer and poor performance status.

    PubMed

    Govindan, Ramaswamy; Garfield, David H

    2004-12-01

    It is estimated that 30% to 40% of patients with advanced non-small cell lung cancer (NSCLC) have a poor performance status (PS)-defined as a score of 2 or higher on the Eastern Cooperative Oncology Group scale-because of their disease burden, comorbidities, or both. Survival is shorter in these patients than in those with a better PS, and they do not tolerate chemotherapy as well. There is now evidence that PS2 patients with advanced NSCLC can benefit from single-agent chemotherapy with drugs such as vinorelbine, gemcitabine, paclitaxel, pemetrexed, and docetaxel and that combination chemotherapy may have additional advantages. The optimal treatment for PS2 patients with NSCLC, however, has yet to be determined. The case histories in this article demonstrate that PS2 patients are a heterogeneous group and that selecting the chemotherapy for each patient must take into consideration comorbidities and disease-related symptoms, as well as the potential toxicity of treatment. Large prospective clinical trials are needed to determine whether, and in which patients, combination chemotherapy or novel agents, such as the epidermal growth factor receptor inhibitors or paclitaxel poliglumex, have advantages. Three large phase III trials-Selective Targeting for Efficacy in Lung Cancer, Lower Adverse Reactions trials (STELLAR)-are now being conducted in PS2 patients with NSCLC. It is hoped that their findings will aid in determining the best treatment options for these patients.

  10. Comparison of Advection–Diffusion Models and Neural Networks for Prediction of Advanced Water Treatment Effluent

    PubMed Central

    Mortula, Mohammed Maruf; Abdalla, Jamal; Ghadban, Ahmad A.

    2012-01-01

    Abstract An artificial neural network (ANN) can help in the prediction of advanced water treatment effluent and thus facilitate design practices. In this study, sets of 225 experimental data were obtained from a wastewater treatment process for the removal of phosphorus using oven-dried alum residuals in fixed-bed adsorbers. Five input variables (pH, initial phosphorus concentration, wastewater flow rate, porosity, and time) were used to test the efficiency of phosphorus removal at different times, and ANNs were then used to predict the effluent phosphorus concentration. Results of experiments that were conducted for different values of the input parameters made up the data used to train and test a multilayer perceptron using the back-propagation algorithm of the ANN. Values predicted by the ANN and the experimentally measured values were compared, and the accuracy of the ANN was evaluated. When ANN results were compared to the experimental results, it was concluded that the ANN results were accurate, especially during conditions of high phosphorus concentration. While the ANN model was able to predict the breakthrough point with good accuracy, the conventional advection–diffusion equation was not as accurate. A parametric study conducted to examine the effect of the initial pH and initial phosphorus concentration on the effluent phosphorus concentration at different times showed that lower influent pH values are the most suitable for this advanced treatment system. PMID:22783063

  11. 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

  12. Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders: From Animal Models to Human Studies.

    PubMed

    Murawski, Nathen J; Moore, Eileen M; Thomas, Jennifer D; Riley, Edward P

    2015-01-01

    Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facial characteristics of exposure, and examination of the relation between face, brain, and behavior. Basic research also is pointing toward potential new interventions for FASD involving pharmacotherapies, nutritional therapies, and exercise interventions. Although researchers have assessed the majority of these treatments in animal models of FASD, a limited number of recent clinical studies exist. An assessment of this literature suggests that targeted interventions can improve some impairments resulting from developmental alcohol exposure. However, combining interventions may prove more efficacious. Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.

  13. Chemical monitoring strategy for the assessment of advanced water treatment plant performance.

    PubMed

    Drewes, J E; McDonald, J A; Trinh, T; Storey, M V; Khan, S J

    2011-01-01

    A pilot-scale plant was employed to validate the performance of a proposed full-scale advanced water treatment plant (AWTP) in Sydney, Australia. The primary aim of this study was to develop a chemical monitoring program that can demonstrate proper plant operation resulting in the removal of priority chemical constituents in the product water. The feed water quality to the pilot plant was tertiary-treated effluent from a wastewater treatment plant. The unit processes of the AWTP were comprised of an integrated membrane system (ultrafiltration, reverse osmosis) followed by final chlorination generating a water quality that does not present a source of human or environmental health concern. The chemical monitoring program was undertaken over 6 weeks during pilot plant operation and involved the quantitative analysis of pharmaceuticals and personal care products, steroidal hormones, industrial chemicals, pesticides, N-nitrosamines and halomethanes. The first phase consisted of baseline monitoring of target compounds to quantify influent concentrations in feed waters to the plant. This was followed by a period of validation monitoring utilising indicator chemicals and surrogate measures suitable to assess proper process performance at various stages of the AWTP. This effort was supported by challenge testing experiments to further validate removal of a series of indicator chemicals by reverse osmosis. This pilot-scale study demonstrated a simplified analytical approach that can be employed to assure proper operation of advanced water treatment processes and the absence of trace organic chemicals.

  14. 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

  15. Infrared recordings for characterizing an aircraft plume

    NASA Astrophysics Data System (ADS)

    Retief, S. J. P.; Dreyer, M. M.; Brink, C.

    2014-06-01

    Some key electro-optical measurements required to characterize an aircraft plume for automated recognition are shown, as well as some aspects of the processing and use of these measurements. Plume measurements with Short Wavelength Infrared (1.1 - 2.5 um), Mid-Wavelength Infrared (2.5 - 7 um) and Long Wavelength Infrared (7 - 15 um) cameras are presented, as well as spectroradiometer measurements covering the whole Mid-Wavelength, Long Wavelength and upper part of the Short Wavelength Infrared bands. The two limiting factors for the detection of the plume, i.e. the atmospheric transmission bands and the plume emission bands, are discussed, and it is shown how a micro turbine engine can assist in aircraft plume studies. One such a study, regarding the differentiation between an aircraft plume and a blackbody emitter using subbands in the Mid-Wavelength Infrared, is presented. The factors influencing aircraft plume emission are discussed, and the measurements required to characterize an aircraft plume for the purpose of constructing a mathematical plume model are indicated. Since the required measurements are prescribed by the plume model requirements, a brief overview of the plume model, that can be used to simulate the results of the plume's emission under different conditions and observation configurations, is given. Such a model can be used to test the robustness of algorithms, like the mentioned subband method, for identifying aircraft plumes. Such a model furthermore enables the simulation of measurements that would be obtained by an electro-optical system, like an infrared seekerhead of a missile, of a plume for the purpose of algorithm training under various simulated environmental conditions.

  16. Ship exhaust gas plume cooling

    NASA Astrophysics Data System (ADS)

    Schleijpen, H. M. A.; Neele, Filip P.

    2004-08-01

    The exhaust gas plume is an important and sometimes dominating contributor to the infrared signature of ships. Suppression of the infrared ship signatures has been studied by TNO for the Royal Netherlands Navy over considerable time. This study deals with the suppression effects, which can be achieved using a spray of cold water in the inner parts of the exhaust system. The effects are compared with the effect of cooling with air. A typical frigate size diesel engine serves as an example for gas flow, composition and temperature of the plume. The infrared emission of the cooled an un-cooled exhaust gases is calculated. Both the spectral behaviour and the integrated values over typical bands are discussed. Apart from the signature also some advantages of water exhaust gas cooling for the ship design are discussed.

  17. 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

  18. 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.

  19. 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.

  20. [Advances in the research of pathogenesis and treatment of severe smoke inhalation injury].

    PubMed

    Feng, Shengjuan; Jia, Chiyu; Liu, Zhen; Lyu, Xiaowu

    2016-02-01

    Among the fire victims, respiratory tract injury resulted from smoke inhalation is the major cause of death. Particulate substances in smoke, toxic and harmful gas, and chemical substances act together would rapidly induce the occurrence of dramatic pathophysiologic reaction in the respiratory tract, resulting in acute injury to the respiratory tract, thus inducing serious injury to it and acute respiratory distress syndrome, leading to death of the victims. In recent years, the pathophysiologic mechanism of severe smoke inhalation injury has been gradually clarified, thus appreciable advances in its treatment have been achieved. This paper is a brief review of above-mentioned aspects.

  1. 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

  2. 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

  3. Advances in the pathogenesis, diagnosis and treatment of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome.

    PubMed

    Franchini, Massimo; Zaffanello, Marco; Veneri, Dino

    2006-01-01

    The thrombotic microangiopathies are microvascular occlusive disorders characterized by hemolytic anemia caused by fragmentation of erythrocytes and thrombocytopenia due to increased platelet aggregation and thrombus formation, eventually leading to disturbed microcirculation with reduced organ perfusion. Depending on whether brain or renal lesions prevail, two different entities have been described: thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). However, not rarely the clinical distinctions between these two conditions remain questionable. Recent studies have contributed greatly to our current understanding of the molecular mechanisms leading to TTP and HUS. In this review, we briefly focus on the most important advances in the pathophysiology, diagnosis and treatment of these two thrombotic microangiopathies.

  4. 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

  5. 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

  6. 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.

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

    SciTech Connect

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

    1999-04-28

    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.

  8. 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.

  9. Prosthodontic treatment for a patient with advanced hydantoin-associated gingival hyperplasia: a case report.

    PubMed

    Hayakawa, I; Osada, E; Morisawa, M; Nakagawa, Y; Watanabe, I

    1996-04-01

    A patient in whom gingival hyperplasia was caused by prolonged use of an anticonvulsant drug (hydantoin) is described. Advanced gingival hyperplasia and significant displacement of the remaining teeth caused severe damage, especially to the patient's appearance. It was not possible to cure the problems completely with routine periodontal treatment. It was decided to extract all the remaining teeth and restore function and esthetics early with complete dentures. Cephalometric analysis was used to determine the degree to which the teeth had drifted. During fabrication of the dentures, the analysis was very useful in deciding the position of the anterior teeth and checking the vertical dimension of occlusion.

  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. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Irritants in cigarette smoke plumes

    SciTech Connect

    Ayer, H.E.; Yeager, D.W.

    1982-11-01

    Concentrations of the irritants formaldehyde and acrolein in side stream cigarette smoke plumes are up to three orders of magnitude above occupational limits, readily accounting for eye and nasal irritation. ''Low-tar'' cigarettes appear at least as irritating as other cigarettes. More than half the irritant is associated with the particulate phase of the smoke, permitting deposition throughout the entire respiratory tract and raising the issue of whether formaldehyde in smoke is associated with bronchial cancer.

  17. 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.

  18. 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

  19. 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

  20. Advanced treatment of the reverse osmosis concentrate produced during reclamation of municipal wastewater.

    PubMed

    Dialynas, Emmanuel; Mantzavinos, Dionissios; Diamadopoulos, Evan

    2008-11-01

    The work investigated the treatment of the concentrate produced from the reverse osmosis treatment of an MBR effluent. Two conventional chemical processes, coagulation and activated carbon adsorption, and three advanced oxidation processes (electrochemical treatment, photocatalysis and sonolysis) were applied. Coagulation with alum gave dissolved organic carbon (DOC) removals up to 42%, while FeCl(3) achieved higher removals (52%) at lower molar doses. Adsorption with granular activated carbon showed the highest DOC removals up to 91.3% for 5 g/L. The adsorption isotherm was linear with a non-adsorbable organic fraction of around 1.2 mg/L DOC. The three oxidation methods employed, electrolytic oxidation over a boron-doped diamond electrode, UVA/TiO2 photocatalysis and sonolysis at 80 kHz, showed similar behavior: during the first few minutes of treatment there was a moderate removal of DOC followed by further oxidation at a very slow rate. Electrolytic oxidation was capable of removing up to 36% at 17.8A after 30 min of treatment, sonolysis removed up to 34% at 135W after 60 min, while photocatalysis was capable of removing up to 50% at 60 min. PMID:18823926

  1. 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.

  2. 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

  3. 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.

  4. GnRH antagonists in the treatment of advanced prostate cancer.

    PubMed

    Pommerville, Peter J; de Boer, Johan G

    2010-04-01

    Analogues of the gonadotropin releasing hormone (GnRH) inhibit the hypothalamic-pituitary-gonadal axis. This has provided treatment modalities for advanced and metastatic prostate cancer. The latest group of analogues, the GnRH antagonists, make promising treatments available that avoid the transient surge in testosterone that occurs with the use of GnRH agonists. Such surges may stimulate tumor growth, causing patients to experience new or worsening cancer symptoms and potential serious adverse effects, including increased bone pain, urinary retention, and spinal cord compression and consequently delay the therapeutic benefits of agonist therapy. Degarelix, an antagonist, recently approved in the United States and Europe, achieves faster, more profound and sustained testosterone suppression and with fewer adverse effects when compared with agonists and other antagonists. This review discusses and compares the compounds degarelix, abarelix, and cetrorelix.

  5. Magnetic resonance imaging for planning intracavitary brachytherapy for the treatment of locally advanced cervical cancer.

    PubMed

    Oñate Miranda, M; Pinho, D F; Wardak, Z; Albuquerque, K; Pedrosa, I

    2016-01-01

    Cervical cancer is the third most common gynecological cancer. Its treatment depends on tumor staging at the time of diagnosis, and a combination of chemotherapy and radiotherapy is the treatment of choice in locally advanced cervical cancers. The combined use of external beam radiotherapy and brachytherapy increases survival in these patients. Brachytherapy enables a larger dose of radiation to be delivered to the tumor with less toxicity for neighboring tissues with less toxicity for neighboring tissues compared to the use of external beam radiotherapy alone. For years, brachytherapy was planned exclusively using computed tomography (CT). The recent incorporation of magnetic resonance imaging (MRI) provides essential information about the tumor and neighboring structures making possible to better define the target volumes. Nevertheless, MRI has limitations, some of which can be compensated for by fusing CT and MRI. Fusing the images from the two techniques ensures optimal planning by combining the advantages of each technique.

  6. [Advances in mechanisms of treatment for spinal cord injury with lithium].

    PubMed

    Duo, Zhang; He, Xi-jing

    2015-07-01

    Spinal cord injury is a serious disabling disease caused by a series of internal and external factors in the field of orthopaedics and neuroscience, which is a big problem for doctors all over the world. Lithium has been used to treat dipolar disorder for over 100 years. It has been reported that lithium is benefit for brain neuron. The treatment effect for spinal cord injury gets more and more attention. Researches indicate that lithium is benefit for spinal cord injury by protecting neuron,reducing after-injury inflammation increasing the produce and release of neurotrophins, stimulating neurogenesis, enhancing autophagy and inhibiting apoptosis. This article summaries advances in mechanism of treatment for spinal cord injury with lithium by reviewing and analyzing researches. Therapy combined with lithium has a good application prospect.

  7. 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

  8. Targeted delivery of albumin bound paclitaxel in the treatment of advanced breast cancer

    PubMed Central

    Di Costanzo, Francesco; Gasperoni, Silvia; Rotella, Virginia; Di Costanzo, Federica

    2009-01-01

    Taxanes are chemotherapeutic agents with a large spectrum of antitumor activity when used as monotherapy or in combination regimens. Paclitaxel and docetaxel have poor solubility and require a complex solvent system for their commercial formulation, Cremophor EL® (CrEL) and Tween 80® respectively. Both these biological surfactants have recently been implicated as contributing not only to the hypersensitivity reactions, but also to the degree of peripheral neurotoxicity and myelosuppression, and may antagonize the cytotoxicity. Nab-paclitaxel, or nanoparticle albumin-bound paclitaxel (ABI-007; Abraxane®), is a novel formulation of paclitaxel that does not employ the CrEL solvent system. Nab-paclitaxel demonstrates greater efficacy and a favorable safety profile compared with standard paclitaxel in patients with advanced disease (breast cancer, non-small cell lung cancer, melanoma, ovarian cancer). Clinical studies in breast cancer have shown that nab-paclitaxel is significantly more effective than standard paclitaxel in terms of overall objective response rate (ORR) and time to progression. Nab-paclitaxel in combination with gemcitabine, capecitabine or bevacizumab has been shown to be very active in patients with advanced breast cancer. An economic analysis showed that nab-paclitaxel would be an economically reasonable alternative to docetaxel or standard paclitaxel in metastatic breast cancer. Favorable tumor ORR and manageable toxicities have been reported for nab-paclitaxel as monotherapy or in combination treatment in advanced breast cancer. PMID:20616905

  9. 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

  10. Mantle plumes on Venus revisited

    NASA Technical Reports Server (NTRS)

    Kiefer, Walter S.

    1992-01-01

    The Equatorial Highlands of Venus consist of a series of quasicircular regions of high topography, rising up to about 5 km above the mean planetary radius. These highlands are strongly correlated with positive geoid anomalies, with a peak amplitude of 120 m at Atla Regio. Shield volcanism is observed at Beta, Eistla, Bell, and Atla Regiones and in the Hathor Mons-Innini Mons-Ushas Mons region of the southern hemisphere. Volcanos have also been mapped in Phoebe Regio and flood volcanism is observed in Ovda and Thetis Regiones. Extensional tectonism is also observed in Ovda and Thetis Regiones. Extensional tectonism is also observed in many of these regions. It is now widely accepted that at least Beta, Atla, Eistla, and Bell Regiones are the surface expressions of hot, rising mantel plumes. Upwelling plumes are consistent with both the volcanism and the extensional tectonism observed in these regions. The geoid anomalies and topography of these four regions show considerable variation. Peak geoid anomalies exceed 90 m at Beta and Atla, but are only 40 m at Eistla and 24 m at Bell. Similarly, the peak topography is greater at Beta and Atla than at Eistla and Bell. Such a range of values is not surprising because terrestrial hotspot swells also have a side range of geoid anomalies and topographic uplifts. Kiefer and Hager used cylindrical axisymmetric, steady-state convection calculations to show that mantle plumes can quantitatively account for both the amplitude and the shape of the long-wavelength geoid and topography at Beta and Atla. In these models, most of the topography of these highlands is due to uplift by the vertical normal stress associated with the rising plume. Additional topography may also be present due to crustal thickening by volcanism and crustal thinning by rifting. Smrekar and Phillips have also considered the geoid and topography of plumes on Venus, but they restricted themselves to considering only the geoid-topography ratio and did not

  11. Seismically imaging the Afar plume

    NASA Astrophysics Data System (ADS)

    Hammond, J. O.; Kendall, J. M.; Bastow, I. D.; Stuart, G. W.; Keir, D.; Ayele, A.; Ogubazghi, G.; Ebinger, C. J.; Belachew, M.

    2011-12-01

    Plume related flood basalt volcanism in Ethiopia has long been cited to have instigated continental breakup in northeast Africa. However, to date seismic images of the mantle beneath the region have not produced conclusive evidence of a plume-like structure. As a result the nature and even existence of a plume in the region and its role in rift initiation and continental rupture are debated. Previous seismic studies using regional deployments of sensors in East-Africa show that low seismic velocities underlie northeast Africa, but their resolution is limited to the top 200-300km of the Earth. Thus, the connection between the low velocities in the uppermost mantle and those imaged in global studies in the lower mantle is unclear. We have combined new data from Afar, Ethiopia with 6 other regional experiments and global network stations across Ethiopia, Eritrea, Djibouti and Yemen, to produce high-resolution models of upper mantle P- and S- wave velocities to the base of the transition zone. Relative travel time tomographic inversions show that the top 100km is dominated by focussed low velocity zones, likely associated with melt in the lithosphere/uppermost asthenosphere. Below these depths a broad SW-NE oriented sheet like upwelling extends down to the top of the transition zone. Within the transition zone two focussed sharp-sided low velocity regions exist: one beneath the Western Ethiopian plateau outside the rift valley, and the other beneath the Afar depression. The nature of the transition zone anomalies suggests that small upwellings may rise from a broader low velocity plume-like feature in the lower mantle. This interpretation is supported by numerical and analogue experiments that suggest the 660km phase change and viscosity jump may impede flow from the lower to upper mantle creating a thermal boundary layer at the base of the transition zone. This allows smaller, secondary upwellings to initiate and rise to the surface. Our images of secondary upwellings

  12. 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

  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.

  15. Treatment of advanced non-small-cell lung cancer in the elderly.

    PubMed

    Gridelli, Cesare; Maione, Paolo; Rossi, Antonio; Ferrara, Marianna Luciana; Castaldo, Vincenzo; Palazzolo, Giovanni; Mazzeo, Nicole

    2009-12-01

    Lung cancer in the older individual is an increasingly common problem faced by the oncologist. Elderly patients have more co-morbidities and tend to tolerate toxic medical treatments more poorly than their younger counterparts. Thus, clinical data obtained in a younger population cannot be automatically extrapolated to the great majority of non-selected elderly patients with non-small-cell lung cancer (NSCLC). The bulk of prospective clinical data regarding chemotherapy and molecularly targeted therapy for elderly NSCLC patients comes from studies in advanced disease. In elderly advanced NSCLC patients single-agent chemotherapy with third-generation agents (vinorelbine, gemcitabine, taxanes) is to be considered as the standard treatment for unselected patients, based on several phase II and III trials specifically designed for this special population. Retrospective analyses found no differences in survival between elderly and younger patients treated with cisplatin-based chemotherapy, with a small but significant increase in toxicity in the elderly. Cisplatin-based chemotherapy with cisplatin at attenuated doses has demonstrated to be an active and feasible option in phase II trials and deserves prospective phase III comparison against monochemotherapy. Among targeted therapies, the epidermal growth factor receptor tyrosine kinase inhibitors erlotinib and gefitinib are the most promising agents and have relevant phase II prospective data showing activity and good tolerability as first-line treatment in this population. Concerning the anti-vascular endothelial growth factor monoclonal antibody bevacizumab, particular care must be taken for elderly patients because of a possible higher incidence of cardiovascular co-morbidities. However its role in this population remains controversial and specific prospective studies are warranted to clarify this topic. Further specifically designed phase III randomized trials are needed to optimize medical treatment of NSCLC in

  16. 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

  17. Monitoring the biological activity of micropollutants during advanced wastewater treatment with ozonation and activated carbon filtration.

    PubMed

    Macova, M; Escher, B I; Reungoat, J; Carswell, S; Chue, K Lee; Keller, J; Mueller, J F

    2010-01-01

    A bioanalytical test battery was used to monitor the removal efficiency of organic micropollutants during advanced wastewater treatment in the South Caboolture Water Reclamation Plant, Queensland, Australia. This plant treats effluent from a conventional sewage treatment plant for industrial water reuse. The aqueous samples were enriched using solid-phase extraction to separate some organic micropollutants of interest from metals, nutrients and matrix components. The bioassays were chosen to provide information on groups of chemicals with a common mode of toxic action. Therefore they can be considered as sum indicators to detect certain relevant groups of chemicals, not as the most ecologically or human health relevant endpoints. The baseline toxicity was quantified with the bioluminescence inhibition test using the marine bacterium Vibrio fischeri. The specific modes of toxic action that were targeted with five additional bioassays included aspects of estrogenicity, dioxin-like activity, genotoxicity, neurotoxicity, and phytotoxicity. While the accompanying publication discusses the treatment steps in more detail by drawing from the results of chemical analysis as well as the bioanalytical results, here we focus on the applicability and limitations of using bioassays for the purpose of determining the treatment efficacy of advanced water treatment and for water quality assessment in general. Results are reported in toxic equivalent concentrations (TEQ), that is, the concentration of a reference compound required to elicit the same response as the unknown and unidentified mixture of micropollutants actually present. TEQ proved to be useful and easily communicable despite some limitations and uncertainties in their derivation based on the mixture toxicity theory. The results obtained were reproducible, robust and sensitive. The TEQ in the influent ranged in the same order of magnitude as typically seen in effluents of conventional sewage treatment plants. In the

  18. Technological Advances in the Treatment of Cancer: Combining Modalities to Optimize Outcomes.

    PubMed

    Wong, Eric T; Toms, Steven A; Ahluwalia, Manmeet S

    2015-11-01

    The anticancer treatment modality tumor treating fields (TTFields; Optune, Novocure) use the lower frequency range of the electromagnetic spectrum to destroy tumor cells during mitosis. This treatment has been evaluated in several trials of patients with glioblastoma. In these patients, TTFields are delivered through 4 transducer arrays applied to the scalp. In a phase 3 clinical trial of patients with recurrent glioblastoma, TTFields were as effective as chemotherapy, and were associated with fewer and milder systemic toxicities. Data from a phase 3 trial in newly diagnosed glioblastoma suggested that the addition of TTFields to postoperative radiation therapy and chemotherapy represents an important advance in the management of newly diagnosed glioblastoma. Ongoing clinical trials are investigating the efficacy and safety of TTFields in other tumor types, including pancreatic cancer, mesothelioma, ovarian cancer, and non–small cell lung cancer. Other recent advances in the management of cancer have been seen with immunomodulatory therapy, including immune checkpoint inhibitors. Further study will be necessary to evaluate whether TTFields will enhance or impair other established and newly emerging therapies.

  19. Conformal Radiotherapy in the Treatment of Advanced Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension: An Institutional Experience

    SciTech Connect

    Chakraborty, Santam; Ghoshal, Sushmita; Patil, Vijay Maruti; Oinam, Arun Singh; Sharma, Suresh C.

    2011-08-01

    Purpose: To describe the results of conformal radiotherapy in advanced juvenile nasopharyngeal angiofibroma in a tertiary care institution. Methods and Materials: Retrospective chart review was conducted for 8 patients treated with conformal radiotherapy between 2006 and 2009. The median follow-up was 17 months. All patients had Stage IIIB disease with intracranial extension. Radiotherapy was considered as treatment because patients were deemed inoperable owing to extensive intracranial/intraorbital extension or proximity to optic nerve. All but 1 patient were treated with intensity-modulated radiotherapy using seven coplanar fields. Median (range) dose prescribed was 39.6 (30-46) Gy. Actuarial analysis of local control and descriptive analysis of toxicity profile was conducted. Results: Despite the large and complex target volume (median planning target volume, 292 cm{sup 3}), intensity-modulated radiotherapy achieved conformal dose distributions (median van't Reit index, 0.66). Significant sparing of the surrounding organs at risk was obtained. No significant Grade 3/4 toxicities were experienced during or after treatment. Actual local control at 2 years was 87.5%. One patient died 1 month after radiotherapy secondary to massive epistaxis. The remaining 7 patients had progressive resolution of disease and were symptom-free at last follow-up. Persistent rhinitis was the only significant toxicity, seen in 1 patient. Conclusions: Conformal radiotherapy results in good local control with minimal acute and late side effects in juvenile nasopharyngeal angiofibromas, even in the presence of advanced disease.

  20. Cryptic parasite revealed improved prospects for treatment and control of human cryptosporidiosis through advanced technologies.

    PubMed

    Jex, Aaron R; Smith, Huw V; Nolan, Matthew J; Campbell, Bronwyn E; Young, Neil D; Cantacessi, Cinzia; Gasser, Robin B

    2011-01-01

    Cryptosporidium is an important genus of parasitic protozoa of humans and other vertebrates and is a major cause of intestinal disease globally. Unlike many common causes of infectious enteritis, there are no widely available, effective vaccine or drug-based intervention strategies for Cryptosporidium, and control is focused mainly on prevention. This approach is particularly deficient for infections of severely immunocompromised and/or suppressed, the elderly or malnourished people. However, cryptosporidiosis also presents a significant burden on immunocompetent individuals, and can, for example have lasting effects on the physical and mental development of children infected at an early age. In the last few decades, our understanding of Cryptosporidium has expanded significantly in numerous areas, including the parasite life-cycle, the processes of excystation, cellular invasion and reproduction, and the interplay between parasite and host. Nonetheless, despite extensive research, many aspects of the biology of Cryptosporidium remain unknown, and treatment and control are challenging. Here, we review the current state of knowledge of Cryptosporidium, with a focus on major advances arising from the recently completed genome sequences of the two species of greatest relevance in humans, namely Cryptosporidium hominis and Cryptosporidium parvum. In addition, we discuss the potential of next-generation sequencing technologies, new advances in in silico analyses and progress in in vitro culturing systems to bridge these gaps and to lead toward effective treatment and control of cryptosporidiosis.

  1. 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

  2. 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

  3. Integrated nitrogen removal biofilter system with ceramic membrane for advanced post-treatment of municipal wastewater.

    PubMed

    Son, Dong-Jin; Yun, Chan-Young; Kim, Woo-Yeol; Zhang, Xing-Ya; Kim, Dae-Gun; Chang, Duk; Sunwoo, Young; Hong, Ki-Ho

    2016-12-01

    The pre-denitrification biofilm process for nitrogen removal was combined with ceramic membrane with pore sizes of 0.05-0.1 µm as a system for advanced post-treatment of municipal wastewater. The system was operated under an empty bed hydraulic retention time of 7.8 h, recirculation ratio of 3, and transmembrane pressure of 0.47 bar. The system showed average removals of organics, total nitrogen, and solids as high as 93%, 80%, and 100%, respectively. Rapid nitrification could be achieved and denitrification was performed in the anoxic filter without external carbon supplements. The residual particulate organics and nitrogen in effluent from biofilm process could be also removed successfully through membrane filtration and the removal of total coliform was noticeably improved after membrane filtration. Thus, a system composed of the pre-denitrification biofilm process with ceramic membrane would be a compact and flexible option for advanced post-treatment of municipal wastewater. PMID:27108849

  4. The changing face of acromegaly--advances in diagnosis and treatment.

    PubMed

    Ribeiro-Oliveira, Antônio; Barkan, Ariel

    2012-10-01

    Acromegaly is a chronic disease characterized by the presence of a pituitary growth hormone (GH)-producing tumour, excessive secretion of growth hormone, raised levels of insulin-like growth factor I (IGF-I) and characteristic clinical presentation of acral enlargement. Over the past two decades, major advances have occurred in the understanding of some aspects of acromegaly--such as the biology of pituitary tumours, the physiology, molecular mechanisms of GH secretion and IGF-I generation, and the pathogenesis of comorbidities. Moreover, new approaches to diagnosis and surveillance (both in terms of screening and follow-up) of acromegaly have led to increases in the number of patients diagnosed with active disease, many of whom would previously have been missed. The development of sensitive assays for detecting plasma GH and IGF-I levels, as well as the widespread use of MRI for visualization of small tumours, have been major contributing factors to these improvements. Treatment advances have resulted in improved cure rates and disease control through novel neurosurgical techniques and pharmacological approaches. This Review summarizes and discusses the changes in our understanding of the epidemiology, diagnosis, treatment, and follow-up of acromegaly and its comorbidities.

  5. 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

  6. 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

  7. Dynamic tension EMG to characterize the effects of DBS treatment of advanced Parkinson's disease.

    PubMed

    Ruonala, V; Pekkonen, E; Rissanen, S; Airaksinen, O; Miroshnichenko, G; Kankaanpää, M; Karjalainen, P

    2014-01-01

    Deep brain stimulation (DBS) is an effective treatment method for motor symptoms of advanced Parkinson's disease. DBS-electrode is implanted to subthalamic nucleus to give precisely allocated electrical stimuli to brain. The optimal stimulus type has to be adjusted individually. Disease severity, main symptoms and biological factors play a role in correctly setting up the device. Currently there are no objective methods to assess the efficacy of DBS, hence the adjustment is based solely on clinical assessment. In optimal case an objectively measurable feature would point the right settings of DBS. Surface electromyographic and kinematic measurements have been used in Parkinson's disease research. As Parkinson's disease symptoms are known to change the EMG signal properties, these methods could be helpful aid in the clinical adjustment of DBS. In this study, 13 patients with advanced Parkinson's disease who received DBS treatment were measured. The patients were measured with seven different settings of the DBS in clinical range including changes in stimulation amplitude, frequency and pulse width. The EMG analysis was based on parameters that characterize EMG signal morphology. Correlation dimension and recurrence rate made the most significant difference in relation to optimal settings. In conclusion, EMG analysis is able to detect differences between the DBS setups, and can help in finding the correct parameters. PMID:25570683

  8. 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

  9. 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

  10. Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

    PubMed Central

    Murray, Bethany; McNew, Brittany

    2015-01-01

    Abstract Purpose This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs). Data sources PubMed searches were conducted using the following keywords: “bipolar disorder and primary care,” restricted to dates 2000 to present; “bipolar disorder and nurse practitioner”; and “bipolar disorder and clinical nurse specialist.” Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals. Conclusions BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients. Implications for practice Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients. PMID:26172568

  11. 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

  12. 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

  13. 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

  14. 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

  15. Radiotherapy and Hyperthermia for Treatment of Primary Locally Advanced Cervix Cancer: Results in 378 Patients

    SciTech Connect

    Franckena, Martine Lutgens, Ludy C.; Koper, Peter C.; Kleynen, Catharina E.; Steen-Banasik, Elsbieta M. van der; Jobsen, Jan J.; Leer, Jan Willem; Creutzberg, Carien L.; Dielwart, Michel F.; Norden, Yvette van; Canters, Richard A.M.; Rhoon, Gerard C. van; Zee, Jacoba van der

    2009-01-01

    Purpose: To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series. Methods and Materials: From 1996 to 2005, a total of 378 patients with LACC (International Federation of Gynecology and Obstetrics Stage IB2-IVA) were treated with RHT. External beam radiotherapy (RT) was applied to 46-50.4 Gy and combined with brachytherapy. The hyperthermia (HT) was prescribed once weekly. Primary end points were complete response (CR) and local control. Secondary end points were overall survival, disease-specific survival, and late toxicity. Patient, tumor, and treatment characteristics predictive for the end points were identified in univariate and multivariate analyses. Results: Overall, a CR was achieved in 77% of patients. At 5 years, local control, disease-specific survival, and incidence of late toxicity Common Terminology Criteria for Adverse Events Grade 3 or higher were 53%, 47%, and 12%, respectively. In multivariate analysis, number of HT treatments emerged as a predictor of outcome in addition to commonly identified prognostic factors. Conclusions: The CR, local control, and survival rates are similar to previously observed results of RHT in the randomized Dutch Deep Hyperthermia Trial. Reported treatment results for currently applied combined treatment modalities (i.e., RT with chemotherapy and/or HT) do not permit definite conclusions about which combination is superior. The present results confirm previously shown beneficial effects from adding HT to RT and justify the application of RHT as first-line treatment in patients with LACC as an alternative to chemoradiation.

  16. Stable plume rise in a shear layer.

    PubMed

    Overcamp, Thomas J

    2007-03-01

    Solutions are given for plume rise assuming a power-law wind speed profile in a stably stratified layer for point and finite sources with initial vertical momentum and buoyancy. For a constant wind speed, these solutions simplify to the conventional plume rise equations in a stable atmosphere. In a shear layer, the point of maximum rise occurs further downwind and is slightly lower compared with the plume rise with a constant wind speed equal to the wind speed at the top of the stack. If the predictions with shear are compared with predictions for an equivalent average wind speed over the depth of the plume, the plume rise with shear is higher than plume rise with an equivalent average wind speed.

  17. 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.

  18. 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

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

    PubMed

    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.

  20. Constraining the source of mantle plumes

    NASA Astrophysics Data System (ADS)

    Cagney, N.; Crameri, F.; Newsome, W. H.; Lithgow-Bertelloni, C.; Cotel, A.; Hart, S. R.; Whitehead, J. A.

    2016-02-01

    In order to link the geochemical signature of hot spot basalts to Earth's deep interior, it is first necessary to understand how plumes sample different regions of the mantle. Here, we investigate the relative amounts of deep and shallow mantle material that are entrained by an ascending plume and constrain its source region. The plumes are generated in a viscous syrup using an isolated heater for a range of Rayleigh numbers. The velocity fields are measured using stereoscopic Particle-Image Velocimetry, and the concept of the 'vortex ring bubble' is used to provide an objective definition of the plume geometry. Using this plume geometry, the plume composition can be analysed in terms of the proportion of material that has been entrained from different depths. We show that the plume composition can be well described using a simple empirical relationship, which depends only on a single parameter, the sampling coefficient, sc. High-sc plumes are composed of material which originated from very deep in the fluid domain, while low-sc plumes contain material entrained from a range of depths. The analysis is also used to show that the geometry of the plume can be described using a similarity solution, in agreement with previous studies. Finally, numerical simulations are used to vary both the Rayleigh number and viscosity contrast independently. The simulations allow us to predict the value of the sampling coefficient for mantle plumes; we find that as a plume reaches the lithosphere, 90% of its composition has been derived from the lowermost 260-750 km in the mantle, and negligible amounts are derived from the shallow half of the lower mantle. This result implies that isotope geochemistry cannot provide direct information about this unsampled region, and that the various known geochemical reservoirs must lie in the deepest few hundred kilometres of the mantle.

  1. Space shuttle main engine plume radiation model

    NASA Technical Reports Server (NTRS)

    Reardon, J. E.; Lee, Y. C.

    1978-01-01

    The methods are described which are used in predicting the thermal radiation received by space shuttles, from the plumes of the main engines. Radiation to representative surface locations were predicted using the NASA gaseous plume radiation GASRAD program. The plume model is used with the radiative view factor (RAVFAC) program to predict sea level radiation at specified body points. The GASRAD program is described along with the predictions. The RAVFAC model is also discussed.

  2. Aggregate particles in the plumes of Enceladus

    NASA Astrophysics Data System (ADS)

    Gao, Peter; Kopparla, Pushkar; Zhang, Xi; Ingersoll, Andrew P.

    2016-01-01

    Estimates of the total particulate mass of the plumes of Enceladus are important to constrain theories of particle formation and transport at the surface and interior of the satellite. We revisit the calculations of Ingersoll and Ewald (Ingersoll, A.P., Ewald, S.P. [2011]. Icarus 216(2), 492-506), who estimated the particulate mass of the Enceladus plumes from strongly forward scattered light in Cassini ISS images. We model the plume as a combination of spherical particles and irregular aggregates resulting from the coagulation of spherical monomers, the latter of which allows for plumes of lower particulate mass. Though a continuum of solutions are permitted by the model, the best fits to the ISS data consist either of low mass plumes composed entirely of small aggregates or high mass plumes composed of mostly spheres. The high particulate mass plumes have total particulate masses of (166 ± 42) × 103 kg, consistent with the results of Ingersoll and Ewald (Ingersoll, A.P., Ewald, S.P. [2011]. Icarus 216(2), 492-506). The low particulate mass plumes have masses of (25 ± 4) × 103 kg, leading to a solid to vapor mass ratio of 0.07 ± 0.01 for the plume. If indeed the plumes are made of such aggregates, then a vapor-based origin for the plume particles cannot be ruled out. Finally, we show that the residence time of the monomers inside the plume vents is sufficiently long for Brownian coagulation to form the aggregates before they are ejected to space.

  3. Redox conditions for mantle plumes

    NASA Astrophysics Data System (ADS)

    Heister, L. E.; Lesher, C. E.

    2005-12-01

    The vanadium to scandium ratio (V/Sc) for basalts from mid-ocean ridge (MOR) and arc environments has been proposed as a proxy for fO2 conditions during partial melting (e.g. [1] and [2]). Contrary to barometric measurements of the fO2 of primitive lavas, the V/Sc ratio of the upper mantle at mid-ocean ridges and arcs is similar, leading previous authors to propose that the upper mantle has uniform redox potential and is well-buffered. We have attempted to broaden the applicability of the V/Sc parameter to plume-influenced localities (both oceanic and continental), where mantle heterogeneities associated with recycled sediments, mafic crust, and metasomatized mantle, whether of shallow or deep origin, exist. We find that primitive basalts from the North Atlantic Igneous Province (NAIP), Hawaii (both the Loa and Kea trends), Deccan, Columbia River, and Siberian Traps show a range of V/Sc ratios that are generally higher (average ~9) than those for MOR (average ~ 6.7) or arc (average ~7) lavas. Based on forward polybaric decompression modeling, we attribute these differences to polybaric melting and melt segregation within the garnet stability field rather than the presence of a more oxidized mantle in plume-influenced settings. Like MORB, the V/Sc ratios for plume-influenced basalts can be accounted for by an oxidation state approximately one log unit below the Ni-NiO buffer (NNO-1). Our analysis suggests that source heterogeneities have little, if any, resolvable influence on mantle redox conditions, although they have significant influence on the trace element and isotopic composition of mantle-derived melts. We suggest that variations in the redox of erupted lavas is largely a function of shallow lithospheric processes rather than intrinsic to the mantle source, regardless of tectonic setting. [1] Li and Lee (2004) EPSL, [2] Lee et al. (2005) J. of Petrology

  4. Relationship between plume and plate tectonics

    NASA Astrophysics Data System (ADS)

    Puchkov, V. N.

    2016-07-01

    The relationship between plate- and plume-tectonics is considered in view of the growth and breakdown of supercontinents, active rifting, the formation of passive volcanic-type continental margins, and the origin of time-progressive volcanic chains on oceanic and continental plates. The mantle wind phenomenon is described, as well as its effect on plume morphology and anisotropy of the ambient mantle. The interaction of plumes and mid-ocean ridges is discussed. The principles and problems of plume activity analysis in subduction- and collision-related foldbelts are considered and illustrated with examples.

  5. The effects of an ion-thruster exhaust plume on S-band carrier transmission

    NASA Technical Reports Server (NTRS)

    Ackerknecht, W. E.; Stanton, P. H.

    1976-01-01

    The study reported here was undertaken (1) to develop models of the effects of an ion-thruster exhaust plume on S-band signals, and (2) to measure the effects. The results show that an S-band signal passing through an ion-thruster plume is reduced in amplitude and advanced in phase. The mathematical models gave reasonable estimates of the average signal attenuation and phase shift. Negligible fluctuations in the signal amplitude and phase were measured during steady-state thruster operation. However, large jumps in phase occurred when changes were made in the thruster operating state. This study confirms that the thruster plume can have a significant effect on S-band communication link performance; hence the plume effects must be considered in S-band link calculations when electric thrusters are used for spacecraft propulsion.

  6. 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

  7. 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.

  8. 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

  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. 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

  11. 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

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

    PubMed

    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.

  13. 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.

  14. Multi-functional electrospun nanofibres for advances in tissue regeneration, energy conversion & storage, and water treatment.

    PubMed

    Peng, Shengjie; Jin, Guorui; Li, Linlin; Li, Kai; Srinivasan, Madhavi; Ramakrishna, Seeram; Chen, Jun

    2016-03-01

    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

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

    PubMed Central

    Léonard, Lucie; Bouarab Chibane, Lynda; Ouled Bouhedda, Balkis; Degraeve, Pascal; Oulahal, Nadia

    2016-01-01

    The investigation on antimicrobial mechanisms is a challenging and crucial issue in the fields of food or clinical microbiology, as it constitutes a prerequisite to the development of new antimicrobial processes or compounds, as well as to anticipate phenomenon of microbial resistance. Nowadays it is accepted that a cells population exposed to a stress can cause the appearance of different cell populations and in particular sub-lethally compromised cells which could be defined as viable but non-culturable (VBNC). Recent advances on flow cytometry (FCM) and especially on multi-parameter flow cytometry (MP-FCM) provide the opportunity to obtain high-speed information at real time on damage at single-cell level. This review gathers MP-FCM methodologies based on individual and simultaneous staining of microbial cells employed to investigate their physiological state following different physical and chemical antimicrobial treatments. Special attention will be paid to recent studies exploiting the possibility to corroborate MP-FCM results with additional techniques (plate counting, microscopy, spectroscopy, molecular biology techniques, membrane modeling) in order to elucidate the antimicrobial mechanism of action of a given antimicrobial treatment or compound. The combination of MP-FCM methodologies with these additional methods is namely a promising and increasingly used approach to give further insight in differences in microbial sub-population evolutions in response to antimicrobial treatments. PMID:27551279

  16. 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

  17. Therapeutic advances in the treatment of nicotine addiction: present and future.

    PubMed

    Casella, Giuseppina; Caponnetto, Pasquale; Polosa, Riccardo

    2010-05-01

    While the proportion of the adult population that smokes has declined steadily in several westernized societies, the rate of successful quit attempts is still low. This is because smokers develop nicotine dependence, a powerful addiction that may require multiple attempts and long-term treatment to achieve enduring abstinence. Currently available first-line agents for smoking cessation therapy include nicotine replacement therapy (available in several formulations, including transdermal patch, gum, nasal spray, inhaler, and lozenge), bupropion (an atypical antidepressant), and varenicline (a partial agonist of the α4β2 nicotinic acetylcholine receptor that was recently developed and approved specifically for smoking cessation therapy). Second-line agents are nortriptyline (a tricyclic antidepressant agent) and the antihypertensive agent clonidine. With the exception of varenicline, which has been shown to offer significant improvement in abstinence rates over bupropion, all of the available treatments appear similarly effective. The adverse event profiles of nortriptyline and clonidine make them more appropriate for second-line therapy, when first-line treatments have failed or are not tolerated. However, the currently marketed smoking cessation drugs reportedly lack high levels of efficacy, particularly in real-life settings. New medications and vaccines with significant clinical advantage are now in the advanced stage of development and offer promise. These include nicotine vaccines and monoamine type B inhibitors. In this review article we discuss current and emerging pharmacotherapies for tobacco dependence focusing on their mechanisms of action, efficacy and adverse event profiles. PMID:23251732

  18. 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

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

    PubMed

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

    2016-06-01

    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.

  20. 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

  1. Is papillomavirus detectable in the plume of laser-treated laryngeal papilloma

    SciTech Connect

    Abramson, A.L.; DiLorenzo, T.P.; Steinberg, B.M. )

    1990-05-01

    The carbon dioxide laser is widely used for the vaporization of lesions in patients with laryngeal papillomatosis. In this study, the smoke plume resulting from the laser treatment of laryngeal papillomas was analyzed for the presence of human papillomavirus DNA. Plumes were collected with a suction tip and trapped in phosphate-buffered saline. The aspirates were then analyzed for the presence of human papillomavirus DNA by Southern blot hybridization. Human papillomavirus DNA cannot be detected in the smoke plume from vaporization of laryngeal papillomas unless direct suction contact is made with the papilloma tissue during surgery. The implications of these findings are discussed.

  2. Online monitoring of Escherichia coli and Bacillus thuringiensis spore inactivation after advanced oxidation treatment.

    PubMed

    Sherchan, Samendra P; Snyder, Shane A; Gerba, Charles P; Pepper, Ian L

    2014-01-01

    Various studies have shown that advanced oxidation processes (AOPs) such as UV light in combination with hydrogen peroxide is an efficient process for the removal of a large variety of emerging contaminants including microorganisms. The mechanism of destruction in the presence of hydrogen peroxide (H2O2) is the enhanced formation of hydroxyl (·OH) radicals, which have a high oxidation potential. The goal of this study was to utilize in-line advanced oxidation to inactivate microbes, and document the inactivation via an in-line, real-time sensor. Escherichia coli cells and Bacillus thuringiensis spores were exposed to UV/H2O2 treatment in DI water, and the online sensor BioSentry(®) was evaluated for its potential to monitor inactivation in real-time. B. thuringiensis was selected as a non-pathogenic surrogate for B. anthracis, the causative agent of anthrax and a proven biological weapon. UV radiation and UV/H2O2 exposure resulted in a >6 log10 reduction of the viable culturable counts of E. coli vegetative cells, and a 3 log10 reduction of B. thuringiensis spores. Scanning electron microscopy of the treated samples revealed severe damage on the surface of most E. coli cells, yet there was no significant change observed in the morphology of the B. thuringiensis spores. Following AOP exposure, the BioSentry sensor showed an increase in the categories of unknown, rod and spores counts, but overall, did not correspond well with viable count assays. Data from this study show that advanced oxidation processes effectively inactivate E. coli vegetative cells, but not B. thuringiensis spores, which were more resistant to AOP. Further, the BioSentry in-line sensor was not successful in documenting destruction of the microbial cells in real-time.

  3. Assessment of plausible bioindicators for plant performance in advanced wastewater treatment systems.

    PubMed

    Pérez-Uz, Blanca; Arregui, Lucía; Calvo, Pilar; Salvadó, Humbert; Fernández, Natividad; Rodríguez, Eva; Zornoza, Andrés; Serrano, Susana

    2010-09-01

    Three full-scale advanced biological systems for nitrogen removal showing different efficiencies were assessed during one year, to investigate the protist communities supported in these wastewater treatment plants (WWTP). The main goal of this research was to explore the differences of these communities from those observed in conventional activated sludge systems. The final objective was to provide background support for the proposal of bioindicators in this type of biological systems, where scarce information was available until now, since only conventional systems had been previously studied from this point of view. Results obtained indicate that, in fact, protist population density and diversity in advanced systems for N-elimination are quite different from other wastewater systems studied before. A statistical approach through multivariate analysis was developed to search for association between protist species and physical-chemical system performance, and specifically N-removal efficiencies. The original hypothesis proposing that previous indicators from conventional systems are not adequate in advanced N-removal mechanisms was proved to be correct. Efficient processes on N-removal, despite what it had been usually found in conventional systems, show important flagellate and amoeba populations and these populations tend to reduce their abundances as nitrogen removal performance decreases (moderate to low). Ciliates are however less abundant in these N-removal efficient systems. Certain groups and genera of protist such as flagellates and small amoebae are thus proposed as indicative of high performance N-removal, while in this case the appearance of certain ciliates were indicative of low performance on N- or high organic matter removal (as COD) efficiencies. PMID:20678787

  4. Strategies to Circumvent Testosterone Surge and Disease Flare in Advanced Prostate Cancer: Emerging Treatment Paradigms.

    PubMed

    Pokuri, Venkata K; Nourkeyhani, Houman; Betsy, Bodie; Herbst, Laurie; Sikorski, Marcus; Spangenthal, Edward; Fabiano, Andrew; George, Saby

    2015-07-01

    The testosterone surge and disease flare is a feared complication from initiation of gonadotropin-releasing hormone (GnRH) agonist treatment in advanced prostate adenocarcinoma. It is a common practice to start an average 7-day pretreatment regimen with an antiandrogen agent before initiating GnRH agonist therapy, to circumvent disease flare from testosterone surge. However, this might not be the best strategy and can be harmful, especially in patients at high risk of imminent organ damage from minimal testosterone surge. Surgical castration is a simple and cost-effective method that should be considered in these scenarios. But most patients refuse this procedure because of the permanent and psychologic impact of surgery. Novel GnRH antagonists, such as degarelix, and cytochrome P450 17 (CYP17) enzyme inhibitors, such as ketoconazole, achieve castrate-equivalent serum testosterone levels much faster than traditional GnRH agonists without the need for coadministration of antiandrogens. This article reports on 3 cases of impending oncologic emergencies in advanced prostate adenocarcinoma treated promptly with degarelix and ketoconazole without any disease flare related to testosterone surge. In the setting of symptomatic hormone-naïve metastatic prostate cancer, the authors suggest clinical trials using abiraterone, orteronel, and other newer agents that target the CYP17 axis (eg, ketoconazole) for fine-tuning the emergent medical castration methods and avoiding the dangers from the flare phenomenon.

  5. Dermal flap advancement combined with conservative sphincterotomy in the treatment of chronic anal fissure.

    PubMed

    Theodoropoulos, George E; Spiropoulos, Vasileios; Bramis, Konstantinos; Plastiras, Aris; Zografos, George

    2015-02-01

    Lateral internal sphincterotomy (LIS) is considered the surgical treatment of choice for chronic anal fissure (CAF). Flap techniques for fissure coverage have the advantage of primary wound healing, potentially providing better functional results and faster pain relief. The standard surgical strategy for CAF consisting of conventional LIS (CLIS) up to the dentate line was modified by "tailoring" the LIS to the apex of the CAF, but never greater than 1 cm, and by advancing a dermal flap for coverage of the CAF (LIS + flap) after fissurectomy. Thirty consecutive patients who underwent "LIS + flap" were compared with 32 patients who had been previously treated by CLIS. A modified, trapezoid-like Y-V flap from perianal skin was advanced into the CAF base. Pain at the first postoperative day, pain at defecation during the first week, postoperative use of analgesics, and time for patients' pain relief were significantly less at the "LIS + flap" group (P < 0.01). Objective healing was achieved faster (P < 0.01) and soiling episodes were less (P < 0.05) after "LIS + flap." The addition of a dermal flap after "conservative" LIS resulted in better healing and significantly less postoperative discomfort than the isolated application of CLIS.

  6. Treatment of coking wastewater by an advanced Fenton oxidation process using iron powder and hydrogen peroxide.

    PubMed

    Chu, Libing; Wang, Jianlong; Dong, Jing; Liu, Haiyang; Sun, Xulin

    2012-01-01

    In this study the treatment of coking wastewater was investigated by an advanced Fenton oxidation process using iron powder and hydrogen peroxide. Particular attention was paid to the effect of initial pH, dosage of H(2)O(2) and to improvement in biodegradation. The results showed that higher COD and total phenol removal rates were achieved with a decrease in initial pH and an increase in H(2)O(2) dosage. At an initial pH of less than 6.5 and H(2)O(2) concentration of 0.3 M, COD removal reached 44-50% and approximately 95% of total phenol removal was achieved at a reaction time of 1 h. The oxygen uptake rate of the effluent measured at a reaction time of 1h increased by approximately 65% compared to that of the raw coking wastewater. This indicated that biodegradation of the coking wastewater was significantly improved. Several organic compounds, including bifuran, quinoline, resorcinol and benzofuranol were removed completely as determined by GC-MS analysis. The advanced Fenton oxidation process is an effective pretreatment method for the removal of organic pollutants from coking wastewater. This process increases biodegradation, and may be combined with a classical biological process to achieve effluent of high quality. PMID:22014660

  7. A Model to Predict Nitrogen Losses in Advanced Soil-Based Wastewater Treatment Systems

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

    Most of the non-point source Nitrogen (N) load in rural areas is attributed to onsite wastewater treatment systems (OWTS). Nitrogen compounds are considered environmental pollutants because they deplete the oxygen availability in water bodies and produce eutrophication. The objective of this study was to simulate the fate and transport of Nitrogen in OWTS. The commercially-available 2D/3D HYDRUS software was used to develop a transport and fate model. Experimental data from a laboratory meso-cosm study included the soil moisture content, NH4 and NO3- data. That data set was used to calibrate the model. Three types of OWTS were simulated: (1) pipe-and-stone (P&S), (2) advanced soil drainfields, pressurized shallow narrow drainfield (SND) and (3) Geomat (GEO), a variation of SND. To better understand the nitrogen removal mechanism and the performance of OWTS technologies, replicate (n = 3) intact soil mesocosms were used with 15N-labelled nitrogen inputs. As a result, it was estimated that N removal by denitrification was predominant in P&S. However, it is suggested that N was removed by nitrification in SND and GEO. The calibrated model was used to estimate Nitrogen fluxes for both conventional and advanced OWTS. Also, the model predicted the N losses from nitrification and denitrification in all OWTS. These findings help to provide practitioners with guidelines to estimate N removal efficiencies for OWTS, and predict N loads and spatial distribution for identifying non-point sources.

  8. Risk-Adapted Treatment of Advanced Hodgkin Lymphoma With PET-CT.

    PubMed

    Lynch, Ryan C; Advani, Ranjana H

    2016-01-01

    Although patients with advanced-stage classic Hodgkin lymphoma have excellent outcomes with contemporary therapy, the outcomes of patients with refractory disease is suboptimal. Identification of these high-risk patients at diagnosis is challenging as the differences in outcomes using clinical criteria are less marked using current modern therapy. Data suggest that an interim PET-CT may be a powerful tool in risk-stratifying patients. Retrospective studies show that a negative interim PET-CT after two to four cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) is predictive of favorable outcome independent of IPS score. Currently, there are several ongoing trials that aim to determine whether early-response assessment can be used to select patients who might benefit from modifications of subsequent therapy, either by intensifying or abbreviating regimens and/or omitting radiotherapy with promising early results. Longer follow-up is required to assess whether this strategy impacts overall survival (OS). Herein, we review the results of recent trials using interim PET-CT-based adaptive design in the treatment of advanced HL. PMID:27249744

  9. 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.

  10. Advances in diagnosis, treatment and palliation of pancreatic carcinoma: 1990-2010

    PubMed Central

    Sharma, Chakshu; Eltawil, Karim M; Renfrew, Paul D; Walsh, Mark J; Molinari, Michele

    2011-01-01

    Several advances in genetics, diagnosis and palliation of pancreatic cancer (PC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. PC is relatively common as it is the fourth leading cause of cancer related mortality. Most patients present with obstructive jaundice, epigastric or back pain, weight loss and anorexia. Despite improvements in diagnostic modalities, the majority of cases are still detected in advanced stages. The only curative treatment for PC remains surgical resection. No more than 20% of patients are candidates for surgery at the time of diagnosis and survival remains quite poor as adjuvant therapies are not very effective. A small percentage of patients with borderline non-resectable PC might benefit from neo-adjuvant chemoradiation therapy enabling them to undergo resection; however, randomized controlled studies are needed to prove the benefits of this strategy. Patients with unresectable PC benefit from palliative interventions such as biliary decompression and celiac plexus block. Further clinical trials to evaluate new chemo and radiation protocols as well as identification of genetic markers for PC are needed to improve the overall survival of patients affected by PC, as the current overall 5-year survival rate of patients affected by PC is still less than 5%. The aim of this article is to review the most recent high quality literature on this topic. PMID:21412497

  11. Subcutaneous nephrovesical bypass: Treatment for ureteral obstruction in advanced metastatic disease

    PubMed Central

    WANG, YUNYAN; WANG, GONGCHENG; HOU, PEIJIN; ZHUANG, HAIJUN; YANG, XIAOSONG; GU, SHUO; WANG, HENGBING; JI, LU; XU, ZONGYUAN; MENG, JUNSONG

    2015-01-01

    The aim of the present study was to explore the value of subcutaneous nephrovesical bypass (SNVB) for the treatment of ureteral obstruction due to pelvic metastatic disease. SNVB stents (n=30) were implanted in 24 patients with advanced metastatic disease between January 2008 and December 2012. Urinalysis, serum creatinine (SCr), glomerular filtration rate (GFR), quality of life (QoL) scores, and renal ultrasonography were evaluated at follow-up. The SNVB procedures were successful in all 24 patients. Patient follow-ups occurred at an average of 10.6 months. Preoperative hydronephrosis was eliminated in 16 cases (53.3%) and reduced in the remaining patients. Following surgery, SCr levels reduced significantly from 256±46 to 124±23 μmol/l (P<0.001). GFRs increased from 25±4.8 to 45±5.3 ml/min (P<0.01). The mean QoL scores were 3.4±1.4 preoperatively and 7.6±1.0 postoperatively (P<0.001). The results showed that SNVB is a minimally invasive, effective and safe procedure for patients with ureteral obstruction resulting from advanced malignant disease. As an alternative procedure to percutaneous nephrostomy, SNVB offers patients a better QoL. PMID:25435997

  12. Therapy for advanced thyroid cancer: treatment of a high risk case.

    PubMed

    Ceriati, F; Cavicchioni, C; Logroscino, C; Pastore, G; Montemaggi, P; Fabiano, A; Mantovani, M; Marino, I R; Ardito, G; De Luca, G

    1987-01-01

    The treatment of a high risk case of an advanced thyroid cancer is reported. The patient had a thyroid cancer with metastatic lesions of the frontal bone, left temporal bone, left sacroiliac joint, lytic destruction of C6 and lytic lesion of C7. A pre-operative immobilization of the cervical spine was performed by a halo cast set on a corset of gypsum. After this, the patient underwent a thyroidectomy and, at the same time, a metallic plate was applied to immobilize C5-C7. A month after he underwent reoperative surgery to stabilize definitively the cervical spine. Subsequently he was treated by TCT and 131I subdivided in several cycles. The latest total body scan demonstrated a complete regression of secondary lesions.

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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

  18. IL-2-Activated Killer Cells and Native Cytokines in Treatment of Patients with Advanced Cancer.

    PubMed

    Ostanin, Alexander A.; Chernykh, Helena R.; Leplina, Olga Y.; Shevela, Ekaterina Ya.; Niconov, Sergey D.; Kozlov, Vladimir A.

    1997-12-01

    We evaluated the efficiency/tolerability of and the immunological changes induced by the adoptive immunotherapy (AIT) with IL-2-activated killer cells, and preparation of native cytokines from swine spleen (PSS) in treatment of 20 patients with advanced cancer (10 patients with primary lung cancer; 3 with metastatic melanoma; 2 with advanced neuroblastoma; 2 with ovarian cancer; renal cancer; gastric adenocarcinoma; and colorectal cancer). The partial/minor response of duration period 2-10 months was observed in 20% of patients. 2/4 patients, who underwent partial surgical tumor resection and following AIT course, sustained the event-free survival for more than 24 months. The response to the therapy was revealed in 4/10 patients with lung cancer, 2/2 patients with neuroblastoma, of whom each had ovarian and colorectal cancers. The evaluation of a dose of infused LAKcells as well as combined i.v./local (endobronchial or endoperitoneal) LAK administration were necessary to assure positive response in patients. The cytokine and/or side effects were moderate and the combined LAK-PSS infusions were generally well tolerated by the patients. The treatment was followed by activation of the patient immune system that included: (i) rebound in amount of peripheral blood lymphocytes; (ii) gain in amount of CD3(+) T cells and those CD4(+) helper/inducer; (iii) enchantment of lymphocyte proliferation and cytokine production (IL-2, IL-1, TNF-alpha). Being injected to patients in combination with LAK cells, cytokines related to PSS action and/or those, either exogenous or secondary, and released by in vitro and in vivo, activated lymphocytes and could cause the therapeutic effects.

  19. Effluent characteristics of advanced treatment for biotreated coking wastewater by electrochemical technology using BDD anodes.

    PubMed

    Wang, Chunrong; Zhang, Mengru; Liu, Wei; Ye, Min; Su, Fujin

    2015-05-01

    Effluent of biotreated coking wastewater comprises hundreds of organic and inorganic pollutants and has the characteristics of high toxicity and difficult biodegradation; thus, its chemical oxygen demand cannot meet drainage standards in China. A boron-doped diamond anode was selected for advanced treatment of biotreated coking wastewater, and considering the efficiency of the removal of total organic carbon and energy consumption, optimal conditions were obtained as current density of 75 mA cm(-2), electrolysis time of 1.5 h, and an electrode gap of 1.0 cm in an orthogonal test. Effluent characteristics were investigated at different electrolysis times. The ratio of the 5-day biochemical oxygen demand (BOD5) to the chemical oxygen demand increased from an initial value of 0.05 to 0.65 at 90 min. Fluorescence spectra were used to evaluate the evolution of refractory organics. Two fluorescence peaks for raw wastewater, corresponding to an aromatic protein-like substance II and humic acid-like substance, weakened at 30 and at 90 min, only the former was detected. The specific oxygen uptake rate was used to assess effluent toxicity, and an obvious inhibition effect was found at 15 min; then, it was significantly faded at 30 and 45 min. The BOD5/NO3 (-)-N ratio increased from an initial value of 0.48 to 1.25 at 45 min and then gradually dropped to 0.69 at 90 min. According to the above effluent characteristics, it is strongly suggested that electrochemical technology using boron-doped diamond anodes is combined with biological denitrification technology for the advanced treatment of biotreated coking wastewater.

  20. Combined treatment technology based on synergism between hydrodynamic cavitation and advanced oxidation processes.

    PubMed

    Gogate, Parag R; Patil, Pankaj N

    2015-07-01

    The present work highlights the novel approach of combination of hydrodynamic cavitation and advanced oxidation processes for wastewater treatment. The initial part of the work concentrates on the critical analysis of the literature related to the combined approaches based on hydrodynamic cavitation followed by a case study of triazophos degradation using different approaches. The analysis of different combinations based on hydrodynamic cavitation with the Fenton chemistry, advanced Fenton chemistry, ozonation, photocatalytic oxidation, and use of hydrogen peroxide has been highlighted with recommendations for important design parameters. Subsequently degradation of triazophos pesticide in aqueous solution (20 ppm solution of commercially available triazophos pesticide) has been investigated using hydrodynamic cavitation and ozonation operated individually and in combination for the first time. Effect of different operating parameters like inlet pressure (1-8 bar) and initial pH (2.5-8) have been investigated initially. The effect of addition of Fenton's reagent at different loadings on the extent of degradation has also been investigated. The combined method of hydrodynamic cavitation and ozone has been studied using two approaches of injecting ozone in the solution tank and at the orifice (at the flow rate of 0.576 g/h and 1.95 g/h). About 50% degradation of triazophos was achieved by hydrodynamic cavitation alone under optimized operating parameters. About 80% degradation of triazophos was achieved by combination of hydrodynamic cavitation and Fenton's reagent whereas complete degradation was achieved using combination of hydrodynamic cavitation and ozonation. TOC removal of 96% was also obtained for the combination of ozone and hydrodynamic cavitation making it the best treatment strategy for removal of triazophos.