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Sample records for ajcc tnm staging

  1. Comparative study between two different staging systems (AJCC TNM VS BALLANTYNE’S) for mucosal melanomas of the Head & Neck

    PubMed Central

    Aguilar-Romero, Madeleine; Villavicencio-Valencia, Verónica; Zepeda-Castilla, Ernesto; Vidrio-Morgado, Horacio; Peteuil, Nathalie; Mosqueda-Taylor, Adalberto

    2016-01-01

    Background Mucosal melanoma (MM) of head and neck (H &N) is a rare entity with a quite poor prognosis. Ballantyne’s staging system has been commonly used since 1970. In the 7th edition of the AJCC Staging Manual a new chapter for the staging of TNM Classification system for mucosal melanoma (MM) of the head and neck (H &N) has been introduced to reflect the particularly aggressive biological behavior of this neoplasm. The aim of this study was to analyze and compare among Ballantyne’s staging system vs TNM H &N in terms of overall survival (OS) and disease-free survival (DFS) in a consecutive population of patients with MM in a cancer centre. Material and Methods Descriptive analysis of demographic, clinical and pathological variables of MM of the Head & Neck were performed. We compared the survival curves for both systems according to the Kaplan-Meier method using the Log-rank test. Results An up-staging migration effect from Ballantyne’s localized disease to moderately and very advanced disease according to AJCC staging system. The 5-year DFS and OS for Ballantyne’s Localized Disease and AJCC Stage III were 31% and 36% vs. 47% and 50%, respectively. For locoregional disease the 5-year DFS / OS were 5% / 10% for Bal-lantyne’s system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively. Conclusions In this series, the TNM staging system for MM of the H &N predicted better the prognosis of the disease when comparing with Ballantyne’s system. Key words:Head and neck, mucosal melanoma, AJCC TNM, Ballantynes´s staging system. PMID:27031071

  2. TNM staging of pancreatic neuroendocrine tumors: an observational analysis and comparison by both AJCC and ENETS systems from 1 single institution.

    PubMed

    Yang, Min; Zeng, Lin; Zhang, Yi; Wang, Wei-guo; Wang, Li; Ke, Neng-wen; Liu, Xu-bao; Tian, Bo-le

    2015-03-01

    We aimed to analyze the clinical characteristics and compare the surgical outcome of pancreatic neuroendocrine tumors (p-NETs) using the 2 tumor-node-metastasis (TNM) systems by both the American Joint Committee on Cancer (AJCC) Staging Manual (seventh edition) and the European Neuroendocrine Tumor Society (ENETS). Moreover, we sought to validate the prognostic value of the new AJCC criterion. Data of 145 consecutive patients who were all surgically treated and histologically diagnosed as p-NETs from January 2002 to June 2013 in our single institution were retrospectively collected and analyzed. The 5-year overall survival (OS) rates for AJCC classifications of stages I, II, III, and IV were 79.5%, 63.1%, 15.0%, and NA, respectively, (P < 0.005). As for the ENETS system, the OS rates at 5 years for stages I, II, III, and IV were 75.5%, 72.7%, 29.0%, and NA, respectively, (P < 0.005). Both criteria present no statistically notable difference between stage I and stage II (P > 0.05) but between stage I and stages III and IV (P < 0.05), as well as those between stage II and stages III and IV (P < 0.05). Difference between stage III and IV by ENETS was significant (P = 0.031), whereas that by the AJCC was not (P = 0.144). What's more, the AJCC Staging Manual (seventh edition) was statistically significant in both uni- and multivariate analyses by Cox regression (P < 0.005 and P = 0.025, respectively). Our study indicated that the ENETS TNM staging system might be superior to the AJCC Staging Manual (seventh edition) for the clinical practice of p-NETs. Together with tumor grade and radical resection, the new AJCC system was also validated to be an independent predictor for p-NETs. PMID:25816036

  3. Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery

    PubMed Central

    Jin, Ying; Chen, Ming; Yu, Xinmin

    2016-01-01

    The present study aims to compare the 7th and the proposed 8th edition of the AJCC/UICC TNM staging system for NSCLC in a cohort of patients from a single institution. A total of 408 patients with NSCLC who underwent radical surgery were analyzed retrospectively. Survivals were analyzed using the Kaplan –Meier method and were compared using the log-rank test. Multivariate analysis was performed by the Cox proportional hazard model. The Akaike information criterion (AIC) and C-index were applied to compare the two prognostic systems with different numbers of stages. The 7th AJCC T categories, the proposed 8th AJCC T categories, N categories, visceral pleural invasion, and vessel invasion were found to have statistically significant associations with disease-free survival (DFS) on univariate analysis. In the 7th edition staging system as well as in the proposed 8th edition, T categories, N categories, and pleural invasion were independent factors for DFS on multivariate analysis. The AIC value was smaller for the 8th edition compared to the 7th edition staging system. The C-index value was larger for the 8th edition compared to the 7th edition staging system. Based on the data from our single center, the proposed 8th AJCC T classification seems to be superior to the 7th AJCC T classification in terms of DFS for patients with NSCLC underwent radical surgery. PMID:27641932

  4. Comparison of the 7(th) and proposed 8(th) editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery.

    PubMed

    Jin, Ying; Chen, Ming; Yu, Xinmin

    2016-01-01

    The present study aims to compare the 7(th) and the proposed 8(th) edition of the AJCC/UICC TNM staging system for NSCLC in a cohort of patients from a single institution. A total of 408 patients with NSCLC who underwent radical surgery were analyzed retrospectively. Survivals were analyzed using the Kaplan -Meier method and were compared using the log-rank test. Multivariate analysis was performed by the Cox proportional hazard model. The Akaike information criterion (AIC) and C-index were applied to compare the two prognostic systems with different numbers of stages. The 7(th) AJCC T categories, the proposed 8(th) AJCC T categories, N categories, visceral pleural invasion, and vessel invasion were found to have statistically significant associations with disease-free survival (DFS) on univariate analysis. In the 7(th) edition staging system as well as in the proposed 8(th) edition, T categories, N categories, and pleural invasion were independent factors for DFS on multivariate analysis. The AIC value was smaller for the 8(th) edition compared to the 7(th) edition staging system. The C-index value was larger for the 8(th) edition compared to the 7(th) edition staging system. Based on the data from our single center, the proposed 8(th) AJCC T classification seems to be superior to the 7(th) AJCC T classification in terms of DFS for patients with NSCLC underwent radical surgery. PMID:27641932

  5. TNM Staging of Pancreatic Neuroendocrine Tumors

    PubMed Central

    Yang, Min; Zeng, Lin; Zhang, Yi; Wang, Wei-guo; Wang, Li; Ke, Neng-wen; Liu, Xu-bao; Tian, Bo-le

    2015-01-01

    Abstract We aimed to analyze the clinical characteristics and compare the surgical outcome of pancreatic neuroendocrine tumors (p-NETs) using the 2 tumor-node-metastasis (TNM) systems by both the American Joint Committee on Cancer (AJCC) Staging Manual (seventh edition) and the European Neuroendocrine Tumor Society (ENETS). Moreover, we sought to validate the prognostic value of the new AJCC criterion. Data of 145 consecutive patients who were all surgically treated and histologically diagnosed as p-NETs from January 2002 to June 2013 in our single institution were retrospectively collected and analyzed. The 5-year overall survival (OS) rates for AJCC classifications of stages I, II, III, and IV were 79.5%, 63.1%, 15.0%, and NA, respectively, (P < 0.005). As for the ENETS system, the OS rates at 5 years for stages I, II, III, and IV were 75.5%, 72.7%, 29.0%, and NA, respectively, (P < 0.005). Both criteria present no statistically notable difference between stage I and stage II (P > 0.05) but between stage I and stages III and IV (P < 0.05), as well as those between stage II and stages III and IV (P < 0.05). Difference between stage III and IV by ENETS was significant (P = 0.031), whereas that by the AJCC was not (P = 0.144). What's more, the AJCC Staging Manual (seventh edition) was statistically significant in both uni- and multivariate analyses by Cox regression (P < 0.005 and P = 0.025, respectively). Our study indicated that the ENETS TNM staging system might be superior to the AJCC Staging Manual (seventh edition) for the clinical practice of p-NETs. Together with tumor grade and radical resection, the new AJCC system was also validated to be an independent predictor for p-NETs. PMID:25816036

  6. New TNM staging system for esophageal cancer: what chest radiologists need to know.

    PubMed

    Hong, Su Jin; Kim, Tae Jung; Nam, Kyung Bum; Lee, In Sun; Yang, Hee Chul; Cho, Sukki; Kim, Kwhanmien; Jheon, Sanghoon; Lee, Kyung Won

    2014-10-01

    Esophageal cancer is a leading cause of cancer-related deaths worldwide, and the 5-year relative survival rate remains less than 20% in the United States. The treatment of esophageal cancer should be stage specific for better clinical outcomes. Recent treatment paradigms tend to involve a multimodality approach to management, which includes surgical resection and preoperative or definitive chemoradiation therapy. Accurate pretreatment staging of esophageal cancer is integral for assessing operability and determining a suitable treatment plan. The American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) have published the seventh edition of the staging manual for cancer in the esophagus and esophagogastric junction. Unlike the sixth edition, the revised staging manual is data driven and harmonized with the staging of stomach cancer. Improvements include new definitions for the anatomic classifications Tis, T4, regional lymph node, N, and M and the addition of nonanatomic cancer characteristics (histopathologic cell type, histologic grade, and cancer location). Given the recent increase in the incidence of adenocarcinoma of the distal esophagus, esophagogastric junction, and gastric cardia, the staging of tumors in the esophagogastric junction has been addressed. Radiologists must understand the details of the seventh edition of the AJCC-UICC staging system for esophageal cancer and use appropriate imaging modalities, such as computed tomography (CT), endoscopic ultrasonography, and positron emission tomography/CT, for initial staging.

  7. Vitronectin and dermcidin serum levels predict the metastatic progression of AJCC I-II early-stage melanoma.

    PubMed

    Ortega-Martínez, Idoia; Gardeazabal, Jesús; Erramuzpe, Asier; Sanchez-Diez, Ana; Cortés, Jesús; García-Vázquez, María D; Pérez-Yarza, Gorka; Izu, Rosa; Luís Díaz-Ramón, Jose; de la Fuente, Ildefonso M; Asumendi, Aintzane; Boyano, María D

    2016-10-01

    Like many cancers, an early diagnosis of melanoma is fundamental to ensure a good prognosis, although an important proportion of stage I-II patients may still develop metastasis during follow-up. The aim of this work was to discover serum biomarkers in patients diagnosed with primary melanoma that identify those at a high risk of developing metastasis during the follow-up period. Proteomic and mass spectrophotometry analysis was performed on serum obtained from patients who developed metastasis during the first years after surgery for primary tumors and compared with that from patients who remained disease-free for more than 10 years after surgery. Five proteins were selected for validation as prognostic factors in 348 melanoma patients and 100 controls by ELISA: serum amyloid A and clusterin; immune system proteins; the cell adhesion molecules plakoglobin and vitronectin and the antimicrobial protein dermcidin. Compared to healthy controls, melanoma patients have high serum levels of these proteins at the moment of melanoma diagnosis, although the specific values were not related to the histopathological stage of the tumors. However, an analysis based on classification together with multivariate statistics showed that tumor stage, vitronectin and dermcidin levels were associated with the metastatic progression of patients with early-stage melanoma. Although melanoma patients have increased serum dermcidin levels, the REPTree classifier showed that levels of dermcidin <2.98 μg/ml predict metastasis in AJCC stage II patients. These data suggest that vitronectin and dermcidin are potent biomarkers of prognosis, which may help to improve the personalized medical care of melanoma patients and their survival. PMID:27216146

  8. TNM-Like Classification: A New Proposed Method for Heart Failure Staging

    PubMed Central

    Fedele, Francesco; D'Ambrosi, Alessandra

    2013-01-01

    Heart Failure (HF) is an acute or chronic syndrome, that causes a lot of damaging effects to every system. The involvement of different systems is variably related to age and others comorbidities. The severity of organ damage is often proportional to the duration of heart failure. The typology of HF and the duration determine which organs will be affected and vice versa the severity of organ damage supplies precious information about prognosis and outcome of patients with heart failure. Moreover, a classification based not only on symptomatic and syndromic typical features of heart failure, but also on functional data of each system, could allow us to apply the most appropriate therapies, to obtain a more accurate prognosis, and to employ necessary and not redundant human and financial resources. With an eye on the TNM staging used in oncology, we drawn up a classification that will consider the different involvement of organs such as lungs, kidneys, and liver in addition to psychological pattern and quality of life in HF patients. For all these reasons, it is our intention to propose a valid and more specific classification available for the clinical staging of HF that takes into account pathophysiological and structural changes that can remark prognosis and management of HF. PMID:24376377

  9. Proper hepatic pedicle clamping during hepatectomy is associated with improved postoperative long-term prognosis in patients with AJCC stage IIIB hepatocellular carcinoma

    PubMed Central

    Guo, Lei; Zhang, Bo; Lin, Zhenhai; Zhang, Jubo; Ye, Qinghai

    2016-01-01

    Intermittent hepatic pedicle clamping (HPC) is often performed during hepatectomy. Whether it affects the long-term prognosis of hepatocellular carcinoma (HCC) patients is still controversial. This study evaluated the impact of HPC in patients with different stages of HCC. The study included 1401 patients who underwent hepatectomy in the primary cohort with 129 AJCC stage IIIB HCC patients; there were 80 AJCC stage IIIB HCC patients in the validation cohort. In each cohort, patients were placed in the long-term HPC (LTHPC) group or the short-term HPC (STHPC) group based on the cut-off time of HPC estimated by the receiver-operating characteristic (ROC) curve. Although HPC did not show significant effects on the prognosis of stage I–IIIA HCC patients in the primary cohort, 1−, 3−, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates of stage IIIB HCC patients who received LTHPC (HPC time > 12 minutes) were significantly higher than those with STHPC (HPC time ≤ 12 minutes or received no HPC), similar in the validation cohort. Multivariate analysis demonstrated HPC time was an independent protective factor for RFS and OS in stage IIIB HCC patients. Herein, we report that proper HPC improved the postoperative prognosis of stage IIIB HCC patients and served as an independent protective factor. PMID:27027437

  10. How Does Magnetic Resonance Imaging Influence Staging According to AJCC Staging System for Nasopharyngeal Carcinoma Compared With Computed Tomography?

    SciTech Connect

    Liao Xinbiao; Mao Yanping; Liu Lizhi; Tang Linglong; Sun Ying; Wang Yan; Lin Aihua; Cui Chunyan; Li Li; Ma Jun

    2008-12-01

    Purpose: To analyze the degree and pattern of influence of magnetic resonance imaging (MRI) on staging according to the 6th edition of the American Joint Committee on Cancer staging system compared with computed tomography (CT). Methods and Materials: The MRI and CT scans and medical records of 420 consecutive patients with newly diagnosed nasopharyngeal carcinoma (NPC) were analyzed retrospectively. The tumors of all patients were staged according to the 6th edition of the American Joint Committee on Cancer staging system. Results: A significant difference (p <0.05) was found between CT and MRI in demonstrating involvement in the oropharynx (CT, 25.0% vs. MRI, 14.5%), prevertebral muscle (CT, 18.4% vs. MRI, 36.0%), parapharyngeal space (CT, 82.6% vs. MRI, 68.8%), skull base (CT, 31.0% vs. MRI, 52.6%), sphenoid sinus (CT, 13.6% vs. MRI, 16.7%), ethmoid sinus (CT, 7.1% vs. MRI, 3.3%), intracranial area (CT, 4.8% vs. MRI, 16.0%), and retropharyngeal lymph nodes (CT, 52.1% vs. MRI, 69.0%). The incidence of cervical lymph node metastasis and lymph node metastasis at each level was similar according to CT and MRI. MRI resulted in changes in 49.8% of T stage cases, 10.7% of N stage cases, and 38.6% of clinical stage cases. Conclusion: MRI demonstrated early primary tumor involvement more precisely and deep primary tumor infiltration more easily. The use of MRI caused dramatic changes in the results of the T stage and clinical staging and should be preferred to CT in staging NPC. Patients would benefit from changes in treatment strategies resulting from the use of MRI.

  11. Proposal for the 8th Edition of the AJCC/UICC Staging System for Nasopharyngeal Cancer in the Era of Intensity-Modulated Radiotherapy

    PubMed Central

    Pan, Jian Ji; Ng, Wai Tong; Zong, Jing Feng; Chan, Lucy L. K.; O’Sullivan, Brian; Lin, Shao Jun; Sze, Henry C. K.; Chen, Yun Bin; Choi, Horace C.W.; Guo, Qiao Juan; Kan, Wai Kuen; Xiao, You Ping; Wei, Xu; Le, Quynh Thu; Glastonbury, Christine M.; Colevas, A. Dimitrios; Weber, Randal S.; Shah, Jatin P.; Lee, Anne W. M.

    2016-01-01

    BACKGROUND An accurate staging system is crucial for cancer management. Evaluations for continual suitability and improvement are needed as staging and treatment methods evolve. METHODS This was a retrospective study of 1609 patients with nasopharyngeal carcinoma investigated by magnetic resonance imaging, staged with the 7th edition of the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system, and irradiated by intensity-modulated radiotherapy at 2 centers in Hong Kong and mainland China. RESULTS Among the patients without other T3/T4 involvement, there were no significant differences in overall survival (OS) between medial pterygoid muscle (MP)±lateral pterygoid muscle (LP), prevertebral muscle, and parapharyngeal space involvement. Patients with extensive soft tissue involvement beyond the aforementioned structures had poor OS similar to that of patients with intracranial extension and/or cranial nerve palsy. Only 2% of the patients had lymph nodes>6cm above the supraclavicular fossa (SCF), and their outcomes resembled the outcomes of those with low extension. Replacing SCF with the lower neck (extension below the caudal border of the cricoid cartilage) did not affect the hazard distinction between different N categories. With the proposed T and N categories, there were no significant differences in outcome between T4N0-2 and T1-4N3 disease. CONCLUSIONS After a review by AJCC/UICC preparatory committees, the changes recommended for the 8th edition include changing MP/LP involvement from T4 to T2, adding prevertebral muscle involvement as T2, replacing SCF with the lower neck and merging this with a maximum nodal diameter>6 cm as N3, and merging T4 and N3 as stage IVA criteria. These changes will lead not only to a better distinction of hazards between adjacent stages/categories but also to optimal balance in clinical practicability and global applicability. PMID:26588425

  12. Gastric Stump Cancer: More Than Just Another Proximal Gastric Cancer and Demanding a More Suitable TNM Staging System

    PubMed Central

    Costa-Pinho, André; Pinto-de-Sousa, J.; Barbosa, José; Costa-Maia, J.

    2013-01-01

    Background. Considerable controversy persists about the biological behavior of gastric stump cancer (GSC). The aim of this study is to clarify if this cancer is just another proximal gastric cancer or if it emerges as a distinctive clinicopathologic entity. Methods. This review of a prospectively collected gastric cancer database identified 73 patients with GSC in a single institution between January 1980 and June 2012 and compared them with 328 patients with proximal gastric cancer (PGC) and 291 patients with esophagogastric junction cancer (EGJC). Results. Patients with GSC were predominantly males. Eighty-three percent of GSC penetrated the subserosal or the serosal layers. The median number of lymph nodes retrieved in GSC patients was significantly lower than in PGC patients or in EGJC patients. Cumulative survival curves were not different between GSC, PGC, or EGJC patients. Unlike that observed in PGC and in EGJC, no significant differences in cumulative survival according to the TNM staging system were observed in GSC cases. Conclusions. The outcome of patients with GSC displayed significant differences when compared to those with other proximal gastric cancers concerning the lack of survival association with the TNM staging system. Therefore a more suitable staging system should be designed for these unique cancers. PMID:24151622

  13. Prognosis Evaluation in Patients with Hepatocellular Carcinoma after Hepatectomy: Comparison of BCLC, TNM and Hangzhou Criteria Staging Systems

    PubMed Central

    Lu, Wu-sheng; Yan, Lu-nan; Xiao, Guang-qin; Jiang, Li; Yang, Jian; Yang, Jia-yin

    2014-01-01

    Purpose This study is to evaluate the Hangzhou criteria (HC) for patients with HCC undergoing surgical resection and to identify whether this staging system is superior to other staging systems in predicting the survival of resectable HCC. Method 774 HCC patients underwent surgical resection between 2007 and 2009 in West China Hospital were enrolled retrospectively. Predictors of survival were identified using the Kaplan–Meier method and the Cox model. The disease state was staged by the HC, as well as by the TNM and BCLC staging systems. Prognostic powers were quantified using a linear trend χ2 test, c-index, and the likelihood ratio (LHR) χ2 test and correlated using Cox's regression model adjusted using the Akaike information criterion (AIC). Results Serum AFP level (P = 0.02), tumor size (P<0.001), tumor number (P<0.001), portal vein invasion (P<0.001), hepatic vein invasion (P<0.001), tumor differentiation (P<0.001), and distant organ (P = 0.016) and lymph node metastasis (P<0.001) were identified as independent risk factors of survival after resection by multivariate analysis. The comparison of the different staging system results showed that BCLC had the best homogeneity (likelihood ratio χ2 test 151.119, P<0.001), the TNM system had the best monotonicity of gradients (linear trend χ2 test 137.523, P<0.001), and discriminatory ability was the highest for the BCLC (the AUCs for 1-year mortality were 0.759) and TNM staging systems (the AUCs for 3-, and 5-year mortality were 0.738 and 0.731, respectively). However, based on the c-index and AIC, the HC was the most informative staging system in predicting survival (c-index 0.6866, AIC 5924.4729). Conclusions The HC can provide important prognostic information after surgery. The HC were shown to be a promising survival predictor in a Chinese cohort of patients with resectable HCC. PMID:25133493

  14. The 7th lung cancer TNM classification and staging system: Review of the changes and implications

    PubMed Central

    Mirsadraee, Saeed; Oswal, Dilip; Alizadeh, Yalda; Caulo, Andrea; van Beek, Edwin JR

    2012-01-01

    Lung cancer is the most common cause of death from cancer in males, accounting for more than 1.4 million deaths in 2008. It is a growing concern in China, Asia and Africa as well. Accurate staging of the disease is an important part of the management as it provides estimation of patient’s prognosis and identifies treatment sterategies. It also helps to build a database for future staging projects. A major revision of lung cancer staging has been announced with effect from January 2010. The new classification is based on a larger surgical and non-surgical cohort of patients, and thus more accurate in terms of outcome prediction compared to the previous classification. There are several original papers regarding this new classification which give comprehensive description of the methodology, the changes in the staging and the statistical analysis. This overview is a simplified description of the changes in the new classification and their potential impact on patients’ treatment and prognosis. PMID:22590666

  15. Evaluation of the 7th edition of the UICC-AJCC tumor, node, metastasis classification for esophageal cancer in a Chinese cohort

    PubMed Central

    Huang, Yan; Guo, Weigang; Shi, Shiming

    2016-01-01

    Background To assess and evaluate the prognostic value of the 7th edition of the Union for International Cancer Control–American Joint Committee on Cancer (UICC-AJCC) tumor, node, metastasis (TNM) staging system for Chinese patients with esophageal cancer in comparison with the 6th edition. Methods A retrospective review was performed on 766 consecutive esophageal cancer patients treated with esophagectomy between 2008 and 2012. Patients were staged according to the 6th and 7th editions for esophageal cancer respectively. Survival was calculated by the Kaplan-Meier method, and multivariate analysis was performed using Cox regression model. Results Overall 3-year survival rate was 59.5%. There were significant differences in 3-year survival rates among T stages both according to the 6th edition and the 7th edition (P<0.001). According to the 7th edition, the 3-year survival rates of N0 (75.4%), N1 (65.2%), N2 (39.7%) and N3 (27.3%) patients were significant differences (P<0.001). Kaplan-Meier curve revealed a good discriminatory ability from stage I to IV, except for stage IB, IIA and IIB in the 7th edition staging system. Based on the 7th edition, the degree of differentiation, tumor length and tumor location were not independent prognostic factors on multivariate analysis. The multivariate analyses suggested that pT-, pN-, pTNM-category were all the independent prognostic factors based on the 6th and 7th edition staging system. Conclusions The 7th edition of AJCC TNM staging system of esophageal cancer should discriminate pT2–3N0M0 (stage IB, IIA and IIB) better when considering the esophageal squamous cell cancer patients. Therefore, to improve and optimize the AJCC TNM classification for Chinese patients with esophageal cancer, more considerations about the value of tumor grade and tumor location in pT2–3N0M0 esophageal squamous cell cancer should be taken in the next new TNM staging system. PMID:27499956

  16. Suggestions for Lymph Node Classification of UICC/AJCC Staging System: A Retrospective Study Based on 1197 Nasopharyngeal Carcinoma Patients Treated With Intensity-Modulated Radiation Therapy

    PubMed Central

    Guo, Qiaojuan; Pan, Jianji; Zong, Jingfeng; Zheng, Wei; Zhang, Chun; Tang, Linbo; Chen, Bijuan; Cui, Xiaofei; Xiao, Youping; Chen, Yunbin; Lin, Shaojun

    2015-01-01

    Abstract This article provides suggestions for N classification of Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system of nasopharyngeal carcinoma (NPC), purely based on magnetic resonance imaging (MRI) in intensity-modulated radiation therapy (IMRT) era. A total of 1197 nonmetastatic NPC patients treated with IMRT were enrolled, and all were scanned by MRI at nasopharynx and neck before treatment. MRI-based nodal variables including level, laterality, maximal axial diameter (MAD), extracapsular spread (ECS), and necrosis were analyzed as potential prognostic factors. Modifications of N classification were then proposed and verified. Only nodal level and laterality were considered to be significant variables affecting the treatment outcome. N classification was thus proposed accordingly: N0, no regional lymph node (LN) metastasis; N1, retropharyngeal LNs involvement (regardless of laterality), and/or unilateral levels I, II, III, and/or Va involvement; N2, bilateral levels I, II, III, and/or Va involvement; and N3, levels IV, Vb, and Vc involvement. This proposal showed significant predicting value in multivariate analysis. N3 patients indicated relatively inferior overall survival (OS) and distant metastasis-free survival (DMFS) than N2 patients; however, the difference showed no statistical significance (P = 0.673 and 0.265 for OS and DMFS, respectively), and this was considered to be correlated with the small sample sizes of N3 patients (79 patients, 6.6%). Nodal level and laterality, but not MAD, ECS, and necrosis, were considered to be significant predicting factors for NPC. The proposed N classification was proved to be powerfully predictive in our cohort; however, treatment outcome of the proposed N2 and N3 patients could not differ significantly from each other. This insignificance may be because of the small sample sizes of N3 patients. Our results are based on a single-center data, to develop a new N

  17. [Clinical aspect of new international gastric cancer staging system].

    PubMed

    Liang, Han

    2013-02-01

    The 7th UICC/AJCC Gastric Cancer TNM Staging System includes major revisions of pT and pN classification. The Japanese Classification and UICC/AJCC TNM System have reached consistency in staging of gastric cancer. There are some new topics of lymphadenectomy in the new guidelines. The new TNM system accepts the database from Japan and Korea and it will be more accurate to predict the prognosis of gastric cancer patients. The rationality of splenectomy, total bursectomy, dissection of No.13 and No.14 lymph nodes is still not very clear and needs more evidences. D2 lymphadenectomy is the recommended surgical approach both in Eastern and Western countries. The benefit of paraaortic lymphadenectmoy for selected patients needs further evidences as well. The international gastric cancer staging project will collect the data from 23 countries and the new staging system will be applicable worldwide. PMID:23446465

  18. [A new classification of pancreatic cancer to guide operative decisions and the comparison with the TNM stage].

    PubMed

    Qin, Renyi

    2015-07-01

    Despite the worldwide application of various terminological and classification systems used for pancreatic cancer, such as UICC classification and JPS classification based on the TNM system, however, little information on their use in operative decision-making is available. A new classification system according to the relationship with the tumor and key vasculature around the pancreas is described, and the pancreatic carcinomas are divided into eight types to provide operative decisions for different types of pancreatic cancer. Furthermore, the relationship between the classification system and TNM system is discussed. The new classification is the first time to discuss the classification for the operative decisions for the pancreatic cancer and this formalized type of approach may provide the best chance of achieving R0 resection and providing improved safety results. PMID:26359069

  19. Clarifying the TNM staging of rectal cancer in the context of modern imaging and neo-adjuvant treatment: 'y''u' and 'p' need 'mr' and 'ct'.

    PubMed

    Moran, B; Brown, G; Cunningham, D; Daniels, I; Heald, R; Quirke, P; Sebag-Montefiore, D

    2008-03-01

    Recent developments in cross-sectional imaging, particularly computerized tomography and magnetic resonance imaging have provided increasingly accurate noninvasive preoperative staging, especially for rectal cancer. Image-based TNM staging, by definition a pathological system, has entered both the literature and everyday usage with no universal agreement as to the exact terminology. Clarification of the current terminology and suggestions to reflect recent developments are outlined to facilitate multidisciplinary team decision processes and objective stratification for entry to, and monitoring of, future clinical trials in rectal cancer. PMID:17498205

  20. Prognostic Impact of the 6th and 7th American Joint Committee on Cancer TNM Staging Systems on Esophageal Cancer Patients Treated With Chemoradiotherapy

    SciTech Connect

    Nomura, Motoo; Shitara, Kohei; Kodaira, Takeshi; Hatooka, Shunzo; Mizota, Ayako; Kondoh, Chihiro; Yokota, Tomoya; Takahari, Daisuke; Ura, Takashi; Muro, Kei

    2012-02-01

    Purpose: The new 7th edition of the American Joint Committee on Cancer TNM staging system is based on pathologic data from esophageal cancers treated by surgery alone. There is no information available on evaluation of the new staging system with regard to prognosis of patients treated with chemoradiotherapy (CRT). The objective of this study was to evaluate the prognostic impact of the new staging system on esophageal cancer patients treated with CRT. Methods and Materials: A retrospective review was performed on 301 consecutive esophageal squamous cell carcinoma patients treated with CRT. Comparisons were made of the prognostic impacts of the 6th and 7th staging systems and the prognostic impacts of stage and prognostic groups, which were newly defined in the 7th edition. Results: There were significant differences between Stages I and III (p < 0.01) according to both editions. However, the 7th edition poorly distinguishes the prognoses of Stages III and IV (p = 0.36 by multivariate analysis) in comparison to the 6th edition (p = 0.08 by multivariate analysis), although these differences were not significant. For all patients, T, M, and gender were independent prognostic factors by multivariate analysis (p < 0.05). For the Stage I and II prognostic groups, survival curves showed a stepwise decrease with increase in stage, except for Stage IIA. However, there were no significant differences seen between each prognostic stage. Conclusions: Our study indicates there are several problems with the 7th TNM staging system regarding prognostic factors in patients undergoing CRT.

  1. Differential expression of Yes-associated protein is correlated with expression of cell cycle markers and pathologic TNM staging in non-small-cell lung carcinoma.

    PubMed

    Kim, Jin Man; Kang, Dong Wook; Long, Liang Zhe; Huang, Song-Mei; Yeo, Min-Kyung; Yi, Eunhee S; Kim, Kyung-Hee

    2011-03-01

    Yes-associated protein, a downstream effector of the Hippo signaling pathway, has been linked to progression of non-small-cell lung carcinoma. The aim of this study was to investigate expression of Yes-associated protein in lung adenocarcinoma and squamous cell carcinoma. Associations of Yes-associated protein expression with clinicopathologic parameters, expression of cell cycle-specific markers, and epidermal growth factor receptor gene amplification were also analyzed. In a univariate analysis of the 66 adenocarcinomas, high nuclear expression of Yes-associated protein was significantly correlated with expression of cyclin A and mitogen-activated protein kinase. Multivariate analysis, including age and sex, showed that cyclin A expression was independently correlated with nuclear expression of Yes-associated protein in adenocarcinomas. Furthermore, high nuclear expression of Yes-associated protein was also a significant predictor of epidermal growth factor receptor gene amplification for adenocarcinoma. For the 102 squamous cell carcinomas, univariate analysis revealed that high cytoplasmic expression of Yes-associated protein was correlated with the low pathologic TNM staging (stage I) and histologic grading. Multivariate analysis, including age and sex, showed that cytoplasmic expression of Yes-associated protein was an independent predictor of low pathologic TNM staging. These results indicate that nuclear overexpression of Yes-associated protein contributes to pulmonary adenocarcinoma growth and that high cytoplasmic expression of Yes-associated protein is an independent predictor of low pathologic TNM staging and histologic grading. The differential effects of Yes-associated protein expression patterns in adenocarcinomas and squamous cell carcinomas suggest that Yes-associated protein may play important roles in different pathways in distinct tumor subtypes. These observations may, therefore, lead to new perspectives on therapeutic targeting of these tumor

  2. Correlation Analysis of Nasopharyngeal Carcinoma TNM Staging with Serum EA IgA and VCA IgA in EBV and VEGF-C and -D

    PubMed Central

    Sun, Ruimei; Wang, Xiaoli; Li, Xiaojiang

    2015-01-01

    Background Nasopharyngeal carcinoma often occurs in humans in the nasopharyngeal epithelium area. Ebstein-Barr (EB) virus plays a key role in the process of nasopharyngeal carcinoma lesions. Early antigen antibody (EA-IgA) and viral capsid antigen IgA (VCA-IgA) of EB virus detection in serum can effectively monitor the process of nasopharyngeal carcinoma lesions. Serum vascular endothelial growth factor (VEGF) -C and VEGF-D expression detection can reflect the distant metastases ability of human tumor cells. Material/Methods 153 cases of nasopharyngeal carcinoma patients in our hospital were enrolled, while 148 cases of healthy adults were selected as control. ELISA was used to detect serum EA-IgA, VCA-IgA, VEGF-C and -D expression levels. Spearman rank correlation analysis was applied to test the correlation of nasopharyngeal carcinoma TNM clinical stage and different indexes. Results Serum EA-IgA, VCA-IgA, VEGF-C and -D expression in nasopharyngeal carcinoma patients was 43.74±2.6 U·mL−1, 62.5±2.7 U·mL−1, 473.25±3.4 pg·mL−1, and 498.36±2.3 pg·mL−1, respectively, which was significantly higher than in the control group as 18.65±3.7 U·mL−1, 23.74±1.5 U·mL−1, 225.42±2.3 pg·mL−1, and 257.24±3.5 pg·mL−1 (P<0.05). Nasopharyngeal carcinoma TNM clinical staging was obviously correlated with serum EA-IgA, VCA-IgA, and VEGF-C (P<0.05), but not VEGF-D (P>0.05). Conclusions Nasopharyngeal carcinoma patient serum EA-IgA and VCA-IgA expression levels were significantly correlated with TNM staging. The high levels of these 3 indicators suggest advanced nasopharyngeal carcinoma TNM staging and serious lesions. PMID:26191775

  3. The IASLC lung cancer staging project: the new database to inform the eighth edition of the TNM classification of lung cancer.

    PubMed

    Rami-Porta, Ramón; Bolejack, Vanessa; Giroux, Dorothy J; Chansky, Kari; Crowley, John; Asamura, Hisao; Goldstraw, Peter

    2014-11-01

    The analyses of the retrospective database of the International Association for the Study of Lung Cancer (IASLC), consisting of more than 81,000 evaluable patients diagnosed with lung cancer between 1990 and 2000, formed the basis of recommendations to the Union for International Cancer Control and the American Joint Committee on Cancer for the revision of the sixth edition of the tumor, node, and metastasis (TNM) classification of lung cancer. However, despite the large number of patients, not all descriptors could be validated. This prompted a new collection of retrospective and prospective data to overcome the limitations of the original retrospective database. The new IASLC database has information on 94,708 new patients diagnosed of lung cancer between 1999 and 2010. They originated from 35 sources in 16 countries, and 4,667 were submitted via the online electronic data capture system. Europe contributed 46,560 patients, Asia: 41,705, North America: 4,660, Australia: 1,593, and South America: 190. After exclusions, 77,156 (70,967 with nonsmall cell lung cancer and 6,189 with small cell lung cancer) remained for analysis. This database will be analyzed according to established objectives for the T, the N, and the M components to inform the eighth edition of the TNM classification of lung cancer due to be published in 2016. The IASLC hopes for the continuing contribution of our partners around the world to improve the classification of anatomical extent of disease, but also to create prognostic groups in a parallel project of the IASLC Staging and Prognostic Factors Committee.

  4. hERG1 positivity and Glut-1 negativity identifies high-risk TNM stage I and II colorectal cancer patients, regardless of adjuvant chemotherapy

    PubMed Central

    Muratori, Leonardo; Petroni, Giulia; Antonuzzo, Lorenzo; Boni, Luca; Iorio, Jessica; Lastraioli, Elena; Bartoli, Gianluca; Messerini, Luca; Di Costanzo, Francesco; Arcangeli, Annarosa

    2016-01-01

    Background The identification of early-stage colorectal cancer (CRC) with high risk of progression is one major clinical challenge, mainly due to lack of validated biomarkers. The aims of the present study were to analyze the prognostic impact of three molecular markers belonging to the ion channels and transporters family: the ether-à-go-go-related gene 1 (hERG1) and the calcium-activated KCa3.1 potassium channels, as well as the glucose transporter 1 (Glut-1); and to define the impact of adjuvant chemotherapy in conjunction with the abovementioned biomarkers, in a cohort of radically resected stage I–III CRC patients. Patients and methods The expressions of hERG1, KCa3.1, and Glut-1 were tested by immunohistochemistry on 162 surgical samples of nonmetastatic, stage I–III CRC patients. The median follow-up was 32 months. The association between biological markers, clinicopathological features, and survival outcomes was investigated by evaluating both disease-free survival and overall survival. Results Although no prognostic valence emerged for KCa3.1, evidence of a negative impact of hERG1 expression on survival outcomes was provided. On the contrary, Glut-1 expression had a positive impact. According to the results of the multivariate analysis, patients were stratified in four risk groups, based on TNM stage and hERG1/Glut-1 expression. After adjusting for adjuvant therapy, stage I and II, Glut-1-negative, and hERG1-positive patients showed the worst survival experience. Conclusion This study strongly indicates that the combination of hERG1 positivity and Glut-1 negativity behaves as a prognostic biomarker in radically resected CRC patients. This combination identifies a group of stage I and II CRC patients with a bad prognosis, even worse than that of stage III patients, regardless of adjuvant therapy accomplishment.

  5. Metallothionein 2A inhibits NF-κB pathway activation and predicts clinical outcome segregated with TNM stage in gastric cancer patients following radical resection

    PubMed Central

    2013-01-01

    Background Metallothionein 2A (MT2A) as a stress protein, plays a protective role in gastric mucosal barrier. Its role in the development of gastric cancer (GC) is unclear. The mechanism of MT2A will be investigated in gastric tumorigenesis. Methods MT2A expression was detected in 973 gastric specimens. The biological function was determined through ectopic expressing MT2A in vitro and in vivo. The possible downstream effectors of MT2A were investigated in NF-κB signaling. The protein levels of MT2A, IκB-α and p-IκB-α (ser32/36) expression were analyzed in a subset of 258 patients by IHC staining. The prognostic effects of MT2A, status of IκB-α and TNM stage were evaluated using the Kaplan-Meier method and compared using the log-rank test. Results Decreased MT2A expression was detected in cell lines and primary tumors of GC. In clinical data, loss of MT2A (MT2A + in Normal (n =171, 76.0%); Intestinal metaplasia (n = 118, 50.8%); GC (n = 684. 22.4%, P < 0.001)) was associated with poor prognosis (P < 0.001), advanced TNM stage (P = 0.05), and down-regulation of IκB-α expression (P < 0.001). Furthermore, MT2A was the independent prognostic signature segregated from the status of IκB-α and pathological features. In addition, MT2A inhibited cell growth through apoptosis and G2/M arrest, which negatively regulated NF-κB pathway through up-regulation of IκB-α and down-regulation of p-IκB-α and cyclin D1 expression. Conclusions MT2A might play a tumor suppressive activity through inhibiting NF-κB signaling and may be a prognostic biomarker and potential target for individual therapy of GC patients. PMID:23870553

  6. Alternative staging of regional lymph nodes in gastric cancer

    PubMed Central

    Szczepanik, Antoni M.; Paszko, Agata; Szura, Miroslaw; Scully-Horner, Thecla; Kulig, Jan

    2016-01-01

    The TNM pN stage based on the number of metastatic lymph nodes is an independent prognostic factor in gastric cancer. Many studies have highlighted the phenomenon of stage migration and problems in comparing groups of patients with different numbers of total lymph nodes harvested within TNM staging. The current version of UICC/AJCC and JGCA TNM classifications postulates a minimal number of 16 lymph nodes as the base for N stage determination. Alternative systems such as lymph node ratio (LNR), positive to negative lymph node ratio (PNLNR), and LOGODDS (or LODDS), were implemented to increase the quality of LN assessment. These methods have reached the background in the literature, but to date no standard approach according to the cut-offs for the stages has been implemented. LOGODDS is the method that most reflects the number of harvested lymph nodes. The rationale for alternative staging methods, their correlations, and limitations are presented. PMID:27713774

  7. SU-E-I-85: Exploring the 18F-Fluorodeoxyglucose PET Characteristics in Staging of Esophageal Squamous Cell Carcinoma

    SciTech Connect

    Ma, C; Yin, Y

    2014-06-01

    Purpose: The aim of this study was to explore the characteristics derived from 18F-fluorodeoxyglucose (18F-FDG) PET image and assess its capacity in staging of esophageal squamous cell carcinoma (ESCC). Methods: 26 patients with newly diagnosed ESCC who underwent 18F-FDG PET scan were included in this study. Different image-derived indices including the standardized uptake value (SUV), gross tumor length, texture features and shape feature were considered. Taken the histopathologic examination as the gold standard, the extracted capacities of indices in staging of ESCC were assessed by Kruskal-Wallis test and Mann-Whitney test. Specificity and sensitivity for each of the studied parameters were derived using receiver-operating characteristic curves. Results: 18F-FDG SUVmax and SUVmean showed statistically significant capability in AJCC and TNM stages. Texture features such as ENT and CORR were significant factors for N stages(p=0.040, p=0.029). Both FDG PET Longitudinal length and shape feature Eccentricity (EC) (p≤0.010) provided powerful stratification in the primary ESCC AJCC and TNM stages than SUV and texture features. Receiver-operating-characteristic curve analysis showed that tumor textural analysis can capability M stages with higher sensitivity than SUV measurement but lower in T and N stages. Conclusion: The 18F-FDG image-derived characteristics of SUV, textural features and shape feature allow for good stratification AJCC and TNM stage in ESCC patients.

  8. Comparison of the Masaoka-Koga staging and the International Association for the Study of Lung Cancer/the International Thymic Malignancies Interest Group proposal for the TNM staging systems based on the Chinese Alliance for Research in Thymomas retrospective database

    PubMed Central

    Liang, Guanghui; Gu, Zhitao; Fu, Jianhua; Shen, Yi; Wei, Yucheng; Tan, Lijie; Zhang, Peng; Han, Yongtao; Chen, Chun; Zhang, Renquan; Chen, Keneng; Chen, Hezhong; Liu, Yongyu; Cui, Youbing; Wang, Yun; Pang, Liewen; Yu, Zhentao; Zhou, Xinming; Liu, Yangchun; Liu, Yuan

    2016-01-01

    Background To compare the predictive effect of the Masaoka-Koga staging system and the International Association for the Study of Lung Cancer (IASLC)/the International Thymic Malignancies Interest Group (ITMIG) proposal for the new TNM staging on prognosis of thymic malignancies using the Chinese Alliance for Research in Thymomas (ChART) retrospective database. Methods From 1992 to 2012, 2,370 patients in ChART database were retrospectively reviewed. Of these, 1,198 patients with complete information on TNM stage, Masaoka-Koga stage, and survival were used for analysis. Cumulative incidence of recurrence (CIR) was assessed in R0 patients. Overall survival (OS) was evaluated both in an R0 resected cohort, as well as in all patients (any R status). CIR and OS were first analyzed according to the Masaoka-Koga staging system. Then, they were compared using the new TNM staging proposal. Results Based on Masaoka-Koga staging system, significant difference was detected in CIR among all stages. However, no survival difference was revealed between stage I and II, or between stage II and III. Stage IV carried the highest risk of recurrence and worst survival. According to the new TNM staging proposal, CIR in T1a was significantly lower comparing to all other T categories (P<0.05) and there is a significant difference in OS between T1a and T1b (P=0.004). T4 had the worst OS comparing to all other T categories. CIR and OS were significantly worse in N (+) than in N0 patients. Significant difference in CIR and OS was detected between M0 and M1b, but not between M0 and M1a. OS was almost always statistically different when comparison was made between stages I–IIIa and stages IIIb–IVb. However, no statistical difference could be detected among stages IIIb to IVb. Conclusions Compared with Masaoka-Koga staging, the IASLC/ITMIG TNM staging proposal not only describes the extent of tumor invasion but also provides information on lymphatic involvement and tumor dissemination

  9. The Tumor-Log Odds of Positive Lymph Nodes-Metastasis Staging System, a Promising New Staging System for Gastric Cancer after D2 Resection in China

    PubMed Central

    Wang, Zhi-qiang; Ren, Chao; Wang, De-shen; Zhang, Dong-sheng; Luo, Hui-yan; Li, Yu-hong; Xu, Rui-hua

    2012-01-01

    Background In this study, we established a hypothetical tumor-lodds-metastasis (TLM) and tumor-ratio-metastasis (TRM) staging system. Moreover, we compared them with the 7th edition of American Joint Committee on Cancer tumor-nodes-metastasis (AJCC TNM) staging system in gastric cancer patients after D2 resection. Methods A total of 1000 gastric carcinoma patients receiving treatment in our center were selected for the analysis. Finally, 730 patients who received D2 resection were retrospectively studied. Patients were staged using the TLM, TRM and the 7th edition AJCC TNM system. Survival analysis was performed with a Cox regression model. We used two parameters to compare the TNM, TRM and TLM staging system, the −2log likelihood and the hazard ratio. Results The cut points of lymph node ratio (LNR) were set as 0, 0–0.3, 0.3–0.6, 0.6–1.0. And for the log odds of positive lymph nodes (LODDS), the cut points were established as≤−0.5, −0.5-0, 0-0.5, >0.5. There were significant differences in survival among patients in different LODDS classifications for each pN or LNR groups. When stratified by the LODDS classifications, the prognosis was highly homologous between those in the according pN or LNR classifications. Multivariate analysis showed that TLM staging system was better than the TRM or TNM system for the prognostic evaluation. Conclusions The TLM system was superior to the TRM or TNM system for prognostic assessment of gastric adenocarcinoma patients after D2 resection. PMID:22348125

  10. Efficacy of Intensity Modulated Radiation Therapy After Surgery in Early Stage of Esophageal Carcinoma;

    ClinicalTrials.gov

    2016-07-30

    Esophageal Neoplasm; Esophageal Cancer TNM Staging Primary Tumor (T) T2; Esophageal Cancer TNM Staging Primary Tumor (T) T3; Esophageal Cancer TNM Staging Regional Lymph Nodes (N) N0; Esophageal Cancer TNM Staging Distal Metastasis (M) M0

  11. [Locally advanced carcinoma of the cervix uteri (stage IIB-IIIB TNM-UICC): radiotherapy combined with simultaneous daily low-dose platinum. Phase II study].

    PubMed

    Micheletti, E; La Face, B; Bianchi, E; Cagna, E; Sartori, E

    1996-05-01

    A prospective, single arm, phase-II trial was performed to assess the efficacy and local toxicity of the combination of low doses of platin and pelvic radiotherapy in patients with locally advanced carcinoma of the cervix. January, 1993, through August, 1994, twenty-three previously untreated patients with squamous carcinoma (stages IIB-IIIB UICC) entered the study. All patients were examined by a gynecologist and by a radiation oncologist and then submitted to conventional pretreatment staging procedures. Nine patients were classified as stage IIB and 14 patients as stage IIIB. Radiotherapy consisted of 60 Gy external beam irradiation (46 Gy to pelvis + 14 Gy boost to cervix uteri and parametria) plus one low dose rate intracavitary treatment to a dose of 8 Gy to point A. Cisplatin (3 mg/m2/day) or carboplatin (12 mg/m2/day) was also given for 6 weeks starting on radiotherapy day 1. The treatment was well tolerated and no patient required radiotherapy discontinuation. With a median follow-up time of 20 months, complete response was seen in 74% (17/23) of the patients. One of the 17 patients who achieved a complete remission, during follow-up, relapsed in the pelvis and one developed lung metastases. Total failure rate in the pelvis was 30.5% (7/23). Distant metastases were observed in 17.5% (4/23) of the patients. Actuarial overall and disease-free survival rates at 33 months were 69.1% and 65.2%, respectively. Late gastrointestinal toxicity (grade 3) occurred in 8.6% (2/23) of patients, with one patient developing a rectal ulcer-which was submitted to colostomy- and one patient a vaginal necrosis. The combination of platin and radiotherapy appears to be an effective regimen for the patients with locally advanced carcinoma of the cervix and caused a relatively low rate of late gastrointestinal complications.

  12. Relationships among serum CA15-3 tumor marker, TNM staging, and estrogen and progesterone receptor expression in benign and malignant breast lesions.

    PubMed

    Atoum, Manar; Nimer, Nisreen; Abdeldayem, Sawsan; Nasr, Hamzah

    2012-01-01

    Serum tumor marker CA15-3 is widely used in follow-up for assessment of breast cancer prognosis. The aim of this study was to evaluate levels among healthy females and patients, to assess differences with tumor stage and grade, and to determine the relationship with estrogen and progesterone receptor expression. One hundred and thirty six Jordanian females were enrolled in this study: Forty-five were healthy females; seventy-two were diagnosed with breast cancer and nineteen diagnosed with benign breast lesions. Elevated serum CA15-3 level was significantly observed among breast cancer patients (37.95±6.65) compared to both healthy (14.97±0.8) and benign females (12.30±1.55), but no significant association was detected between serum CA15-3 level and age of cancer onset, menarche age, menopause age, parity and BMI. Decreased CA15-3 level was significantly associated with hormone therapy and oral contraceptive consumption among breast cancer patients. Significantly elevated CA15-3 serum levels were found among grade II, III and stage II and III breast cancer females compared to normal healthy females. Elevated CA15-3 serum levels were also found among ER+/PR+ (54.242±7.89) and ER+/PR- (37.08±8.22) compared to healthy control females.

  13. Staging of prostate cancer.

    PubMed

    Cheng, Liang; Montironi, Rodolfo; Bostwick, David G; Lopez-Beltran, Antonio; Berney, Daniel M

    2012-01-01

    Prostatic carcinoma (PCa) is a significant cause of cancer morbidity and mortality worldwide. Accurate staging is critical for prognosis assessment and treatment planning for PCa. Despite the large volume of clinical activity and research, the challenge to define the most appropriate and clinically relevant staging system remains. The pathologically complex and uncertain clinical course of prostate cancer further complicates the design of staging classification and a substaging system suitable for individualized care. This review will focus on recent progress and controversial issues related to prostate cancer staging. The 2010 revision of the American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) tumour, node and metastasis (TNM) system is the most widely used staging system at this time. Despite general acceptance of the system as a whole, there is controversy and uncertainty about its application, particularly for T2 subclassification. The three-tiered T2 classification system for organ-confined prostate cancer is superfluous, considering the biology and anatomy of PCa. A tumour size-based substaging system may be considered in the future TNM subclassification of pT2 cancer. Lymph node status is one of the most important prognostic factors for prostate cancer. Nevertheless, clinical outcomes in patients with positive lymph nodes are variable. Identification of patients at the greatest risk of systemic progression helps in the selection of appropriate therapy. The data suggest that the inherent aggressiveness of metastatic prostate cancer is closely linked to the tumour volume of lymph node metastasis. We recommend that a future TNM staging system should consider subclassification of node-positive cancer on the basis of nodal cancer volume, using the diameter of the largest nodal metastasis and/or the number of positive nodes.

  14. Staging of prostate cancer.

    PubMed

    Cheng, Liang; Montironi, Rodolfo; Bostwick, David G; Lopez-Beltran, Antonio; Berney, Daniel M

    2012-01-01

    Prostatic carcinoma (PCa) is a significant cause of cancer morbidity and mortality worldwide. Accurate staging is critical for prognosis assessment and treatment planning for PCa. Despite the large volume of clinical activity and research, the challenge to define the most appropriate and clinically relevant staging system remains. The pathologically complex and uncertain clinical course of prostate cancer further complicates the design of staging classification and a substaging system suitable for individualized care. This review will focus on recent progress and controversial issues related to prostate cancer staging. The 2010 revision of the American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) tumour, node and metastasis (TNM) system is the most widely used staging system at this time. Despite general acceptance of the system as a whole, there is controversy and uncertainty about its application, particularly for T2 subclassification. The three-tiered T2 classification system for organ-confined prostate cancer is superfluous, considering the biology and anatomy of PCa. A tumour size-based substaging system may be considered in the future TNM subclassification of pT2 cancer. Lymph node status is one of the most important prognostic factors for prostate cancer. Nevertheless, clinical outcomes in patients with positive lymph nodes are variable. Identification of patients at the greatest risk of systemic progression helps in the selection of appropriate therapy. The data suggest that the inherent aggressiveness of metastatic prostate cancer is closely linked to the tumour volume of lymph node metastasis. We recommend that a future TNM staging system should consider subclassification of node-positive cancer on the basis of nodal cancer volume, using the diameter of the largest nodal metastasis and/or the number of positive nodes. PMID:22212080

  15. Metastatic lymph node ratio, 6th or 7th AJCC edition: witch is the best lymph node classification for esophageal cancer? Prognosis factor analysis in 487 patients

    PubMed Central

    CORAL, Roberto V.; BIGOLIN, André V.; CORAL, Roberto P.; HARTMANN, Antonio; DRANKA, Carolina; ROEHE, Adriana V.

    2015-01-01

    Background The esophageal cancer is one of the most common and aggressive worldwide. Recently, the AJCC changed the staging system, considering, among others, the important role of the lymph node metastasis on the prognosis. Aim To discuss the applicability of different forms of lymph node staging in a western surgical center. Methods Four hundred eighty seven patients with esophageal cancer were enrolled. Three staging systems were evaluated, the 6th and the 7th AJCC editions and the Lymph Node Metastatic Ratio. Results The majority of the cases were squamous cell carcinoma. The mean lymph node sample was eight. Considering the survival, there was no significant difference between the patients when they were classified by the 7th AJCC edition. Analysis of the Lymph Node Metastatic Ratio, just on the group of patients with 0 to 25%, has shown significant difference (p=0,01). The 6th AJCC edition shows the major significant difference between among the classifications evaluated. Conclusion In this specific population, the 7th AJCC edition for esophageal cancer was not able to find differences in survival when just the lymph node analysis was considered. PMID:26176242

  16. Lymph node staging in colorectal cancer: Old controversies and recent advances

    PubMed Central

    Resch, Annika; Langner, Cord

    2013-01-01

    Outcome prediction based on tumor stage reflected by the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor node metastasis (TNM) system is currently regarded as the strongest prognostic parameter for patients with colorectal cancer. For affected patients, the indication for adjuvant therapy is mainly guided by the presence of regional lymph node metastasis. In addition to the extent of surgical lymph node removal and the thoroughness of the pathologist in dissecting the resection specimen, several parameters that are related to the pathological work-up of the dissected nodes may affect the clinical significance of lymph node staging. These include changing definitions of lymph nodes, involved lymph nodes, and tumor deposits in different editions of the AJCC/UICC TNM system as well as the minimum number of nodes to be dissected. Methods to increase the lymph node yield in the fatty tissue include methylene blue injection and acetone compression. Outcome prediction based on the lymph node ratio, defined as the number of positive lymph nodes divided by the total number of retrieved nodes, may be superior to the absolute numbers of involved nodes. Extracapsular invasion has been identified as additional prognostic factor. Adding step sectioning and immunohistochemistry to the pathological work-up may result in higher accuracy of histological diagnosis. The clinical value of more recent technical advances, such as sentinel lymph node biopsy and molecular analysis of lymph nodes tissue still remains to be defined. PMID:24379568

  17. Prediction of Pathological Stage in Patients with Prostate Cancer: A Neuro-Fuzzy Model

    PubMed Central

    Acampora, Giovanni; Brown, David; Rees, Robert C.

    2016-01-01

    The prediction of cancer staging in prostate cancer is a process for estimating the likelihood that the cancer has spread before treatment is given to the patient. Although important for determining the most suitable treatment and optimal management strategy for patients, staging continues to present significant challenges to clinicians. Clinical test results such as the pre-treatment Prostate-Specific Antigen (PSA) level, the biopsy most common tumor pattern (Primary Gleason pattern) and the second most common tumor pattern (Secondary Gleason pattern) in tissue biopsies, and the clinical T stage can be used by clinicians to predict the pathological stage of cancer. However, not every patient will return abnormal results in all tests. This significantly influences the capacity to effectively predict the stage of prostate cancer. Herein we have developed a neuro-fuzzy computational intelligence model for classifying and predicting the likelihood of a patient having Organ-Confined Disease (OCD) or Extra-Prostatic Disease (ED) using a prostate cancer patient dataset obtained from The Cancer Genome Atlas (TCGA) Research Network. The system input consisted of the following variables: Primary and Secondary Gleason biopsy patterns, PSA levels, age at diagnosis, and clinical T stage. The performance of the neuro-fuzzy system was compared to other computational intelligence based approaches, namely the Artificial Neural Network, Fuzzy C-Means, Support Vector Machine, the Naive Bayes classifiers, and also the AJCC pTNM Staging Nomogram which is commonly used by clinicians. A comparison of the optimal Receiver Operating Characteristic (ROC) points that were identified using these approaches, revealed that the neuro-fuzzy system, at its optimal point, returns the largest Area Under the ROC Curve (AUC), with a low number of false positives (FPR = 0.274, TPR = 0.789, AUC = 0.812). The proposed approach is also an improvement over the AJCC pTNM Staging Nomogram (FPR = 0.032, TPR

  18. Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET)/MRI for Lung Cancer Staging.

    PubMed

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-07-01

    Tumor, lymph node, and metastasis (TNM) classification of lung cancer is typically performed with the TNM staging system, as recommended by the Union Internationale Contre le Cancer (UICC), the American Joint Committee on Cancer (AJCC), and the International Association for the Study of Lung Cancer (IASLC). Radiologic examinations for TNM staging of lung cancer patients include computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG-PET), and FDG-PET combined with CT (FDG-PET/CT) and are used for pretherapeutic assessments. Recent technical advances in MR systems, application of fast and parallel imaging and/or introduction of new MR techniques, and utilization of contrast media have markedly improved the diagnostic utility of MRI in this setting. In addition, FDG-PET can be combined or fused with MRI (PET/MRI) for clinical practice. This review article will focus on these recent advances in MRI as well as on PET/MRI for lung cancer staging, in addition to a discussion of their potential and limitations for routine clinical practice in comparison with other modalities such as CT, FDG-PET, and PET/CT.

  19. The new seventh edition American Joint Committee on Cancer staging of cutaneous non-melanoma skin cancer: a critical review.

    PubMed

    Warner, Christina L; Cockerell, Clay J

    2011-06-01

    The seventh edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual includes a major revision of the staging protocol for cutaneous carcinomas. There are several significant improvements to the Tumor, Nodes, and Metastases (TNM) staging system, including consideration of high-risk factors within the primary T grade, a decrease in the tumor size threshold from 5 cm to 2 cm, improved stratification of patient lymph node status, as well as exclusion of Merkel cell carcinomas from the staging system for squamous cell carcinoma (SCC) and other cutaneous carcinomas. However, some important variables in cutaneous SCC were excluded from consideration. In addition, the AJCC Cancer Staging Manual makes some recommendations that will likely prove difficult to apply in clinical practice, particularly that Clark level, depth of invasion, and presence or absence of perineural invasion should be recorded for each peripheral SCC. In this review, we examine the new recommendations with an emphasis on their utility and practicality. PMID:21469759

  20. Applications of a novel tumor-grading-metastasis staging system for pancreatic neuroendocrine tumors

    PubMed Central

    Yang, Min; Tan, Chun-Lu; Zhang, Yi; Ke, Neng-Wen; Zeng, Lin; Li, Ang; Zhang, Hao; Xiong, Jun-Jie; Guo, Zi-Heng; Tian, Bo-Le; Liu, Xu-Bao

    2016-01-01

    Abstract The ability to stratify patients with pancreatic neuroendocrine tumors (p-NETs) into prognostic groups has been hindered by the absence of a commonly accepted staging system. Both the 7th tumor-node-metastasis (TNM) staging guidelines by the American Joint Committee on Cancer (AJCC) and the 2010 grading classifications by the World Health Organization (WHO) were validated to be unsatisfactory. We aim to evaluate the feasibility of combining the latest AJCC and WHO criteria to devise a novel tumor-grading-metastasis (TGM) staging system. We also sought to examine the stage-specific survival rates and the prognostic value of this new TGM system for p-NETs. Data of 120 patients with surgical resection and histopathological diagnosis of p-NETs from January 2004 to February 2014 in our institution were retrospectively collected and analyzed. Based on the AJCC and WHO criteria, we replaced the stage N0 and N1 with stage Ga (NET G1 and NET G2) and Gb (NET G3 and MANEC) respectively, without changes of the definition of T or M stage. The present novel TGM staging system was grouped as follows: stage I was defined as T1–2, Ga, M0; stage II as T3, Ga, M0 or as T1–3, Gb, M0; stage III as T4, Ga–b, M0 and stage IV as any T, M1. The new TGM staging system successfully distributed 55, 42, 12, and 11 eligible patients in stage I to IV, respectively. Differences of survival compared stage I with III and IV for patients with p-NETs were both statistically significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001). Patients in stage I showed better a survival than those in stage II, whereas difference between stages III and IV was not notable (P = 0.001, P = 0.286, respectively). In multivariate models, when the TGM staging system was evaluated in place of the individual T, G, and M variables, this new criteria were proven to be an independent predictor of survival for surgically resected p-NETs (P < 0.05). Stratifying patients well

  1. The ITMIG/IASLC Thymic Epithelial Tumors Staging Project: A Proposed Lymph Node Map for Thymic Epithelial Tumors in the Forthcoming 8th Edition of the TNM Classification of Malignant Tumors.

    PubMed

    Bhora, Faiz Y; Chen, David J; Detterbeck, Frank C; Asamura, Hisao; Falkson, Conrad; Filosso, Pier Luigi; Giaccone, Giuseppe; Huang, James; Kim, Jhingook; Kondo, Kazuya; Lucchi, Marco; Marino, Mirella; Marom, Edith M; Nicholson, Andrew G; Okumura, Meinoshin; Ruffini, Enrico; Van Schil, Paul

    2014-09-01

    Although the presence of nodal disease is prognostic in thymic malignancy, the significance of the extent of nodal disease has yet to be defined. Lymph node dissection has not been routinely performed, and there is currently no node map defined for thymic malignancy. To establish a universal language for reporting as well as characterize the staging of this disease more accurately, an empiric node map is proposed here. This was developed using prior classification systems, series reporting specifics of nodal involvement, anatomical studies of lymphatic drainage, and preexisting node maps of the chest as defined by the International Association for the Study of Lung Cancer and the neck as defined by the American Academy of Otolaryngology-Head and Neck Surgery and the American Society for Head and Neck Surgery. The development of this node map was a joint effort by the International Thymic Malignancy Interest Group and the Thymic Domain of the IASLC Staging and Prognostic Factors Committee. It was reviewed and subsequently approved by the members of ITMIG. This map will be used as an adjunct to define node staging as part of a universal stage classification for thymic malignancy. As more data are gathered using definitions set forth by this node map, a revision may be undertaken in the future.

  2. Tumor Volume Combined With Number of Positive Lymph Node Stations Is a More Important Prognostic Factor Than TNM Stage for Survival of Non-Small-Cell Lung Cancer Patients Treated With (Chemo)radiotherapy

    SciTech Connect

    Dehing-Oberije, Cary Ruysscher, Dirk de; Weide, Hiska van der; Hochstenbag, Monique; Bootsma, Gerben; Geraedts, Wiel; Pitz, Cordula; Simons, Jean; Teule, Jaap; Rahmy, Ali; Thimister, Paul; Steck, Harald; Lambin, Philippe

    2008-03-15

    Purpose: The current tumor, node, metastasis system needs refinement to improve its ability to predict survival of patients with non-small-cell lung cancer (NSCLC) treated with (chemo)radiation. In this study, we investigated the prognostic value of tumor volume and N status, assessed by using fluorodeoxyglucose-positron emission tomography (PET). Patients and Methods: Clinical data from 270 consecutive patients with inoperable NSCLC Stages I-IIIB treated radically with (chemo)radiation were collected retrospectively. Diagnostic imaging was performed using either integrated PET-computed tomography or computed tomography and PET separately. The Kaplan-Meier method, as well as Cox regression, was used to analyze data. Results: Univariate survival analysis showed that number of positive lymph node stations (PLNSs), as well as N stage on PET, was associated significantly with survival. The final multivariate Cox model consisted of number of PLNSs, gross tumor volume (i.e., volume of the primary tumor plus lymph nodes), sex, World Health Organization performance status, and equivalent radiation dose corrected for time; N stage was no longer significant. Conclusions: Number of PLNSs, assessed by means of fluorodeoxyglucose-PET, was a significant factor for survival of patients with inoperable NSCLC treated with (chemo)radiation. Risk stratification for this group of patients should be based on gross tumor volume, number of PLNSs, sex, World Health Organization performance status, and equivalent radiation dose corrected for time.

  3. The IASLC Lung Cancer Staging Project: Proposals for Coding T Categories for Subsolid Nodules and Assessment of Tumor Size in Part-Solid Tumors in the Forthcoming Eighth Edition of the TNM Classification of Lung Cancer.

    PubMed

    Travis, William D; Asamura, Hisao; Bankier, Alexander A; Beasley, Mary Beth; Detterbeck, Frank; Flieder, Douglas B; Goo, Jin Mo; MacMahon, Heber; Naidich, David; Nicholson, Andrew G; Powell, Charles A; Prokop, Mathias; Rami-Porta, Ramón; Rusch, Valerie; van Schil, Paul; Yatabe, Yasushi

    2016-08-01

    This article proposes codes for the primary tumor categories of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) and a uniform way to measure tumor size in part-solid tumors for the eighth edition of the tumor, node, and metastasis classification of lung cancer. In 2011, new entities of AIS, MIA, and lepidic predominant adenocarcinoma were defined, and they were later incorporated into the 2015 World Health Organization classification of lung cancer. To fit these entities into the T component of the staging system, the Tis category is proposed for AIS, with Tis (AIS) specified if it is to be distinguished from squamous cell carcinoma in situ (SCIS), which is to be designated Tis (SCIS). We also propose that MIA be classified as T1mi. Furthermore, the use of the invasive size for T descriptor size follows a recommendation made in three editions of the Union for International Cancer Control tumor, node, and metastasis supplement since 2003. For tumor size, the greatest dimension should be reported both clinically and pathologically. In nonmucinous lung adenocarcinomas, the computed tomography (CT) findings of ground glass versus solid opacities tend to correspond respectively to lepidic versus invasive patterns seen pathologically. However, this correlation is not absolute; so when CT features suggest nonmucinous AIS, MIA, and lepidic predominant adenocarcinoma, the suspected diagnosis and clinical staging should be regarded as a preliminary assessment that is subject to revision after pathologic evaluation of resected specimens. The ability to predict invasive versus noninvasive size on the basis of solid versus ground glass components is not applicable to mucinous AIS, MIA, or invasive mucinous adenocarcinomas because they generally show solid nodules or consolidation on CT.

  4. Improving the TNM classification: findings from a 10-year continuous literature review.

    PubMed

    Webber, Colleen; Gospodarowicz, Mary; Sobin, Leslie H; Wittekind, Christian; Greene, Frederick L; Mason, Malcolm D; Compton, Carolyn; Brierley, James; Groome, Patti A

    2014-07-15

    The Union for International Cancer Control's (UICC) TNM classification is a globally accepted system to describe the anatomic extent of malignant tumors. Since its development seventy years ago, the TNM classification has undergone significant revisions to reflect the current understanding of extent of disease and its role in prognosis. To ensure that revisions are evidence-based, the UICC implemented a process for continuous improvement of the TNM classification that included a formalized system for submitting proposals for revisions directly to the UICC and an annual review of the scientific literature on staging that assessed, criticized or made suggestions for changes. The process involves review of the proposals and literature by a group of international, multidisciplinary Expert Panels. The process has been in place for 10 years and informed the development of the 7th edition of the TNM classification published in 2009. The purpose of this article is to provide a description of the annual literature review process, including the search strategy, article selection process and the roles and requirements of the Expert Panels in the review of the literature. Since 2002, 147 Expert Panel members in 11 cancer sites have reviewed over 770 articles. The results of the annual literature reviews, Expert Panel feedback and documentation and dissemination of results are described.

  5. Applications of a novel tumor-grading-metastasis staging system for pancreatic neuroendocrine tumors: An analysis of surgical patients from a Chinese institution.

    PubMed

    Yang, Min; Tan, Chun-Lu; Zhang, Yi; Ke, Neng-Wen; Zeng, Lin; Li, Ang; Zhang, Hao; Xiong, Jun-Jie; Guo, Zi-Heng; Tian, Bo-Le; Liu, Xu-Bao

    2016-07-01

    The ability to stratify patients with pancreatic neuroendocrine tumors (p-NETs) into prognostic groups has been hindered by the absence of a commonly accepted staging system. Both the 7th tumor-node-metastasis (TNM) staging guidelines by the American Joint Committee on Cancer (AJCC) and the 2010 grading classifications by the World Health Organization (WHO) were validated to be unsatisfactory.We aim to evaluate the feasibility of combining the latest AJCC and WHO criteria to devise a novel tumor-grading-metastasis (TGM) staging system. We also sought to examine the stage-specific survival rates and the prognostic value of this new TGM system for p-NETs.Data of 120 patients with surgical resection and histopathological diagnosis of p-NETs from January 2004 to February 2014 in our institution were retrospectively collected and analyzed. Based on the AJCC and WHO criteria, we replaced the stage N0 and N1 with stage Ga (NET G1 and NET G2) and Gb (NET G3 and MANEC) respectively, without changes of the definition of T or M stage. The present novel TGM staging system was grouped as follows: stage I was defined as T1-2, Ga, M0; stage II as T3, Ga, M0 or as T1-3, Gb, M0; stage III as T4, Ga-b, M0 and stage IV as any T, M1.The new TGM staging system successfully distributed 55, 42, 12, and 11 eligible patients in stage I to IV, respectively. Differences of survival compared stage I with III and IV for patients with p-NETs were both statistically significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001). Patients in stage I showed better a survival than those in stage II, whereas difference between stages III and IV was not notable (P = 0.001, P = 0.286, respectively). In multivariate models, when the TGM staging system was evaluated in place of the individual T, G, and M variables, this new criteria were proven to be an independent predictor of survival for surgically resected p-NETs (P < 0.05).Stratifying patients well, the current

  6. Applications of a novel tumor-grading-metastasis staging system for pancreatic neuroendocrine tumors: An analysis of surgical patients from a Chinese institution.

    PubMed

    Yang, Min; Tan, Chun-Lu; Zhang, Yi; Ke, Neng-Wen; Zeng, Lin; Li, Ang; Zhang, Hao; Xiong, Jun-Jie; Guo, Zi-Heng; Tian, Bo-Le; Liu, Xu-Bao

    2016-07-01

    The ability to stratify patients with pancreatic neuroendocrine tumors (p-NETs) into prognostic groups has been hindered by the absence of a commonly accepted staging system. Both the 7th tumor-node-metastasis (TNM) staging guidelines by the American Joint Committee on Cancer (AJCC) and the 2010 grading classifications by the World Health Organization (WHO) were validated to be unsatisfactory.We aim to evaluate the feasibility of combining the latest AJCC and WHO criteria to devise a novel tumor-grading-metastasis (TGM) staging system. We also sought to examine the stage-specific survival rates and the prognostic value of this new TGM system for p-NETs.Data of 120 patients with surgical resection and histopathological diagnosis of p-NETs from January 2004 to February 2014 in our institution were retrospectively collected and analyzed. Based on the AJCC and WHO criteria, we replaced the stage N0 and N1 with stage Ga (NET G1 and NET G2) and Gb (NET G3 and MANEC) respectively, without changes of the definition of T or M stage. The present novel TGM staging system was grouped as follows: stage I was defined as T1-2, Ga, M0; stage II as T3, Ga, M0 or as T1-3, Gb, M0; stage III as T4, Ga-b, M0 and stage IV as any T, M1.The new TGM staging system successfully distributed 55, 42, 12, and 11 eligible patients in stage I to IV, respectively. Differences of survival compared stage I with III and IV for patients with p-NETs were both statistically significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001). Patients in stage I showed better a survival than those in stage II, whereas difference between stages III and IV was not notable (P = 0.001, P = 0.286, respectively). In multivariate models, when the TGM staging system was evaluated in place of the individual T, G, and M variables, this new criteria were proven to be an independent predictor of survival for surgically resected p-NETs (P < 0.05).Stratifying patients well, the current

  7. The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?

    PubMed

    van Meerbeeck, Jan P; Janssens, Annelies

    2013-09-01

    Anatomical cancer extent is an important predictor of prognosis and determines treatment choices. In non-small-cell lung cancer (NSCLC) the tumour-node-metastasis (TNM) classification developed by Pierre Denoix replaced in 1968 the Veterans Administration Lung cancer Group (VALG) classification, which was still in use for small-cell lung cancer (SCLC). Clifton Mountain suggested several improvements based on a database of mostly surgically treated United States (US) patients from a limited number of centres. This database was pivotal for a uniform reporting of lung cancer extent by the American Joint Committee of Cancer (AJCC) and the International Union against Cancer (IUCC), but it suffered increasingly from obsolete diagnostic and staging procedures and did not reflect new treatment modalities. Moreover, its findings were not externally validated in large Japanese and European databases, resulting in persisting controversies which could not be solved with the available database. The use of different mediastinal lymph-node maps in Japan, the (US) and Europe facilitated neither the exchange nor the comparison of treatment results. Peter Goldstraw, a United Kingdom (UK) thoracic surgeon, started the process of updating the sixth version in 1996 and brought it to a good end 10 years later. His goals were to improve the TNM system in lung cancer by addressing the ongoing controversies, to validate the modifications and additional descriptors, to validate the TNM for use in staging SCLC and carcinoid tumours, to propose a new uniform lymph-node map and to investigate the prognostic value of non-anatomical factors. A staging committee was formed within the International Association for the Study of Lung Cancer (IASLC) - which supervised the collection of the retrospective data from >100,000 patients with lung cancer - treated throughout the world between 1990 and 2000, analyse them with the help of solid statistics and validate externally with the Surveillance

  8. Paclitaxel, Nab-paclitaxel, or Ixabepilone With or Without Bevacizumab in Treating Patients With Stage IIIC or Stage IV Breast Cancer

    ClinicalTrials.gov

    2016-06-01

    Estrogen Receptor Negative; Estrogen Receptor Positive; HER2/Neu Negative; HER2/Neu Positive; Male Breast Carcinoma; Progesterone Receptor Negative; Progesterone Receptor Positive; Recurrent Breast Carcinoma; Stage IIIC Breast Cancer AJCC v6; Stage IV Breast Cancer

  9. Prognostic Impact of Erythropoietin Expression and Erythropoietin Receptor Expression on Locoregional Control and Survival of Patients Irradiated for Stage II/III Non-Small-Cell Lung Cancer

    SciTech Connect

    Rades, Dirk; Setter, Cornelia; Dahl, Olav; Schild, Steven E.; Noack, Frank

    2011-06-01

    Purpose: Prognostic factors can guide the physician in selecting the optimal treatment for an individual patient. This study investigates the prognostic value of erythropoietin (EPO) and EPO receptor (EPO-R) expression of tumor cells for locoregional control and survival in non-small-cell lung cancer (NSCLC) patients. Methods and Materials: Fourteen factors were investigated in 62 patients irradiated for stage II/III NSCLC, as follows: age, gender, Karnofsky performance score (KPS), histology, grading, TNM/American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, pack years (average number of packages of cigarettes smoked per day multiplied by the number of years smoked), smoking during radiotherapy, hemoglobin levels during radiotherapy, EPO expression, and EPO-R expression. Additionally, patients with tumors expressing both EPO and EPO-R were compared to those expressing either EPO or EPO-R and to those expressing neither EPO nor EPO-R. Results: On univariate analysis, improved locoregional control was associated with AJCC stage II cancer (p < 0.048), surgery (p < 0.042), no smoking during radiotherapy (p = 0.024), and no EPO expression (p = 0.001). A trend was observed for a KPS of >70 (p = 0.08), an N stage of 0 to 1 (p = 0.07), and no EPO-R expression (p = 0.10). On multivariate analysis, AJCC stage II and no EPO expression remained significant. No smoking during radiotherapy was almost significant. On univariate analysis, improved survival was associated with N stage 0 to 1 (p = 0.009), surgery (p = 0.039), hemoglobin levels of {>=}12 g/d (p = 0.016), and no EPO expression (p = 0.001). On multivariate analysis, N stage 0 to 1 and no EPO expression maintained significance. Hemoglobin levels of {>=}12 g/d were almost significant. On subgroup analyses, patients with tumors expressing both EPO and EPO-R had worse outcomes than those expressing either EPO or EPO-R and those expressing neither EPO nor RPO-R. Conclusions: EPO expression of tumor cells

  10. Evaluation of the 5th edition of the TNM classification for gastric cancer: improved prognostic value

    PubMed Central

    Kranenbarg, E Klein; Hermans, J; van Krieken, J H J M; van de Velde, C J H

    2001-01-01

    The main change in the 5th edition (1997) of the TNM classification for gastric cancer compared to the 4th edition (1987) is the use of the number of involved nodes instead of the location of positive nodes. As a result stage grouping is also altered. A second change is the requirement for the examination of at least 15 nodes to justify the N0 status. Patients with fewer examined negative nodes are unclassifiable (Nx). Data were retrieved from a randomized trial database comparing D1 and D2 dissection and 633 curatively operated patients were included. According to the criteria of the 5th edition, 39% of the node-positive patients had another N stage compared to the 4th: 21% had a lower and 18% had a higher stage. 5-year survival rates according to the 4th edition N0, N1 and N2 groups were respectively 72%, 34% and 27%. According to the 5th edition these percentages were for the N0, N1, N2, N3 and Nx groups respectively 75%, 38%, 19%, 8% and 65%. The former 1987 N1 and N2 group were significantly split into three new N 1997 groups (P = 0.006, respectively P< 0.0005). The Cox's regression analysis showed the N 1997 classification to be the most important prognostic variable, with a higher prognostic value than N 1987. In addition, the new TNM stage was also a better prognosticator. The requirement for examining at least 15 nodes, however, could not be fulfilled in 38% of all node-negative patients and we found that a minimum of 5 consecutive negative lymph nodes is a reliable number for staging purposes. We conclude that the 5th edition of the TNM classification provides a better estimation of prognosis, however, examination of at least 15 negative regional lymph nodes is too high a threshold and 5 gives similar prognostic value. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11139315

  11. Prognostic factors in advanced pharyngeal and oral cavity cancer; significance of multimodality imaging in terms of 7th edition of TNM

    PubMed Central

    2014-01-01

    As with most cancers the prognosis in pharyngeal and oral cavity cancer largely depends on tumour stage. Physical examination, including endoscopy should be combined with technical radiologic imaging to record the precise extent of tumour. The TNM staging system of the head and neck region is, in fact, an anatomic staging system that describes the anatomic extent of the primary tumour as well as the involvement of regional lymph nodes and distant metastases. Modifications in the TNM staging system should consider not only the expert opinions and published reports in the literature but the technical advances in technology for improved assessment of tumour extent and the shifting paradigms in therapeutic strategies. “T” stage of the tumour is defined by its size, the depth of the invasion and the involvement of vital structures. In the 7th edition of TNM classification, for stage T4 tumors (larger than 4 cm), subcategories a and b were introduced to indicate the involvement of vital structures and their suitability for surgical resection (except for nasopharynx cancer). Nodal metastasis is the most important predictor of outcome for squamous cell cancer of the head and neck. Better and more reliable methods of pretreatment tumour assessment are therefore crucial to ensure that the clinical assessment of tumor approximates its actual pathologic extent. CT and MRI are both useful for assessing extensions of pharyngeal- and oral cavity cancer in advanced stage. MRI is superior in visualizing most primary tumour sites. PMID:25608735

  12. Lung Cancer Staging and Prognosis.

    PubMed

    Woodard, Gavitt A; Jones, Kirk D; Jablons, David M

    2016-01-01

    The seventh edition of the non-small cell lung cancer (NSCLC) TNM staging system was developed by the International Association for the Staging of Lung Cancer (IASLC) Lung Cancer Staging Project by a coordinated international effort to develop data-derived TNM classifications with significant survival differences. Based on these TNM groupings, current 5-year survival estimates in NSLCC range from 73 % in stage IA disease to 13 % in stage IV disease. TNM stage remains the most important prognostic factor in predicting recurrence rates and survival times, followed by tumor histologic grade, and patient sex, age, and performance status. Molecular prognostication in lung cancer is an exploding area of research where interest has moved beyond TNM stage and into individualized genetic tumor analysis with immunohistochemistry, microarray, and mutation profiles. However, despite intense research efforts and countless publications, no molecular prognostic marker has been adopted into clinical use since most fail in subsequent cross-validation with few exceptions. The recent interest in immunotherapy for NSCLC has identified new biomarkers with early evidence that suggests that PD-L1 is a predictive marker of a good response to new immunotherapy drugs but a poor prognostic indicator of overall survival. Future prognostication of outcomes in NSCLC will likely be based on a combination of TNM stage and molecular tumor profiling and yield more precise, individualized survival estimates and treatment algorithms. PMID:27535389

  13. Evaluation of the 7th edition of the TNM classification in patients with resected esophageal squamous cell carcinoma

    PubMed Central

    Wang, Jia; Wu, Nan; Zheng, Qing-Feng; Yan, Shi; Lv, Chao; Li, Shao-Lei; Yang, Yue

    2014-01-01

    AIM: To evaluate the prognostic factors and tumor stages of the 7th edition TNM classification for esophageal cancer. METHODS: In total, 1033 patients with esophageal squamous cell carcinoma (ESCC) who underwent surgical resection with or without (neo)adjuvant therapy between January 2003 and June 2012 at the Thoracic Surgery Department II of the Beijing Cancer Hospital, Beijing, China were included in this study. The following eligibility criteria were applied: (1) squamous cell carcinoma of the esophagus or gastroesophageal junction identified by histopathological examination; (2) treatment with esophagectomy plus lymphadenectomy with curative intent; and (3) complete pathologic reports and follow-up data. Patients who underwent non-curative (R1) resection and patients who died in hospital were excluded. Patients who received (neo)adjuvant therapy were also included in this analysis. All patients were restaged using the 7th edition of the Union for International Cancer Control and the American Joint Committee on Cancer TNM staging systems. Univariate and multivariate analyses were performed to identify the prognostic factors for survival. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to evaluate differences between the subgroups. RESULTS: Of the 1033 patients, 273 patients received (neo)adjuvant therapy, and 760 patients were treated with surgery alone. The median follow-up time was 51.6 mo (range: 5-112 mo) and the overall 5-year survival rate was 36.4%. Gender, “pT” and “pN” descriptors, (neo)adjuvant therapy, and the 7th edition TNM stage grouping were independent prognostic factors in the univariate and multivariate analyses. However, neither histologic grade nor cancer location were independent prognostic factors in the univariate and multivariate analyses. The 5-year stage-based survival rates were as follows: IA, 84.9%; IB, 70.9%; IIA, 56.2%; IIB, 43.3%; IIIA, 37.9%; IIIB, 23.3%; IIIC,12.9% and IV, 3

  14. Clinical and Prognostic Factors for Renal Parenchymal, Pelvis, and Ureter Cancers in SEER Registries: Collaborative Stage Data Collection System, Version 2

    PubMed Central

    Altekruse, Sean F.; Dickie, Lois; Wu, Xiao-Cheng; Hsieh, Mei-Chin; Wu, Manxia; Lee, Richard; Delacroix, Scott

    2015-01-01

    BACKGROUND The American Joint Committee on Cancer’s (AJCC) 7th edition cancer staging manual reflects recent changes in cancer care practices. This report assesses changes from the AJCC 6th to the AJCC 7th edition stage distributions and the quality of site-specific factors (SSFs). METHODS Incidence data for renal parenchyma and pelvis and ureter cancers from 18 Surveillance, Epidemiology, and End Results (SEER) registries were examined, including staging trends during 2004–2010, stage distribution changes between the AJCC 6th and 7th editions, and SSF completeness for cases diagnosed in 2010. RESULTS From 2004 to 2010, the percentage of stage I renal parenchyma cancers increased from 50% to 58%, whereas stage IV and unknown stage cases decreased (18% to 15%, and 10% to 6%, respectively). During this period, the percentage of stage 0a renal pelvis and ureter cancers increased from 21% to 25%, and stage IV and unknown stage tumors decreased (20% to 18%, and 7% to 5%, respectively). Stage distributions under the AJCC 6th and 7th editions were about the same. For renal parenchymal cancers, 71%–90% of cases had known values for 6 required SSFs. For renal pelvis and ureter cancers, 74% of cases were coded as known for SSF1 (WHO/ISUP grade) and 47% as known for SSF2 (depth of renal parenchymal invasion). SSF values were known for larger proportions of cases with reported resections. CONCLUSIONS Stage distributions between the AJCC 6th and 7th editions were similar. SSFs were known for more than two-thirds of cases, providing more detail in the SEER database relevant to prognosis. PMID:25412394

  15. TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (EORTC).

    PubMed

    Kim, Youn H; Willemze, Rein; Pimpinelli, Nicola; Whittaker, Sean; Olsen, Elise A; Ranki, Annamari; Dummer, Reinhard; Hoppe, Richard T

    2007-07-15

    Currently availabel staging systems for non-Hodgkin lymphomas are not useful for clinical staging classification of most primary cutaneous lymphomas. The tumor, node, metastases (TNM) system used for mycosis fungoides (MF) and Sézary syndrome (SS) is not appropriate for other primary cutaneous lymphomas. A usable, unified staging system would improve the communication about the state of disease, selection of appropriate management, standardization of enrollment/response criteria in clinical trials, and collection/analysis of prospective survival data. Toward this goal, during the recent meetings of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC), the representatives have established a consensus proposal of a TNM classification system applicable for all primary cutaneous lymphomas other than MF and SS. Due to the clinical and pathologic heterogeneity of the cutaneous lymphomas, the currently proposed TNM system is meant to be primarily an anatomic documentation of disease extent and not to be used as a prognostic guide.

  16. Conforming to cancer staging, prognostic indicators and national treatment guidelines.

    PubMed

    Dykstra-Long, Gwendylen R

    2011-01-01

    Clinical cancer staging and prognostic indicators guide treatment planning, and as such the American College of Surgeons Commission on Cancer Commission on Cancer (ACoS CoC) and the American Joint Committee on Cancer (AJCC) have recognized this as quality patient care. Overton Brooks Veterans Administration (OBVAMC) developed an organizational policy and procedure, flow algorithms, treatment plan templates, and education strategies in order to conform to this quality care approach. The purpose of this article is to share this systematic approach that is able to support clinical and working cancer stage and prognostic indicators which have been recognized by national standard setting organizations as quality patient care.

  17. Staging of transitional cell carcinoma: Has anything changed?

    PubMed Central

    Kulkarni, J. N.; Bakshi, G. K.

    2008-01-01

    Objective: This article is a systematic review of various changes in the evolution of the contemporary clinico-pathological staging of transitional cell carcinoma (TCC). Materials and Methods: A thorough search of the literature was done by Medline and other internet references. Results: Accurate staging of TCC is necessary for designing optimal therapy in clinical practice. Further, the current emphasis on bladder conservation and improved long-term disease free survival (DFS) necessitates minimal errors in staging and it's predictability towards recurrence and progression. Traditionally, the staging of TCC revolves around clinical and pathological findings. The staging has evolved through the understanding of various clinico- pathological factors like tumor appearance, number, size, grade, depth of invasion, muscle substratification, lymphovascular invasion and has reached the standard TNM classification. Cystoscopy and transurethral resection still remain the mainstay of staging and noninvasive imaging techniques have further enhanced the accuracy. Conclusion: The TNM classification for bladder cancer is currently the gold standard for TCC. PMID:19468363

  18. Esophageal cancer: anatomic particularities, staging, and imaging techniques.

    PubMed

    Encinas de la Iglesia, J; Corral de la Calle, M A; Fernández Pérez, G C; Ruano Pérez, R; Álvarez Delgado, A

    2016-01-01

    Cancer of the esophagus is a tumor with aggressive behavior that is usually diagnosed in advanced stages. The absence of serosa allows it to spread quickly to neighboring mediastinal structures, and an extensive lymphatic drainage network facilitates tumor spread even in early stages. The current TNM classification, harmonized with the classification for gastric cancer, provides new definitions for the anatomic classification, adds non-anatomic characteristics of the tumor, and includes tumors of the gastroesophageal junction. Combining endoscopic ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging provides greater accuracy in determining the initial clinical stage, and these imaging techniques play an essential role in the selection, planning, and evaluation of treatment. In this article, we review some particularities that explain the behavior of this tumor and we describe the current TNM staging system; furthermore, we discuss the different imaging tests available for its evaluation and include a diagnostic algorithm.

  19. Esophageal cancer: anatomic particularities, staging, and imaging techniques.

    PubMed

    Encinas de la Iglesia, J; Corral de la Calle, M A; Fernández Pérez, G C; Ruano Pérez, R; Álvarez Delgado, A

    2016-01-01

    Cancer of the esophagus is a tumor with aggressive behavior that is usually diagnosed in advanced stages. The absence of serosa allows it to spread quickly to neighboring mediastinal structures, and an extensive lymphatic drainage network facilitates tumor spread even in early stages. The current TNM classification, harmonized with the classification for gastric cancer, provides new definitions for the anatomic classification, adds non-anatomic characteristics of the tumor, and includes tumors of the gastroesophageal junction. Combining endoscopic ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging provides greater accuracy in determining the initial clinical stage, and these imaging techniques play an essential role in the selection, planning, and evaluation of treatment. In this article, we review some particularities that explain the behavior of this tumor and we describe the current TNM staging system; furthermore, we discuss the different imaging tests available for its evaluation and include a diagnostic algorithm. PMID:27469407

  20. Discrepancies between two alternative staging systems (European Neuroendocrine Tumor Society 2006 and American Joint Committee on Cancer/Union for International Cancer Control 2010) of neuroendocrine neoplasms of the pancreas. A study of 50 cases.

    PubMed

    Liszka, Łukasz; Pająk, Jacek; Mrowiec, Sławomir; Zielińska-Pająk, Ewa; Gołka, Dariusz; Lampe, Paweł

    2011-04-15

    The aim of our study was to identify and describe potential inconsistencies between two alternative staging systems of pancreatic neuroendocrine neoplasms (pNENs)--the European Neuroendocrine Tumor Society (ENETS) system (2006) and the American Joint Committee on Cancer/Union for International Cancer Control (AJCC-UICC) system (2010). To address this issue, we performed a retrospective clinico-pathological study of 50 cases of pNENs. We found 9 (18%) cases of ENETS/AJCC-UICC discrepancies regarding the primary tumor stage. They included 7 cases of T2/T3 disagreement and 2 cases of T3/T4 disagreement. In addition, we discussed the issue of potential T1/T2 discrepancy (however, we did not observe any such a case). Another inconsistency was related to the application of different stage prognostic groupings between both systems. In conclusion, the discrepancies between ENETS and AJCC-UICC staging systems for pNENs are relatively frequent and heterogeneous. We believe that they should be rigorously recognized. This is necessary for the evaluation of prognostic factors and the effectiveness of therapeutic options used in patients with pNENs.

  1. On the significance of fuzzification of the N and m in cancer staging.

    PubMed

    Yones, Sara A; Moussa, Ahmed S; Hassan, Hesham; Alieldin, Nelly H

    2014-01-01

    The tumor, node, metastasis (TNM) staging system has been regarded as one of the most widely used staging systems for solid cancer. The "T" is assigned a value according to the primary tumor size, whereas the "N" and "M" are dependent on the number of regional lymph nodes and the presence of distant metastasis, respectively. The current TNM model classifies stages into five crisp classes. This is unrealistic since the drastic modification in treatment that is based on a change in one class may be based on a slight shift around the class boundary. Moreover, the system considers any tumor that has distant metastasis as stage 4, disregarding the metastatic lesion concentration and size. We had handled the problem of T staging in previous studies using fuzzy logic. In this study, we focus on the fuzzification of N and M staging for more accurate and realistic modeling which may, in turn, lead to better treatment and medical decisions. PMID:25089089

  2. Validation and Comparison of the 7th Edition of the American Joint Committee on Cancer Staging System and Other Prognostic Models to Predict Relapse-Free Survival in Asian Patients with Parotid Cancer

    PubMed Central

    Lu, Chang-Hsien; Liu, Chien-Ting; Chang, Pei-Hung; Yeh, Kun-Yun; Hung, Chia-Yen; Li, Shau-Hsuan; Lin, Yung-Chang; Yeh, Ta-Sen; Hung, Yung-Shin; Chou, Wen-Chi

    2016-01-01

    Purpose: Parotid cancer is a rare malignancy characterized by a heterogeneous histologic subtype and distinct biologic behavior. The present study aimed to externally validate and compare the performances of the American Joint Committee on Cancer (AJCC) staging system (7th Edition), Carrillo score, and Vander Poorten score in the prediction of tumor relapse probability in a large cohort of Asian parotid cancer patients. Methods: In total, 261 patients who underwent primary surgery for localized parotid cancer between 2002 and 2014 at the four affiliated hospitals of Chang Gung Memorial Hospital were identified. All patients were categorized into different prognostic groups defined by these three models for the comparison of associated relapse-free survival (RFS) rates. Results: The 5-year overall survival, cancer-specific survival, and RFS rates were 82.9%, 86.2%, and 77.5%, respectively. All three models were significantly powerful in discriminating between the tumors of patients in the lowest and highest risk groups. The c-statistic for predicting the 5-year RFS was 0.74 for the AJCC staging, 0.74 for the Vander Poorten score, and 0.62 for the Carrillo score. The AJCC staging and Vander Poorten score gave significantly high c-statistic values compared to the Carrillo score. Conclusion: Our data validated that all three models are significantly powerful in discriminating tumor relapse between patients in lowest and highest risk groups. The AJCC system and Vander Poorten score proved superior to the Carrillo score, and showed similar performances in discriminating between the 5-year RFS probabilities of low and high-risk Asian parotid cancer patients.

  3. Validation of T Stage According to Depth of Invasion and N Stage Subclassification Based on Number of Metastatic Lymph Nodes for Distal Extrahepatic Bile Duct (EBD) Carcinoma

    PubMed Central

    Moon, Ahrim; Choi, Dong Wook; Choi, Seoung Ho; Heo, Jin Seok; Jang, Kee-Taek

    2015-01-01

    Abstract According to the current AJCC staging system, the T stage of distal extrahepatic bile duct carcinoma (EBD) is classified according to the extent of the tumor within or beyond the bile duct wall. However many invasive carcinoma accompany stromal desmoplasia that obscure lower boundary of bile duct wall; it is frequently difficult to clearly define the extent of tumors using the current T classification system. In this study, we validated an alternative T classification system by depth of invasion (DoI; T1: < 5 mm, T2: 5 to 12 mm, and T3: ≥ 12 mm). Specifically, we evaluated DoI in 114 cases of distal EBD carcinoma using digital scan images to achieve more objective measurements of tumor DoI. In addition, we evaluated the effect of the number of metastatic lymph nodes (LNs) as well as the number of total examined LNs on the survival rate in the same patient group, and performed a comparative analysis of these data to assess patient survival. We also analyzed 114 cases of distal EBD carcinoma using the current T and N classification of the AJCC staging system (7th edition). The T stage of the current AJCC staging system was not associated with significant differences in patient survival, especially between T2 and T3. However, T staging by DoI was associated with statistically significant differences in patient survival (P < 0.001 in DoI-1, P = 0.002 in DoI-2). With respect to N stage, we divided patients into 3 tiers comprising class 1 (no nodal metastasis), class 2 (1–3 nodal metastases), and class 3 (4 or more nodal metastases). In 3-tier classification analysis, the median survival times for classes 1, 2, and 3 were 79.2, 28.8, and 10.9 months, respectively. The difference in survival among the 3 classes was statistically significant (P < 0.001). We found the cut-off value of 11 LNs (1 to 10 vs ≥ 11) for N0 stage showed most significant difference (P = 0.007). We think at least 11 LNs should be examined for more

  4. Development of national reference energy mean emission levels for the FHWA traffic noise model (FHWA TNM (trade name)), version 1.0. Final report, July 1993-November 1995

    SciTech Connect

    Fleming, G.G.; Rapoza, A.S.; Lee, C.S.Y.

    1995-11-01

    During the period, July 1993 through November 1995, the U.S. Department of Transportation , Research and Special Programs Administration, John A. Volpe National Transportation Systems Center (Volpe Center), Acoustics Facility. This report also presents the results of the study, including the measurement, data reduction and analysis procedures used to develop the Data Base. It discusses data for constant-flow and interrupted-flow roadway traffic, and data related to vehicle subsource heights. This report also presents the statistical methodology used to establish the Data Base for the FHWA TNM. Sound level regressions are presented as a function of several parameters, including vehicle speed, vehicle type, one-third octave-band frequency, roadway pavement type, roadway grade, traffic-flow condition and vehicle subsource height.

  5. Evaluation of preoperative staging for esophageal squamous cell carcinoma

    PubMed Central

    Luo, Lin-Na; He, Long-Jun; Gao, Xiao-Yan; Huang, Xin-Xin; Shan, Hong-Bo; Luo, Guang-Yu; Li, Yin; Lin, Shi-Yong; Wang, Guo-Bao; Zhang, Rong; Xu, Guo-Liang; Li, Jian-Jun

    2016-01-01

    Esophageal squamous cell carcinoma (ESCC) is known for its rapid progression and poor outcomes. China has the highest incidence and mortality in the world. Diagnoses made at early stages and accurate staging are associated with better outcomes, all of which can play a significant role in the selection of treatment protocols. ESCC is staged according to the widely accepted TNM system. Common imaging modalities used in staging ESCC before treatment include endoscopy, computed tomography (CT), positron emission tomography (PET) and magnetic resonance imaging (MRI). Endoscopic ultrasound is useful for staging tumor depth and nodal status. Narrow band imaging is valuable for early stage disease assessment. CT and PET provide additional valuable information regarding node and metastasis staging. The ability of MRI to delineate ESCC is continuously being improved and adds information regarding locoregional status to routine examinations. PMID:27547011

  6. A new staging system for nasopharyngeal carcinoma based on intensity-modulated radiation therapy: results of a prospective multicentric clinical study

    PubMed Central

    Kang, Min; Long, Jianxiong; Li, Guisheng; Yan, Haolin; Feng, Guosheng; Liu, Meilian; Zhu, Jinxian; Wang, Rensheng

    2016-01-01

    Purpose To establish a new clinical staging standard for nasopharyngeal carcinoma (NPC), based on intensity-modulated radiotherapy (IMRT), through a prospective multicenter clinical trial. Experiment Design 492 NPC patients were selected from six hospitals in the Guangxi Zhuang Autonomous Region, China from January 2006 to December 2009. Kaplan-Meier method was adopted to calculate survival rates. Log-rank test was used to compare survival differences. Results According to the seventh edition of the UICC/AJCC staging system, the differences between T1, T2 and T3 are not statistically significant, suggesting that T1, T2 and T3 could be combined as new T1. There were significant differences between all N stages except those of N3a and N3b, suggesting that N3a and N3b could be combined as new N3. Additionally, the overall survival (OS) curves of stages I, II, III and IVa were not significantly different. Therefore, we propose a new clinical NPC staging standard based on magnetic resonance imaging (MRI) and IMRT as T stage (including T1 and T2), N stage (including N0, N1, N2 and N3) and clinical staging includes I (T1N0M0), II (T1N1-2M0, T2N0M0), III (T2N1-2M0), IVa (TxN3M0) and IVb (TxNxM1). Recommended staging system performs better in risk difference and distribution balance. Furthermore, the differences in the 5-year curves of local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and OS were all statistically more significant than the seventh edition of the UICC/AJCC staging system. Conclusions Proposed staging system is more adaptable to IMRT and predicts the prognosis of NPC patients more accurately. PMID:26918446

  7. Survival Analyses for Patients With Surgically Resected Pancreatic Neuroendocrine Tumors by World Health Organization 2010 Grading Classifications and American Joint Committee on Cancer 2010 Staging Systems.

    PubMed

    Yang, Min; Ke, Neng-wen; Zeng, Lin; Zhang, Yi; Tan, Chun-lu; Zhang, Hao; Mai, Gang; Tian, Bo-le; Liu, Xu-bao

    2015-12-01

    In 2010, World Health Organization (WHO) reclassified pancreatic neuroendocrine tumors (p-NETs) into 4 main groups: neuroendocrine tumor G1 (NET G1), neuroendocrine tumor G2 (NET G2), neuroendocrine carcinoma G3 (NEC G3), mixed adeno and neuroendocrine carcinoma (MANEC). Clinical value of these newly updated WHO grading criteria has not been rigorously validated. The authors aimed to evaluate the clinical consistency of the new 2010 grading classifications by WHO and the 2010 tumor-node metastasis staging systems by American Joint Committee on Cancer (AJCC) on survivals for patients with surgically resected p-NETs. Moreover, the authors would validate the prognostic value of both criteria for p-NETs.The authors retrospectively collected the clinicopathologic data of 120 eligible patients who were all surgically treated and histopathologically diagnosed as p-NETs from January 2004 to February 2014 in our single institution. The new WHO criteria were assigned to 4 stratified groups with a respective distribution of 62, 35, 17, and 6 patients. Patients with NET G1 or NET G2 obtained a statistically better survival compared with those with NEC G3 or MANEC (P < 0.001). Survivals of NET G1 was also better than those of NET G2 (P = 0.023), whereas difference of survivals between NEC G3 and MANEC present no obvious significance (P = 0.071). The AJCC 2010 staging systems were respectively defined in 61, 36, 12, and 11 patients for each stage. Differences of survivals of stage I with stage III and IV were significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001); whereas comparisons of stage I with stage II and stage III with IV were not statistically significant (P = 0.129, P = 0.286; respectively). Together with radical resection, these 2 systems were both significant in univariate and multivariate analysis (P < 0.05).The newly updated WHO 2010 grading classifications and the AJCC 2010 staging systems could consistently reflect the clinical outcome

  8. Survival Analyses for Patients With Surgically Resected Pancreatic Neuroendocrine Tumors by World Health Organization 2010 Grading Classifications and American Joint Committee on Cancer 2010 Staging Systems

    PubMed Central

    Yang, Min; Ke, Neng-wen; Zeng, Lin; Zhang, Yi; Tan, Chun-lu; Zhang, Hao; Mai, Gang; Tian, Bo-le; Liu, Xu-bao

    2015-01-01

    Abstract In 2010, World Health Organization (WHO) reclassified pancreatic neuroendocrine tumors (p-NETs) into 4 main groups: neuroendocrine tumor G1 (NET G1), neuroendocrine tumor G2 (NET G2), neuroendocrine carcinoma G3 (NEC G3), mixed adeno and neuroendocrine carcinoma (MANEC). Clinical value of these newly updated WHO grading criteria has not been rigorously validated. The authors aimed to evaluate the clinical consistency of the new 2010 grading classifications by WHO and the 2010 tumor-node metastasis staging systems by American Joint Committee on Cancer (AJCC) on survivals for patients with surgically resected p-NETs. Moreover, the authors would validate the prognostic value of both criteria for p-NETs. The authors retrospectively collected the clinicopathologic data of 120 eligible patients who were all surgically treated and histopathologically diagnosed as p-NETs from January 2004 to February 2014 in our single institution. The new WHO criteria were assigned to 4 stratified groups with a respective distribution of 62, 35, 17, and 6 patients. Patients with NET G1 or NET G2 obtained a statistically better survival compared with those with NEC G3 or MANEC (P < 0.001). Survivals of NET G1 was also better than those of NET G2 (P = 0.023), whereas difference of survivals between NEC G3 and MANEC present no obvious significance (P = 0.071). The AJCC 2010 staging systems were respectively defined in 61, 36, 12, and 11 patients for each stage. Differences of survivals of stage I with stage III and IV were significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001); whereas comparisons of stage I with stage II and stage III with IV were not statistically significant (P = 0.129, P = 0.286; respectively). Together with radical resection, these 2 systems were both significant in univariate and multivariate analysis (P < 0.05). The newly updated WHO 2010 grading classifications and the AJCC 2010 staging systems could

  9. Survival Analyses for Patients With Surgically Resected Pancreatic Neuroendocrine Tumors by World Health Organization 2010 Grading Classifications and American Joint Committee on Cancer 2010 Staging Systems.

    PubMed

    Yang, Min; Ke, Neng-wen; Zeng, Lin; Zhang, Yi; Tan, Chun-lu; Zhang, Hao; Mai, Gang; Tian, Bo-le; Liu, Xu-bao

    2015-12-01

    In 2010, World Health Organization (WHO) reclassified pancreatic neuroendocrine tumors (p-NETs) into 4 main groups: neuroendocrine tumor G1 (NET G1), neuroendocrine tumor G2 (NET G2), neuroendocrine carcinoma G3 (NEC G3), mixed adeno and neuroendocrine carcinoma (MANEC). Clinical value of these newly updated WHO grading criteria has not been rigorously validated. The authors aimed to evaluate the clinical consistency of the new 2010 grading classifications by WHO and the 2010 tumor-node metastasis staging systems by American Joint Committee on Cancer (AJCC) on survivals for patients with surgically resected p-NETs. Moreover, the authors would validate the prognostic value of both criteria for p-NETs.The authors retrospectively collected the clinicopathologic data of 120 eligible patients who were all surgically treated and histopathologically diagnosed as p-NETs from January 2004 to February 2014 in our single institution. The new WHO criteria were assigned to 4 stratified groups with a respective distribution of 62, 35, 17, and 6 patients. Patients with NET G1 or NET G2 obtained a statistically better survival compared with those with NEC G3 or MANEC (P < 0.001). Survivals of NET G1 was also better than those of NET G2 (P = 0.023), whereas difference of survivals between NEC G3 and MANEC present no obvious significance (P = 0.071). The AJCC 2010 staging systems were respectively defined in 61, 36, 12, and 11 patients for each stage. Differences of survivals of stage I with stage III and IV were significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001); whereas comparisons of stage I with stage II and stage III with IV were not statistically significant (P = 0.129, P = 0.286; respectively). Together with radical resection, these 2 systems were both significant in univariate and multivariate analysis (P < 0.05).The newly updated WHO 2010 grading classifications and the AJCC 2010 staging systems could consistently reflect the clinical outcome

  10. Oral cancer staging established by magnetic resonance imaging.

    PubMed

    Paiva, Rogério Ribeiro de; Figueiredo, Paulo Tadeu de Souza; Leite, André Ferreira; Silva, Maria Alves Garcia; Guerra, Eliete Neves Silva

    2011-01-01

    The aim of this study was to compare clinical staging and magnetic resonance imaging (MRI) staging for oral cancer, and to assess inter-observer agreement between oral and medical radiologists. A total of 10 patients diagnosed with oral cancer were assessed before treatment. A head and neck surgeon performed clinical TNM staging. Two medical radiologists and two oral radiologists performed a new staging assessment by interpreting MRI scans, without prior knowledge of the clinical staging. They evaluated the extent of the primary tumor (T), metastasis to regional lymph nodes (N) and grouping by stages. The data were analyzed using the Kappa Index. There was significant agreement (p < 0.05) between the clinical and MRI staging assessments made by one oral radiologist for N stage, and between those made by one medical radiologist for the T and N stages and for the grouping by stages. In the MRI assessment, there was significant agreement among all four observers for both T stage and grouping by stages. For the N stage, there was no significant agreement between one oral radiologist and one medical radiologist or between both medical radiologists. There was significant agreement among the remaining radiologists. There was no agreement between the clinical and MRI staging. These results indicate the importance of using MRI for the diagnosis of oral cancer. Training initiatives and calibration of medical and oral radiologists should be promoted to provide an improved multidisciplinary approach to oral cancer.

  11. Promoter CpG island methylation of RET predicts poor prognosis in stage II colorectal cancer patients.

    PubMed

    Draht, Muriel X G; Smits, Kim M; Tournier, Benjamin; Jooste, Valerie; Chapusot, Caroline; Carvalho, Beatriz; Cleven, Arjen H G; Derks, Sarah; Wouters, Kim A D; Belt, Eric J T; Stockmann, Hein B A C; Bril, Herman; Weijenberg, Matty P; van den Brandt, Piet A; de Bruïne, Adriaan P; Herman, James G; Meijer, Gerrit A; Piard, Françoise; Melotte, Veerle; van Engeland, Manon

    2014-05-01

    Improved prognostic stratification of patients with TNM stage II colorectal cancer (CRC) is desired, since 20-30% of high-risk stage II patients may die within five years of diagnosis. This study was conducted to investigate REarranged during Transfection (RET) gene promoter CpG island methylation as a possible prognostic marker for TNM stage II CRC patients. The utility of RET promoter CpG island methylation in tumors of stage II CRC patients as a prognostic biomarker for CRC related death was studied in three independent series (including 233, 231, and 294 TNM stage II patients, respectively) by using MSP and pyrosequencing. The prognostic value of RET promoter CpG island methylation was analyzed by using Cox regression analysis. In the first series, analyzed by MSP, CRC stage II patients (n = 233) with RET methylated tumors had a significantly worse overall survival as compared to those with unmethylated tumors (HRmultivariable = 2.51, 95%-CI: 1.42-4.43). Despite a significant prognostic effect of RET methylation in stage III patients of a second series, analyzed by MSP, the prognostic effect in stage II patients (n = 231) was not statistically significant (HRmultivariable = 1.16, 95%-CI 0.71-1.92). The third series (n = 294), analyzed by pyrosequencing, confirmed a statistically significant association between RET methylation and poor overall survival in stage II patients (HRmultivariable = 1.91, 95%-CI: 1.04-3.53). Our results show that RET promoter CpG island methylation, analyzed by two different techniques, is associated with a poor prognosis in stage II CRC in two independent series and a poor prognosis in stage III CRC in one series. RET methylation may serve as a useful and robust tool for clinical practice to identify high-risk stage II CRC patients with a poor prognosis. This merits further investigation. PMID:24560444

  12. SEPAR guidelines for lung cancer staging.

    PubMed

    Sánchez de Cos, Julio; Hernández, Jesús Hernández; López, Marcelo F Jiménez; Sánchez, Susana Padrones; Gratacós, Antoni Rosell; Porta, Ramón Rami

    2011-09-01

    The latest tumour, lymph node and metastasis (TNM) classification by the International Association for the Study of Lung Cancer (IASLC), based on the analysis of patients from all over the world, has incorporated changes in the descriptors, especially those regarding tumor size, while proposing new group staging. A new lymph node map has also been developed with the intention of facilitating the classification of the "N" component. SEPAR recommends using this new classification. As for the procedures recommended for staging, in addition to the generalized use of computed tomography (CT), it points to the role of positron emission tomography (PET) or image fusion methods (PET/CT), which provide a better evaluation of the mediastinum and extrathoracic metastases. Endobronchial ultrasound (EBUS) and esophageal ultrasound (EUS) for obtaining cytohistological samples have been incorporated in the staging algorithm, and it emphasizes the importance of precise re-staging after induction treatment in order to make new therapeutic decisions. Comment is made on the foreseeable incorporation in the near future of molecular staging, and systematic lymph node dissection is recommended with the intention of making a more exact surgical-pathological classification.

  13. Seventh tumor-node-metastasis staging of gastric cancer: Five-year follow-up.

    PubMed

    Rausei, Stefano; Ruspi, Laura; Galli, Federica; Pappalardo, Vincenzo; Di Rocco, Giuseppe; Martignoni, Francesco; Frattini, Francesco; Rovera, Francesca; Boni, Luigi; Dionigi, Gianlorenzo

    2016-09-14

    Seventh tumor-node-metastasis (TNM) classification for gastric cancer, published in 2010, introduced changes in all of its three parameters with the aim to increase its accuracy in prognostication. The aim of this review is to analyze the efficacy of these changes and their implication in clinical practice. We reviewed relevant Literature concerning staging systems in gastric cancer from 2010 up to March 2016. Adenocarcinoma of the esophago-gastric junction still remains a debated entity, due to its peculiar anatomical and histological situation: further improvement in its staging are required. Concerning distant metastases, positive peritoneal cytology has been adopted as a criterion to define metastatic disease: however, its search in clinical practice is still far from being routinely performed, as staging laparoscopy has not yet reached wide diffusion. Regarding definition of T and N: in the era of multimodal treatment these parameters should more influence both staging and surgery. The changes about T-staging suggested some modifications in clinical practice. Differently, many controversies on lymph node staging are still ongoing, with the proposal of alternative classification systems in order to minimize the extent of lymphadenectomy. The next TNM classification should take into account all of these aspects to improve its accuracy and the comparability of prognosis in patients from both Eastern and Western world. PMID:27678357

  14. Seventh tumor-node-metastasis staging of gastric cancer: Five-year follow-up

    PubMed Central

    Rausei, Stefano; Ruspi, Laura; Galli, Federica; Pappalardo, Vincenzo; Di Rocco, Giuseppe; Martignoni, Francesco; Frattini, Francesco; Rovera, Francesca; Boni, Luigi; Dionigi, Gianlorenzo

    2016-01-01

    Seventh tumor-node-metastasis (TNM) classification for gastric cancer, published in 2010, introduced changes in all of its three parameters with the aim to increase its accuracy in prognostication. The aim of this review is to analyze the efficacy of these changes and their implication in clinical practice. We reviewed relevant Literature concerning staging systems in gastric cancer from 2010 up to March 2016. Adenocarcinoma of the esophago-gastric junction still remains a debated entity, due to its peculiar anatomical and histological situation: further improvement in its staging are required. Concerning distant metastases, positive peritoneal cytology has been adopted as a criterion to define metastatic disease: however, its search in clinical practice is still far from being routinely performed, as staging laparoscopy has not yet reached wide diffusion. Regarding definition of T and N: in the era of multimodal treatment these parameters should more influence both staging and surgery. The changes about T-staging suggested some modifications in clinical practice. Differently, many controversies on lymph node staging are still ongoing, with the proposal of alternative classification systems in order to minimize the extent of lymphadenectomy. The next TNM classification should take into account all of these aspects to improve its accuracy and the comparability of prognosis in patients from both Eastern and Western world. PMID:27678357

  15. Seventh tumor-node-metastasis staging of gastric cancer: Five-year follow-up

    PubMed Central

    Rausei, Stefano; Ruspi, Laura; Galli, Federica; Pappalardo, Vincenzo; Di Rocco, Giuseppe; Martignoni, Francesco; Frattini, Francesco; Rovera, Francesca; Boni, Luigi; Dionigi, Gianlorenzo

    2016-01-01

    Seventh tumor-node-metastasis (TNM) classification for gastric cancer, published in 2010, introduced changes in all of its three parameters with the aim to increase its accuracy in prognostication. The aim of this review is to analyze the efficacy of these changes and their implication in clinical practice. We reviewed relevant Literature concerning staging systems in gastric cancer from 2010 up to March 2016. Adenocarcinoma of the esophago-gastric junction still remains a debated entity, due to its peculiar anatomical and histological situation: further improvement in its staging are required. Concerning distant metastases, positive peritoneal cytology has been adopted as a criterion to define metastatic disease: however, its search in clinical practice is still far from being routinely performed, as staging laparoscopy has not yet reached wide diffusion. Regarding definition of T and N: in the era of multimodal treatment these parameters should more influence both staging and surgery. The changes about T-staging suggested some modifications in clinical practice. Differently, many controversies on lymph node staging are still ongoing, with the proposal of alternative classification systems in order to minimize the extent of lymphadenectomy. The next TNM classification should take into account all of these aspects to improve its accuracy and the comparability of prognosis in patients from both Eastern and Western world.

  16. Stage design

    DOEpatents

    Shacter, J.

    1975-12-01

    A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage.

  17. Fibre intake and incident colorectal cancer depending on fibre source, sex, tumour location and Tumour, Node, Metastasis stage.

    PubMed

    Vulcan, Alexandra; Brändstedt, Jenny; Manjer, Jonas; Jirström, Karin; Ohlsson, Bodil; Ericson, Ulrika

    2015-09-28

    Studies on fibre intake and incident colorectal cancer (CRC) indicate inverse associations. Differences by tumour stage have not been examined. We examined associations between fibre intake and its sources, and incidental CRC. Separate analyses were carried out on the basis of sex, tumour location and the Tumour, Node, Metastasis (TNM) classification. The Malmö Diet and Cancer Study is a population-based cohort study, including individuals aged 45-74 years. Dietary data were collected through a modified diet history method. The TNM classification was obtained from pathology/clinical records and re-evaluated. Among 27 931 individuals (60% women), we found 728 incident CRC cases during 428 924 person-years of follow-up. Fibre intake was inversely associated with CRC risk (P(trend) = 0.026). Concerning colon cancer, we observed borderline interaction between fibre intake and sex (P = 0.052) and significant protective association restricted to women (P(trend) = 0.013). Intake of fruits and berries was inversely associated with colon cancer in women (P(trend) = 0.022). We also observed significant interactions between intakes of fibre (P = 0.048) and vegetables (P = 0.039) and sex on rectal cancer, but no significant associations were seen between intake of fibre, or its sources, in either of the sexes. Except for inverse associations between intake of fibre-rich cereal products and N0- and M0-tumours, we did not observe significant associations with different TNM stages. Our findings suggest different associations between fibre intake and CRC depending on sex, tumour site and fibre source. High fibre intake, especially from fruits and berries, may, above all, prevent tumour development in the colon in women. No clear differences by TNM classification were detected. PMID:26281852

  18. Should All Nasopharyngeal Carcinoma with Paranasal Sinus Invasion Be Staged as T3 in the Intensity-Modulated Radiotherapy Era? A Study of 1811 Cases

    PubMed Central

    Zhang, Yuan; Peng, Hao; Guo, Rui; Li, Wen-Fei; Chen, Lei; Liu, Xu; Tang, Ling-Long; Liu, Li-Zhi; Li, Li; Liu, Qing; Sun, Ying; Ma, Jun

    2016-01-01

    Background: Currently, there is no uniform consensus regarding the appropriate staging for invasion of the paranasal sinuses in nasopharyngeal carcinoma (NPC). In the current AJCC staging system for NPC, paranasal sinus invasion is defined within the T3 classification. However, according to the Chinese 2008 staging system, which is also widely used in the regions where NPC is endemic in China, paranasal sinus invasion is classified as T4 disease. Methods: Patients (n = 1811) with non-metastatic, histologically-proven NPC treated with intensity-modulated radiotherapy (IMRT) were retrospectively analyzed. Results: Paranasal sinus invasion was identified in 289/1811 patients (16.0%). Multivariate analysis revealed ethmoid sinus invasion (HR, 2.889; 95% CI, 1.362-6.131; P = 0.006) and maxillary sinus invasion (HR, 3.110; 95% CI, 1.439-6.721; P = 0.004) were independent prognostic factors for local relapse-free survival (LRFS). T3 patients with ethmoid sinus or maxillary sinus invasion had similar 3-year LRFS (83.6% vs. 92.2%, P = 0.132) as T4 patients, and had poorer LRFS (83.6% vs. 98.3%, P = 0.006) than T3 patients with sphenoid sinus invasion alone. Also, T3 patients with sphenoid sinus invasion alone had similar 3-year LRFS (98.3 vs. 96.4%, P = 0.391) as T3 patients without paranasal sinus invasion, and a trend toward higher LRFS (98.3% vs. 92.2%, P = 0.065) than T4 patients. Conclusion: In patients underwent IMRT, tumors with ethmoid sinus or maxillary sinus invasion had a higher risk of local failure than those with sphenoid sinus invasion alone. Sphenoid sinus invasion alone should be classified as T3 disease and ethmoid sinus or maxillary sinus involvement as T4 disease in the current AJCC staging system for NPC. PMID:27390611

  19. Site-specific tumor grading system in colorectal cancer: multicenter pathologic review of the value of quantifying poorly differentiated clusters.

    PubMed

    Ueno, Hideki; Hase, Kazuo; Hashiguchi, Yojiro; Shimazaki, Hideyuki; Tanaka, Masafumi; Miyake, Ohki; Masaki, Tadahiko; Shimada, Yoshifumi; Kinugasa, Yusuke; Mori, Yoshiyuki; Kishimoto, Mitsuo; Kameoka, Shingo; Sato, Yu; Matsuda, Keiji; Nakadoi, Koichi; Shinto, Eiji; Nakamura, Takahiro; Sugihara, Kenichi

    2014-02-01

    The study aimed to determine the value of a novel site-specific grading system based on quantifying poorly differentiated clusters (PDC; Grade(PDC)) in colorectal cancer (CRC). A multicenter pathologic review involving 12 institutions was performed on 3243 CRC cases (stage I, 583; II, 1331; III, 1329). Cancer clusters of ≥5 cancer cells and lacking a gland-like structure (PDCs) were counted under a ×20 objective lens in a field containing the maximum clusters. Tumors with <5, 5 to 9, and ≥10 PDCs were classified as grades G1, G2, and G3, respectively. According to Grade(PDC), 1594, 1005, and 644 tumors were classified as G1, G2, and G3 and had 5-year recurrence-free survival rates of 91.6%, 75.4%, and 59.6%, respectively (P<0.0001). Multivariate analysis showed that Grade exerted an influence on prognostic outcome independently of TNM staging; approximately 20% and 46% of stage I and II patients, respectively, were selected by Grade(PDC) as a population whose survival estimate was comparable to or even worse than that of stage III patients. Grade(PDC) surpassed TNM staging in the ability to stratify patients by recurrence-free survival (Akaike information criterion, 2915.6 vs. 2994.0) and had a higher prognostic value than American Joint Committee on Cancer (AJCC) grading (Grade(AJCC)) at all stages. Regarding judgment reproducibility of grading tumors, weighted κ among the 12 institutions was 0.40 for Grade(AJCC) and 0.52 for Grade(PDC). Grade(PDC) has a robust prognostic power and promises to be of sufficient clinical value to merit implementation as a site-specific grading system in CRC.

  20. [Comparison of the Masaoka-Koga and The IASLC/ITMIG Proposal for The TNMStaging Systems Based on the Chinese Alliance for Research in Thymomas (ChART)
Retrospective Database].

    PubMed

    Liang, Guanghui; Gu, Zhitao; Li, Yin; Fu, Jianhua; Shen, Yi; Wei, Yucheng; Tan, Lijie; Zhang, Peng; Han, Yongtao; Chen, Chun; Zhang, Renquan; Chen, Ke-Neng; Chen, Hezhong; Liu, Yongyu; Cui, Youbing; Wang, Yun; Pang, Liewen; Yu, Zhentao; Zhou, Xinming; Liu, Yangchun; Liu, Yuan; Fang, Wentao

    2016-07-20

    背景与目的 使用中国胸腺协作组(Chinese Alliance for Research in Thymomas, ChART)回顾性数据,比较Masaoka-Koga分期系统和国际肺癌协会(International Association for the Study of Lung Cancer, IASLC)/国际胸腺肿瘤协作组(International Thymic Malignancies Interest Group, ITMIG)推荐的新TNM分期对胸腺肿瘤预后的预测作用。方法 我们回顾分析了1992年-2012年ChART数据库共2,370例患者。其中1,198例信息完整的患者被纳入研究,按照TNM及Masaoka-Koga分期系统进行分期,并进行生存分析。评估指标为R0患者的累积复发率(cumulative incidence of recurrence, CIR)以及患者总生存率(overall survival, OS)。对比分析Masaoka-Koga分期系统和新的TNM分期系统。结果 根据Masaoka-Koga分期系统,不同分期CIR差异具有统计学意义,其中I期和II期或者II期和III期之间累积复发率无差异,IV期的患者具有更高的复发率,预后最差。根据新的TNM分期系统,T1a患者的累积复发率低于其他患者(P<0.05),T1a患者总生存高于T1b患者(P=0.004),T4患者总生存率差于其它患者。N(+)患者累及复发率及总生存率差于N0患者。在M0患者与M1b患者之间总体累积复发率和总体生存率差异具有统计学意义,但在M0和M1b患者之间二者无差异。I期-IIIa期与IIIb 期-IVb期患者之间总生存率具有差异,然而IIIb期与IVb期患者之间总生存率无差异。结论 与Masaoka-Koga分期相比,IASLC/ITMIG TNM分期系统不仅描述了肿瘤侵犯的范围,也提供了有关淋巴结转移和肿瘤播散的情况。使用新的TNM分期系统进行前瞻性研究有助于更好的对胸腺肿瘤分组,预测预后,并指导治疗。.

  1. Third Stage

    NASA Video Gallery

    Once the third stage finishes its work, Kepler will have sufficient energy to leave the gravitational pull of Earth and go into orbit around the Sun, trailing behind Earth and slowly drifting away ...

  2. Cancer classification using the Immunoscore: a worldwide task force.

    PubMed

    Galon, Jérôme; Pagès, Franck; Marincola, Francesco M; Angell, Helen K; Thurin, Magdalena; Lugli, Alessandro; Zlobec, Inti; Berger, Anne; Bifulco, Carlo; Botti, Gerardo; Tatangelo, Fabiana; Britten, Cedrik M; Kreiter, Sebastian; Chouchane, Lotfi; Delrio, Paolo; Arndt, Hartmann; Asslaber, Martin; Maio, Michele; Masucci, Giuseppe V; Mihm, Martin; Vidal-Vanaclocha, Fernando; Allison, James P; Gnjatic, Sacha; Hakansson, Leif; Huber, Christoph; Singh-Jasuja, Harpreet; Ottensmeier, Christian; Zwierzina, Heinz; Laghi, Luigi; Grizzi, Fabio; Ohashi, Pamela S; Shaw, Patricia A; Clarke, Blaise A; Wouters, Bradly G; Kawakami, Yutaka; Hazama, Shoichi; Okuno, Kiyotaka; Wang, Ena; O'Donnell-Tormey, Jill; Lagorce, Christine; Pawelec, Graham; Nishimura, Michael I; Hawkins, Robert; Lapointe, Réjean; Lundqvist, Andreas; Khleif, Samir N; Ogino, Shuji; Gibbs, Peter; Waring, Paul; Sato, Noriyuki; Torigoe, Toshihiko; Itoh, Kyogo; Patel, Prabhu S; Shukla, Shilin N; Palmqvist, Richard; Nagtegaal, Iris D; Wang, Yili; D'Arrigo, Corrado; Kopetz, Scott; Sinicrope, Frank A; Trinchieri, Giorgio; Gajewski, Thomas F; Ascierto, Paolo A; Fox, Bernard A

    2012-10-03

    Prediction of clinical outcome in cancer is usually achieved by histopathological evaluation of tissue samples obtained during surgical resection of the primary tumor. Traditional tumor staging (AJCC/UICC-TNM classification) summarizes data on tumor burden (T), presence of cancer cells in draining and regional lymph nodes (N) and evidence for metastases (M). However, it is now recognized that clinical outcome can significantly vary among patients within the same stage. The current classification provides limited prognostic information, and does not predict response to therapy. Recent literature has alluded to the importance of the host immune system in controlling tumor progression. Thus, evidence supports the notion to include immunological biomarkers, implemented as a tool for the prediction of prognosis and response to therapy. Accumulating data, collected from large cohorts of human cancers, has demonstrated the impact of immune-classification, which has a prognostic value that may add to the significance of the AJCC/UICC TNM-classification. It is therefore imperative to begin to incorporate the 'Immunoscore' into traditional classification, thus providing an essential prognostic and potentially predictive tool. Introduction of this parameter as a biomarker to classify cancers, as part of routine diagnostic and prognostic assessment of tumors, will facilitate clinical decision-making including rational stratification of patient treatment. Equally, the inherent complexity of quantitative immunohistochemistry, in conjunction with protocol variation across laboratories, analysis of different immune cell types, inconsistent region selection criteria, and variable ways to quantify immune infiltration, all underline the urgent requirement to reach assay harmonization. In an effort to promote the Immunoscore in routine clinical settings, an international task force was initiated. This review represents a follow-up of the announcement of this initiative, and of the J

  3. Comparison of magnetic resonance imaging and computed tomography in the preoperative staging of rectal cancer.

    PubMed

    Guinet, C; Buy, J N; Ghossain, M A; Sézeur, A; Mallet, A; Bigot, J M; Vadrot, D; Ecoiffier, J

    1990-03-01

    Nineteen patients with middle and lower rectal carcinomas were operated on, with abdominoperineal resection in 10 patients, lower anterior resection with coloanal anastomosis in 6 patients, and colorectal anastomosis in 3 patients. The distance of the lower margin of the tumor to insertion of the levator ani on the rectal wall was correctly evaluated by computed tomography in 12 (63%) of 19 patients and by magnetic resonance imaging in 13 (68%) of 19 patients, while digital examination correctly assessed the distance in 15 (79%) of 19 patients. Computed tomography and magnetic resonance imaging were unable to assess extension through the rectal wall. No significant difference was observed between computed tomography and magnetic resonance imaging in assessing extension to the perivesical fat, adjacent organs, pelvic side wall, or lymph nodes. According to the TNM classification, magnetic resonance imaging correctly staged 74% (14/19) of carcinomas, while computed tomography correctly staged 68% (13/19).

  4. Differential oxidative status and immune characterization of the early and advanced stages of human breast cancer.

    PubMed

    Panis, C; Victorino, V J; Herrera, A C S A; Freitas, L F; De Rossi, T; Campos, F C; Simão, A N Colado; Barbosa, D S; Pinge-Filho, P; Cecchini, R; Cecchini, A L

    2012-06-01

    Breast cancer is the malignant neoplasia with the highest incidence in women worldwide. Chronic oxidative stress and inflammation have been indicated as major mediators during carcinogenesis and cancer progression. Human studies have not considered the complexity of tumor biology during the stages of cancer advance, limiting their clinical application. The purpose of this study was to characterize systemic oxidative stress and immune response parameters in early (ED; TNM I and II) and advanced disease (AD; TNM III and IV) of patients diagnosed with infiltrative ductal carcinoma breast cancer. Oxidative stress parameters were evaluated by plasmatic lipoperoxidation, carbonyl content, thiobarbituric reactive substances (TBARS), nitric oxide levels (NO), total radical antioxidant parameter (TRAP), superoxide dismutase, and catalase activities and GSH levels. Immune evaluation was determined by TNF-α, IL-1β, IL-12, and IL-10 levels and leukocytes oxidative burst evaluation by chemiluminescence. Tissue damage analysis included heart (total CK and CKMB), liver (AST, ALT, GGT), and renal (creatinine, urea, and uric acid) plasmatic markers. C-reactive protein (CRP) and iron metabolism were also evaluated. Analysis of the results verified different oxidative stress statuses occur at distinct cancer stages. ED was characterized by reduction in catalase, 8-isoprostanes, and GSH levels, with enhanced lipid peroxidation and TBARS levels. AD exhibited more pronounced oxidative status, with reduction in catalase activity and TRAP, intense lipid peroxidation and high levels of NO, TBARs, and carbonyl content. ED patients presented a Th2 immune pattern, while AD exhibited Th1 status. CRP levels and ferritin were increased in both stages of disease. Leukocytes burst impairment was observed in both the groups. Plasma iron levels were significantly elevated in AD. The data obtained indicated that oxidative stress enhancement and immune response impairment may be necessary to ensure

  5. Second Stage Separation

    NASA Video Gallery

    When the second stage burn is complete, the spacecraft and third stage are spun up to 55 rpm to stabilize the third stage during its short firing. The second stage is then jettisoned and the third ...

  6. [ADHERING TO MEDICAL STANDARTS, EVIDENCE-BASED STAGING IN GYNECOLOGICAL CANCER].

    PubMed

    Chakalova, G

    2016-01-01

    Among the key factors that influence the survival of patients is adherence to medical treatment standards. Indicators are assessing the degree of adherence to medical standards and represent the relative shares (%) of patients who fulfilled the relevant aspect of any subject. Data from the BNCR of 9842 cases of patients with malignant diseases of the female reproductive diagnosed in 2011-2013 in Bulgaria has been analyzed. Patients with tumors of the vulva were incorrectly staged in 15% to 30% of the cases, and those with vaginal tumors were incorrectly staged in 20% to 23% of cases. In patients with malignant tumors of the cervix incorrect staging was established in 19% to 47% of the cases. Patients with tumors of the uterus were incorrectly staged in 6% to 26% of the cases. Among the patients with ovarian tumors were incorrectly staged in 18% to 43%. Our results show that one in three patients with gynecological cancer in Bulgaria was incorrectly staged. We recommend using the current TNM and FIGO systems. PMID:27514165

  7. Single-Stage Minimally Invasive Surgery for Synchronous Primary Pulmonary Adenocarcinoma and Left Atrial Myxoma.

    PubMed

    van der Merwe, Johan; Beelen, Roel; Martens, Sebastiaan; Van Praet, Frank

    2015-12-01

    We report the first successful short-term outcome of single-stage combined video-assisted thoracoscopic surgery lobectomy and port access surgery in a patient with operable primary right lower lobe adenocarcinoma and a synchronous cardiac myxoma. The video-assisted thoracic surgery right lower lobectomy with systematic lymph node dissection was performed first, followed by myxoma excision by port access surgery through the same working port incision. The histopathologic analysis confirmed a pT2a N0 M0 R0 (TNM 7th edition) primary poorly differentiated pulmonary adenocarcinoma and a completely excised cardiac myxoma. Postoperative recovery was uneventful, and follow-up at 6 weeks confirmed an excellent surgical and oncologic outcome.

  8. Activation of the PI3K/AKT pathway correlates with prognosis in stage II colon cancer

    PubMed Central

    Malinowsky, K; Nitsche, U; Janssen, K-P; Bader, F G; Späth, C; Drecoll, E; Keller, G; Höfler, H; Slotta-Huspenina, J; Becker, K-F

    2014-01-01

    Background: Patients with UICC/AJCC stage II colon cancer have a high 5-year overall survival rate after surgery. Nevertheless, a significant subgroup of patients develops tumour recurrence. Currently, there are no clinically established biomarkers available to identify this patient group. We applied reverse-phase protein arrays (RPPA) for phosphatidylinositide-3-kinase pathway activation mapping to stratify patients according to their risk of tumour recurrence after surgery. Methods: Full-length proteins were extracted from formalin-fixed, paraffin-embedded tissue samples of 118 patients who underwent curative resection. RPPA technology was used to analyse expression and/or phosphorylation levels of six major factors of the phosphatidylinositide-3-kinase pathway. Oncogenic mutations of KRAS and BRAF, and DNA microsatellite status, currently discussed as prognostic markers, were analysed in parallel. Results: Expression of phospho-AKT (HR=3.52; P=0.032), S6RP (HR=6.3; P=0.044), and phospho-4E-BP1 (HR=4.12; P=0.011) were prognostic factors for disease-free survival. None of the molecular genetic alterations were significantly associated with prognosis. Conclusions: Our data indicate that activation of the PI3K/AKT pathway evidenced on the protein level might be a valuable prognostic marker to stratify patients for their risk of tumour recurrence. Beside adjuvant chemotherapy targeting of upregulated PI3K/AKT signalling may be an attractive strategy for treatment of high-risk patients. PMID:24619078

  9. Pancreatic Cancer Stage 3

    MedlinePlus

    ... historical Searches are case-insensitive Pancreatic Cancer Stage 3 Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Pancreatic Cancer Stage 3 Description: Stage III pancreatic cancer; drawing shows cancer ...

  10. MR staging of bladder carcinoma: correlation with pathologic findings.

    PubMed

    Buy, J N; Moss, A A; Guinet, C; Ghossain, M A; Malbec, L; Arrive, L; Vadrot, D

    1988-12-01

    Forty patients with bladder carcinoma were examined preoperatively by means of magnetic resonance (MR) imaging. In all patients, total cystectomy with enterocystoplasty and pelvic node dissection was performed. The surgical and pathologic findings were correlated with the MR findings. Extension through the deep muscle of the bladder wall was present in 20 of the 40 patients and was diagnosed with a sensitivity of 95% and a specificity of 95%. Extension to perivesical fat was present in 18 of 40 patients and was diagnosed with a sensitivity of 66% and a specificity of 100%. Invasion of the adjacent organs was present in nine of 40 patients and was diagnosed with a sensitivity of 44% and a specificity of 96%. On the basis of the MR findings, the tumor was correctly staged, according to the TNM classification, in 24 of 40 (60%) patients, tumor extension was overestimated in three of 40 (7.5%) patients, and tumor extension was underestimated in 13 of 40 (32.5%) patients. MR imaging has been shown to be accurate in identification of macroscopic lymph node involvement and deep muscle involvement. It appears to be at least as useful as computed tomography (CT) in the evaluation of perivesical fat involvement and to be superior to CT in the detection of invasion of adjacent organs. One limitation of MR imaging is in the evaluation of tumor extension into the periurethral glands.

  11. Single Nucleotide Polymorphisms as Prognostic and Predictive Factors of Adjuvant Chemotherapy in Colorectal Cancer of Stages I and II

    PubMed Central

    Horvat, Matej; Potočnik, Uroš; Repnik, Katja; Kavalar, Rajko; Štabuc, Borut

    2016-01-01

    Colorectal cancer (CRC) is a highly heterogeneous disease regarding the stage at time of diagnosis and there is special attention regarding adjuvant chemotherapy in unselected patients with stage I and stage II. The clinicohistologically based TNM staging system with emphasis on histological evaluation of primary tumor and resected regional lymph nodes remains the standard of staging, but it has restricted sensitivity resulting in false downward stage migration. Molecular characteristics might predispose tumors to a worse prognosis and identification of those enables identifying patients with high risk of disease recurrence. Suitable predictive markers also enable choosing the most appropriate therapy. The current challenge facing adjuvant chemotherapy in stages I and II CRC is choosing patients with the highest risk of disease recurrence who are going to derive most benefit without facing unnecessary adverse effects. Single nucleotide polymorphisms (SNPs) are one of the potential molecular markers that might help us identify patients with unfavorable prognostic factors regarding disease initiation and recurrence and could determine selection of an appropriate chemotherapy regimen in the adjuvant and metastatic setting. In this paper, we discuss SNPs of genes involved in the multistep processes of cancerogenesis, metastasis, and the metabolism of chemotherapy that might prove clinically significant. PMID:26884752

  12. Impact of FDG-PET/CT on Radiotherapy Volume Delineation in Non-Small-Cell Lung Cancer and Correlation of Imaging Stage With Pathologic Findings

    SciTech Connect

    Faria, Sergio L. Menard, Sonia; Devic, Slobodan; Sirois, Christian; Souhami, Luis; Lisbona, Robert; Freeman, Carolyn R.

    2008-03-15

    Purpose: Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is more accurate than CT in determining the extent of non-small-cell lung cancer. We performed a study to evaluate the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT without using any mathematical algorithm and to correlate the findings with the pathologic examination findings. Methods and Materials: A total of 32 patients with proven non-small-cell lung cancer, pathologic specimens from the mediastinum and lung primary, and pretreatment chest CT and FDG-PET/CT scans were studied. For each patient, two data sets of theoretical gross tumor volumes were contoured. One set was determined using the chest CT only, and the second, done separately, was based on the co-registered FDG-PET/CT data. The disease stage of each patient was determined using the TNM staging system for three data sets: the CT scan only, FDG-PET/CT scan, and pathologic findings. Results: Pathologic examination altered the CT-determined stage in 22 (69%) of 32 patients and the PET-determined stage in 16 (50%) of 32 patients. The most significant alterations were related to the N stage. PET altered the TNM stage in 15 (44%) of 32 patients compared with CT alone, but only 7 of these 15 alterations were confirmed by the pathologic findings. With respect to contouring the tumor volume for radiotherapy, PET altered the contour in 18 (56%) of 32 cases compared with CT alone. Conclusion: The contour of the tumor volume of non-small-cell lung cancer patients with co-registered FDG-PET/CT resulted in >50% alterations compared with CT targeting, findings similar to those of other publications. However, the significance of this change is unknown. Furthermore, pathologic examination showed that PET is not always accurate and histologic examination should be obtained to confirm the findings of PET whenever possible.

  13. Factors related to advanced stage oral squamous cell carcinoma in southern Thailand.

    PubMed

    Kerdpon, D; Sriplung, H

    2001-04-01

    A critical factor that indicates a poor prognosis of oral squamous cell carcinoma (OSCC) is advanced stage disease. This study, therefore, aimed to identify the factors related to advanced stage (TNM staging III, IV) OSCC in Thailand. There were 161 patients with squamous cell carcinoma of the oral cavity and lip (ICD-9 140, 141, 143-5), included in the study. Sixty-two per cent of the patients presented with advanced stage disease. Information on demographic characteristics, risk habits, health-seeking behaviour prior to health care professional (HCP) consultation, tumour characteristics and patient and professional delay was obtained by questionnaire-based interview of the patients. These variables were included as initial variables in a logistic regression to calculate the odds ratio (OR) of advanced versus early stage OSCC. Having traditional herbal medication before HCP consultation significantly increased the risk of advanced stage OSCC (OR 5.77; 95% C.I. 1.25-26.62). Floor of mouth location of tumour was associated with a lower risk of advanced stage disease (OR 0.27; 95% C.I. 0.09-0.82) as was having an ulcer (OR 0.43, 95% C.I. 0.02-0.89). The findings indicate that having traditional herbal medication before HCP consultation increased the risk of advanced stage disease. The lower risk of advanced stage OSCC associated with ulcerative tumours and those on the floor of the mouth may be due to their being more readily detected by the patients. PMID:11287274

  14. A clinical staging system and treatment guidelines for maxillary osteoradionecrosis in irradiated nasopharyngeal carcinoma patients

    SciTech Connect

    Cheng, S.-J.; Lee, J.-J.; Ting, L.-L.; Tseng, I.-Y.; Chang, H.-H.; Chen, H.-M.; Kuo, Y.-S.; Hahn, L.-J.; Kok, S.-H. . E-mail: kok@ha.mc.ntu.edu.tw

    2006-01-01

    Purpose: To develop a clinical staging system for maxillary osteoradionecrosis (ORN) in irradiated nasopharyngeal carcinoma (NPC) patients. Methods and Materials: The data of maxillary ORN cases among 1,758 irradiated NPC patients were analyzed. A staging system based on the degrees of bone exposure (E), infection (I), and bleeding (B) was developed. Correlations between various clinical parameters and stages of maxillary ORN and relationships between treatment modalities and outcomes at each stage were evaluated. Cumulative success of treatment and risk factors that affect treatment outcomes were analyzed. Results: The incidence of maxillary ORN was 2.7% (48/1,758). TNM stage of NPC (p < 0.001), radiation dose (p = 0.029), and tooth extraction (p < 0.001) appeared to have significant influences on disease severity. Success rates between conservative therapy and surgical treatment were not significantly different for Stage I ORN but differed significantly for Stage II (p = 0.013) and Stage III (p = 0.008) lesions. Grade 3 infection and bleeding significantly jeopardized treatment success (p = 0.043 and 0.015, respectively). The risk ratios of treatment failure for Grade 3 infection and bleeding were 2.523 (p = 0.034) and 3.141 (p = 0.027), respectively. Conclusions: More serious maxillary ORN tended to occur in cases with more advanced NPC, higher radiation dose, and history of tooth extraction. Surgical treatment was usually required in Stage II and III ORN. The grades of infection and bleeding are important factors in guidance of treatment and prediction of outcomes.

  15. Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities.

    PubMed

    Napier, Kyle J; Scheerer, Mary; Misra, Subhasis

    2014-05-15

    Esophageal cancer is a serious malignancy with regards to mortality and prognosis. It is a growing health concern that is expected to increase in incidence over the next 10 years. Squamous cell carcinoma is the most common histological type of esophageal cancer worldwide, with a higher incidence in developing nations. With the increased prevalence of gastroesophageal reflux disease and obesity in developed nations, the incidence of esophageal adenocarcinoma has dramatically increased in the past 40 years. Esophageal cancer is staged according to the widely accepted TNM system. Staging plays an integral part in guiding stage specific treatment protocols and has a great impact on overall survival. Common imaging modalities used in staging include computed tomography, endoscopic ultrasound and positron emission tomography scans. Current treatment options include multimodality therapy mainstays of current treatment include surgery, radiation and chemotherapy. Tumor markers of esophageal cancer are an advancing area of research that could potentially lead to earlier diagnosis as well as playing a part in assessing tumor response to therapy.

  16. Low Level of Microsatellite Instability Correlates with Poor Clinical Prognosis in Stage II Colorectal Cancer Patients

    PubMed Central

    Mojarad, Ehsan Nazemalhosseini; Kashfi, Seyed Mohammad Hossein; Mirtalebi, Hanieh; Taleghani, Mohammad Yaghoob; Azimzadeh, Pedram; Savabkar, Sanaz; Pourhoseingholi, Mohammad Amin; Jalaeikhoo, Hasan; Asadzadeh Aghdaei, Hamid; Kuppen, Peter J. K.; Zali, Mohammad Reza

    2016-01-01

    The influence of microsatellite instability (MSI) on the prognosis of colorectal cancer (CRC) requires more investigation. We assessed the role of MSI status in survival of individuals diagnosed with primary colorectal cancer. In this retrospective cross-sectional study the MSI status was determined in 158 formalin-fixed paraffin-embedded tumors and their matched normal tissues from patients who underwent curative surgery. Cox proportional hazard modeling was performed to assess the clinical prognostic significance. In this study we found that MSI-H tumors were predominantly located in the colon versus rectum (p = 0.03), associated with poorer differentiation (p = 0.003) and TNM stage II/III of tumors (p = 0.02). In CRC patients with stage II, MSI-L cases showed significantly poorer survival compared with patients who had MSI-H or MSS tumors (p = 0.04). This study indicates that MSI-L tumors correlate with poorer clinical outcome in patients with stage II tumors (p = 0.04) or in tumors located in the colon (p = 0.02). MSI-L characterizes a distinct subgroup of CRC patients who have a poorer outcome. This study suggests that MSI status in CRC, as a clinical prognostic marker, is dependent on other factors, such as tumor stage and location. PMID:27429617

  17. Development of a New Classification Method for Penile Squamous Cell Carcinoma Based on Lymph Node Density and Standard Pathological Risk Factors: The ND Staging System

    PubMed Central

    Li, Zai-Shang; Yao, Kai; Chen, Peng; Wang, Bin; Mi, Qi-Wu; Chen, Jie-Ping; Li, Yong-Hong; Deng, Chuang-Zhong; Liu, Zhuo-Wei; Qin, Zi-Ke; Zhou, Fang-Jian; Han, Hui

    2016-01-01

    Object: In this study, we evaluated the role of lymph node density (LND) and validated whether LND increases the accuracy of survival prediction when combined with the American Joint Committee on Cancer (AJCC) pathological node (N) staging system for penile cancer (7th edition). Methods: A total of 270 Chinese penile cancer patients treated between March 1999 and October 2014 were retrospectively analyzed. LND was analyzed as a trichotomous variable for the prediction of DSS in this cohort. We developed a new prediction model, which we refer to as the ND staging system, that is based on LND and pathological N staging. The predictive accuracy of this model was further assessed using the concordance index. Results: LND was correlated with the laterality of lymph node metastasis, extranodal extension, pelvic lymph node metastases, and pathologic tumor (T) and N stages (P<0.05). In separate multivariate Cox regression models, the LND (hazard ratio [HR], 1.966, 95% confidence interval [CI], (1.112-3.473, P=0.020) yielded independent effects on the outcome. According to the LND classification, the 3-year disease-specific survival (DSS) rates for patients with LNDs <7.0%, 7.0 to 16.9%, and ≥17.0% were 90.9%, 66.5%, and 22.2%, respectively (P<7.0%; 7.0%-16.9%=0.006; P7.0-16.9%; ≥17.0%=0.001). The corresponding rates were 95.7%, 76.7%, and 28.1% for the ND1, ND2, and ND3 patients, respectively (PND1-ND2=0.047; PND2-ND3<0.001). The indexes indicated that the accuracy of the pathological ND category that incorporated LND was significantly increased. Conclusion: LND was associated with some prognosticators and is thus a prognostic factor. The ND staging system that incorporates the LND better reflects the prognoses of penile cancer patients. PMID:26918038

  18. Lunar Module Ascent Stage

    NASA Technical Reports Server (NTRS)

    1969-01-01

    The Lunar Module 'Spider' ascent stage is photographed from the Command/Service Module on the fifth day of the Apollo 9 earth-orbital mission. The Lunar Module's descent stage had already been jettisoned.

  19. Stages of Adolescence

    MedlinePlus

    ... Español Text Size Email Print Share Stages of Adolescence Page Content Article Body Adolescence, these years from puberty to adulthood, may be roughly divided into three stages: early adolescence, generally ages eleven to fourteen; middle adolescence, ages ...

  20. Breast cancer staging

    MedlinePlus

    Doctors use 7 main stages to describe breast cancer. Stage 0, also called carcinoma in situ. This is cancer that is confined to the lobules or ducts in the breast. It has not spread to surrounding tissue. ...

  1. Ovarian Cancer Stage IV

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage IV Add to My Pictures View /Download : ... 1200x1335 View Download Large: 2400x2670 View Download Title: Ovarian Cancer Stage IV Description: Drawing of stage IV shows ...

  2. Ovarian Cancer Stage IIIC

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage IIIC Add to My Pictures View /Download : ... 1530x1350 View Download Large: 3060x2700 View Download Title: Ovarian Cancer Stage IIIC Description: Drawing of stage IIIC shows ...

  3. Ovarian Cancer Stage II

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage II Add to My Pictures View /Download : ... 1650x675 View Download Large: 3300x1350 View Download Title: Ovarian Cancer Stage II Description: Three-panel drawing of stage ...

  4. Ovarian Cancer Stage I

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage I Add to My Pictures View /Download : ... 1650x675 View Download Large: 3300x1350 View Download Title: Ovarian Cancer Stage I Description: Three-panel drawing of stage ...

  5. Beyond Erikson's Eight Stages.

    ERIC Educational Resources Information Center

    Whitney, Ruth

    1979-01-01

    Erik Erikson has described eight stages of the healthy personality. This essay offers a revised version of the eight stages. Although most individuals develop through the eight stages, each is personally unique because patterns of fluctuation between safety and growth differ from one individual to another. (Author)

  6. Second stage of labor.

    PubMed

    Cheng, Yvonne W; Caughey, Aaron B

    2015-06-01

    Current American College of Obstetricians and Gynecologists' definition of prolonged second stage diagnoses 10% to 14% of nulliparous and 3% to 3.5% of multiparous women as having a prolonged second stage. The progression of labor in modern obstetrics may have deviated from the current labor norms established in the 1950s, likely due to differences in obstetric population characteristics and variation in clinical practice. Optimal management of the second stage in women with and without epidural remains debatable. Although prolonged second stage is associated with increased risk of maternal morbidity, conflicting data exist regarding the duration of second stage and associated neonatal morbidity and mortality.

  7. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    ClinicalTrials.gov

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  8. Staged electrostatic precipitator

    DOEpatents

    Miller, Stanley J.; Almlie, Jay C.; Zhuang, Ye

    2016-03-01

    A device includes a chamber having an air inlet and an air outlet. The device includes a plurality of stages including at least a first stage adjacent a second stage. The plurality of stages are disposed in the chamber and each stage has a plurality of discharge electrodes disposed in an interior region and is bounded by an upstream baffle on an end proximate the air inlet and bounded by a downstream baffle on an end proximate the air outlet. Each stage has at least one sidewall between the upstream baffle and the downstream baffle. The sidewall is configured as a collection electrode and has a plurality of apertures disposed along a length between the upstream baffle and the downstream baffle. The upstream baffle of the first stage is positioned in staggered alignment relative to the upstream baffle of the second stage and the downstream baffle of the first stage are positioned in staggered alignment relative to the downstream baffle of the second stage.

  9. Two stage catalytic combustor

    NASA Technical Reports Server (NTRS)

    Alvin, Mary Anne (Inventor); Bachovchin, Dennis (Inventor); Smeltzer, Eugene E. (Inventor); Lippert, Thomas E. (Inventor); Bruck, Gerald J. (Inventor)

    2010-01-01

    A catalytic combustor (14) includes a first catalytic stage (30), a second catalytic stage (40), and an oxidation completion stage (49). The first catalytic stage receives an oxidizer (e.g., 20) and a fuel (26) and discharges a partially oxidized fuel/oxidizer mixture (36). The second catalytic stage receives the partially oxidized fuel/oxidizer mixture and further oxidizes the mixture. The second catalytic stage may include a passageway (47) for conducting a bypass portion (46) of the mixture past a catalyst (e.g., 41) disposed therein. The second catalytic stage may have an outlet temperature elevated sufficiently to complete oxidation of the mixture without using a separate ignition source. The oxidation completion stage is disposed downstream of the second catalytic stage and may recombine the bypass portion with a catalyst exposed portion (48) of the mixture and complete oxidation of the mixture. The second catalytic stage may also include a reticulated foam support (50), a honeycomb support, a tube support or a plate support.

  10. D-Dimer and Carcinoembryonic Antigen Levels: Useful Indicators for Predicting the Tumor Stage and Postoperative Survival.

    PubMed

    Tekeşin, Kemal; Bayrak, Savaş; Esatoğlu, Varol; Özdemir, Ebru; Özel, Leyla; Melih Kara, Veli

    2016-01-01

    The purpose of this prospective study is to determine the preoperative plasma D-dimer and serum Carcinoembryonic Antigen (CEA) levels of patients scheduled for curative surgical resection for colorectal cancer and to evaluate the significance of these levels on the prognosis and postoperative survival rate. One hundred sixty-five patients with colorectal cancer, who were scheduled to have elective resection between January 2008 and January 2011, were included in the study. A significant increase was observed in the D-dimer levels, particularly in poorly differentiated tumors. The distance covered by the tumor inside the walls of the colon and rectum (T-stage) was significant for both D-dimer and CEA levels. As the T-stage increased, there was also a significant increase in the D-dimer and CEA levels. A high significance and correlation level was detected between the TNM staging and both D-dimer and CEA. A significant relationship was found between the advanced tumor stage and short postoperative survival rate of patients with colorectal cancer. Therefore, the analysis of preoperative D-dimer and CEA levels can be useful in predicting the stage and differentiation of the tumor and the postoperative survival rate. PMID:27651789

  11. D-Dimer and Carcinoembryonic Antigen Levels: Useful Indicators for Predicting the Tumor Stage and Postoperative Survival

    PubMed Central

    Tekeşin, Kemal; Esatoğlu, Varol; Özdemir, Ebru; Özel, Leyla; Melih Kara, Veli

    2016-01-01

    The purpose of this prospective study is to determine the preoperative plasma D-dimer and serum Carcinoembryonic Antigen (CEA) levels of patients scheduled for curative surgical resection for colorectal cancer and to evaluate the significance of these levels on the prognosis and postoperative survival rate. One hundred sixty-five patients with colorectal cancer, who were scheduled to have elective resection between January 2008 and January 2011, were included in the study. A significant increase was observed in the D-dimer levels, particularly in poorly differentiated tumors. The distance covered by the tumor inside the walls of the colon and rectum (T-stage) was significant for both D-dimer and CEA levels. As the T-stage increased, there was also a significant increase in the D-dimer and CEA levels. A high significance and correlation level was detected between the TNM staging and both D-dimer and CEA. A significant relationship was found between the advanced tumor stage and short postoperative survival rate of patients with colorectal cancer. Therefore, the analysis of preoperative D-dimer and CEA levels can be useful in predicting the stage and differentiation of the tumor and the postoperative survival rate. PMID:27651789

  12. [Incidence of melanoma and changes in stage-specific incidence after implementation of skin cancer screening in Schleswig-Holstein].

    PubMed

    Eisemann, N; Waldmann, A; Katalinic, A

    2014-01-01

    A pilot project in skin cancer screening (SCREEN) was conducted in Schleswig-Holstein from July 2003 to June 2004. Although the impact of this screening on the stage-specific incidence of melanoma is of great importance for screening evaluation, it remains unknown. In theory, an effective skin cancer screening program should result in a medium-term incidence decrease of melanomas with a prognostically unfavorable stage. This is studied on a population-based level by using cancer registry data. Based on data from the Cancer Registry of Schleswig-Holstein for 1999-2009, stage-specific (T-category of the TNM-classification system) age-standardized incidence rates were calculated. After implementation of the SCREEN project, the incidence of prognostically favorable melanomas (in situ and T1) was higher than before, while the incidence of advanced melanomas (T2, T3, and for women also T4) decreased considerably. The classification of tumor stages changed during the project period, which may have contributed to an artificial decrease of the stages with a poor prognosis. Nevertheless, the results are in agreement with the observed decrease of melanoma mortality in the screening region.

  13. Staging Early Esophageal Cancer.

    PubMed

    Old, O J; Isabelle, M; Barr, H

    2016-01-01

    Staging esophageal cancer provides a standardized measure of the extent of disease that can be used to inform decisions about therapy and guide prognosis. For esophageal cancer, the treatment pathways vary greatly depending on stage of disease, and accurate staging is therefore crucial in ensuring the optimal therapy for each patient. For early esophageal cancer (T1 lesions), endoscopic resection can be curative and simultaneously gives accurate staging of depth of invasion. For tumors invading the submucosa or more advanced disease, comprehensive investigation is required to accurately stage the tumor and assess suitability for curative resection. A combined imaging approach of computed tomography (CT), positron emission tomography (PET), and endoscopic ultrasound (EUS) offers complementary diagnostic information and gives the greatest chance of accurate staging. Staging laparoscopy can identify peritoneal disease and small superficial liver lesions that could be missed on CT or PET, and alters management in up to 20 % of patients. Optical diagnostic techniques offer the prospect of further extending the possibilities of endoscopic staging in real time. Optical coherence tomography can image superficial lesions and could provide information on depth of invasion for these lesions. Real-time lymph node analysis using optical diagnostics such as Raman spectroscopy could be used to support immediate endoscopic therapy without waiting for results of cytology or further investigations. PMID:27573772

  14. AACE/ACE disease state clinical review: pancreatic neuroendocrine incidentalomas.

    PubMed

    Herrera, Miguel F; Åkerström, Göran; Angelos, Peter; Grant, Clive S; Hoff, Ana O; Pantoja, Juan Pablo; Pérez-Johnston, Rocio; Sahani, Dushyant V; Wong, Richard J; Randolph, Gregory

    2015-05-01

    Incidental detection of pancreatic neuroendocrine tumors (PNETs) has substantially increased over the last decade due to widespread use of advanced imaging studies. Reliable initial imaging-based characterization is crucial for the differential diagnosis from other exocrine neoplasms and to determine the appropriate management plan. Measurements of chromogranin A, pancreatic polypeptide, and calcitonin are recommended for the biochemical evaluation. A thorough medical history needs to be performed to rule out multiple endocrine neoplasia (MEN) type 1. The European Neuroendocrine Tumor Society (ENETS)/Tumor Node Metastasis (TNM) staging system together with a grading based on the Ki-67 proliferation index and mitotic counts has proven to give more appropriate prognostic information than the World Health Organization (WHO)/American Joint Committee on Cancer (AJCC) TNM staging but may still fail to safely differentiate benign from malignant lesions. Poorly differentiated PNETs generally present with metastases and are rarely amenable for resection. Well- or intermediately differentiated tumors ≥2 cm with imaging evidence of malignancy or with a Ki-67 >2% should be resected. It has been suggested that non-MEN related, nonfunctioning, and asymptomatic PNETs <2 cm with a Ki-67 index ≤2% carry a low risk of metastasis and may be observed in the absence of clinical or radiologic criteria of malignancy or progression, especially in older patients. However, because metastases may occur with long delay with smaller PNETS, physicians should consider patient age, lesion location, and the risks of operation, and patients not undergoing surgery need to be closely followed closely.

  15. Staging for vulvar cancer.

    PubMed

    Hacker, Neville F; Barlow, Ellen L

    2015-08-01

    Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system.

  16. [Contribution of MRI in the staging of cancer of the bladder. Apropos of 40 cases].

    PubMed

    Buy, J N; Ghossain, M; Guinet, C; Richard, F; Doucet, M; Bigot, J M; Vadrot, D; Laval-Jeantet, M; Ecoiffier, J

    1989-02-01

    56 patients with bladder carcinoma were examined by magnetic resonance in the pre-operative staging. In 40 patients where total cystectomy with enterocystoplasty and pelvic node dissection were performed, a good correlation with surgical and pathologic findings was obtained. MR examination using T1 (TR 400 ms, TE 28 ms) and T2 (TR 1,200-1,600 ms, TE 40 80 120 ms) weighted images in different planes where performed after biopsy of the bladder tumor through endoscopy and within 1 or 2 weeks before surgery. Neoplasms were characterized by site, size and growth pattern. Extension through the deep muscle of the bladder wall was correctly identified in 95% with a sensitivity of 95% and a specificity of 95%. Extension through perivesical fat was assessed accurately in 85% with a sensitivity of 66% and a specificity of 100%. Accuracy in evaluating invasion of adjacent organs was 85%, sensitivity 44%, specificity 96%. Lymphadenopathy has been accurately assessed in 97.5% with a sensitivity of 83% and a specificity of 100%. MR correctly staged the tumor according to TNM classification in 24/40 (60%) patients, overestimated the extension in 3/40 (7.5%) and underestimated the extension in 13/40 (32.5%).

  17. [Is there alternative to FOLFOX adjuvant chemotherapy for stage III colorectal cancer patients?].

    PubMed

    Esch, Anouk; Coriat, Romain; Perkins, Géraldine; Brezault, Catherine; Chaussade, Stanislas

    2012-01-01

    Being the second cancer for men and the third cancer for women in France, colorectal cancer represents a serious public health issue. Its incidence has increased these last years and despite new therapeutics being developed, it still has a bad prognostic. Thanks in part to Hemoccult national mass screening program, its diagnosis is made possible at an earlier stage, which makes a surgical curative resection and the carrying out of adjuvant chemotherapy possible. For stage III colic cancer that has been surgically removed, adjuvant chemotherapy by FOLFOX 4 has to be offered. Nevertheless, because of its toxicities, the patient's high age, important comorbidities or post-surgical complications, this chemotherapy occasionally cannot be done. What are the colorectal cancer prognostic factors which would guide the chemotherapy? TNM classification, number of examined lymph nodes, MSI status, and presence or not of a perforation or a perinervous, lymphatic or venous invasion is recognized prognostic factors. Also, what are the alternatives of FOLFOX 4 regimen as colorectal cancer adjuvant treatment?

  18. Staging Airliner Service

    NASA Technical Reports Server (NTRS)

    Hahn, Andrew S.

    2007-01-01

    There is a general consensus building that historically high fuel prices and greater public awareness of the emissions that result from burning fuel are going to be long-term concerns for those who design, build, and operate airliners. The possibility of saving both fuel and reducing emissions has rekindled interest in breaking very long-range airline flights into multiple stages or even adopting in-flight refueling. It is likely that staging will result in lower fuel burn, and recent published reports have suggested that the savings are substantial, particularly if the airliner is designed from the outset for this kind of operation. Given that staging runs against the design and operation historical trend, this result begs for further attention. This paper will examine the staging question, examining both analytic and numeric performance estimation methodologies to quantify the likely amount of fuel savings that can be expected and the resulting design impacts on the airliner.

  19. Understanding cancer staging

    MedlinePlus

    ... the body. The spread of cancer is called metastasis . Cancer staging is used to help describe the ... cancer has spread to nearby lymph nodes (N) Metastasis (M) , or if and how much the cancer ...

  20. Stages of Pregnancy

    MedlinePlus

    ... your baby in these three stages. First trimester (week 1-week 12) First trimester See how your baby is ... is each pregnancy. Return to top Second trimester (week 13-week 28) Second trimester See how your ...

  1. Cryogenic Propulsion Stage

    NASA Technical Reports Server (NTRS)

    Jones, David

    2011-01-01

    The CPS is an in-space cryogenic propulsive stage based largely on state of the practice design for launch vehicle upper stages. However, unlike conventional propulsive stages, it also contains power generation and thermal control systems to limit the loss of liquid hydrogen and oxygen due to boil-off during extended in-space storage. The CPS provides the necessary (Delta)V for rapid transfer of in-space elements to their destinations or staging points (i.e., E-M L1). The CPS is designed around a block upgrade strategy to provide maximum mission/architecture flexibility. Block 1 CPS: Short duration flight times (hours), passive cryo fluid management. Block 2 CPS: Long duration flight times (days/weeks/months), active and passive cryo fluid management.

  2. Stages of Pancreatic Cancer

    MedlinePlus

    ... cancer) cells form in the tissues of the pancreas. The pancreas is a gland about 6 inches ... spleen , and bile ducts . Tests that examine the pancreas are used to detect (find), diagnose, and stage ...

  3. Radar stage uncertainty

    USGS Publications Warehouse

    Fulford, J.M.; Davies, W.J.

    2005-01-01

    The U.S. Geological Survey is investigating the performance of radars used for stage (or water-level) measurement. This paper presents a comparison of estimated uncertainties and data for radar water-level measurements with float, bubbler, and wire weight water-level measurements. The radar sensor was also temperature-tested in a laboratory. The uncertainty estimates indicate that radar measurements are more accurate than uncorrected pressure sensors at higher water stages, but are less accurate than pressure sensors at low stages. Field data at two sites indicate that radar sensors may have a small negative bias. Comparison of field radar measurements with wire weight measurements found that the radar tends to measure slightly lower values as stage increases. Copyright ASCE 2005.

  4. Precision adjustable stage

    DOEpatents

    Cutburth, Ronald W.; Silva, Leonard L.

    1988-01-01

    An improved mounting stage of the type used for the detection of laser beams is disclosed. A stage center block is mounted on each of two opposite sides by a pair of spaced ball bearing tracks which provide stability as well as simplicity. The use of the spaced ball bearing pairs in conjunction with an adjustment screw which also provides support eliminates extraneous stabilization components and permits maximization of the area of the center block laser transmission hole.

  5. Multiple stage railgun

    DOEpatents

    Hawke, Ronald S.; Scudder, Jonathan K.; Aaland, Kristian

    1982-01-01

    A multiple stage magnetic railgun accelerator (10) for accelerating a projectile (15) by movement of a plasma arc (13) along the rails (11,12). The railgun (10) is divided into a plurality of successive rail stages (10a-n) which are sequentially energized by separate energy sources (14a-n) as the projectile (15) moves through the bore (17) of the railgun (10). Propagation of energy from an energized rail stage back towards the breech end (29) of the railgun (10) can be prevented by connection of the energy sources (14a-n) to the rails (11,12) through isolation diodes (34a-n). Propagation of energy from an energized rail stage back towards the breech end of the railgun can also be prevented by dividing the rails (11,12) into electrically isolated rail sections (11a-n, 12a-n). In such case means (55a-n) are used to extinguish the arc at the end of each energized stage and a fuse (31) or laser device (61) is used to initiate a new plasma arc in the next energized rail stage.

  6. Bioimpedance Spectroscopy in Detecting Lower-Extremity Lymphedema in Patients With Stage I, Stage II, Stage III, or Stage IV Vulvar Cancer Undergoing Surgery and Lymphadenectomy

    ClinicalTrials.gov

    2016-02-09

    Lymphedema; Perioperative/Postoperative Complications; Stage IA Vulvar Cancer; Stage IB Vulvar Cancer; Stage II Vulvar Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Vulvar Cancer; Stage IVB Vulvar Cancer

  7. Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2016-02-09

    Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  8. 2-Stage Classification Modeling

    1994-11-01

    CIRCUIT2.4 is used to design optimum two-stage classification configurations and operating conditions for energy conservation. It permits simulation of five basic grinding-classification circuits, including one single-stage and four two-stage classification arrangements. Hydrocyclones, spiral classifiers, and sieve band screens can be simulated, and the user may choose the combination of devices for the flowsheet simulation. In addition, the user may select from four classification modeling methods to achieve the goals of a simulation project using themore » most familiar concepts. Circuit performance is modeled based on classification parameters or equipment operating conditions. A modular approach was taken in designing the program, which allows future addition of other models with relatively minor changes.« less

  9. 2-Stage Classification Modeling

    SciTech Connect

    Baltich, L. K.

    1994-11-01

    CIRCUIT2.4 is used to design optimum two-stage classification configurations and operating conditions for energy conservation. It permits simulation of five basic grinding-classification circuits, including one single-stage and four two-stage classification arrangements. Hydrocyclones, spiral classifiers, and sieve band screens can be simulated, and the user may choose the combination of devices for the flowsheet simulation. In addition, the user may select from four classification modeling methods to achieve the goals of a simulation project using the most familiar concepts. Circuit performance is modeled based on classification parameters or equipment operating conditions. A modular approach was taken in designing the program, which allows future addition of other models with relatively minor changes.

  10. Stage cementing apparatus

    SciTech Connect

    Blamford, D.M.; Easter, J.H.

    1988-06-21

    A stage cementing apparatus for selectively passing cement from the interior passage of a casing to the annulus between the exterior of the casing and borehole, the casing having an upper portion and a lower portion, is described comprising: a barrel secured to the upper portion of the casing; a mandrel secured to the lower portion of the casing, and a stage cementing tool having a generally cylindrical configuration adapted for attachment to the lower end of the barrel about a portion of the mandrel.

  11. Staged fluidized bed

    DOEpatents

    Mallon, R.G.

    1983-05-13

    The invention relates to oil shale retorting and more particularly to staged fluidized bed oil shale retorting. Method and apparatus are disclosed for narrowing the distribution of residence times of any size particle and equalizing the residence times of large and small particles in fluidized beds. Particles are moved up one fluidized column and down a second fluidized column with the relative heights selected to equalize residence times of large and small particles. Additional pairs of columns are staged to narrow the distribution of residence times and provide complete processing of the material.

  12. Crescentic ramp turbine stage

    NASA Technical Reports Server (NTRS)

    Lee, Ching-Pang (Inventor); Tam, Anna (Inventor); Kirtley, Kevin Richard (Inventor); Lamson, Scott Henry (Inventor)

    2007-01-01

    A turbine stage includes a row of airfoils joined to corresponding platforms to define flow passages therebetween. Each airfoil includes opposite pressure and suction sides and extends in chord between opposite leading and trailing edges. Each platform includes a crescentic ramp increasing in height from the leading and trailing edges toward the midchord of the airfoil along the pressure side thereof.

  13. Pancreatic Cancer Stage 4

    MedlinePlus

    ... lung, liver, and peritoneal cavity. An inset shows cancer cells spreading from the pancreas, through the blood and lymph system, to another ... abdomen that contains the intestines, stomach, and liver). Cancer may also have spread to ... pancreas or to lymph nodes. Stage IV pancreatic cancer. ...

  14. Stage a Water Show

    ERIC Educational Resources Information Center

    Frasier, Debra

    2008-01-01

    In the author's book titled "The Incredible Water Show," the characters from "Miss Alaineus: A Vocabulary Disaster" used an ocean of information to stage an inventive performance about the water cycle. In this article, the author relates how she turned the story into hands-on science teaching for real-life fifth-grade students. The author also…

  15. STS upper stage operations

    NASA Technical Reports Server (NTRS)

    Kitchens, M. D.; Schnyer, A. D.

    1977-01-01

    Several design/development and operational approaches for STS upper stages are being pursued to realize maximum operational and economic benefits upon the introduction of the STS in the 1980s. The paper focuses special attention on safety operations, launch site operations and on-orbit operations.

  16. End-Stage.

    ERIC Educational Resources Information Center

    Moua, Mai Neng

    2001-01-01

    Through her reflections on dealing with dialysis for end-stage renal disease and awaiting a kidney transplant, the author presents insights into how her experience was shaped by the physical, emotional, and multicultural forces she faced. Among the issues discussed are her ambivalent feelings between pursuing a regular lifestyle and receiving…

  17. Thymidine phosphorylase and hypoxia-inducible factor 1-α expression in clinical stage II/III rectal cancer: association with response to neoadjuvant chemoradiation therapy and prognosis.

    PubMed

    Lin, Shuhan; Lai, Hao; Qin, Yuzhou; Chen, Jiansi; Lin, Yuan

    2015-01-01

    The aim of this study was to determine whether pretreatment status of thymidine phosphorylase (TP), and hypoxia-inducible factor alpha (HIF-1α) could predict pathologic response to neoadjuvant chemoradiation therapy with oxaliplatin and capecitabine (XELOXART) and outcomes for clinical stage II/III rectal cancer patients. A total of 180 patients diagnosed with clinical stage II/III rectal cancer received XELOXART. The status of TP, and HIF-1α were determined in pretreatment biopsies by immunohistochemistry (IHC). Tumor response was assessed in resected regimens using the tumor regression grade system and TNM staging system. 5-year disease free survival (DFS) and 5-year overall survival (OS) were evaluated with the Kaplan-Meier method and were compared by the log-rank test. Over expression of TP and low expression of HIF-1α were associated with pathologic response to XELOXART and better outcomes (DFS and OS) in clinical stage II/III rectal cancer patients (P < 0.05). Our result suggested that pretreatment status of TP and HIF-1α were found to predict pathologic response and outcomes in clinical stage II/III rectal cancer received XELOXART. Additional well-designed, large sample, multicenter, prospective studies are needed to confirm the result of this study.

  18. Cyclin D1 and Ki-67 expression correlates to tumor staging in tongue squamous cell carcinoma

    PubMed Central

    de Carli, Marina-Lara; Sperandio, Felipe-Fornias; Hanemann, João-Adolfo-Costa; Pereira, Alessandro-Antônio-Costa

    2015-01-01

    Background The immunohistochemical expression of Cyclin D1 and Ki-67 were analyzed in tongue squamous cell carcinomas (SCC), relating them to the clinical and morphological exhibition of these tumors. Material and Methods Twenty-nine patients fulfilled the inclusion criteria; clinical data included gender, age, ethnicity and use of licit drugs such as alcohol and tobacco. The TNM staging and histopathological differentiation grading was assessed for each case. In addition, T1 patients were gathered with T2 patients; and T3 patients were gathered with T4 patients to assemble two distinct groups: (T1/T2) and (T3/T4). Results The mean follow-up time was 24 months and 30% of the patients died as a consequence of the disease, while 23.3% lived with the disease and 46.7% lived lesion-free. T1 and T2 tumors showed statistically lesser Ki-67 and Cyclin D1 staining when compared to T3 and T4 tumors. Conclusions Ki-67 and Cyclin D1 pose as auxiliary tools when determining the progression of tongue SCC at the time of diagnosis. Key words:Carcinoma, squamous cell, cyclin D, immunohistochemistry, Ki-67 antigen, prognosis. PMID:26449430

  19. MICE Staging and Status

    NASA Astrophysics Data System (ADS)

    Hanlet, Pierrick

    2010-03-01

    Ionization cooling will be a key technique for a high-intensity Neutrino Factory or Muon Collider. The Muon Ionization Cooling Experiment (MICE) is a high-precision, staged accelerator experiment being performed at Rutherford Appleton Laboratory in the UK. Its goal is the first demonstration, with 0.1% resolution, of the feasibility of reducing the transverse emittance of a beam of muons by ionization cooling in low-Z absorbers. MICE is being staged in the following steps: I. Creating and characterizing a beam of muons; II. Measuring their emittance; III. Systematic comparison of successive measurements; IV. Inserting absorber; V. Reaccelerating longitudinally; and VI. Complete "10%-cooling" test. Step I is currently in progress with Step II to commence next year; completion of Step VI is anticipated in ˜2012.

  20. Saturn IB Second Stage (S-IVB Stage)

    NASA Technical Reports Server (NTRS)

    1968-01-01

    This cutaway drawing shows the S-IVB stage in its Saturn IB configuration. As a part of the Marshall Space Flight Center's (MSFC) 'building block' approach to the Saturn development, the S-IVB stage was utilized in the Saturn IB launch vehicle as a second stage and, later, the Saturn V launch vehicle as a third stage. The stage was powered by a single J-2 engine, initially capable of 200,000 pounds of thrust.

  1. Staged Event Architecture

    SciTech Connect

    Hoschek, Wolfgang; Berket, Karlo

    2005-05-30

    Sea is a framework for a Staged Event Architecture, designed around non-blocking asynchronous communication facilities that are decoupled from the threading model chosen by any given application, Components for P networking and in-memory communication are provided. The Sea Java library encapsulates these concepts. Sea is used to easily build efficient and flexible low-level network clients and servers, and in particular as a basic communication substrate for Peer-to-Peer applications.

  2. Staged depressurization system

    DOEpatents

    Schulz, T.L.

    1993-11-02

    A nuclear reactor having a reactor vessel disposed in a containment shell is depressurized in stages using depressurizer valves coupled in fluid communication with the coolant circuit. At least one sparger submerged in the in-containment refueling water storage tank which can be drained into the containment sump communicates between one or more of the valves and an inside of the containment shell. The depressurizer valves are opened in stages, preferably at progressively lower coolant levels and for opening progressively larger flowpaths to effect depressurization through a number of the valves in parallel. The valves can be associated with a pressurizer tank in the containment shell, coupled to a coolant outlet of the reactor. At least one depressurization valve stage openable at a lowest pressure is coupled directly between the coolant circuit and the containment shell. The reactor is disposed in the open sump in the containment shell, and a further valve couples the open sump to a conduit coupling the refueling water storage tank to the coolant circuit for adding water to the coolant circuit, whereby water in the containment shell can be added to the reactor from the open sump. 4 figures.

  3. Staged depressurization system

    DOEpatents

    Schulz, Terry L.

    1993-01-01

    A nuclear reactor having a reactor vessel disposed in a containment shell is depressurized in stages using depressurizer valves coupled in fluid communication with the coolant circuit. At least one sparger submerged in the in-containment refueling water storage tank which can be drained into the containment sump communicates between one or more of the valves and an inside of the containment shell. The depressurizer valves are opened in stages, preferably at progressively lower coolant levels and for opening progressively larger flowpaths to effect depressurization through a number of the valves in parallel. The valves can be associated with a pressurizer tank in the containment shell, coupled to a coolant outlet of the reactor. At least one depressurization valve stage openable at a lowest pressure is coupled directly between the coolant circuit and the containment shell. The reactor is disposed in the open sump in the containment shell, and a further valve couples the open sump to a conduit coupling the refueling water storage tank to the coolant circuit for adding water to the coolant circuit, whereby water in the containment shell can be added to the reactor from the open sump.

  4. Staged cascade fluidized bed combustor

    DOEpatents

    Cannon, Joseph N.; De Lucia, David E.; Jackson, William M.; Porter, James H.

    1984-01-01

    A fluid bed combustor comprising a plurality of fluidized bed stages interconnected by downcomers providing controlled solids transfer from stage to stage. Each stage is formed from a number of heat transfer tubes carried by a multiapertured web which passes fluidizing air to upper stages. The combustor cross section is tapered inwardly from the middle towards the top and bottom ends. Sorbent materials, as well as non-volatile solid fuels, are added to the top stages of the combustor, and volatile solid fuels are added at an intermediate stage.

  5. Dual stage check valve

    NASA Technical Reports Server (NTRS)

    Whitten, D. E. (Inventor)

    1973-01-01

    A dual stage seat valve head arrangement is described which consists of a primary sealing point located between a fixed orifice seat and a valve poppet, and a secondary sealing point between an orifice poppet and a valve poppet. Upstream of the valve orifice is a flexible, convoluted metal diaphragm attached to the orifice poppet. Downstream of the valve orifice, a finger spring exerts a force against the valve poppet, tending to keep the valve in a closed position. The series arrangement of a double seat and poppet is able to tolerate small particle contamination while minimizing chatter by controlling throttling or metering across the secondary seat, thus preserving the primary sealing surface.

  6. Nuclear Cryogenic Propulsion Stage

    NASA Technical Reports Server (NTRS)

    Houts, Michael G.; Borowski, S. K.; George, J. A.; Kim, T.; Emrich, W. J.; Hickman, R. R.; Broadway, J. W.; Gerrish, H. P.; Adams, R. B.

    2012-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced NEP.

  7. Chimpanzee sleep stages.

    NASA Technical Reports Server (NTRS)

    Freemon, F. R.; Mcnew, J. J.; Adey, W. R.

    1971-01-01

    The electroencephalogram and electro-oculogram of two unrestrained juvenile chimpanzees was monitored for 7 consecutive nights using telemetry methods. Of the sleeping time, 23% was spent in the rapid eye movement of REM type of sleep, whereas 8, 4, 15, and 10% were spent in non-REM stages 1 through 4, respectively. Seven to nine periods of REM sleep occurred per night. The average time from the beginning of one REM period to the beginning of the next was approximately 85 min.

  8. Two stages splicing system

    NASA Astrophysics Data System (ADS)

    Mudaber, Mohammad Hassan; Yusof, Yuhani

    2015-05-01

    The study of the biological process of deoxyribonucleic acid (DNA) splicing system in a translucent approach was investigated in 2012 by Yusof under the framework of formal language theory. In this work, the concepts of splicing system in two stages as well as splicing languages are mathematically and biologically discussed. Additionally, some theorems based on recognition site factor of initial strings at the existence of two initial strings and two rules are provided via Yusof-Goode (Y-G) approach. Besides, an example is also given in showing the biological meaning of the introduced concept.

  9. Feasibility and efficacy of helical intensity-modulated radiotherapy for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT

    PubMed Central

    He, Jian; Huang, Yan; Chen, Yixing; Shi, Shiming; Ye, Luxi; Hu, Yong; Zhang, Jianying

    2016-01-01

    Background The standard treatment for stage III non-small-cell lung cancer (NSCLC) is still 60 Gy in conventional fractions combined with concurrent chemotherapy; however, the resulting local controls are disappointing. The aim of this study was to compare and assess the feasibility and efficacy of hypofractionated chemoradiotherapy using helical tomotherapy (HT) with conventional fractionation as opposed to using three-dimensional conformal radiotherapy (3D-CRT) for stage III NSCLC. Methods Sixty-nine patients with stage III (AJCC 7th edition) NSCLC who underwent definitive radiation treatment at our institution between July 2011 and November 2013 were reviewed and analyzed retrospectively. A dose of 60 Gy in 20 fractions was delivered in the HT group (n=34), whereas 60 Gy in 30 fractions in the 3D-CRT group (n=35). Primary endpoints were toxicity, overall response rate, overall survival (OS) and progression-free survival (PFS). Results The median follow-up period was 26.4 months. V20 (P=0.005), V30 (P=0.001), V40 (P=0.004), mean lung dose (P=0.000) and max dose of spinal cord (P=0.005) were significantly lower in the HT group than in the 3D-CRT group. There was no significant difference in the incidences of acute radiation pneumonitis (RP) ≥ grade 2 between the two groups, whereas the incidences of acute radiation esophagitis ≥ grade 2 were significantly lower in the HT group than in the 3D-CRT group (P=0.027). Two-year overall response rate was significantly higher in the HT group than in the 3D-CRT group (P=0.015). One- and 2-year OS rates were significantly higher in the HT group (95.0% and 68.7%, respectively) than in the 3D-CRT group (85.5% and 47.6%, respectively; P=0.0236). One- and 2-year PFS rates were significantly higher in the HT group (57.8% and 26.3%, respectively) than in the 3D-CRT group (32.7% and 11.4%, respectively; P=0.0351). Univariate analysis indicated that performance status (PS), T stage and radiotherapy technique were significant

  10. Two-gene signature improves the discriminatory power of IASLC/ATS/ERS classification to predict the survival of patients with early-stage lung adenocarcinoma

    PubMed Central

    Sun, Yifeng; Hou, Likun; Yang, Yu; Xie, Huikang; Yang, Yang; Li, Zhigang; Zhao, Heng; Gao, Wen; Su, Bo

    2016-01-01

    Background In this study, we investigated the contribution of a gene expression–based signature (composed of BAG1, BRCA1, CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR) to survival prediction for early-stage lung adenocarcinoma categorized by the new International Association for the Study of Lung Cancer (IASLC)/the American Thoracic Society (ATS)/the European Respiratory Society (ERS) classification. We also aimed to verify whether gene signature improves the risk discrimination of IASLC/ATS/ERS classification in early-stage lung adenocarcinoma. Patients and methods Total RNA was extracted from 93 patients with pathologically confirmed TNM stage Ia and Ib lung adenocarcinoma. The mRNA expression levels of ten genes in the signature (BAG1, BRCA1, CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, and SH3BGR) were detected using real-time polymerase chain reaction. Each patient was categorized according to the new IASLC/ATS/ERS classification by accessing hematoxylin–eosin-stained slides. The corresponding Kaplan–Meier survival analysis by the log-rank statistic, multivariate Cox proportional hazards modeling, and c-index calculation were conducted using the programming language R (Version 2.15.1) with the “risksetROC” package. Results The multivariate analysis demonstrated that the risk factor of the ten-gene expression signature can significantly improve the discriminatory value of TNM staging in survival prediction, but not the value of the IASLC/ATS/ERS classification. Further analysis suggested that only BRCA1 and ERBB3 in the signature were independent risk factors after adjusting for the IASLC/ATS/ERS classification by Cox regression. A new algorithm of the two-gene expression signature containing BRCA1 and ERBB3 was generated. Adding the two-gene signature into the IASLC/ATS/ERS classification model further improved the discriminatory c-statistic from 0.728 to 0.756. Conclusion The two-gene signature composed of BRCA1 and ERBB3 was an independent

  11. Changes in Brain Function in Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer Who Are Receiving Chemotherapy

    ClinicalTrials.gov

    2016-10-26

    Cognitive Side Effects of Cancer Therapy; Malignant Ovarian Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Carcinosarcoma; Ovarian Choriocarcinoma; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Dysgerminoma; Ovarian Embryonal Carcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Germ Cell Tumor; Ovarian Mucinous Cystadenocarcinoma; Ovarian Polyembryoma; Ovarian Sarcoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Teratoma; Ovarian Yolk Sac Tumor; Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Cancer; Stage IC Ovarian Germ Cell Tumor; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

  12. Upper stage technology evaluation studies

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Studies to evaluate advanced technology relative to chemical upper stages and orbit-to-orbit stages are reported. The work described includes: development of LH2/LOX stage data, development of data to indicate stage sensitivity to engine tolerance, modified thermal routines to accommodate storable propellants, added stage geometries to computer program for monopropellant configurations, determination of the relative gain obtainable through improvement of stage mass fraction, future propulsion concepts, effect of ultrahigh chamber-pressure increases, and relative gains obtainable through improved mass fraction.

  13. Pancreatic Cancer Stage 2B

    MedlinePlus

    ... 2B Description: Stage IIB pancreatic cancer; drawing shows cancer in the pancreas and in nearby lymph nodes. Also shown are the bile duct, pancreatic duct, and duodenum. Stage IIB pancreatic cancer. Cancer has spread to nearby lymph nodes and ...

  14. Pancreatic Cancer Stage 2A

    MedlinePlus

    ... 2A Description: Stage IIA pancreatic cancer; drawing shows cancer in the pancreas and duodenum. The bile duct and pancreatic duct are also shown. Stage IIA pancreatic cancer. Cancer has spread to nearby tissue and organs ...

  15. Metabolomics provide new insights on lung cancer staging and discrimination from chronic obstructive pulmonary disease.

    PubMed

    Deja, Stanislaw; Porebska, Irena; Kowal, Aneta; Zabek, Adam; Barg, Wojciech; Pawelczyk, Konrad; Stanimirova, Ivana; Daszykowski, Michal; Korzeniewska, Anna; Jankowska, Renata; Mlynarz, Piotr

    2014-11-01

    Chronic obstructive pulmonary disease (COPD) and lung cancer are widespread lung diseases. Cigarette smoking is a high risk factor for both the diseases. COPD may increase the risk of developing lung cancer. Thus, it is crucial to be able to distinguish between these two pathological states, especially considering the early stages of lung cancer. Novel diagnostic and monitoring tools are required to properly determine lung cancer progression because this information directly impacts the type of the treatment prescribed. In this study, serum samples collected from 22 COPD and 77 lung cancer (TNM stages I, II, III, and IV) patients were analyzed. Then, a collection of NMR metabolic fingerprints was modeled using discriminant orthogonal partial least squares regression (OPLS-DA) and further interpreted by univariate statistics. The constructed discriminant models helped to successfully distinguish between the metabolic fingerprints of COPD and lung cancer patients (AUC training=0.972, AUC test=0.993), COPD and early lung cancer patients (AUC training=1.000, AUC test=1.000), and COPD and advanced lung cancer patients (AUC training=0.983, AUC test=1.000). Decreased acetate, citrate, and methanol levels together with the increased N-acetylated glycoproteins, leucine, lysine, mannose, choline, and lipid (CH3-(CH2)n-) levels were observed in all lung cancer patients compared with the COPD group. The evaluation of lung cancer progression was also successful using OPLS-DA (AUC training=0.811, AUC test=0.904). Based on the results, the following metabolite biomarkers may prove useful in distinguishing lung cancer states: isoleucine, acetoacetate, and creatine as well as the two NMR signals of N-acetylated glycoproteins and glycerol.

  16. A modified duodenal neuroendocrine tumor staging schema better defines the risk of lymph node metastasis and disease-free survival.

    PubMed

    Kachare, Swapnil D; Liner, Kendall R; Vohra, Nasreen A; Zervos, Emmanuel E; Fitzgerald, Timothy L

    2014-08-01

    Duodenal neuroendocrine tumors are rare but increasing in incidence and optimal management is hindered by lack of duodenum-specific staging. Duodenal carcinoids were identified in the Surveillance, Epidemiology and End Results tumor registry. Depth of invasion was defined as limited to lamina propria (LP), invading muscularis propria (MP), through muscularis propria (TMP), and through serosa (S). Nine hundred forty-nine patients were identified with majorities being male (57%), white (70%), and node-negative (87%). Tumor size (cm) was less than 1, 47 per cent; 1 to 2, 35 per cent; and greater than 2, 8 per cent with 76 per cent LP. Lymph node (LN) involvement was associated with age, depth of invasion (LP 4%, MP 28%, TMP 54%, and S 57%) and size (less than 1 cm, 3%; 1 to 2 cm, 13%; and greater than 2 cm, 40%). Using the current T staging, LN involvement was: T1 (LP) 2 per cent, T2 (MP or greater than 1 cm) 13 per cent, T3 (TMP) 54 per cent, and T4 (S) 57 per cent. We reclassified current T1 to T1a and current T2 stage to T1b (1 to 2 cm and LP) and T2 (MP or greater than 2 cm). LN metastasis for T1b tumors was 4.7 per cent compared with 20.8 per cent for T2. The resulting TNM classification better defines 5-year disease-specific survival. Our modified staging schema identifies a low-risk group (T1a and T1b) that may be considered for local therapy.

  17. Utility of peritoneal washing cytology in staging and prognosis of ovarian and fallopian tube neoplasms: a 10-year retrospective analysis.

    PubMed

    Davidson, Whitney; Madan, Rashna; O'Neil, Maura; Tawfik, Ossama W; Fan, Fang

    2016-06-01

    The prognostic significance of peritoneal washing cytology in gynecologic neoplasms is controversial. The presence of neoplastic cells in peritoneal washings is currently part of the Federation of Gynecology and Obstetrics and American Joint Committee on Cancer TNM staging systems in cases of ovarian and fallopian tube neoplasms without metastasis beyond the pelvis. In this study, we retrospectively reviewed all cases of ovarian and fallopian tube neoplasms in which cytologic studies were performed. The utility of cytology in tumor staging and the relationship between cytology results and patient outcome are studied. All cases of ovarian and fallopian tube neoplasms in our institution between July 2002 and July 2012 were reviewed. Primary tumor characteristics including type and pelvic extension were collected, categorized, and correlated with peritoneal washing cytology. Final tumor staging was reviewed and the impact of positive cytology was evaluated. A total of 120 cases of ovarian and fallopian tube neoplasms without extrapelvic metastasis were identified within the study period. Peritoneal washing cytology was positive in 24% (29/120) of neoplasms and upstaged the tumor 83% (24/29) of the time when positive. Overall, 20% (24/120) of reviewed cases were upstaged based on positive cytology results. Peritoneal washing cytology remains a useful staging tool for ovarian and fallopian tube neoplasms limited to the pelvic cavity. Positive cytology results in upstaging in a significant proportion of the cases regardless of the tumor type. A larger study is needed to analyze follow-up data to determine if upstaging based on positive cytology adversely affects outcome. PMID:27180061

  18. Time-to-Progression of NSCLC from Early to Advanced Stages: An Analysis of data from SEER Registry and a Single Institute

    PubMed Central

    Yuan, Ping; Cao, Jin Lin; Rustam, Azmat; Zhang, Chong; Yuan, Xiao Shuai; Bao, Fei Chao; Lv, Wang; Hu, Jian

    2016-01-01

    The average time required for cancers to progress through stages can be reflected in the average age of the patients diagnosed at each stage of disease. To estimate the time it takes for non-small-cell lung cancer (NSCLC) to progress through different tumor, node and metastasis (TNM) stages and sizes, we compared the mean adjusted age of 45904 NSCLC patients with different stages and tumor sizes from Surveillance, Epidemiology and End Results (SEER) cancer registry database and our institute. Multiple-linear-regression models for age were generated adjusting for various factors. Caucasian, African-American and Asian patients with stage IA cancers were on average 0.8, 1.0 and 1.38 adjusted years younger, respectively, than those with stage IIIB cancers (p < 0.001). And these with T1a cancers were on average 0.84, 0.92 and 1.21 adjusted years younger, respectively, than patients with T3 cancers (p < 0.001). Patients with tumors measuring larger than 8 cm in diameter were on average 0.85 adjusted years older than these with tumors smaller than 1 cm (p < 0.001), with Caucasian demonstrating the shortest age span (0.79 years, P < 0.001). In conclusion, the time-to-progression of NSCLC from early to advanced stages varied among ethnicities, Caucasian patients demonstrating a more rapid progression nature of tumor than their African-American and Asian counterparts. PMID:27346236

  19. Bevacizumab, Cisplatin, Radiation Therapy, and Fluorouracil in Treating Patients With Stage IIB, Stage III, Stage IVA, or Stage IVB Nasopharyngeal Cancer

    ClinicalTrials.gov

    2014-04-21

    Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage IV Lymphoepithelioma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx

  20. Oblimersen Sodium and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage I, Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

    ClinicalTrials.gov

    2012-10-11

    Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

  1. Melanoma staging: facts and controversies.

    PubMed

    Forschner, Andrea; Eigentler, Thomas Kurt; Pflugfelder, Annette; Leiter, Ulrike; Weide, Benjamin; Held, Laura; Meier, Friedegund; Garbe, Claus

    2010-01-01

    The value of staging examinations remains controversial for the initial staging in melanoma patients at the time of the primary diagnosis and for surveillance. Issues concerning tumor recurrences and progression must be discussed separately for different risk groups. For low-risk patients (stage IA; tumor thickness less than 1 mm), staging examinations like sentinel lymph node biopsy (SLNB), blood tests, or imaging can generally be abandoned. Baseline staging with simple techniques is at the discretion of the physician. In intermediate-risk patients (stages IB and IIA), an initial staging examination involving SLNB and computed tomography (CT) scans is recommended. Further follow-up may be restricted to physical examinations, blood tests of tumor marker protein S100beta, and to lymph node ultrasonography. If findings are suspicious, further imaging procedures may be involved. In high-risk patients (stages IIB to III), an initial staging examination with CT is recommended, and regular follow-up every 6 months with whole body imaging by CT or magnetic resonance imaging seems useful. Physical examinations, blood tests of tumor marker protein S100beta, and lymph node ultrasound imaging should be routine. This intense follow-up may enable surgical treatments with complete removal of all recognizable metastases in about 15% to 25% of patients and improve their prognosis. The risk of recurrence or tumor progression is very high in stage IV patients, and their management is individualized. PMID:20541679

  2. Staged membrane oxidation reactor system

    SciTech Connect

    Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

    2013-04-16

    Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

  3. Staged membrane oxidation reactor system

    SciTech Connect

    Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

    2014-05-20

    Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

  4. Staged membrane oxidation reactor system

    DOEpatents

    Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

    2012-09-11

    Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

  5. Staged Repository Development Programmes

    SciTech Connect

    Isaacs, T

    2003-10-01

    Programs to manage and ultimately dispose of high-level radioactive wastes are unique from scientific and technological as well as socio-political aspects. From a scientific and technological perspective, high-level radioactive wastes remain potentially hazardous for geological time periods-many millennia-and scientific and technological programs must be put in place that result in a system that provides high confidence that the wastes will be isolated from the accessible environment for these many thousands of years. Of course, ''proof'' in the classical sense is not possible at the outset, since the performance of the system can only be known with assurance, if ever, after the waste has been emplaced for those geological time periods. Adding to this challenge, many uncertainties exist in both the natural and engineered systems that are intended to isolate the wastes, and some of the uncertainties will remain regardless of the time and expense in attempting to characterize the system and assess its performance. What was perhaps underappreciated in the early days of waste management and repository program development were the unique and intense reactions that the institutional, political, and public bodies would have to repository program development, particularly in programs attempting to identify and then select sites for characterization, design, licensing, and ultimate development. Reactions in most nations were strong, focused, unrelenting, and often successful in hindering, derailing, and even stopping national repository programs. The reasons for such reactions and the measures to successfully respond to them are still evolving and continue to be the focus of many national program and political leaders. Adaptive Staging suggests an approach to repository program development that reflects the unique challenges associated with the disposal of high-level radioactive waste. The step-wise, incremental, learn-as-you-go approach is intended to maximize the

  6. Outcomes of Positron Emission Tomography-Staged Clinical N3 Breast Cancer Treated With Neoadjuvant Chemotherapy, Surgery, and Radiotherapy

    SciTech Connect

    Park, Hae Jin; Shin, Kyung Hwan; Cho, Kwan Ho; Park, In Hae; Lee, Keun Seok; Ro, Jungsil; Jung, So-Youn; Lee, Seeyoun; Kim, Seok Won; Kang, Han-Sung; Chie, Eui Kyu; Ha, Sung Whan

    2011-12-01

    Purpose: To evaluate the treatment outcome and efficacy of regional lymph node irradiation after neoadjuvant chemotherapy (NCT) and surgery in positron emission tomography (PET)-positive clinical N3 (cN3) breast cancer patients. Methods and Materials: A total of 55 patients with ipsilateral infraclavicular (ICL), internal mammary (IMN), or supraclavicular (SCL) lymph node involvement in the absence of distant metastases, as revealed by an initial PET scan, were retrospectively analyzed. The clinical nodal stage at diagnosis (2002 AJCC) was cN3a in 14 patients (26%), cN3b in 12 patients (22%), and cN3c in 29 patients (53%). All patients were treated with NCT, followed by mastectomy or breast-conserving surgery and subsequent radiotherapy (RT) with curative intent. Results: At the median follow-up of 38 months (range, 9-80 months), 20 patients (36%) had developed treatment failures, including distant metastases either alone or combined with locoregional recurrences that included one ipsilateral breast recurrence (IBR), six regional failures (RF), and one case of combined IBR and RF. Only 3 patients (5.5%) exhibited treatment failure at the initial PET-positive clinical N3 lymph node. The 5-year locoregional relapse-free survival, disease-free survival (DFS), and overall survival rates were 80%, 60%, and 79%, respectively. RT delivered to PET-positive IMN regions in cN3b patients and at higher doses ({>=}55 Gy) to SCL regions in cN3c patients was not associated with improved 5-year IMN/SCL relapse-free survival or DFS. Conclusion: NCT followed by surgery and RT, including the regional lymph nodes, resulted in excellent locoregional control for patients with PET-positive cN3 breast cancer. The primary treatment failure in this group was due to distant metastasis rather than RF. Neither higher-dose RT directed at PET-positive SCL nodes nor coverage of PET-positive IMN nodes was associated with additional gains in locoregional control or DFS.

  7. Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

    ClinicalTrials.gov

    2016-02-09

    Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

  8. Second stage gasifier in staged gasification and integrated process

    SciTech Connect

    Liu, Guohai; Vimalchand, Pannalal; Peng, Wan Wang

    2015-10-06

    A second stage gasification unit in a staged gasification integrated process flow scheme and operating methods are disclosed to gasify a wide range of low reactivity fuels. The inclusion of second stage gasification unit operating at high temperatures closer to ash fusion temperatures in the bed provides sufficient flexibility in unit configurations, operating conditions and methods to achieve an overall carbon conversion of over 95% for low reactivity materials such as bituminous and anthracite coals, petroleum residues and coke. The second stage gasification unit includes a stationary fluidized bed gasifier operating with a sufficiently turbulent bed of predefined inert bed material with lean char carbon content. The second stage gasifier fluidized bed is operated at relatively high temperatures up to 1400.degree. C. Steam and oxidant mixture can be injected to further increase the freeboard region operating temperature in the range of approximately from 50 to 100.degree. C. above the bed temperature.

  9. Multiple stage miniature stepping motor

    DOEpatents

    Niven, William A.; Shikany, S. David; Shira, Michael L.

    1981-01-01

    A stepping motor comprising a plurality of stages which may be selectively activated to effect stepping movement of the motor, and which are mounted along a common rotor shaft to achieve considerable reduction in motor size and minimum diameter, whereby sequential activation of the stages results in successive rotor steps with direction being determined by the particular activating sequence followed.

  10. A Model of Moral Stages

    ERIC Educational Resources Information Center

    Reed, Don Collins

    2008-01-01

    The argument of this paper focuses on the relationship between cognitive structures and structures of interaction. It contends that there is still a place in moral development theory and research for a concept of moral stages. The thesis, in short, is that moral stages are not structures of thought. They are structures of action encoded in…

  11. The Theatre Student: Stage Violence.

    ERIC Educational Resources Information Center

    Katz, Albert M.

    Stage violence is a complex art which, when conceived inventively, approached with professional care and respect, and practiced with patience and energy, can be the highlight of a scene or of an entire play. This book is designed for amateurs who have not had the benefit of formal training in stage violence. Chapters discuss falling (the…

  12. Stage fluctuations of Wisconsin lakes

    USGS Publications Warehouse

    House, Leo B.

    1985-01-01

    This report describes lake-stage fluctuations of 83 gaged lakes in Wisconsin and presents techniques for estimating stage fluctuation at ungaged lakes. Included are stage information at 83 lakes and stage-frequency data for 32 of these lakes that had sufficient record for analysis. Lakes are classified by a hydrologic-topographic lake classification scheme as ground-water flowthrough (GWF) lakes, surface-water drainage (SWD) lakes, and surface-water flow-through (SWF) lakes. Lakes within the same class were found to have similar water-level fluctuations. The lake-stage records indicate that most annual maximums occur during the months of May and June for all three classes. Annual minimum lake levels generally occur in September for surface-water drainage lakes, in March for surface-water flowthrough lakes, and in November for ground-water flow-through lakes. Data for each lake include location, period of water-level record, hydrologic classification, drainage area, surface area, lake volume, maximum depth, long-term mean stage and its standard deviation, maximum and minimum observed lake stage, and the average annual lake-stage fluctuation.

  13. Writing Stages: A Developmental Hierarchy.

    ERIC Educational Resources Information Center

    Milner, Joseph O.

    The developmental stages of writing can be related to Jean Piaget's final three stages of development (preoperational, concrete operational, and formal operational) and to the narrative, descriptive, explanative, analytical, and artistic rhetorical modes. As the child enters kindergarten or the first grade, narrative blooms. By this age most young…

  14. Multi-stage wax hydrocracking

    SciTech Connect

    Lipinski, J.J.; Nye, J.R.; Soudek, M.

    1991-02-19

    This patent describes improvement in a process for the shape selective catalytic dewaxing of a wax containing feed. It consists of at least one of atmospheric gas oil and vacuum gas oil by passing the feed with about 1000 to 5000 standard cubic feet per barrel of hydrogen over a dewaxing catalyst comprising a shape selective zeolite to produce a dewaxed product and wherein the hydrogen is added to retard catalyst aging. The improvement comprises conducting the dewaxing reaction in at least two states, with a first stage containing at least 20 wt. % of the dewaxing catalyst and in at least one second stage containing at least 20 wt. % of the dewaxing catalyst and adding at least a portion of the hydrogen downstream of the first stage reactor wherein the total hydrogen to the second stage is greater than the total hydrogen to the first stage.

  15. Subminiature infrared detector translation stage

    NASA Astrophysics Data System (ADS)

    Bell, Alan D.

    1989-11-01

    This paper describes a precision subminiature three-axis translation stage used in the GOES Sounder to provide positional adjustment of 12 cooled infrared detectors. Four separate translation stages and detectors are packaged into a detector mechanism which has an overall size of 0.850 x 1.230 x 0.600 inches. Each translation stage is capable of + or - 0.015 inch motion in the X and Y axes and +0.050/-0.025 inch motion in the Z axis with a sensitivity of 0.0002 inches. The function of the detector translation stage allows real time detector signal peaking during Sounder alignment. The translation stage operates in a cryogenic environment under a 10 to the -6th torr vacuum.

  16. Subminiature infrared detector translation stage

    NASA Technical Reports Server (NTRS)

    Bell, Alan D.

    1989-01-01

    This paper describes a precision subminiature three-axis translation stage used in the GOES Sounder to provide positional adjustment of 12 cooled infrared detectors. Four separate translation stages and detectors are packaged into a detector mechanism which has an overall size of 0.850 x 1.230 x 0.600 inches. Each translation stage is capable of + or - 0.015 inch motion in the X and Y axes and +0.050/-0.025 inch motion in the Z axis with a sensitivity of 0.0002 inches. The function of the detector translation stage allows real time detector signal peaking during Sounder alignment. The translation stage operates in a cryogenic environment under a 10 to the -6th torr vacuum.

  17. Stage measurement at gaging stations

    USGS Publications Warehouse

    Sauer, Vernon B.; Turnipseed, D. Phil

    2010-01-01

    Stream and reservoir stage are critical parameters in the computation of stream discharge and reservoir volume, respectively. In addition, a record of stream stage is useful in the design of structures that may be affected by stream elevation, as well as for the planning for various uses of flood plains. This report describes equipment and methodology for the observation, sensing, and recording of stage in streams and reservoirs. Although the U.S. Geological Survey (USGS) still uses the traditional, basic stilling-well float system as a predominant gaging station, modern electronic stage sensors and water-level recorders are now commonly used. Bubble gages coupled with nonsubmersible pressure transducers eliminate the need for stilling wells. Submersible pressure transducers have become common in use for the measurement of stage in both rivers and lakes. Furthermore, noncontact methods, such as radar, acoustic, and laser methods of sensing water levels, are being developed and tested, and in the case of radar, are commonly used for the measurement of stage. This report describes commonly used gaging-station structures, as well as the design and operation of gaging stations. Almost all of the equipment and instruments described in this report will meet the accuracy standard set by the USGS Office of Surface Water (OSW) for the measurement of stage for most applications, which is ?0.01 foot (ft) or 0.2 percent of the effective stage. Several telemetry systems are used to transmit stage data from the gaging station to the office, although satellite telemetry has become the standard. These telemetry systems provide near real-time stage data, as well as other information that alerts the hydrographer to extreme or abnormal events, and instrument malfunctions.

  18. Combined pulmonary and thoracic wall resection for stage III lung cancer.

    PubMed Central

    Shah, S. S.; Goldstraw, P.

    1995-01-01

    BACKGROUND--Carcinoma of the lung with thoracic wall involvement constitutes stage III disease. The management of patients with this condition is complicated. However, improvement in perioperative care coupled with advances in surgical technique have enabled a more aggressive approach to the problem to be adopted. METHODS--A retrospective review was carried out of 58 patients (40 men) of mean age 63 years who underwent thoracotomy for lung cancer with chest wall invasion between 1980 and 1993. RESULTS--Chest wall resection was performed in 55 patients (94.8%); in three patients the discovery of N2 disease at operation precluded resection. The TNM status was T3N0M0 in 38 patients, T3N1M0 in 13, and T3N2M0 in seven. Squamous cell carcinoma was the commonest cell type (26 patients). Reconstruction of the chest wall was performed in 29 patients (Marlex mesh in six, Marlex-methacrylate in 22, myocutaneous flap in one patient). The morbidity and mortality were 22.4% and 3.4% respectively. Follow up was complete in 51 patients. Nineteen (37.2%) survived > or = 5 years. The absolute five year survival for N0 and N1 disease was 44.7% and 38.4%, respectively. No patients with N2 disease survived five years. CONCLUSIONS--In patients with carcinoma of the lung and chest wall invasion, combined pulmonary and thoracic wall resection offers the prospect of cure with minimal morbidity and mortality. The prognosis of patients with coexistent N2 disease remains poor. PMID:7570416

  19. A Validated Prediction Model for Overall Survival From Stage III Non-Small Cell Lung Cancer: Toward Survival Prediction for Individual Patients

    SciTech Connect

    Oberije, Cary; De Ruysscher, Dirk; Houben, Ruud; Heuvel, Michel van de; Uyterlinde, Wilma; Deasy, Joseph O.; Belderbos, Jose; Dingemans, Anne-Marie C.; Rimner, Andreas; Din, Shaun; Lambin, Philippe

    2015-07-15

    Purpose: Although patients with stage III non-small cell lung cancer (NSCLC) are homogeneous according to the TNM staging system, they form a heterogeneous group, which is reflected in the survival outcome. The increasing amount of information for an individual patient and the growing number of treatment options facilitate personalized treatment, but they also complicate treatment decision making. Decision support systems (DSS), which provide individualized prognostic information, can overcome this but are currently lacking. A DSS for stage III NSCLC requires the development and integration of multiple models. The current study takes the first step in this process by developing and validating a model that can provide physicians with a survival probability for an individual NSCLC patient. Methods and Materials: Data from 548 patients with stage III NSCLC were available to enable the development of a prediction model, using stratified Cox regression. Variables were selected by using a bootstrap procedure. Performance of the model was expressed as the c statistic, assessed internally and on 2 external data sets (n=174 and n=130). Results: The final multivariate model, stratified for treatment, consisted of age, gender, World Health Organization performance status, overall treatment time, equivalent radiation dose, number of positive lymph node stations, and gross tumor volume. The bootstrapped c statistic was 0.62. The model could identify risk groups in external data sets. Nomograms were constructed to predict an individual patient's survival probability ( (www.predictcancer.org)). The data set can be downloaded at (https://www.cancerdata.org/10.1016/j.ijrobp.2015.02.048). Conclusions: The prediction model for overall survival of patients with stage III NSCLC highlights the importance of combining patient, clinical, and treatment variables. Nomograms were developed and validated. This tool could be used as a first building block for a decision support system.

  20. Cognitive Development and Group Stages.

    ERIC Educational Resources Information Center

    Saidla, Debie D.

    1990-01-01

    Attempts to integrate Perry's (1970) scheme of the cognitive development of college students with a model of group development adapted by Waldo (1985) based on Tuckman's (1965) formulation of developmental group stages. (Author)

  1. Evaluating the Stage Learning Hypothesis.

    ERIC Educational Resources Information Center

    Thomas, Hoben

    1980-01-01

    A procedure for evaluating the Genevan stage learning hypothesis is illustrated by analyzing Inhelder, Sinclair, and Bovet's guided learning experiments (in "Learning and the Development of Cognition." Cambridge: Harvard University Press, 1974). (Author/MP)

  2. Two stage to orbit design

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A preliminary design of a two-stage to orbit vehicle was conducted with the requirements to carry a 10,000 pound payload into a 300 mile low-earth orbit using an airbreathing first stage, and to take off and land unassisted on a 15,000 foot runway. The goal of the design analysis was to produce the most efficient vehicle in size and weight which could accomplish the mission requirements. Initial parametric analysis indicated that the weight of the orbiter and the transonic performance of the system were the two parameters that had the largest impact on the design. The resulting system uses a turbofan ramjet powered first stage to propel a scramjet and rocket powered orbiter to the stage point of Mach 6 to 6.5 at an altitude of 90,000 ft.

  3. Two stage liquefaction of coal

    DOEpatents

    Neuworth, Martin B.

    1981-01-01

    A two stage coal liquefaction process and apparatus comprising hydrogen donor solvent extracting, solvent deashing, and catalytic hydrocracking. Preferrably, the catalytic hydrocracking is performed in an ebullating bed hydrocracker.

  4. CK19 and Glypican 3 Expression Profiling in the Prognostic Indication for Patients with HCC after Surgical Resection

    PubMed Central

    Chang, Chun; Yu, Lu; Cao, Fang; Zhu, Guohua; Chen, Feng; Xia, Hui; Lv, Fudong; Zhang, Shijie; Sun, Lin

    2016-01-01

    This retrospective study was designed to investigate the correlation between a novel immunosubtyping method for hepatocellular carcinoma (HCC) and biological behavior of tumor cells. A series of 346 patients, who received hepatectomy at two surgical centers from January 2007 to October 2010, were enrolled in this study. The expressions of cytokeratin 19 (CK19), glypican 3 (GPC3), and CD34 were detected by immunohistochemical staining. The clinical stage was assessed using the sixth edition tumor–node–metastasis (TNM) system (UICC/AJCC, 2010).Vascular invasion comprised both microscopic and macroscopic invasion. The tumor size, lymph node involvement, and metastasis were determined by pathological as well as imaging studies. Recurrence was defined as the appearance of new lesions with radiological features typical of HCC, seen by at least two imaging methods. Survival curves for the patients were plotted using the Kaplan–Meier method, and differences between the curves were assessed using the log-rank test. Significant differences in morphology, histological grading, and TNM staging were observed between groups. Based on the immunohistochemical staining, the enrolled cases were divided into CK19+/GPC3+, CK19−/GPC3+ and CK19−/GPC3− three subtypes. CK19+/GPC3+ HCC has the highest risk of multifocality, microvascular invasion, regional lymph node involvement, and distant metastasis, followed by CK19−/GPC3+ HCC, then CK19−/GPC3−HCC. CK19+/GPC3+ HCC has the shortest recurrence time compared to other immunophenotype HCCs. CK19 and GPC3 expression profiling is an independent prognostic indicator in patients with HCC, and a larger sample size is needed to further investigate the effect of this immunosubtyping model in stratifying the outcome of HCC patients. PMID:26977595

  5. Staged regenerative sorption heat pump

    NASA Technical Reports Server (NTRS)

    Jones, Jack A. (Inventor)

    1995-01-01

    A regenerative adsorbent heat pump process and system for cooling and heating a space. A sorbent is confined in a plurality of compressors of which at least four are first stage and at least four are second stage. The first stage operates over a first pressure region and the second stage over a second pressure region which is higher than the first. Sorbate from the first stage enters the second stage. The sorbate loop includes a condenser, expansion valve, evaporator and the compressors. A single sorbate loop can be employed for single-temperature-control such as air conditioning and heating. Two sorbate loops can be used for two-temperature-control as in a refrigerator and freezer. The evaporator temperatures control the freezer and refrigerator temperatures. Alternatively the refrigerator temperature can be cooled by the freezer with one sorbate loop. A heat transfer fluid is circulated in a closed loop which includes a radiator and the compressors. Low temperature heat is exhausted by the radiator. High temperature heat is added to the heat transfer fluid entering the compressors which are desorbing vapor. Heat is transferred from compressors which are sorbing vapor to the heat transfer fluid, and from the heat transfer fluid to the compressors which are desorbing vapor. Each compressor is subjected to the following phases, heating to its highest temperature, cooling down from its highest temperature, cooling to its lowest temperature, and warming up from its lowest temperature. The phases are repeated to complete a cycle and regenerate heat.

  6. Crew Launch Vehicle Upper Stage

    NASA Technical Reports Server (NTRS)

    Davis, D. J.; Cook, J. R.

    2006-01-01

    The Agency s Crew Launch Vehicle (CLV) will be the first human rated space transportation system developed in the United States since the Space Shuttle. The CLV will utilize existing Shuttle heritage hardware and systems combined with a "clean sheet design" for the Upper Stage. The Upper Stage element will be designed and developed by a team of NASA engineers managed by the Marshall Space Flight Center (MSFC) in Huntsville, Alabama. The team will design the Upper Stage based on the Exploration Systems Architecture Study (ESAS) Team s point of departure conceptual design as illustrated in the figure below. This concept is a self-supporting cylindrical structure, approximately 1 15 feet long and 216 inches in diameter. While this "clean-sheet" upper stage design inherently carries more risk than utilizing a modified design, the approach also has many advantages. This paper will discuss the advantages and disadvantages of pursuing a "clean-sheet" design for the new CLV Upper Stage as well as describe in detail the overall design of the Upper Stage and its integration into NASA s CLV.

  7. Membrane bile acid receptor TGR5 predicts good prognosis in ampullary adenocarcinoma patients with hyperbilirubinemia

    PubMed Central

    Chen, Min-Chan; Chen, Yi-Ling; Wang, Tzu-Wen; Hsu, Hui-Ping; Lai, Ming-Derg

    2016-01-01

    Bile acids are potential carcinogens in gastrointestinal cancer, and interact with nuclear and membrane receptors to initiate downstream signaling. The effect of TGR5 [also known as G protein-coupled bile acid receptor 1 (GPBAR1)] on cancer progression is dependent on the tissue where it is activated. In this report, the function of TGR5 expression in cancer was studied using a bioinformatic approach. TGR5 expression in ampullary adenocarcinoma and normal duodenum was compared by western blotting, reverse transcription polymerase chain reaction, and immunohistochemistry (IHC). High GPBAR1 gene expression was found to be an indicator of worse prognosis in gastric and breast cancer patients, and an indication of better prognosis in ovarian cancer patients. The level of GPBAR1 gene expression was higher in bile-acid exposed cancer than in other types of cancer, and was increased in well-differentiated ampullary adenocarcinoma. Negative, weak or mild expression of TGR5 was correlated with younger age, higher plasma level of total/direct bilirubin, higher plasma concentration of CA-125, advanced tumor stage and advanced AJCC TNM stage. The disease-specific survival rate was highest in ampullary adenocarcinoma patients with high TGR5 expression and high total bilirubin level. In summary, TGR5 functions as a tumor-suppressor in patients with ampullary adenocarcinoma and preoperative hyperbilirubinemia. Further study of the suppressive mechanism may provide a new therapeutic option for patients with ampullary adenocarcinoma. PMID:27510297

  8. Membrane bile acid receptor TGR5 predicts good prognosis in ampullary adenocarcinoma patients with hyperbilirubinemia.

    PubMed

    Chen, Min-Chan; Chen, Yi-Ling; Wang, Tzu-Wen; Hsu, Hui-Ping; Lai, Ming-Derg

    2016-10-01

    Bile acids are potential carcinogens in gastrointestinal cancer, and interact with nuclear and membrane receptors to initiate downstream signaling. The effect of TGR5 [also known as G protein-coupled bile acid receptor 1 (GPBAR1)] on cancer progression is dependent on the tissue where it is activated. In this report, the function of TGR5 expression in cancer was studied using a bioinformatic approach. TGR5 expression in ampullary adenocarcinoma and normal duodenum was compared by western blotting, reverse transcription polymerase chain reaction, and immunohistochemistry (IHC). High GPBAR1 gene expression was found to be an indicator of worse prognosis in gastric and breast cancer patients, and an indication of better prognosis in ovarian cancer patients. The level of GPBAR1 gene expression was higher in bile‑acid exposed cancer than in other types of cancer, and was increased in well-differentiated ampullary adenocarcinoma. Negative, weak or mild expression of TGR5 was correlated with younger age, higher plasma level of total/direct bilirubin, higher plasma concentration of CA-125, advanced tumor stage and advanced AJCC TNM stage. The disease-specific survival rate was highest in ampullary adenocarcinoma patients with high TGR5 expression and high total bilirubin level. In summary, TGR5 functions as a tumor-suppressor in patients with ampullary adenocarcinoma and preoperative hyperbilirubinemia. Further study of the suppressive mechanism may provide a new therapeutic option for patients with ampullary adenocarcinoma. PMID:27510297

  9. Stereotactic Body Radiation Therapy for Early-Stage Non-Small-Cell Lung Cancer: The Pattern of Failure Is Distant

    SciTech Connect

    Bradley, Jeffrey D.; El Naqa, Issam; Drzymala, Robert E.; Trovo, Marco; Jones, Griffin; Denning, Mary Dee

    2010-07-15

    Background: Stereotactic body radiation therapy (SBRT) represents a substantial paradigm shift in the treatment of patients with medically inoperable Stage I/II non-small-cell lung cancer. We reviewed our experience using either three- or five-fraction SBRT for peripheral or central tumors, respectively. Methods and Materials: A total of 91 patients signed an institutional review board-approved consent form, were treated with SBRT, and have had {>=}6 months of follow-up. Patients were referred for SBRT because of underlying comorbidities (poor performance status in 31 or poor lung function in 52) or refusal of surgery (8 patients). Of the cancers, 83 were peripheral and eight were central. Peripheral cancers received a mean dose of 18 Gy x three fractions. Cancers within 2 cm of the bronchus, esophagus, or brachial plexus were treated with 9 Gy x five fractions. Results: The median follow-up duration for these patients was 18 months (range, 6-42 months). TNM staging was as follows: 58 patients with T1N0M0, 22 with T2N0M0, 2 with T3N0M0 (chest wall), and 6 with T1N0M1 cancers. The median tumor diameter was 2 cm (range, 1-5 cm). The median forced expiratory volume in 1 s was 46% (range, 17-133%) and the median carbon monoxide diffusing capacity (DLCO) was 49% (range, 15-144%). Two-year local tumor control was achieved in 86% of patients. The predominant pattern of failure was the development of distant metastasis or second lung cancer. The development of distant metastasis was the only significant prognostic factor for overall survival on multivariate analysis. Conclusions: Local tumor control was shown to be high using SBRT for non-small-cell lung cancer. Overall survival is highly coerrelated with the development of distant metastasis.

  10. Saturn IB First Stage (S-IB Stage) at MSFC

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Marshall Space Flight Center (MSFC) workers lower S-IB-200D, a dynamic test version of the Saturn IB launch vehicle's first stage (S-IB stage), into the Center's Dynamic Test Stand on January 12, 1965. Test Laboratory persornel assembled a complete Saturn IB to test the structural soundness of the launch vehicle. Developed by the MSFC as an interim vehicle in MSFC's 'building block' approach to Saturn rocket development, the Saturn IB utilized Saturn I technology to further develop and refine large boosters and the Apollo spacecraft capabilities required for the manned lunar missions.

  11. Saturn IB First Stage (S-IB Stage) at MSFC

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Workers at the Marshall Space Flight Center (MSFC) begin hoisting S-IB-200D, a dynamic test version of the Saturn IB launch vehicle's first stage (S-IB stage), into the Center's Dynamic Test Stand on January 11, 1965. Test Laboratory persornel assembled a complete Saturn IB to test the structural soundness of the launch vehicle. Developed by the MSFC as an interim vehicle in MSFC's 'building block' approach to Saturn rocket development, the Saturn IB utilized Saturn I technology to further develop and refine large boosters and the Apollo spacecraft capabilities required for the manned lunar missions.

  12. Two-Stage Centrifugal Fan

    NASA Technical Reports Server (NTRS)

    Converse, David

    2011-01-01

    Fan designs are often constrained by envelope, rotational speed, weight, and power. Aerodynamic performance and motor electrical performance are heavily influenced by rotational speed. The fan used in this work is at a practical limit for rotational speed due to motor performance characteristics, and there is no more space available in the packaging for a larger fan. The pressure rise requirements keep growing. The way to ordinarily accommodate a higher DP is to spin faster or grow the fan rotor diameter. The invention is to put two radially oriented stages on a single disk. Flow enters the first stage from the center; energy is imparted to the flow in the first stage blades, the flow is redirected some amount opposite to the direction of rotation in the fixed stators, and more energy is imparted to the flow in the second- stage blades. Without increasing either rotational speed or disk diameter, it is believed that as much as 50 percent more DP can be achieved with this design than with an ordinary, single-stage centrifugal design. This invention is useful primarily for fans having relatively low flow rates with relatively high pressure rise requirements.

  13. Three stages of medical dialogue.

    PubMed

    Abramovitch, H; Schwartz, E

    1996-06-01

    The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the "humanistic crisis" in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physician may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These "Three Stages of Medical Dialogue" include: 1. An Initial Personal Meeting stage, which initiates the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or "Healing Through Meeting" Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed.

  14. Stage Separation Performance Analysis Project

    NASA Technical Reports Server (NTRS)

    Chen, Yen-Sen; Zhang, Sijun; Liu, Jiwen; Wang, Ten-See

    2001-01-01

    Stage separation process is an important phenomenon in multi-stage launch vehicle operation. The transient flowfield coupled with the multi-body systems is a challenging problem in design analysis. The thermodynamics environment with burning propellants during the upper-stage engine start in the separation processes adds to the complexity of the-entire system. Understanding the underlying flow physics and vehicle dynamics during stage separation is required in designing a multi-stage launch vehicle with good flight performance. A computational fluid dynamics model with the capability to coupling transient multi-body dynamics systems will be a useful tool for simulating the effects of transient flowfield, plume/jet heating and vehicle dynamics. A computational model using generalize mesh system will be used as the basis of this development. The multi-body dynamics system will be solved, by integrating a system of six-degree-of-freedom equations of motion with high accuracy. Multi-body mesh system and their interactions will be modeled using parallel computing algorithms. Adaptive mesh refinement method will also be employed to enhance solution accuracy in the transient process.

  15. Outcome Study of Cobalt Based Stereotactic Body Radiation Therapy for Patients with Inoperable Stage III Non-small Cell Lung Cancer.

    PubMed

    Wang, Yingjie; Lan, Fengming; Kang, Xiaoli; Shao, Yinjian; Li, Hongqi; Li, Ping; Wu, Weizhang; Wang, Jidong; Chang, Dongshu; Wang, Yong; Xia, Tingyi

    2015-10-01

    Aim of this paper is to retrospectively evaluate the efficacy and toxicity of specialized Body Cobalt based system (BCBS) treatment in the senior patients group (.65 years) with Stage III non-small cell lung carcinoma (NSCLC). A total of 49 patients (41 males and 8 females) with Stage III NSCLC according to UICC TNM classification (6(th) edition) were treated using OUR-QGD™ BCBS which was designed and manufactured in China. Post treatment evaluation with follow-up information was collected from April 2001 to December 2006 in our department. Median age of enrolled patients was 71 years old (65-85). Among those patients, 36 patients were pathologically identified with squamous cell carcinoma, and the other 13 patients were confirmed as adenocarcinoma. All patients were immobilized by vacuum based immobilization mold and then performed slow CT scan without any respiration gating devices. The daily radiation prescription dose was defined at 50% isodose line covering primary lesions and metastatic lymph nodes with doses from 2.5 to 6 Gy in 5 fractions per week according to the tumor stage and internally approved treatment protocols by the Institutional Review Board (IRB). Median daily dose and total delivery dose of 50% isodose line were 4 Gy and 41 Gy, respectively. In this study group, total of 3 patients received neoadjuvant cisplatin-based chemotherapy. Tumor response evaluated 12 weeks after radiation has demonstrated 13 complete responses (26.5%), 21 partial responses (42.9%). The overall survival (OS) rate of 1-year, 2-year and 3-year was 63.3%, 40.8% and 20.4%, respectively. The median and mean survival time was 22 and 24 months. All 49 patients tolerated the treatment well and have completed the planned therapy regiment. Body Cobalt based system treatment of those over 65 years old patients with Stage III NSCLC had reasonable and superior curative effect as well as local control, and at the same time without severe radiation side effects.

  16. Drama for Classroom and Stage.

    ERIC Educational Resources Information Center

    Johnson, Albert and Bertha

    This book with a three-part format contains information which the would-be thespian needs to know for maximum enjoyment and success in stage activities. The first part, "Heritage," traces the history and development of the theater from primitive ritual through the drama of classical Greece and Rome, the Renaissance, and modern Europe and America,…

  17. Stage 2--Information Seeking Strategies

    ERIC Educational Resources Information Center

    Elsenberg, Michael B.

    2005-01-01

    A brief overview of one Big6 stage by Mike Eisenberg, followed by articles by two exemplary Big6 teachers, Barbara Jansen and Rob Darrow, offering practical uses of the Big6 in elementary and secondary situations is presented. The two-part nature of information seeking strategies that includes brainstorming and choosing is emphasized.

  18. The Beginning Stages of Reading.

    ERIC Educational Resources Information Center

    Wilkie, Fiona, Comp.

    Noting that in the beginning stages of reading it is helpful for children to be surrounded by the written word and to be read to by adults, this article offers brief encapsulations of and responses to five articles about beginning reading and reading readiness. The five articles are as follows: (1) "Three-Year-Olds in Their Reading Corner" by…

  19. Ares I Stage Separation Test

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, an Ares I x-test involves the upper stage separating from the first stage. This particular test was conducted at the NASA Langley Research Center in July 2007. (Highest resolution available)

  20. Multi-stage flash degaser

    DOEpatents

    Rapier, P.M.

    1980-06-26

    A multi-stage flash degaser is incorporated in an energy conversion system having a direct-contact, binary-fluid heat exchanger to remove essentially all of the noncondensable gases from geothermal brine ahead of the direct-contact binary-fluid heat exchanger in order that the heat exchanger and a turbine and condenser of the system can operate at optimal efficiency.

  1. All the World's a Stage

    ERIC Educational Resources Information Center

    Stanistreet, Paul

    2011-01-01

    Open Stages is Britain's biggest amateur theatre project, a hugely ambitious scheme to bring the professional and amateur theatre worlds together. It is a learning project but, as the Royal Shakespeare Company's Ian Wainwright tells this author, it is not only the amateurs who are learning. Wainwright states that the amateur and professional…

  2. Stage I: Development of VOICE.

    ERIC Educational Resources Information Center

    Echternacht, Gary J.; And Others

    The initial stages of test development of the Vocational and Occupational Interest Choice Examination (VOICE), developed for Air Force recruiters, are described. Reviewed are a number of relevant occupational interest inventories from which a pool of 400 items was drawn corresponding to eight career fields: general accounting, administration,…

  3. CRYOGENIC UPPER STAGE SYSTEM SAFETY

    NASA Technical Reports Server (NTRS)

    Smith, R. Kenneth; French, James V.; LaRue, Peter F.; Taylor, James L.; Pollard, Kathy (Technical Monitor)

    2005-01-01

    NASA s Exploration Initiative will require development of many new systems or systems of systems. One specific example is that safe, affordable, and reliable upper stage systems to place cargo and crew in stable low earth orbit are urgently required. In this paper, we examine the failure history of previous upper stages with liquid oxygen (LOX)/liquid hydrogen (LH2) propulsion systems. Launch data from 1964 until midyear 2005 are analyzed and presented. This data analysis covers upper stage systems from the Ariane, Centaur, H-IIA, Saturn, and Atlas in addition to other vehicles. Upper stage propulsion system elements have the highest impact on reliability. This paper discusses failure occurrence in all aspects of the operational phases (Le., initial burn, coast, restarts, and trends in failure rates over time). In an effort to understand the likelihood of future failures in flight, we present timelines of engine system failures relevant to initial flight histories. Some evidence suggests that propulsion system failures as a result of design problems occur shortly after initial development of the propulsion system; whereas failures because of manufacturing or assembly processing errors may occur during any phase of the system builds process, This paper also explores the detectability of historical failures. Observations from this review are used to ascertain the potential for increased upper stage reliability given investments in integrated system health management. Based on a clear understanding of the failure and success history of previous efforts by multiple space hardware development groups, the paper will investigate potential improvements that can be realized through application of system safety principles.

  4. Operation of staged membrane oxidation reactor systems

    DOEpatents

    Repasky, John Michael

    2012-10-16

    A method of operating a multi-stage ion transport membrane oxidation system. The method comprises providing a multi-stage ion transport membrane oxidation system with at least a first membrane oxidation stage and a second membrane oxidation stage, operating the ion transport membrane oxidation system at operating conditions including a characteristic temperature of the first membrane oxidation stage and a characteristic temperature of the second membrane oxidation stage; and controlling the production capacity and/or the product quality by changing the characteristic temperature of the first membrane oxidation stage and/or changing the characteristic temperature of the second membrane oxidation stage.

  5. Upper-Stage Flight Experiment

    NASA Technical Reports Server (NTRS)

    Anderson, W. E.; Boxwell, R.; Crockett, D. V.; Ross, R.; Lewis, T.; McNeal, C.; Verdarame, K.

    1999-01-01

    For propulsion applications that require that the propellants are storable for long periods, have a high density impulse, and are environmentally clean and non-toxic, the best choice is a combination of high-concentration hydrogen peroxide (High Test Peroxide, or HTP) and a liquid hydrocarbon (LHC) fuel. The HTP/LHC combination is suitable for low-cost launch vehicles, space taxi and space maneuvering vehicles, and kick stages. Orbital Sciences Corporation is under contract with the NASA Marshall Space Flight Center in cooperation with the Air Force Research Lab to design, develop and demonstrate a new low-cost liquid upper stage based on HTP and JP-8. The Upper Stage Flight Experiment (USFE) focuses on key technologies necessary to demonstrate the operation of an inherently simple propulsion system with an innovative, state-of-the-art structure. Two key low-cost vehicle elements will be demonstrated - a 10,000 lbf thrust engine and an integrated composite tank structure. The suborbital flight test of the USFE is scheduled for 2001. Preceding the flight tests are two major series of ground tests at NASA Stennis Space Center and a subscale tank development program to identify compatible composite materials and to verify their compatibility over long periods of time. The ground tests include a thrust chamber development test series and an integrated stage test. This paper summarizes the results from the first phase of the thrust chamber development tests and the results to date from the tank material compatibility tests. Engine and tank configurations that meet the goals of the program are described.

  6. Multi-stage flash degaser

    DOEpatents

    Rapier, Pascal M.

    1982-01-01

    A multi-stage flash degaser (18) is incorporated in an energy conversion system (10) having a direct-contact, binary-fluid heat exchanger to remove essentially all of the noncondensable gases from geothermal brine ahead of the direct-contact binary-fluid heat exchanger (22) in order that the heat exchanger (22) and a turbine (48) and condenser (32) of the system (10) can operate at optimal efficiency.

  7. Early stage of nanocrystal growth

    SciTech Connect

    2012-01-01

    Berkeley Lab researchers at the Molecular Foundry have elucidated important mechanisms behind oriented attachment, the phenomenon that drives biomineralization and the growth of nanocrystals. This electron microscopy movie shows the early stage of nanocrystal growth. Nanoparticles make transient contact at many points and orientations until their lattices are perfectly matched. The particles then make a sudden jump-to-contact to form attached aggregates. (Movie courtesy of Jim DeYoreo)

  8. Commercializing the transfer orbit stage

    NASA Technical Reports Server (NTRS)

    Miller, M. W.

    1984-01-01

    Key milestones necessary to establish the transfer orbit stage are examined. The selection of the project concept and synthesis of the company are described followed by an analysis venture capability support and the selection of a major aerospace company as prime contractor. A landmark agreement with NASA sanctioned the commercial TOS concept and provided the critical support necessary to raise the next round of venture capital. Project management and customer commitments are also discussed.

  9. Ares I Upper Stage Update

    NASA Technical Reports Server (NTRS)

    Davis, Daniel J.

    2010-01-01

    These presentation slides review the progress in the development of the Ares I upper stage. The development includes development of a manufacturing and processing assembly that will reduce the time required over 100 days, development of a weld tool that is a robotic tool that is the largest welder of its kind in the United States, development of avionics and software, and development of logisitics and operations systems.

  10. [A new WHO classification of prostate tumors].

    PubMed

    Frank, G A; Andreeva, Yu Yu; Moskvina, L V; Efremov, G D; Samoilova, S I

    2016-01-01

    The paper reviews the 2016 WHO classification of prostate tumors, notes the alterations made, and describes approaches to the diagnosis of cancer types and grades. It also gives original photomicrographs from the authors' collection. The main alterations were as follows: - The types of prostate adenocarcinoma were added by pleomorphic giant-cell carcinoma; oncocytic (8290/3) and lymphoepithelial (8082/3) carcinomas were excluded. - Grade III prostatic intraepithelial neoplasia (PIN) was substituted for high grade PIN (8148/2). - Intraductal carcinoma (8500/2) was added. - Basal cell adenoma (8147/0) was excluded. - Carcinoids were referred to as low-grade neuroendocrine tumors according to the current terminology; large cell neuroendocrine cancer (8013/3) was added. - Paraganglioma (8613/3) and neuroblastoma (9500/3) were excluded. Stromal tumors were grouped with mesenchymal neoplasms. -Malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, chondroma, and hemangiopericytoma were excluded. - Synovial sarcoma (9040/3), inflammatory myofibroblastic tumor (8825/1), osteosarcoma (9180/3), undifferentiated pleomorphic sarcoma (8802/3), solitary fibrous tumor (8815/1), and malignant solitary fibrous tumor (8815/3) were added. The section of lymphoproliferative diseases was extended. The tumors of unknown origin included paraganglioma and neuroblastoma from a group of neuroendocrine tumors. The TNM staging was completely consistent with the 2010 AJCC version. PMID:27600780

  11. Overexpression of Bmi-1 contributes to the invasion and metastasis of hepatocellular carcinoma by increasing the expression of matrix metalloproteinase (MMP)‑2, MMP-9 and vascular endothelial growth factor via the PTEN/PI3K/Akt pathway.

    PubMed

    Li, Xiaolei; Yang, Zhaoxu; Song, Wenjie; Zhou, Liang; Li, Qingjun; Tao, Kaishan; Zhou, Jingshi; Wang, Xing; Zheng, Zhigang; You, Nan; Dou, Kefeng; Li, Haimin

    2013-09-01

    Hepatocellular carcinoma (HCC) is one of the most common malignant tumours and it carries a poor prognosis due to a high rate of recurrence or metastasis after surgery. Bmi-1 plays a significant role in the growth and metastasis of many solid tumours. However, the exact mechanisms underlying Bmi-1-mediated cell invasion and metastasis, especially in HCC, are not yet known. In the present study, we sought to evaluate the expression of Bmi-1 in HCC samples and its relationship with clinicopathological characteristics and prognostic value, we also investigated related mechanisms underlying Bmi-1-mediated cell invasion in HCC. Our results showed that Bmi-1 is upregulated in HCC tissues compared to matched non-cancer liver tissues; and its expression is positively associated with tumour size, metastasis, venous invasion and AJCC TNM stage, respectively; multivariate analysis showed that high expression of Bmi-1 was an independent prognostic factor for overall survival. In addition, the shRNA-mediated inhibition of Bmi-1 reduced the invasiveness of two HCC cell lines in vitro by upregulating phosphatase and the tensin homolog deleted on chromosome 10 (PTEN) expression, inhibiting the phosphatidylinositol 3-kinase (PI3K)/Akt signalling pathway and downregulating the expression and activities of matrix metalloproteinase (MMP)-2 and MMP-9 and vascular endothelial growth factor (VEGF). These data demonstrate that Bmi-1 plays a vital role in HCC invasion and that Bmi-1 is a potential therapeutic target for HCC.

  12. Surgically Resected Gall Bladder: Is Histopathology Needed for All?

    PubMed

    Talreja, Vikash; Ali, Aun; Khawaja, Rabel; Rani, Kiran; Samnani, Sunil Sadruddin; Farid, Farah Naz

    2016-01-01

    Background. Laparoscopic cholecystectomy is considered to be gold standard for symptomatic gall stones. As a routine every specimen is sent for histopathological examination postoperatively. Incidentally finding gall bladder cancers in those specimens is around 0.5-1.1%. The aim of this study is to identify those preoperative and intraoperative factors in patients with incidental gall bladder cancer to reduce unnecessary work load on pathologist and cost of investigation particularly in a developing world. Methods. Retrospective records were analyzed from January 2005 to February 2015 in a surgical unit. Demographic data, preoperative imaging, peroperative findings, macroscopic appearance, and histopathological findings were noted. Gall bladder wall was considered to be thickened if ≥3 mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. AJCC TNM system was used to stage gall bladder cancer. Results. 973 patients underwent cholecystectomy for symptomatic gallstone disease. Gallbladder carcinoma was incidentally found in 11 cases. Macroscopic abnormalities of the gallbladder were found in all those 11 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. Conclusion. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy. PMID:27123469

  13. [A new WHO classification of prostate tumors].

    PubMed

    Frank, G A; Andreeva, Yu Yu; Moskvina, L V; Efremov, G D; Samoilova, S I

    2016-01-01

    The paper reviews the 2016 WHO classification of prostate tumors, notes the alterations made, and describes approaches to the diagnosis of cancer types and grades. It also gives original photomicrographs from the authors' collection. The main alterations were as follows: - The types of prostate adenocarcinoma were added by pleomorphic giant-cell carcinoma; oncocytic (8290/3) and lymphoepithelial (8082/3) carcinomas were excluded. - Grade III prostatic intraepithelial neoplasia (PIN) was substituted for high grade PIN (8148/2). - Intraductal carcinoma (8500/2) was added. - Basal cell adenoma (8147/0) was excluded. - Carcinoids were referred to as low-grade neuroendocrine tumors according to the current terminology; large cell neuroendocrine cancer (8013/3) was added. - Paraganglioma (8613/3) and neuroblastoma (9500/3) were excluded. Stromal tumors were grouped with mesenchymal neoplasms. -Malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, chondroma, and hemangiopericytoma were excluded. - Synovial sarcoma (9040/3), inflammatory myofibroblastic tumor (8825/1), osteosarcoma (9180/3), undifferentiated pleomorphic sarcoma (8802/3), solitary fibrous tumor (8815/1), and malignant solitary fibrous tumor (8815/3) were added. The section of lymphoproliferative diseases was extended. The tumors of unknown origin included paraganglioma and neuroblastoma from a group of neuroendocrine tumors. The TNM staging was completely consistent with the 2010 AJCC version.

  14. The Prognostic Yield of Biomarkers Harvested in Chemotherapy-Naive Stage II Colon Cancer: Can We Separate the Wheat from the Chaff?

    PubMed Central

    Watson, Martin M; Søreide, Kjetil

    2016-01-01

    The tumor-node-metastasis (TNM) system fails to accurately predict disease recurrence in a considerable number of patients. Although node-negative (stage II) colon cancer is considered to have an overall good prognosis, the 5-year cancer-specific survival is reported at 81–83% in patients who did not have adjuvant chemotherapy. Thus, reliance on node status alone has led to undertreatment in a subgroup of stage II patients with an unfavorable prognosis. The search for new and better prognosticators in stage II colon cancer has suggested several proposed biomarkers of better prognostication and prediction. However, few such biomarkers have reached widespread clinical utility. For the clinician swimming in the sea of emerging biomarkers, it may be hard to recognize the true floating aid from the surrounding debris in the search for more precise decision-making. Proposed markers include microsatellite instability (MSI) and KRAS and BRAF mutations, but a number of gene panels and consensus molecular subtypes are proposed for clinical prediction and prognostication as well. Although several studies suggest such biomarkers or panels to have a prognostic role in subgroups of patients, a number of studies are reported in heterogeneous groups with in part discordant findings, which again distorts the predictive and prognostic ability of each marker. Lack of homogeneous cohorts, underpowered studies in strict subgroups and challenges in analytical and clinical validity may hamper the progress toward widespread clinical utility. The harvest of prognostic biomarkers in colon cancer has yielded a huge number of candidates for which it is now time to separate the wheat from the chaff. PMID:27262159

  15. Reflexive Learning: Stages towards Wisdom with Dreyfus

    ERIC Educational Resources Information Center

    McPherson, Ian

    2005-01-01

    The Dreyfus (2001) account of seven stages of learning is considered in the context of the Dreyfus (1980s) account of five stages of skill development. The two new stages, Mastery and Practical Wisdom, make more explicit certain themes implicit in the five-stage account. In this way Dreyfus (2001) encourages a more reflexive approach. The themes…

  16. Saturn IB First Stage (S-IB Stage) at MSFC

    NASA Technical Reports Server (NTRS)

    1965-01-01

    S-IB-200D, a dynamic test version of the Saturn IB launch vehicle's first stage (S-IB), makes its way to the Marshall Space Flight Center (MSFC) East Test Area on January 4, 1965. Test Laboratory persornel assembled a complete Saturn IB to test the structural soundness of the launch vehicle in the Dynamic Test Stand. Developed by the MSFC as an interim vehicle in MSFC's 'building block' approach to the Saturn rocket development, the Saturn IB utilized Saturn I technology to further develop and refine the larger boosters and the Apollo spacecraft capabilities required for the manned lunar missions.

  17. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2006-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts a manufactured aluminum panel, that will fabricate the Ares I upper stage barrel, undergoing a confidence panel test. In this test, bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  18. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image, depicts a manufactured aluminum panel, that will be used to fabricate the Ares I upper stage barrel, undergoing a confidence panel test. In this test, the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  19. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts a manufactured aluminum panel that will be used to fabricate the Ares I upper stage barrel, undergoing a confidence panel test. In this test, the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California.

  20. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, processes for upper stage barrel fabrication are talking place. The aluminum panels are manufacturing process demonstration articles that will undergo testing until perfected. The panels are built by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  1. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2006-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts a manufactured aluminum panel that will be used to fabricate the Ares I upper stage barrel, undergoing a confidence panel test. In this test, the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  2. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2006-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, processes for upper stage barrel fabrication are talking place. The aluminum panels are manufacturing process demonstration articles that will undergo testing until perfected. The panels are built by AMRO Manufacturing located in El Monte, California. (Highest resolution Available)

  3. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts confidence testing of a manufactured aluminum panel that will fabricate the Ares I upper stage barrel. In this test, bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  4. ARES I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, processes for upper stage barrel fabrication are talking place. Aluminum panels are manufacturing process demonstration articles that will undergo testing until perfected. The panels are built by AMRO Manufacturing located in El Monte, California. (Largest resolution available)

  5. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts a manufactured panel that will be used for the Ares I upper stage barrel fabrication. The aluminum panels are manufacturing process demonstration articles that will undergo testing until perfected. The panels are built by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  6. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts a manufactured aluminum panel, that will fabricate the Ares I upper stage barrel, undergoing a confidence panel test. In this test, the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  7. Stages of change or changes of stage? Predicting transitions in transtheoretical model stages in relation to healthy food choice.

    PubMed

    Armitage, Christopher J; Sheeran, Paschal; Conner, Mark; Arden, Madelynne A

    2004-06-01

    Relatively little research has examined factors that account for transitions between transtheoretical model (TTM) stages of change. The present study (N = 787) used sociodemographic, TTM, and theory of planned behavior (TPB) variables, as well as theory-driven interventions to predict changes in stage. Longitudinal analyses revealed that sociodemographic, TPB, and 1 of the interventions predicted transitions between most stages of change. In fact, only progression from the preparation stage was not predictable. However, given that this change of stage marks the transition between cognition and actual behavior, the identification of variables that bridge this gap is crucial for the development of interventions to promote stage transitions. PMID:15279532

  8. Morphogenesis of early stage melanoma

    NASA Astrophysics Data System (ADS)

    Chatelain, Clément; Amar, Martine Ben

    2015-08-01

    Melanoma early detection is possible by simple skin examination and can insure a high survival probability when successful. However it requires efficient methods for identifying malignant lesions from common moles. This paper provides an overview first of the biological and physical mechanisms controlling melanoma early evolution, and then of the clinical tools available today for detecting melanoma in vivo at an early stage. It highlights the lack of diagnosis methods rationally linking macroscopic observables to the microscopic properties of the tissue, which define the malignancy of the tumor. The possible inputs of multiscale models for improving these methods are shortly discussed.

  9. Single-stage Mars mission

    NASA Technical Reports Server (NTRS)

    1991-01-01

    President Bush established a three phase Space Exploration Initiative for the future of space exploration. The first phase is the design and construction of Space Station Freedom. The second phase is permanent lunar base. The last phase of the Initiative is the construction of a Mars outpost. The design presented is the concept of a single-stage Mars mission developed by the University of Minnesota Aerospace Design Course. The mission will last approximately 500 days including a 30-60 day stay on Mars.

  10. [Initial stages of steel biocorrosion].

    PubMed

    Zhigletsova, S K; Rodin, V B; Kobelev, V S; Aleksandrova, N V; Rasulova, G E; Kholodenko, V P

    2000-01-01

    Initial stages of corrosion of mild steel induced by Klebsiela rhinoscleromatis BO2 were studied in various media. The effect of the microorganism was detected 8-10 h after inoculation. The number of viable cells were virtually unchanged within one month in all media, but the corrosive activity of the strain decreased. The corrosive activity of microorganisms can be determined by spectrophotometry even only after incubation for 24 h. At a low level of organic substrate, even strong colonization with microorganisms does not inevitably result in a significant damage to metals.

  11. Two stage indirect evaporative cooling system

    DOEpatents

    Bourne, Richard C.; Lee, Brian E.; Callaway, Duncan

    2005-08-23

    A two stage indirect evaporative cooler that moves air from a blower mounted above the unit, vertically downward into dry air passages in an indirect stage and turns the air flow horizontally before leaving the indirect stage. After leaving the dry passages, a major air portion travels into the direct stage and the remainder of the air is induced by a pressure drop in the direct stage to turn 180.degree. and returns horizontally through wet passages in the indirect stage and out of the unit as exhaust air.

  12. Second Stage Turbine Bucket Airfoil.

    DOEpatents

    Xu, Liming; Ahmadi, Majid; Humanchuk, David John; Moretto, Nicholas; Delehanty, Richard Edward

    2003-05-06

    The second-stage buckets have airfoil profiles substantially in accordance with Cartesian coordinate values of X, Y and Z set forth in inches in Table I wherein Z is a perpendicular distance from a plane normal to a radius of the turbine centerline and containing the X and Y values with the Z value commencing at zero in the X, Y plane at the radially innermost aerodynamic section of the airfoil and X and Y are coordinate values defining the airfoil profile at each distance Z. The X, Y and Z values may be scaled as a function of the same constant or number to provide a scaled-up or scaled-down airfoil section for the bucket.

  13. Early stages of Ostwald ripening

    NASA Astrophysics Data System (ADS)

    Shneidman, Vitaly A.

    2013-07-01

    The Becker-Döring (BD) nucleation equation is known to predict a narrow double-exponential front (DEF) in the distribution of growing particles over sizes, which is due to early transient effects. When mass conservation is included, nucleation is eventually exhausted while independent growth is replaced by ripening. Despite the enormous difference in the associated time scales, and the resulting demand on numerics, within the generalized BD model the early DEF is shown to be crucial for the selection of the unique self-similar Lifshitz-Slyozov-Wagner asymptotic regime. Being preserved till the latest stages of growth, the DEF provides a universal part of the initial conditions for the ripening problem, regardless of the mass exchange mechanism between the nucleus and the matrix.

  14. Stages in the research process.

    PubMed

    Gelling, Leslie

    2015-03-01

    Research should be conducted in a systematic manner, allowing the researcher to progress from a general idea or clinical problem to scientifically rigorous research findings that enable new developments to improve clinical practice. Using a research process helps guide this process. This article is the first in a 26-part series on nursing research. It examines the process that is common to all research, and provides insights into ten different stages of this process: developing the research question, searching and evaluating the literature, selecting the research approach, selecting research methods, gaining access to the research site and data, pilot study, sampling and recruitment, data collection, data analysis, and dissemination of results and implementation of findings.

  15. The Nuclear Cryogenic Propulsion Stage

    NASA Technical Reports Server (NTRS)

    Houts, Michael G.; Kim, Tony; Emrich, William J.; Hickman, Robert R.; Broadway, Jeramie W.; Gerrish, Harold P.; Doughty, Glen; Belvin, Anthony; Borowski, Stanley K.; Scott, John

    2014-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP). Nuclear propulsion can be affordable and viable compared to other propulsion systems and must overcome a biased public fear due to hyper-environmentalism and a false perception of radiation and explosion risk.

  16. The Nuclear Cryogenic Propulsion Stage

    NASA Technical Reports Server (NTRS)

    Houts, Michael G.; Kim, Tony; Emrich, William J.; Hickman, Robert R.; Broadway, Jeramie W.; Gerrish, Harold P.; Doughty, Glen; Belvin, Anthony; Borowski, Stanley K.; Scott, John

    2014-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progres made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP).

  17. Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts the manufacturing of aluminum panels that will be used to form the Ares I barrel. The panels are manufacturing process demonstration articles that will undergo testing until perfected. The panels are built by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  18. Tumor Stage Mycosis Fungoides in a Child.

    PubMed

    Dulmage, Brittany O'Neill; Villaseñor-Park, Jennifer; Ho, Jonhan; Geskin, Larisa J; Grandinetti, Lisa M

    2015-01-01

    Mycosis fungoides is uncommon in children and most often presents as stage IA/IB. We present a case of stage IIB mycosis fungoides in a 13-year-old boy and discuss diagnostic examination and treatment considerations.

  19. Cisplatin and Paclitaxel in Treating Patients With Stage IIB, Stage IIC, Stage III, or Stage IV Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cavity Cancer

    ClinicalTrials.gov

    2014-12-29

    Chemotherapeutic Agent Toxicity; Endometrial Adenocarcinoma; Fallopian Tube Carcinoma; Gastrointestinal Complication; Malignant Ovarian Mixed Epithelial Tumor; Neurotoxicity Syndrome; Ovarian Brenner Tumor; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Primary Peritoneal Carcinoma; Stage II Ovarian Cancer; Stage III Ovarian Cancer; Stage IV Ovarian Cancer; Undifferentiated Ovarian Carcinoma

  20. E-cadherin downregulation at the infiltrating tumour front is associated with histological grade and stage in colorectal carcinoma of Malaysians.

    PubMed

    Dass, Serena Diane; Cheah, Phaik-Leng; Ong, Diana Bee-Lan; Teoh, Kean-Hooi; Looi, Lai-Meng

    2015-04-01

    Loss of E-cadherin, a 120 kDA transmembrane glycoprotein responsible for cell-cell adhesion, is one of the hallmarks of epithelial-mesenchymal-transition (EMT). E-cadherin expression was immunohistochemically studied in 94 histopathologically re-confirmed colorectal carcinomas (CRC) using a monoclonal antibody to E-cadherin (Dako: Clone NCH-38) on a Ventana Benchmark XT automated system. Each case was assessed for E-cadherin immunopositivity at two separate locations viz the tumour centre (TC) as well as the infiltrating front (IF). Expression was semiquantitated for proportion of immunopositive malignant cells as 0 (negative), 1 (1-25% staining), 2 (26-50% staining), 3 (51-75% staining) and 4 (>75% staining) and staining intensity: 0 (negative), 1 (weak), 2 (moderate) and 3 (strong). The final histoscore of E-cadherin immunopositivity was arbitrarily computed as proportion of immunopositivity multiplied by staining intensity of the malignant cells. E-cadherin histoscores were significantly lower at the IF (4.5±2.5) compared with TC (10.7±2.4). Furthermore, the histoscores were significantly reduced at the IF of 49 TNM III+IV tumours (3.6±2.5) compared with 45 II+III CRC (5.4±2.2). Reduction of E-cadherin expression was also noted in the 23 high grade (TC=8.6±3.2; IF=2.6±2.3) compared with 71 low grade tumours (TC=11.4±1.5; IF=5.1±2.3). E-cadherin is downregulated at the infiltrating front of CRC, possibly marking for EMT at this location. The downregulation is further enhanced amongst late stage and high grade tumours compared with earlier stage and low grade tumours; findings which are similar to that noted in CRC of other populations.

  1. Long-term respiratory function recovery in patients with stage I lung cancer receiving video-assisted thoracic surgery versus thoracotomy

    PubMed Central

    Park, Young Sik

    2016-01-01

    Background Video-assisted thoracic surgery (VATS) and thoracotomy are standard treatment methods for early lung cancer. We compared their effects on the long-term recovery of pulmonary function in patients with stage I non-small cell lung cancer (NSCLC). Methods We retrospectively reviewed 203 patients with early NSCLC who underwent VATS or thoracotomy at Seoul University Hospital from January 2005 to December 2010. Two matched groups (VATS and thoracotomy) each consisting of 60 patients were created via propensity score matching according to TNM stage, age, sex, smoking history, lung disease history, and preoperative pulmonary function. Results There were no significant differences in the recovery of forced expiratory volume in 1 second, the forced vital capacity (FVC), or the peak flow rate (PFR), presented as the postoperative value/predicted value, between the VATS and thoracotomy groups during the 12-month follow-up period. The standardized functional loss ratio [(measured postoperative value – predicted postoperative value)/(predicted postoperative value × 100)] did not differ between the two groups at 6 and 12 months. In an intragroup analysis, the postoperative FVC in the thoracotomy group remained below predicted postoperative value during the follow-up period and did not reach the predicted postoperative FVC (6 months/12 months: –6.58%/–2.43%). The analgesic requirements and pain procedures were similar in the VATS and thoracotomy groups during the 12-month follow-up period. Conclusions There were no significant differences in pulmonary function recovery during the late postoperative period in NSCLC patients receiving VATS versus thoracotomy. We suggest that the volume of the resected lung and preoperative lung function are the main determinants of late recovery, rather than postoperative pain. PMID:26904225

  2. Paclitaxel and Carboplatin With or Without Bevacizumab in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2015-12-21

    Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Malignant Ovarian Mixed Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Clear Cell Adenocarcinofibroma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Adenocarcinoma; Ovarian Serous Adenocarcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

  3. The Nuclear Cryogenic Propulsion Stage

    NASA Technical Reports Server (NTRS)

    Houts, Michael G.; Kim, Tony; Emrich, William J.; Hickman, Robert R.; Broadway, Jeramie W.; Gerrish, Harold P.; Belvin, Anthony D.; Borowski, Stanley K.; Scott, John H.

    2014-01-01

    Nuclear Thermal Propulsion (NTP) development efforts in the United States have demonstrated the technical viability and performance potential of NTP systems. For example, Project Rover (1955 - 1973) completed 22 high power rocket reactor tests. Peak performances included operating at an average hydrogen exhaust temperature of 2550 K and a peak fuel power density of 5200 MW/m3 (Pewee test), operating at a thrust of 930 kN (Phoebus-2A test), and operating for 62.7 minutes in a single burn (NRX-A6 test). Results from Project Rover indicated that an NTP system with a high thrust-to-weight ratio and a specific impulse greater than 900 s would be feasible. Excellent results were also obtained by the former Soviet Union. Although historical programs had promising results, many factors would affect the development of a 21st century nuclear thermal rocket (NTR). Test facilities built in the US during Project Rover no longer exist. However, advances in analytical techniques, the ability to utilize or adapt existing facilities and infrastructure, and the ability to develop a limited number of new test facilities may enable affordable development, qualification, and utilization of a Nuclear Cryogenic Propulsion Stage (NCPS). Bead-loaded graphite fuel was utilized throughout the Rover/NERVA program, and coated graphite composite fuel (tested in the Nuclear Furnace) and cermet fuel both show potential for even higher performance than that demonstrated in the Rover/NERVA engine tests.. NASA's NCPS project was initiated in October, 2011, with the goal of assessing the affordability and viability of an NCPS. FY 2014 activities are focused on fabrication and test (non-nuclear) of both coated graphite composite fuel elements and cermet fuel elements. Additional activities include developing a pre-conceptual design of the NCPS stage and evaluating affordable strategies for NCPS development, qualification, and utilization. NCPS stage designs are focused on supporting human Mars

  4. Three stage semelparous Leslie models.

    PubMed

    Cushing, J M

    2009-07-01

    oscillations (not necessarily periodic) with separated life-cycle stages, while weak interactions promote stable equilibration with overlapping life-cycle stages. Methods used include the theory of planar monotone maps, average Lyapunov functions, and bifurcation theory techniques.

  5. Three stage semelparous Leslie models.

    PubMed

    Cushing, J M

    2009-07-01

    oscillations (not necessarily periodic) with separated life-cycle stages, while weak interactions promote stable equilibration with overlapping life-cycle stages. Methods used include the theory of planar monotone maps, average Lyapunov functions, and bifurcation theory techniques. PMID:18777023

  6. Saturn V S-IVB (Third Stage)

    NASA Technical Reports Server (NTRS)

    1967-01-01

    This cutaway drawing shows the S-IVB (third stage) of the Saturn V launch vehicle. As a part of the Marshall Space Flight Center's (MSFC) 'building block' approach to the Saturn development, the S-IVB stage was utilized in the Saturn IB launch vehicle as a second stage and, later, the Saturn V launch vehicle as a third stage. The 59 foot long and 22 feet diameter stage was powered by a single J-2 engine, initially capable of 200,000 pounds of thrust.

  7. Lenalidomide and Rituximab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-07-28

    Stage II Grade 1 Contiguous Follicular Lymphoma; Stage II Grade 1 Non-Contiguous Follicular Lymphoma; Stage II Grade 2 Contiguous Follicular Lymphoma; Stage II Grade 2 Non-Contiguous Follicular Lymphoma; Stage II Grade 3 Contiguous Follicular Lymphoma; Stage II Grade 3 Non-Contiguous Follicular Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma

  8. The Final Stages of Life

    NASA Astrophysics Data System (ADS)

    Winget, D.

    2014-04-01

    The overwhelming majority of all stars end their lives as white dwarf stars. These stars and their environs have a deep personal significance for humanity: this is the expected fate of our own sun. Once a star becomes a white dwarf, its remaining evolution is best described as an exponential cooling. In the final throws of post-main sequence mass-loss the former stellar core becomes a white dwarf, emerging phoenix-like from amongst the ashes. Some planets may survive and others may form as a sort of second generation from the cast-off material. Life may survive or may be reborn on any planets that remain; life may also arise on newly formed planets. The prospects will depend in a significant way on the timescales of the central white dwarf star's cooling evolution and how its radiation shapes the environment. We will discuss white dwarf evolutionary timescales with an eye towards the potential habitability of planets, both new and old. We will consider the uncertainties in these timescales from both an empirical and a theoretical perspective. We will critique the existing evidence for planets and summarize what we have learned so far through direct imaging and stellar pulsations. We will close with the very bright prospects for the future of planets and life in the final stages.

  9. Neutron interferometry with cold stage

    NASA Astrophysics Data System (ADS)

    Mineeva, Taisiya; Arif, M.; Huber, M. G.; Shahi, C. B.; Clark, C. W.; Cory, D. G.; Nsofini, J.; Sarenac, D.; Pushin, D. A.

    Neutron interferometry (NI) is amongst the most precise methods for characterizing neutron interactions by measuring the relative difference between two neutron paths, one of which contains a sample-of-interest. Because neutrons carry magnetic moment and are deeply penetrating, they are excellent probes to investigate properties of magnetic materials. The advantage of NI is its unique sensitivity which allows to directly measure magnetic and structural transitions in materials. Up to now NI has been sparingly used in material research due to its sensitivity to environmental noise. However, recent successes in implementing Quantum Error Correction principles lead to an improved NI design making it robust against mechanical vibrations. Following these advances, a new user facility at the National Institute for Standards and Technology was built to study condensed matter applications, biology and quantum physics. Incorporating cold sample stage inside NI is the first of its kind experiment which can be carried out on large range of temperatures down to 4K. Upon successful realization, it will open new frontiers to characterize magnetic domains, phase transitions and spin properties in a variety of materials such as, for example, iron-based superconductors and spintronic materials. Supported in part by CERC, CIFAR, NSERC and CREATE.

  10. Advanced two-stage incinerator

    SciTech Connect

    Rehmat, A.; Khinkis, M.

    1991-01-01

    The Institute of Gas Technology (IGT) is developing an advanced incinerator that combines the fluidized-bed agglomeration/incineration and cyclonic combustion/incineration technologies that have been developed separately at IGT over many years. This combination results in a unique and extremely flexible incinerator for solid, sludge, liquid, and gaseous wastes. This system can operate over a wide range of conditions in the first stage, from low temperature (desorption) to high temperature (agglomeration), including gasification of high-Btu wastes. In the combined system, solid, liquid, and gaseous organic wastes would be easily and efficiently destroyed (>99.99% destruction and removal efficiency (DRE)), whereas solid inorganic contaminants would be contained within a glassy matrix, rendering them benign and suitable for disposal in an ordinary landfill. This technology is different from other existing technologies because of its agglomeration and encapsulation capability and its flexibility with respect to the types wastes it can handle. Both the fluidized-bed as well as the cyclonic incineration technologies have been fully developed and tested separately at pilot scales. 12 refs., 4 figs., 4 tabs.

  11. Staged direct injection diesel engine

    DOEpatents

    Baker, Quentin A.

    1985-01-01

    A diesel engine having staged injection for using lower cetane number fuels than No. 2 diesel fuel. The engine includes a main fuel injector and a pilot fuel injector. Pilot and main fuel may be the same fuel. The pilot injector injects from five to fifteen percent of the total fuel at timings from 20.degree. to 180.degree. BTDC depending upon the quantity of pilot fuel injected, the fuel cetane number and speed and load. The pilot fuel injector is directed toward the centerline of the diesel cylinder and at an angle toward the top of the piston, avoiding the walls of the cylinder. Stratification of the early injected pilot fuel is needed to reduce the fuel-air mixing rate, prevent loss of pilot fuel to quench zones, and keep the fuel-air mixture from becoming too fuel lean to become effective. In one embodiment, the pilot fuel injector includes a single hole for injection of the fuel and is directed at approximately 48.degree. below the head of the cylinder.

  12. 14 CFR 91.859 - Modification to meet Stage 3 or Stage 4 noise levels.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... noise levels. 91.859 Section 91.859 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Noise Limits § 91.859 Modification to meet Stage 3 or Stage 4 noise levels. For an airplane subject to... Stage 3 or Stage 4 noise levels....

  13. 14 CFR 91.859 - Modification to meet Stage 3 or Stage 4 noise levels.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... noise levels. 91.859 Section 91.859 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Noise Limits § 91.859 Modification to meet Stage 3 or Stage 4 noise levels. For an airplane subject to... Stage 3 or Stage 4 noise levels....

  14. Acting Antarctica: science on stage

    NASA Astrophysics Data System (ADS)

    Ciceri, Piera; Tizzoni, Paola; Pierro, Luigia

    2016-04-01

    Key-words: Polar science, Earth science, Theatre, Hands on activities The legendary Antarctic Expedition of sir E. Shackleton and his crew of 27 aboard the Endurance (1914/16) trapped in the Antarctic ice has become the starting point to learn about Polar Science and Climate Change. While the students were involved into this incredible adventure by the astonishing images of the Australian photographer Frank Hurley (who joined the crew), they discovered the world in which this story happened. Students were then involved in hands-on activities and role plays and have become the writers of the play "Uomini a scienza ai confini del mondo". They act the story of Shackelton's expedition and they tell at the same time to the audience about ice pack, ice cores and their role in understanding the past of the climate, physical and geographical characteristic of polar regions, thermal phenomena related to adaptations of polar animals, solar radiation at different latitude, day/night duration. The theater was the place to "stage" some scientific experiments and to explain the current research carried out in polar regions and their importance in climate change studies and to stress some similarities between Antarctica and space. The project was carried out from teachers of science, letters and geography and was born in collaboration with the "Piccolo Teatro di Milano" and the association "Science Under 18" with the support of a professional actor and director and was played for other schools at "EXPO 2015" in Milano (Italy). In our opinion drama activities improve reading comprehension, and both verbal and non-verbal communication skills. To be able to write and to act, students need a deep understanding of contents. Arts, including theatre, are a good key to involve emotionally students. To have an audience different from their own teachers and classmates offers a real task and the opportunity to play and let grow real skills.

  15. Computed Tomography Staging of Middle Ear Cholesteatoma

    PubMed Central

    Razek, Ahmed Abdel Khalek Abdel; Ghonim, Mohamed Rashad; Ashraf, Bassem

    2015-01-01

    Summary Background To establish computed tomography (CT) staging of middle ear cholesteatoma and assess its impact on the selection of the surgical procedure. Material/Methods Prospective study was conducted on 61 consecutive patients (mean age 26.8 years) with middle ear cholesteatoma. CT scan of the temporal bone and surgery were performed in all patients. CT staging classified cholesteatoma according to its location in the tympanic cavity (T); extension into the mastoid (M); and associated complications (C). Cholesteatoma was staged as stage I (T1, T2), stage II (T3, M1, M2, C1), and stage III (C2). Results The overall sensitivity of CT staging of cholesteatoma compared to surgery was 88% with excellent agreement and correlation between CT findings and intra-operative findings (K=0.863, r=0.86, P=0.001). There was excellent agreement and correlation of CT staging with surgical findings for T location (K=0.811, r=0.89, P=0.001), good for M extension (K=0.734, r=0.88, P=0.001), and excellent for associated C complications (K=1.00, r=1.0, P=0.001). Atticotympanotomy was carried out in stage I (n=14), intact canal wall surgery was performed in stage II (n=38), and canal wall down surgery was done in stage III (n=5) and stage II (n=4). Conclusions We established CT staging of middle ear cholesteatoma that helps surgeons to select an appropriate surgery. PMID:26171086

  16. Vorinostat, Rituximab, and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

    ClinicalTrials.gov

    2016-09-08

    Stage II Contiguous Adult Diffuse Large Cell Lymphoma; Stage II Non-Contiguous Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

  17. Staging of laser-plasma accelerators

    NASA Astrophysics Data System (ADS)

    Steinke, S.; van Tilborg, J.; Benedetti, C.; Geddes, C. G. R.; Daniels, J.; Swanson, K. K.; Gonsalves, A. J.; Nakamura, K.; Shaw, B. H.; Schroeder, C. B.; Esarey, E.; Leemans, W. P.

    2016-05-01

    We present results of an experiment where two laser-plasma-accelerator stages are coupled at a short distance by a plasma mirror. Stable electron beams from the first stage were used to longitudinally probe the dark-current-free, quasi-linear wakefield excited by the laser of the second stage. Changing the arrival time of the electron beam with respect to the second stage laser pulse allowed reconstruction of the temporal wakefield structure, determination of the plasma density, and inference of the length of the electron beam. The first stage electron beam could be focused by an active plasma lens to a spot size smaller than the transverse wake size at the entrance of the second stage. This permitted electron beam trapping, verified by a 100 MeV energy gain.

  18. Compact 6-DOF Stage for Optical Adjustments

    NASA Technical Reports Server (NTRS)

    Shafaat, Syed; Chang, Daniel

    2008-01-01

    The figure depicts selected aspects of a six-degree-of-freedom (6-DOF) stage for mechanical adjustment of an optical component. The six degrees of freedom are translations along the Cartesian axes (x, y, and z) and rotations about these axes (theta x, theta y, and theta z, respectively). Relative to prior such stages, this stage offers advantages of compactness, stability, and robustness, plus other advantages as described below. The stage was designed specifically as part of a laser velocimeter and altimeter in which light reflected by a distant object is collected by a Cassegrainian telescope and focused into a single-mode, polarization-maintaining optical fiber. The stage is used to position and orient the input end of the optical fiber with respect to the focal point of the telescope. Stages like this one can also be adapted for use in positioning and orienting other optical components, including lenses, prisms, apertures, and photodetectors.

  19. Pantex staging study near-term alternatives

    SciTech Connect

    Madden, M.S.; Adickes, M.D.; Hostick, C.J.; Nealey, S.M.; Smith, B.W.

    1992-12-01

    As the result of bilateral treaties to reduce the number of weapons in the nuclear stockpile, the US Department of Energy must now address the requirements for additional storage of the plutonium components (pits) from the retired weapons at Pantex until the components` final disposition. Because of the critical need to take action, Pantex has initiated two related efforts: Project Stage Right and this Staging Study. While support of Project Stage Right is a key objective of this study, the scope covers a broader range of activities and aspects of the pit staging problem. This study provides estimates of worker radiation exposures under the current scenario as well as estimated radiation exposure for workers under four alternative staging scenarios. An important objective of this study also identifies and recommends for future study other activities related to staging where radiation safety and overall efficiency can be improved.

  20. Pantex staging study near-term alternatives

    SciTech Connect

    Madden, M.S.; Adickes, M.D.; Hostick, C.J.; Nealey, S.M.; Smith, B.W.

    1992-12-01

    As the result of bilateral treaties to reduce the number of weapons in the nuclear stockpile, the US Department of Energy must now address the requirements for additional storage of the plutonium components (pits) from the retired weapons at Pantex until the components' final disposition. Because of the critical need to take action, Pantex has initiated two related efforts: Project Stage Right and this Staging Study. While support of Project Stage Right is a key objective of this study, the scope covers a broader range of activities and aspects of the pit staging problem. This study provides estimates of worker radiation exposures under the current scenario as well as estimated radiation exposure for workers under four alternative staging scenarios. An important objective of this study also identifies and recommends for future study other activities related to staging where radiation safety and overall efficiency can be improved.

  1. Saturn IBC S-IVB Stage

    NASA Technical Reports Server (NTRS)

    1967-01-01

    Workmen secure a J-2 engine onto the S-IVB (second) stage thrust structure. As part of Marshall Space Center's 'building block' approach to the Saturn development, the S-IVB was utilized in the Saturn IBC launch vehicle as a second stage and the Saturn V launch vehicle as a third stage. The booster, built for NASA by McDornell Douglas Corporation, was powered by a single J-2 engine, initially capable of 200,000 pounds of thrust.

  2. Protein Folding Stages and Universal Exponents

    NASA Astrophysics Data System (ADS)

    Huang, Kerson

    We propose three stages in protein folding, based on physical arguements involving the interplay between the hydrophobic effect and hydrogen bonding, and computer simulations using the CSAW (conditioned self-avoiding walk) model. These stages are characterized by universal exponents ν = 3/5, 3/7, 2/5 in the power law R ~ Nν, where R is the radius of gyration and N is the number of residues. They correspond to the experimentally observed stages: unfolded, preglobule, molten globule.

  3. Protein Folding Stages and Universal Exponents

    NASA Astrophysics Data System (ADS)

    Huang, Kerson

    2011-11-01

    We propose three stages in protein folding, based on physical arguements involving the interplay between the hydrophobic effect and hydrogen bonding, and computer simulations using the CSAW (conditioned self-avoiding walk) model. These stages are characterized by universal exponents ν = 3/5, 3/7, 2/5 in the power law R ˜ Nν, where R is the radius of gyration and N is the number of residues. They correspond to the experimentally observed stages: unfolded, preglobule, molten globule.

  4. Evolution in Stage-Structured Populations

    PubMed Central

    Barfield, Michael; Holt, Robert D.; Gomulkiewicz, Richard

    2016-01-01

    For many organisms, stage is a better predictor of demographic rates than age. Yet no general theoretical framework exists for understanding or predicting evolution in stage-structured populations. Here, we provide a general modeling approach that can be used to predict evolution and demography of stage-structured populations. This advances our ability to understand evolution in stage-structured populations to a level previously available only for populations structured by age. We use this framework to provide the first rigorous proof that Lande’s theorem, which relates adaptive evolution to population growth, applies to stage-classified populations, assuming only normality and that evolution is slow relative to population dynamics. We extend this theorem to allow for different means or variances among stages. Our next major result is the formulation of Price’s theorem, a fundamental law of evolution, for stage-structured populations. In addition, we use data from Trillium grandiflorum to demonstrate how our models can be applied to a real-world population and thereby show their practical potential to generate accurate projections of evolutionary and population dynamics. Finally, we use our framework to compare rates of evolution in age- versus stage-structured populations, which shows how our methods can yield biological insights about evolution in stage-structured populations. PMID:21460563

  5. Stages of Change or Changes of Stage? Predicting Transitions in Transtheoretical Model Stages in Relation to Healthy Food Choice

    ERIC Educational Resources Information Center

    Armitage, Christopher J.; Sheeran, Paschal; Conner, Mark; Arden, Madelynne A.

    2004-01-01

    Relatively little research has examined factors that account for transitions between transtheoretical model (TTM) stages of change. The present study (N=787) used sociodemographic, TTM, and theory of planned behavior (TPB) variables, as well as theory-driven interventions to predict changes in stage. Longitudinal analyses revealed that…

  6. Erlotinib Hydrochloride in Treating Patients With Stage I-III Colorectal Cancer or Adenoma

    ClinicalTrials.gov

    2014-12-22

    Adenomatous Polyp; Recurrent Colon Cancer; Recurrent Rectal Cancer; Stage I Colon Cancer; Stage I Rectal Cancer; Stage IIA Colon Cancer; Stage IIA Rectal Cancer; Stage IIB Colon Cancer; Stage IIB Rectal Cancer; Stage IIC Colon Cancer; Stage IIC Rectal Cancer; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer

  7. Metastatic axillary lymph node ratio (LNR) is prognostically superior to pN staging in patients with breast cancer--results for 804 Chinese patients from a single institution.

    PubMed

    Xiao, Xiang-Sheng; Tang, Hai-Lin; Xie, Xin-Hua; Li, Lai-Sheng; Kong, Ya-Nan; Wu, Min-Qing; Yang, Lu; Gao, Jie; Wei, Wei-Dong; Xie, Xiaoming

    2013-01-01

    The number of axillary lymph nodes involved and retrieved are important prognostic factors in breast cancer. The purpose of our study was to investigate whether the lymph node ratio (LNR) is a better prognostic factor in predicting disease-free survival (DFS) for breast cancer patients as compared with pN staging. The analysis was based on 804 breast cancer patients who had underwent axillary lymph node dissection between 1999 and 2008 in Sun Yat-Sen University Cancer Center. Optimal cutoff points of LNR were calculated using X-tile software and validated by bootstrapping. Patients were then divided into three groups (low-, intermediate-, and high-risk) according to the cutoff points. Predicting risk factors for relapse were performed according to Cox proportional hazards analysis. DFS was estimated using the Kaplan-Meier method and compared by the log-rank test. The 5-year DFS rate decreased significantly with increasing LNRs and pN. Univariate analysis found that the pT , pN, LNR, molecule type, HER2, pTNM stage and radiotherapy well classified patients with significantly different prognosis. By multivariate analysis, only LNR classification was retained as an independent prognostic factor. Furthermore, there was a significant prognostic difference among different LNR categories for pN2 category, but no apparent prognostic difference was seen between different pN categories in any LNR category. Therefore, LNR rather than pN staging is preferable in predicting DFS in node positive breast cancer patients, and routine clinical decision-making should take the LNR into consideration.

  8. Clinical significance of detecting lymphatic and blood vessel invasion in stage II colon cancer using markers D2-40 and CD34 in combination.

    PubMed

    Lai, Jin-Huo; Zhou, Yong-Jian; Bin, Du; Qiangchen; Wang, Shao-Yuan

    2014-01-01

    This research was conducted to compare differences in colon cancer lymphatic vessel invasion (LVI) with D2-40 antibody labeling and regular HE staining, blood vessel invasion (BVI) with CD34 antibody labeling and HE staining and to assess the possibility of using D2-40-LVI/CD34-BVI in combination for predicting stage II colon cancer prognosis and guiding adjuvant chemotherapy.Anti-D2-40 and anti-CD34 antibodies were applied to tissue samples of 220 cases of stage II colon cancer to label lymphatic vessels and small blood vessels, respectively. LVI and BVI were assessed and multivariate COX regression analysis was performed for associations with colon cancer prognosis. Regular HE staining proved unable to differentiate lymphatic vessels from blood vessels, while D2-40 selectively labeled lymphatic endothelial cell cytosol and CD34 was widely expressed in large and small blood vessels of tumors as well as normal tissues. Compared to regular HE staining, D2-40-labeling for LVI and CD34-labeling for BVI significantly increased positive rate (22.3% vs 10.0% for LVI, and 19.1% vs 9.1% for BVI). Multivariate analysis indicated that TNM stage, pathology tissue type, post-surgery adjuvant chemotherapy, D2-40-LVI, and CD34-BVI were independent factors affecting whole group colon cancer prognosis, while HE staining-BVI, HE staining-LVI were not significantly related. When CD34-BVI/D2-40-LVI were used in combination for detection, the risk of death for patients with two or one positive results was 5.003 times that in the LVI(-)andBVI(-) group (95% CI 2.365 - 9.679). D2-40 antibody LVI labeling and CD34 antibody BVI labeling have higher specificity and accuracy than regular HE staining and can be used as molecular biological indicators for prognosis prediction and guidance of adjuvant chemotherapy for stage II colon cancer.

  9. Is There a Scribble Stage for Sculpture?

    ERIC Educational Resources Information Center

    Hathaway, Nan

    2006-01-01

    Most parents and educators are not as familiar or comfortable with the developmental stages that may also occur in three-dimensional work, yet no doubt a similar progression exists. Is there a scribble stage in sculpture? Do children need to master one set of skills before they are able to move on to the next? Do students have opportunity and…

  10. The Stages of Mailed Questionnaire Returning Behavior.

    ERIC Educational Resources Information Center

    Lockhart, Daniel C.

    1984-01-01

    Six stages are hypothesized that define the behavior of returning mailed questionnaires: receiving the questionnaire, opening the mail, forming an overall impression, answering the questions, returning the questionnaire, and dealing with nonrespondents. The researcher must provide incentives at each stage if potential respondents are to complete a…

  11. Dislocation generation during early stage sintering.

    NASA Technical Reports Server (NTRS)

    Sheehan, J. E.; Lenel, F. V.; Ansell, G. S.

    1973-01-01

    Discussion of the effects of capillarity-induced stresses on dislocations during early stage sintering. A special version of Hirth's (1963) theoretical calculation procedures modified to describe dislocation nucleation on planes meeting the sintering body's neck surface obliquely is shown to predict plastic flow at stress levels know to exist between micron size metal particles in the early stages of sintering.

  12. Stages of Interpersonal Development in Young Adulthood.

    ERIC Educational Resources Information Center

    Bar-Yam, Aureet

    A validation study of 30 married females and 30 married males was conducted on a theoretical model of stages in interpersonal development developed by Bar-Yam Hassan (Bar-Yam Hassan & Bar-Yam, 1987). According to the model, the five stages of adult interpersonal development are: (1) Social Relatedness versus Self-Insistence, or need for Approval;…

  13. THE SPACE STAGE--FAD OR FUTURE.

    ERIC Educational Resources Information Center

    DECHAINE, FABER

    DISSATISFACTION WITH THE PROSCENIUM ARCH THEATRE, THE NEED FOR ECONOMY IN PUBLICLY-FINANCED STRUCTURES, AND THE ADVANTAGES OF INTIMATE THEATRE, HAVE LED TO THE DEVELOPMENT OF THE SPACE STAGE, WHICH PROJECTS INTO THE AUDITORIUM AND IS SURROUNDED ON THREE SIDES BY SEATING. THE SPACE STAGE CONCEPT IS USED IN THIS EXAMPLE TO PROVIDE A PERFORMING ARTS…

  14. Teacher Concerns and Teacher Life Stages

    ERIC Educational Resources Information Center

    Mok, Yan Fung

    2005-01-01

    This article examines teaching concerns at successive life stages among teachers with up to twenty years' or more teaching experience. Three concern stages are discerned. Nine common concern factors were found from factor-analysing thirty-three concern items. Results show that student discipline, relations with students, and students' learning and…

  15. Light weight high-stiffness stage platen

    DOEpatents

    Spence, Paul A.

    2001-01-01

    An improved light weight, stiff stage platen for photolithography is provided. The high stiffness of the stage platen is exemplified by a relatively high first resonant vibrational mode as determined, for instance, by finite element modal analysis. The stage platen can be employed to support a chuck that is designed to secure a mask or wafer. The stage platen includes a frame that has interior walls that define an interior region and that has exterior walls wherein the outer surfaces of at least two adjacent walls are reflective mirror surfaces; and a matrix of ribs within the interior region that is connected to the interior walls wherein the stage platen exhibits a first vibrational mode at a frequency of greater than about 1000 Hz.

  16. Endoscopic options for early stage esophageal cancer

    PubMed Central

    Shah, Pari M.

    2015-01-01

    Surgery has traditionally been the preferred treatment for early stage esophageal cancer. Recent advances in endoscopic treatments have been shown to be effective and safe. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) allow endoscopists to remove small, superficial lesions, providing tumor specimen that can be examined for accurate pathologic tumor staging and assessment of adequacy of resection. Endoscopic ablation procedures, including photodynamic therapy (PDT) and radio frequency ablation (RFA), have also been shown to safely and effectively treat esophageal dysplasia and early stage neoplasia, with excellent long-term disease control. Both approaches are becoming more widely available around the world, and provide an alternative, safe, low risk strategy for treating early stage disease, making combined endoscopic therapy the recommended treatment of choice for early stage esophageal cancers. PMID:25642334

  17. Structural stages and evolution of the Urals

    NASA Astrophysics Data System (ADS)

    Puchkov, V. N.

    2013-02-01

    Five main structural and historical stages are established in the territory of the Urals: 1) Archean-Paleoproterozoic, a time of formation of the Volgo-Uralia subcontinent and its amalgamation with the other blocks of the craton of Baltica; 2) Riphean-Vendian (Meso- and Neoproterozoic), а stage that was finished with formation of Timanides; 3) Paleozoic-Early Mesozoic stage, corresponding to the development of the Uralides; 4) Mid-Jurassic-to Miocene platform stage; 5) Pliocene-Quaternary neo-orogenic stage. In this paper stratigraphic data are discussed, schemes of the structural zonation are presented, and the problems of the structural geology and geodynamics of sedimentary and magmatic complexes are discussed in a chronological order. Ideologically, the paper is based on plate and plume tectonics, in their modern versions.

  18. Sequential scintigraphic staging of small cell carcinoma

    SciTech Connect

    Bitran, J.D.; Bekerman, C.; Pinsky, S.

    1981-04-15

    Thirty patients with small cell carcinoma (SCC) of the lung were sequentially staged following a history and physical exam with liver, bran, bone, and gallium-67 citrate scans. Scintigraphic evaluation disclosed 7 of 30 patients (23%) with advanced disease, stage IIIM1. When Gallium-67 scans were used as the sole criteria for staging, they proved to be accurate and identified six of the seven patients with occult metastatic disease. Gallium-67 scans proved to be accurate in detecting thoracic and extrathoracic metastases in the 30 patients with SCC, especially within the liver and lymph node-bearing area. The diagnostic accuracy of gallium-67 fell in regions such as bone or brain. Despite the limitations of gallium-67 scanning, the authors conclude that these scans are useful in staging patients with SCC and should be the initial scans used in staging such patients.

  19. Bortezomib in Treating Patients With Stage IIIB or Stage IV Lung Cancer

    ClinicalTrials.gov

    2014-08-04

    Adenocarcinoma of the Lung; Bronchoalveolar Cell Lung Cancer; Non-small Cell Lung Cancer; Recurrent Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer

  20. Assessment of Growth Using Mandibular Canine Calcification Stages and Its Correlation with Modified MP3 Stages

    PubMed Central

    Nayak, US Krishna; Hegde, Gautam

    2010-01-01

    Background and objectives Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Methods A total of 160 periapical radiographs (80 males and 80 females), of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian’s stages of dental calcification and the modified MP3 stages. Results The correlation between the developmental stages of MP3 and the mandibular right canine in male and female groups, is of high statistical significance (p = 0.001). The correlation coefficient between MP3 stages and developmental stages of mandibular canine and chronological age in male and females was found to be not significant. Conclusions The correlation between the mandibular canine calcification stages and MP3 stages was found to be significant. The developmental stages of the mandibular canine could be used very reliably as a sole indicator for assessment of skeletal maturity.

  1. Third Stage of Labor and Acupuncture

    PubMed Central

    Djakovic, Zeljko; Bilić, Nada; Košec, Vesna

    2015-01-01

    Abstract Background: Acupuncture use in obstetrics has been increasing in Western medicine, especially to alleviate complications of pregnancy, the most important cause of maternal mortality worldwide. One quarter of maternal deaths are caused by complications in the third stage of labor, an interval between complete delivery of the baby and the complete expulsion of the placenta. Methods: This review analyzes the increased acupuncture use for pregnancy complications as a potential method of reducting maternal mortality during the third stage of labor. This overview focuses on acupuncture points and techniques to manage the third stage of labor and help patients with retained placentas. Passive (or expectant) management of the third stage of labor is occasionally associated with massive obstetric hemorrhage, a major cause of maternal morbidity and mortality, especially in low-income countries. Conclusions: Active management of the third stage of labor has been shown to reduce the risk of postpartum hemorrhage. Use of acupuncture in the first and second stages of labor could lead to a faster separation of the placenta in the third stage of labor. The possible effects of acupuncture in cases of retained placentas may have significant implications for possible complications and final outcomes of labor. Further studies are needed for more conclusive results. PMID:25784967

  2. Observing river stages using unmanned aerial vehicles

    NASA Astrophysics Data System (ADS)

    Niedzielski, Tomasz; Witek, Matylda; Spallek, Waldemar

    2016-08-01

    We elaborated a new method for observing water surface areas and river stages using unmanned aerial vehicles (UAVs). It is based on processing multitemporal five orthophotomaps produced from the UAV-taken visible light images of nine sites of the river, acquired with a sufficient overlap in each part. Water surface areas are calculated in the first place, and subsequently expressed as fractions of total areas of water-covered terrain at a given site of the river recorded on five dates. The logarithms of the fractions are later calculated, producing five samples, each consisted of nine elements. In order to detect statistically significant increments of water surface areas between two orthophotomaps, we apply the asymptotic and bootstrapped versions of the Student's t test, preceded by other tests that aim to check model assumptions. The procedure is applied to five orthophotomaps covering nine sites of the Ścinawka river (south-western (SW) Poland). The data have been acquired during the experimental campaign, at which flight settings were kept unchanged over nearly 3 years (2012-2014). We have found that it is possible to detect transitions between water surface areas associated with all characteristic water levels (low, mean, intermediate and high stages). In addition, we infer that the identified transitions hold for characteristic river stages as well. In the experiment we detected all increments of water level: (1) from low stages to mean, intermediate and high stages; (2) from mean stages to intermediate and high stages; and (3) from intermediate stages to high stages. Potential applications of the elaborated method include verification of hydrodynamic models and the associated predictions of high flows as well as monitoring water levels of rivers in ungauged basins.

  3. The role of post-operative radiotherapy in non-small-cell lung cancer: a multicentre randomised trial in patients with pathologically staged T1-2, N1-2, M0 disease. Medical Research Council Lung Cancer Working Party.

    PubMed Central

    Stephens, R. J.; Girling, D. J.; Bleehen, N. M.; Moghissi, K.; Yosef, H. M.; Machin, D.

    1996-01-01

    The role of post-operative radiotherapy for patients with non-small-cell lung cancer (NSCLC) is unclear despite five previous randomised trials. One deficiency with these trials was that they did not include adequate TNM staging, and so the present randomised trial was designed to compare surgery alone (S) with surgery plus post-operative radiotherapy (SR) in patients with pathologically staged T1-2, N1-2. M0 NSCLC. Between July 1986 and October 1993, 308 patients (154 S, 154 SR) were entered from 16 centres in the UK. The median age of the patients was 62 years, 74% were male, > 85% had normal or near normal levels of general condition, activity and breathlessness, 68% had squamous carcinoma, 52% had had a pneumonectomy, 63% had N1 disease and 37% N2 disease. SR patients received 40 Gy in 15 fractions starting 4-6 weeks post-operatively. Overall there was no advantage to either group in terms of survival, although definite local recurrence and bony metastases appeared less frequently and later in the SR group. In a subgroup analysis, in the N1 group no differences between the treatment groups were seen, but in the N2 group SR patients appeared to gain a one month survival advantage, delayed time to local recurrence and time to appearance of the bone metastases. There is, therefore, no clear indication for post-operative radiotherapy in N1 disease, but the question remains unresolved in N2 disease. PMID:8761382

  4. Dual stage active magnetic regenerator and method

    DOEpatents

    Pecharsky, Vitalij K.; Gschneidner, Jr., Karl A.

    1999-03-30

    A dual stage active magnetic regenerator refrigerator as well as method using the Joule-Brayton thermodynamic cycle includes a high temperature stage refrigerant comprising DyAl.sub.2 or (Dy.sub.1-x Er.sub.x)Al.sub.2 where x is selected to be greater than 0 and less than about 0.3 in combination with a low temperature stage comprising (Dy.sub.1-x Er.sub.x)Al.sub.2 where x is selected to be greater than about 0.5 and less than 1 to provide significantly improved refrigeration efficiency in the liquefaction of gaseous hydrogen.

  5. Lymph node staging in prostate cancer.

    PubMed

    Sankineni, Sandeep; Brown, Anna M; Fascelli, Michele; Law, Yan Mee; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-05-01

    Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed.

  6. Dual stage active magnetic regenerator and method

    DOEpatents

    Pecharsky, V.K.; Gschneidner, K.A. Jr.

    1999-03-30

    A dual stage active magnetic regenerator refrigerator as well as method using the Joule-Brayton thermodynamic cycle includes a high temperature stage refrigerant comprising DyAl{sub 2} or (Dy{sub 1{minus}x}Er{sub x})Al{sub 2} where x is selected to be greater than 0 and less than about 0.3 in combination with a low temperature stage comprising (Dy{sub 1{minus}x}Er{sub x})Al{sub 2} where x is selected to be greater than about 0.5 and less than 1 to provide significantly improved refrigeration efficiency in the liquefaction of gaseous hydrogen. 17 figs.

  7. Developmental Stages in School Computer Use: Neither Marx Nor Piaget.

    ERIC Educational Resources Information Center

    Lengel, James G.

    Karl Marx's theory of stages can be applied to computer use in the schools. The first stage, the P Stage, comprises the entry of the computer into the school. Computer use at this stage is personal and tends to center around one personality. Social studies teachers are seldom among this select few. The second stage of computer use, the D Stage, is…

  8. Design considerations for single-stage and two-stage pneumatic pellet injectors

    SciTech Connect

    Gouge, M.J.; Combs, S.K.; Fisher, P.W.; Milora, S.L.

    1988-09-01

    Performance of single-stage pneumatic pellet injectors is compared with several models for one-dimensional, compressible fluid flow. Agreement is quite good for models that reflect actual breech chamber geometry and incorporate nonideal effects such as gas friction. Several methods of improving the performance of single-stage pneumatic pellet injectors in the near term are outlined. The design and performance of two-stage pneumatic pellet injectors are discussed, and initial data from the two-stage pneumatic pellet injector test facility at Oak Ridge National Laboratory are presented. Finally, a concept for a repeating two-stage pneumatic pellet injector is described. 27 refs., 8 figs., 3 tabs.

  9. Core compressor exit stage study. Volume 4: Data and performance report for the best stage configuration

    NASA Technical Reports Server (NTRS)

    Wisler, D. C.

    1981-01-01

    The core compressor exit stage study program develops rear stage blading designs that have lower losses in their endwall boundary layer regions. The test data and performance results for the best stage configuration consisting of Rotor-B running with Stator-B are described. The technical approach in this efficiency improvement program utilizes a low speed research compressor. Tests were conducted in two ways: (1) to use four identical stages of blading to obtain test data in a true multistage environment and (2) to use a single stage of blading to compare with the multistage test results. The effects of increased rotor tip clearances and circumferential groove casing treatment are evaluated.

  10. Large cell lymphoma stage IA/IAE.

    PubMed

    Nussbaum, H; Koo, C; Kagan, A R; Rao, A; Ryoo, M C

    1991-06-01

    Fifty-two patients with large cell lymphoma stage IA/IAE were retrospectively reviewed for the purpose of evaluation of treatment methods. All pathology slides were reviewed by one pathologist with a special interest in lymphoma. There were 24 patients at stage IA and 28 at stage IAE. Twenty-six patients were treated with radiation alone (10 IA, 16 IAE) and 26 patients were treated with radiation therapy and chemotherapy (13 IA, 13 IAE). Patients treated with radiation therapy alone and those with combined modality therapy (CMT) have similar survival curves with p values greater than 0.05. Recurrence patterns are similar for either method of treatment. While the majority of the literature recommends CMT for large cell lymphoma, our study of 52 patients reveals no difference in survival or recurrence patterns for these patients by either method of treatment. We recommend radiation therapy alone for stage IA/IAE large cell lymphoma, with chemotherapy held in reserve for failure.

  11. TRIDENT 1 third stage motor separation system

    NASA Technical Reports Server (NTRS)

    Welch, B. H.; Richter, B. J.; Sue, P.

    1977-01-01

    The third stage engine separation system has shown through test and analysis that it can effectively and reliably perform its function. The weight of the hardware associated with this system is well within the targeted value.

  12. Stages as models of scene geometry.

    PubMed

    Nedović, Vladimir; Smeulders, Arnold W M; Redert, André; Geusebroek, Jan-Mark

    2010-09-01

    Reconstruction of 3D scene geometry is an important element for scene understanding, autonomous vehicle and robot navigation, image retrieval, and 3D television. We propose accounting for the inherent structure of the visual world when trying to solve the scene reconstruction problem. Consequently, we identify geometric scene categorization as the first step toward robust and efficient depth estimation from single images. We introduce 15 typical 3D scene geometries called stages, each with a unique depth profile, which roughly correspond to a large majority of broadcast video frames. Stage information serves as a first approximation of global depth, narrowing down the search space in depth estimation and object localization. We propose different sets of low-level features for depth estimation, and perform stage classification on two diverse data sets of television broadcasts. Classification results demonstrate that stages can often be efficiently learned from low-dimensional image representations. PMID:20634560

  13. Treatment Options by Stage (Pancreatic Cancer)

    MedlinePlus

    ... cancer) cells form in the tissues of the pancreas. The pancreas is a gland about 6 inches ... spleen , and bile ducts . Tests that examine the pancreas are used to detect (find), diagnose, and stage ...

  14. Two-stage hybrid microcircuit amplifier

    SciTech Connect

    Pyo, M.L.

    1987-04-01

    This report documents the design, development, and fabrication of a two-stage amplifier operating at 400 to 600 MHz. Included are characterization data, predictions generated during design, and measured performance.

  15. Evaluation, Diagnosis, and Staging of Cutaneous Lymphoma.

    PubMed

    Olsen, Elise A

    2015-10-01

    Primary cutaneous lymphomas (PCLs) are an extremely heterogeneous group of non-Hodgkin lymphomas that manifest in the skin. Their diagnosis is complex and based on clinical lesion type and evaluation of findings on light microscopic examination, immunohistochemistry and molecular analysis of representative skin biopsies. The evaluation, classification, and staging system is unique for mycosis fungoides (MF) and Sézary syndrome (SS), the most common subtypes of cutaneous T-cell lymphoma (CTCL) versus the other subtypes of Non-MF/Non-SS CTCL and the subtypes of cutaneous B-cell lymphoma (CBCL). Since current treatment is stage-based, it is particularly important that the correct diagnosis and stage be ascertained initially. The purpose of this article is to review the current evaluation, diagnosis, classification, staging, assessment techniques, and response criteria for the various types of both T-cell and B-cell PCLs. PMID:26433839

  16. Two stage gear tooth dynamics program

    NASA Technical Reports Server (NTRS)

    Boyd, Linda S.

    1989-01-01

    The epicyclic gear dynamics program was expanded to add the option of evaluating the tooth pair dynamics for two epicyclic gear stages with peripheral components. This was a practical extension to the program as multiple gear stages are often used for speed reduction, space, weight, and/or auxiliary units. The option was developed for either stage to be a basic planetary, star, single external-external mesh, or single external-internal mesh. The two stage system allows for modeling of the peripherals with an input mass and shaft, an output mass and shaft, and a connecting shaft. Execution of the initial test case indicated an instability in the solution with the tooth paid loads growing to excessive magnitudes. A procedure to trace the instability is recommended as well as a method of reducing the program's computation time by reducing the number of boundary condition iterations.

  17. Classification in two-stage screening.

    PubMed

    Longford, Nicholas T

    2015-11-10

    Decision theory is applied to the problem of setting thresholds in medical screening when it is organised in two stages. In the first stage that involves a less expensive procedure that can be applied on a mass scale, an individual is classified as a negative or a likely positive. In the second stage, the likely positives are subjected to another test that classifies them as (definite) positives or negatives. The second-stage test is more accurate, but also more expensive and more involved, and so there are incentives to restrict its application. Robustness of the method with respect to the parameters, some of which have to be set by elicitation, is assessed by sensitivity analysis.

  18. Coordinated X-Y stage apparatus

    DOEpatents

    Morimoto, Alan K.; Kozlowski, David M.; Charles, Steven T.; Spalding, James A.

    2000-01-01

    An apparatus based on precision X-Y stages that are stacked. Attached to arms projecting from each X-Y stage are a set of two axis gimbals. Attached to the gimbals is a rod, which provides motion along the axis of the rod and rotation around its axis. A dual-planar apparatus that provides six degrees of freedom of motion precise to within microns of motion.

  19. Impact cratering at geologic stage boundaries

    NASA Technical Reports Server (NTRS)

    Stothers, Richard B.

    1993-01-01

    The largest known Cenozoic impact craters with the most accurately measured ages are found to correlate very closely with geologic stage boundaries. The level of confidence in this result is 98-99 percent even under the most pessimistic assumptions concerning dating errors. One or more large impacts may have led, in at least some cases, to the extinctions and first appearances of biotic species that mark many of the geologic stage boundaries.

  20. High Head Unshrouded Impeller Pump Stage Technology

    NASA Technical Reports Server (NTRS)

    Williams, Robert W.; Skelley, Stephen E.; Stewart, Eric T.; Droege, Alan R.; Prueger, George H.; Chen, Wei-Chung; Williams, Morgan; Turner, James E. (Technical Monitor)

    2000-01-01

    A team of engineers at NASA/MSFC and Boeing, Rocketdyne division, are developing unshrouded impeller technologies that will increase payload and decrease cost of future reusable launch vehicles. Using the latest analytical techniques and experimental data, a two-stage unshrouded fuel pump is being designed that will meet the performance requirements of a three-stage shrouded pump. Benefits of the new pump include lower manufacturing costs, reduced weight, and increased payload to orbit.

  1. [Juvenile nasopharyngeal angiofibroma: stage and surgical approach].

    PubMed

    Hanamure, Yutaka; Tanaka, Norimitsu; Kawabata, Takayuki; Kasano, Fujihiko; Kashima, Naoko

    2005-05-01

    Juvenile nasopharyngeal angiofibromas (JNAs) are benign tumors that occasionally invade the pterygopalatine fossa, infratemporal fossa, or middle cranial fossa. Several surgical approaches have been used based on the location of the tumor, including transpalatal, transmaxillary, and lateral rhinotomy, midfacial degloving, and Le Fort type I osteotomy. We reviewed 4 cases of JNA that had been treated by resection in the Department of Otolaryngology of Kagoshima City Hospital and 31 cases of JNA reported in the Japanese literature between 1990 and 2003. We analyzed the outcome of the surgical treatment of JNA in these cases to identify the surgical approaches that were most effective in removing tumors at several different stages. Radkowski staging showed that 17 (48.6%), 2 (5.7%), 4 (11.4%), 9 (25.7%) and 3 (8.6%) patients had stage IA, IB, IIA, IIC, and IIIA tumors, respectively. A transpalatal approach was employed in 11 cases (31.4%), a transmaxillary approach in 9 cases (25.7%), a transnasal approach in 6 cases (17.1%), and other approaches, (25.7%). The recurrence rate was, 5% in the stage I cases, 38% in the stage II cases, and 33% in the stage III cases. The transpalatal approach was followed by a high recurrence rate in the cases of stage II and higher stage. Several factors are critical when choosing the surgical approach to JNA: adequate exposure of the tumor, ability to control bleeding, prevention of postoperative facial deformity, and avoidance of interference with growth of the face.

  2. Core compressor exit stage study, volume 6

    NASA Technical Reports Server (NTRS)

    Wisler, D. C.

    1981-01-01

    Rear stage blading designs that have lower losses in their endwall boundary layer regions were studied. A baseline Stage A was designed as a low-speed model of stage 7 of a 10-stage compressor. Candidate rotors and stators were designed which have the potential of reducing endwall losses relative to the baseline. Rotor B uses a type of meanline in the tip region that unloads the leading edge and loads the trailing edge relative to the baseline rotor A designs. Rotor C incorporates a more skewed (hub strong) radial distribution of total pressure and smoother distribution of static pressure on the rotor tip than those of rotor B. Candidate stator B embodies twist gradients in the endwall region. Stator C embodies airfoil sections near the endwalls that have reduced trailing edge loading relative to stator A. The baseline and candidate bladings were tested using four identical stages to produce a true multistage environment. Single-stage tests were also conducted. The test data were analyzed and performances were compared. Several of the candidate configurations showed a performance improvement relative to the baseline.

  3. Behaviorism and the Stages of Scientific Activity

    PubMed Central

    Moore, J

    2010-01-01

    Following from an earlier analysis by B. F. Skinner, the present article suggests that the verbal processes in science may usefully be viewed as following a three-stage progression. This progression starts with (a) identification of basic data, then moves to (b) description of relations among those data, and ultimately concludes with (c) the deployment of higher order concepts in statements about organizations of data. The article emphasizes the importance of viewing theory and explanation as examples of verbal processes at the later stages, guided by the stimulus control from the earlier stages. The article further suggests that many theories and explanations in traditional psychology often take a form that appears to be from the later stages. However, adequate activity at the earlier stages has not preceded those theories and explanations. They therefore do not have the benefit of suitable stimulus control from the earlier stages. Rather, they reflect some degree of stimulus control by many mentalistic assumptions about causal entities and relations. Ultimately, traditional theories and explanations influenced by mentalistic assumptions occasion less effective interaction with natural events (e.g., through prediction and control) than they might otherwise. PMID:22479126

  4. Epacadostat and Vaccine Therapy in Treating Patients With Stage III-IV Melanoma

    ClinicalTrials.gov

    2016-10-31

    Mucosal Melanoma; Recurrent Melanoma; Recurrent Uveal Melanoma; Stage IIIA Skin Melanoma; Stage IIIA Uveal Melanoma; Stage IIIB Skin Melanoma; Stage IIIB Uveal Melanoma; Stage IIIC Skin Melanoma; Stage IIIC Uveal Melanoma; Stage IV Skin Melanoma; Stage IV Uveal Melanoma

  5. Extraoral implants for orbit rehabilitation: a comparison between one-stage and two-stage surgeries.

    PubMed

    de Mello, M C L M P; Guedes, R; de Oliveira, J A P; Pecorari, V A; Abrahão, M; Dib, L L

    2014-03-01

    The aim of the study was to compare the osseointegration success rate and time for delivery of the prosthesis among cases treated by two-stage or one-stage surgery for orbit rehabilitation between 2003 and 2011. Forty-five patients were included, 31 males and 14 females; 22 patients had two-stage surgery and 23 patients had one-stage surgery. A total 138 implants were installed, 42 (30.4%) on previously irradiated bone. The implant survival rate was 96.4%, with a success rate of 99.0% among non-irradiated patients and 90.5% among irradiated patients. Two-stage patients received 74 implants with a survival rate of 94.6% (four implants lost); one-stage surgery patients received 64 implants with a survival rate of 98.4% (one implant lost). The median time interval between implant fixation and delivery of the prosthesis for the two-stage group was 9.6 months and for the one-stage group was 4.0 months (P < 0.001). The one-stage technique proved to be reliable and was associated with few risks and complications; the rate of successful osseointegration was similar to those reported in the literature. The one-stage technique should be considered a viable procedure that shortens the time to final rehabilitation and facilitates appropriate patient follow-up treatment.

  6. Ultra-high speed vacuum pump system with first stage turbofan and second stage turbomolecular pump

    DOEpatents

    Jostlein, Hans

    2006-04-04

    An ultra-high speed vacuum pump evacuation system includes a first stage ultra-high speed turbofan and a second stage conventional turbomolecular pump. The turbofan is either connected in series to a chamber to be evacuated, or is optionally disposed entirely within the chamber. The turbofan employs large diameter rotor blades operating at high linear blade velocity to impart an ultra-high pumping speed to a fluid. The second stage turbomolecular pump is fluidly connected downstream from the first stage turbofan. In operation, the first stage turbofan operates in a pre-existing vacuum, with the fluid asserting only small axial forces upon the rotor blades. The turbofan imparts a velocity to fluid particles towards an outlet at a high volume rate, but moderate compression ratio. The second stage conventional turbomolecular pump then compresses the fluid to pressures for evacuation by a roughing pump.

  7. Stage-by-Stage and Parallel Flow Path Compressor Modeling for a Variable Cycle Engine

    NASA Technical Reports Server (NTRS)

    Kopasakis, George; Connolly, Joseph W.; Cheng, Larry

    2015-01-01

    This paper covers the development of stage-by-stage and parallel flow path compressor modeling approaches for a Variable Cycle Engine. The stage-by-stage compressor modeling approach is an extension of a technique for lumped volume dynamics and performance characteristic modeling. It was developed to improve the accuracy of axial compressor dynamics over lumped volume dynamics modeling. The stage-by-stage compressor model presented here is formulated into a parallel flow path model that includes both axial and rotational dynamics. This is done to enable the study of compressor and propulsion system dynamic performance under flow distortion conditions. The approaches utilized here are generic and should be applicable for the modeling of any axial flow compressor design.

  8. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2016-03-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  9. TBCC Fan Stage Operability and Performance

    NASA Technical Reports Server (NTRS)

    Suder, Kenneth L.

    2007-01-01

    NASA s Fundamental Aeronautics Program is investigating turbine-based propulsion systems for access to space because it provides the potential for aircraft-like, space-launch operations that may significantly reduce launch costs and improve safety. Studies performed under NASA s NGLT and the NASP High Speed Propulsion Assessment (HiSPA) program indicated a variable cycle turbofan/ramjet was the best configuration to satisfy access-to-space mission requirements because this configuration maximizes the engine thrust-to-weight ratio while minimizing frontal area. To this end, NASA and GE teamed to design a Mach 4 variable cycle turbofan/ramjet engine for access to space. To enable the wide operating range of a Mach 4+ variable cycle turbofan ramjet required the development of a unique fan stage design capable of multi-point operation to accommodate variations in bypass ratio (10X), fan speed (7X), inlet mass flow (3.5X), inlet pressure (8X), and inlet temperature (3X). The primary goal of the fan stage was to provide a high pressure ratio level with good efficiency at takeoff through the mid range of engine operation, while avoiding stall and losses at the higher flight Mach numbers, without the use of variable inlet guide vanes. Overall fan performance and operability therefore requires major consideration, as competing goals at different operating points and aeromechanical issues become major drivers in the design. To mitigate risk of meeting the unique design requirements for the fan stage, NASA and GE teamed to design and build a 57% engine scaled fan stage to be tested in NASA s transonic compressor facility. The objectives of this test are to assess the aerodynamic and aero mechanic performance and operability characteristics of the fan stage over the entire range of engine operation including: 1) sea level static take-off, 2) transition over large swings in fan bypass ratio, 3) transition from turbofan to ramjet, and 4) fan windmilling operation at high Mach

  10. Performance of 15-Stage Experimental J71 Axial-Flow Compressor: II - Individual Stage Performance Characteristics

    NASA Technical Reports Server (NTRS)

    Lucas, James G.; Filippi, Richard E.

    1954-01-01

    The first four stages were found to cause a major part of the poor low-speed efficiency of this compressor. The low design-speed over-all pressure ratio at surge was caused by the first and the twelfth to fifteenth stages. The multiple over-all performance curves in the intermediate-speed range were at least partly the result of double-branched characteristic curves for the third and seventh stages.

  11. Staged mold for encapsulating hazardous wastes

    DOEpatents

    Unger, Samuel L.; Telles, Rodney W.; Lubowitz, Hyman R.

    1988-01-01

    A staged mold for stabilizing hazardous wastes for final disposal by molding an agglomerate of the hazardous wastes and encapsulating the agglomerate. Three stages are employed in the process. In the first stage, a first mold body is positioned on a first mold base, a mixture of the hazardous wastes and a thermosetting plastic is loaded into the mold, the mixture is mechanically compressed, heat is applied to cure the mixture to form a rigid agglomerate, and the first mold body is removed leaving the agglomerate sitting on the first mold base. In the second stage, a clamshell second mold body is positioned around the agglomerate and the first mold base, a powdered thermoplastic resin is poured on top of the agglomerate and in the gap between the sides of the agglomerate and the second mold body, the thermoplastic is compressed, heat is applied to melt the thermoplastic, and the plastic is cooled jacketing the agglomerate on the top and sides. In the third stage, the mold with the jacketed agglomerate is inverted, the first mold base is removed exposing the former bottom of the agglomerate, powdered thermoplastic is poured over the former bottom, the first mold base is replaced to compress the thermoplastic, heat is applied to melt the new thermoplastic and the top part of the jacket on the sides, the plastic is cooled jacketing the bottom and fusing with the jacketing on the sides to complete the seamless encapsulation of the agglomerate.

  12. Staged mold for encapsulating hazardous wastes

    DOEpatents

    Unger, Samuel L.; Telles, Rodney W.; Lubowitz, Hyman R.

    1990-01-01

    A staged mold for stabilizing hazardous wastes for final disposal by molding an agglomerate of the hazardous wastes and encapsulating the agglomerate. Three stages are employed in the process. In the first stage, a first mold body is positioned on a first mold base, a mixture of the hazardous wastes and a thermosetting plastic is loaded into the mold, the mixture is mechanically compressed, heat is applied to cure the mixture to form a rigid agglomerate, and the first mold body is removed leaving the agglomerate sitting on the first mold base. In the second stage, a clamshell second mold body is positioned around the agglomerate and the first mold base, a powdered thermoplastic resin is poured on top of the agglomerate and in the gap between the sides of the agglomerate and the second mold body, the thermoplastic is compressed, heat is applied to melt the thermoplastic, and the plastic is cooled jacketing the agglomerate on the top and sides. In the third stage, the mold with the jacketed agglomerate is inverted, the first mold base is removed exposing the former bottom of the agglomerate, powdered thermoplastic is poured over the former bottom, the first mold base is replaced to compress the thermoplastic, heat is applied to melt the new thermoplastic and the top part of the jacket on the sides, the plastic is cooled jacketing the bottom and fusing with the jacketing on the sides to complete the seamless encapsulation of the agglomerate.

  13. A dynamic deep sleep stage in Drosophila

    PubMed Central

    van Alphen, Bart; Yap, Melvyn H.W.; Kirszenblat, Leonie; Kottler, Benjamin; van Swinderen, Bruno

    2013-01-01

    How might one determine whether simple animals such as flies sleep in stages? Sleep in mammals is a dynamic process involving different stages of sleep intensity, and these are typically associated with measurable changes in brain activity (Blake and Gerard, 1937; Rechtschaffen and Kales, 1968; Webb and Agnew, 1971). Evidence for different sleep stages in invertebrates remains elusive, even though it has been well established that many invertebrate species require sleep (Campbell and Tobler, 1984; Hendricks et al., 2000; Shaw et al., 2000; Sauer et al., 2003). Here we use electrophysiology and arousal-testing paradigms to show that the fruit fly, Drosophila melanogaster, transitions between deeper and lighter sleep within extended bouts of inactivity, with deeper sleep intensities after ~15 and ~30 minutes of inactivity. As in mammals, the timing and intensity of these dynamic sleep processes in flies is homeostatically regulated and modulated by behavioral experience. Two molecules linked to synaptic plasticity regulate the intensity of the first deep sleep stage. Optogenetic upregulation of cyclic adenosine monophosphate (cAMP) during the day increases sleep intensity at night, whereas loss of function of a molecule involved in synaptic pruning, the fragile-X mental retardation protein (FMRP), increases sleep intensity during the day. Our results show that sleep is not homogenous in insects, and suggest that waking behavior and associated synaptic plasticity mechanisms determine the timing and intensity of deep sleep stages in Drosophila. PMID:23595750

  14. [Ultrasound in oncology: screening and staging].

    PubMed

    Delorme, S

    2012-03-01

    This is a review on the role of ultrasound for early detection and staging of cancer. In breast cancer screening ultrasound serves to clarify mammographically unclear lesions and is a primary screening tool for hereditary breast cancer. Renal neoplasms are commonly diagnosed as incidental sonographic findings and in this case are more often in a curable stage than symptomatic neoplasms. In chronic hepatitis or liver cirrhosis the annual incidence of hepatocellular cancer is more than 2% and ultrasound is used as a screening tool with 60% sensitivity and 97% specificity. According to the literature the sensitivity of native ultrasound for detecting metastases is 60% and the sensitivity of contrast-enhanced ultrasound (CEUS) is 79% or higher, i.e comparable with the sensitivity of contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Its role in staging is, however, limited as CT and MRI are necessary for local staging of the primary tumor and also include the liver. In the differential diagnosis of liver lesions the specificity of CEUS ranges from 82% to 99% depending on the lesion entity and is thereby comparable to contrast-enhanced CT. For staging of cervical lymph node metastases ultrasound is preferable to CT or MRI as the sensitivity lies between 79% and 90% and specificity is reported to be 90%. PMID:22354462

  15. Shortening the second stage of labor?

    PubMed Central

    Mahendru, Rajiv

    2010-01-01

    Objective To evaluate the benefits and risks of using uterine fundal pressure in shortening the second stage of labor and on the obstetrical outcome. Material and Methods A pilot study comprising 209 primigravidae between 37 and 40 gestational weeks with singleton fetus in cephalic presentation admitted to the delivery suite were considered and were randomly allocated into two groups: I (n=101) and II (n=108), with or without manual fundal pressure, respectively, during the second stage of labor. Main observation measures considered were: duration of the second stage of labor was the primary outcome measure and the secondary outcome measures were severe maternal morbidity/mortality, neonatal trauma, admission to neonatal intensive care unit, and neonatal death. Results There were no significant differences in the mean duration of the second stage of labor and secondary outcome measures. Significant adverse findings having no mention in the earlier literature, were noticed which were: one case each of retained placenta and uterine prolapse besides increased evidence of maternal exhaustion and perineal injuries (including one case of complete perineal tear) in the group where fundal pressure was exercised. Conclusion Application of uterine fundal pressure in a delivering woman was not only ineffective in shortening the second stage of labor but added to the risks during parturition. PMID:24591907

  16. Morphology based field rice density detection from rice transplant stage to rice jointing stage

    NASA Astrophysics Data System (ADS)

    Bai, X. D.; Cao, Z. G.; Wang, Y.; Ye, M. N.; Yu, Z. H.; Li, Y. N.

    2013-10-01

    Rice yield estimation is an important aspect in the agriculture research field. For the rice yield estimation, rice density is one of its useful factors. In this paper, we propose a new method to automatically detect the rice density from the rice transplanting stage to rice jointing stage. It devotes to detect rice planting density by image low-level features of the rice image sequences taken in the fields. Moreover, a rice jointing stage automatic detection method is proposed so as to terminate the rice density detection algorithm. The validities of the proposed rice density detection method and the rice jointing stage automatic detection method are proved in the experiment.

  17. Malaria Blood Stage Suppression of Liver Stage Immunity by Dendritic Cells

    PubMed Central

    Ocaña-Morgner, Carlos; Mota, Maria M.; Rodriguez, Ana

    2003-01-01

    Malaria starts with Plasmodium sporozoites infection of the host's liver, where development into blood stage parasites occurs. It is not clear why natural infections do not induce protection against the initial liver stage and generate low CD8+ T cell responses. Using a rodent malaria model, we show that Plasmodium blood stage infection suppresses CD8+ T cell immune responses that were induced against the initial liver stage. Blood stage Plasmodium affects dendritic cell (DC) functions, inhibiting maturation and the capacity to initiate immune responses and inverting the interleukin (IL)-12/IL-10 secretion pattern. The interaction of blood stage parasites with DCs induces the secretion of soluble factors that inhibit the activation of CD8+ T cells in vitro and the suppression of protective CD8+ T cell responses against the liver stage in vivo. We propose that blood stage infection induces DCs to suppress CD8+ T cell responses in natural malaria infections. This evasion mechanism leaves the host unprotected against reinfection by inhibiting the immune response against the initial liver stage of the disease. PMID:12538654

  18. Optics of two-stage photovoltaic concentrators with dielectric second stages.

    PubMed

    Ning, X; O'Gallagher, J; Winston, R

    1987-04-01

    Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions. PMID:20454302

  19. Article mounting and position adjustment stage

    DOEpatents

    Cutburth, R.W.; Silva, L.L.

    1988-05-10

    An improved adjustment and mounting stage of the type used for the detection of laser beams is disclosed. A ring sensor holder has locating pins on a first side thereof which are positioned within a linear keyway in a surrounding housing for permitting reciprocal movement of the ring along the keyway. A rotatable ring gear is positioned within the housing on the other side of the ring from the linear keyway and includes an oval keyway which drives the ring along the linear keyway upon rotation of the gear. Motor-driven single-stage and dual (x, y) stage adjustment systems are disclosed which are of compact construction and include a large laser transmission hole. 6 figs.

  20. Article mounting and position adjustment stage

    DOEpatents

    Cutburth, Ronald W.; Silva, Leonard L.

    1988-01-01

    An improved adjustment and mounting stage of the type used for the detection of laser beams is disclosed. A ring sensor holder has locating pins on a first side thereof which are positioned within a linear keyway in a surrounding housing for permitting reciprocal movement of the ring along the keyway. A rotatable ring gear is positioned within the housing on the other side of the ring from the linear keyway and includes an oval keyway which drives the ring along the linear keyway upon rotation of the gear. Motor-driven single-stage and dual (x, y) stage adjustment systems are disclosed which are of compact construction and include a large laser transmission hole.

  1. Alignment Stage for a Cryogenic Dilatometer

    NASA Technical Reports Server (NTRS)

    Dudik, Matthew; Moore, Donald

    2005-01-01

    A three-degree-of-freedom alignment stage has been designed and built for use in a cryogenic dilatometer that is used to measure thermal strains. The alignment stage enables precise adjustments of the positions and orientations of optical components to be used in the measurements and, once adjustments have been completed, keeps the components precisely aligned during cryogenic-dilatometer operations that can last as long as several days. The alignment stage includes a case, a circular tilt/tip platform, and a variety of flexural couplings between the case and the platform, all machined from a single block of the low-thermal-expansion iron/nickel alloy Invar, in order to minimize effects of temperature gradients and to obtain couplings that are free of stiction and friction. There are three sets of flexural couplings clocked at equal angles of 120 degrees around the platform, constituting a three-point kinematic support system.

  2. Two stage principal component analysis of color.

    PubMed

    Lenz, Reiner

    2002-01-01

    We introduce a two-stage analysis of color spectra. In the first processing stage, correlation with the first eigenvector of a spectral database is used to measure the intensity of a color spectrum. In the second step, a perspective projection is used to map the color spectrum to the hyperspace of spectra with first eigenvector coefficient equal to unity. The location in this hyperspace describes the chromaticity of the color spectrum. In this new projection space, a second basis of eigenvectors is computed and the projected spectrum is described by the expansion in this chromaticity basis. This description is possible since the space of color spectra is conical. We compare this two-stage process with traditional principal component analysis and find that the results of the new structure are closer to the structure of traditional chromaticity descriptors than traditional principal component analysis.

  3. Nuclear electric propulsion stage requirements and description

    NASA Technical Reports Server (NTRS)

    Mondt, J. F.; Peelgren, M. L.; Nakashima, A. M.; Nsieh, T. M.; Phillips, W. M.; Kikin, G. M.

    1974-01-01

    The application of a nuclear electric propulsion (NEP) stage in the exploration of near-earth, cometary, and planetary space was discussed. The NEP stage is powered by a liquid-metal-cooled, fast spectrum thermionic reactor capable of providing 120 kWe for 20,000 hours. This power is used to drive a number of mercury ion bombardment thrusters with specific impulse in the range of 4000-5000 seconds. The NEP description, characteristics, and functional requirements are discussed. These requirements are based on a set of five coordinate missions, which are described in detail. These five missions are a representative part of a larger set of missions used as a basic for an advanced propulsion comparison study. Additionally, the NEP stage development plan and test program is outlined and a schedule presented.

  4. Is a staged SST the answer

    SciTech Connect

    Not Available

    1991-02-01

    Recent studies indicate that a staged supersonic transport concept offers several advantages over conventional SST configurations. A staged SST could be optimized for cruise flight and also would not be subject to the noise and runway-length constraints normally associated with a transport aircraft. The cumulative effect of the various weight saving factors is an appreciably lower launch/takeoff weight. Other advantages include the fact that a landing gear would not be required and the staged SST can be designed to low-speed criteria. These initial studies suggest that launch and recovery operations from another aircraft could be made feasible with the use of a 747 type aircraft as the support vehicle.

  5. Thermally integrated staged methanol reformer and method

    DOEpatents

    Skala, Glenn William; Hart-Predmore, David James; Pettit, William Henry; Borup, Rodney Lynn

    2001-01-01

    A thermally integrated two-stage methanol reformer including a heat exchanger and first and second reactors colocated in a common housing in which a gaseous heat transfer medium circulates to carry heat from the heat exchanger into the reactors. The heat transfer medium comprises principally hydrogen, carbon dioxide, methanol vapor and water vapor formed in a first stage reforming reaction. A small portion of the circulating heat transfer medium is drawn off and reacted in a second stage reforming reaction which substantially completes the reaction of the methanol and water remaining in the drawn-off portion. Preferably, a PrOx reactor will be included in the housing upstream of the heat exchanger to supplement the heat provided by the heat exchanger.

  6. Photoacoustic Imaging for Cancer Detection and Staging

    PubMed Central

    Mehrmohammadi, Mohammad; Yoon, Soon Joon; Yeager, Douglas; Emelianov, Stanislav Y.

    2013-01-01

    Cancer is one of the leading causes of death in the world. Diagnosing a cancer at its early stages of development can decrease the mortality rate significantly and reduce healthcare costs. Over the past two decades, photoacoustic imaging has seen steady growth and has demonstrated notable capabilities to detect cancerous cells and stage cancer. Furthermore, photoacoustic imaging combined with ultrasound imaging and augmented with molecular targeted contrast agents is capable of imaging cancer at the cellular and molecular level, thus opening diverse opportunities to improve diagnosis of tumors, detect circulating tumor cells and identify metastatic lymph nodes. In this paper we introduce the principles of photoacoustic imaging, and review recent developments in photoacoustic imagingas an emerging imaging modality for cancer diagnosis and staging. PMID:24032095

  7. Life stages: interactions and spatial patterns.

    PubMed

    Robertson, Suzanne L; Cushing, J M; Costantino, R F

    2012-02-01

    In many stage-structured species, different life stages often occupy separate spatial niches in a heterogeneous environment. Life stages of the giant flour beetle Tribolium brevicornis (Leconte), in particular adults and pupae, occupy different locations in a homogeneous habitat. This unique spatial pattern does not occur in the well-studied stored grain pests T. castaneum (Herbst) and T. confusum (Duval). We propose density dependent dispersal as a causal mechanism for this spatial pattern. We model and explore the spatial dynamics of T. brevicornis with a set of four density dependent integrodifference and difference equations. The spatial model exhibits multiple attractors: a spatially uniform attractor and a patchy attractor with pupae and adults spatially separated. The model attractors are consistent with experimental observations.

  8. A toolbox to study liver stage malaria.

    PubMed

    Prudêncio, Miguel; Mota, Maria M; Mendes, António M

    2011-12-01

    The first obligatory phase of mammalian infection by Plasmodium parasites, the causative agents of malaria, occurs in the liver of the host. This stage of Plasmodium infection bears enormous potential for anti-malarial intervention. Recent technological progress has strongly contributed to overcoming some of the long-standing difficulties in experimentally assessing hepatic infection by Plasmodium. Here, we review appropriate infection models and infection assessment tools, and provide a comprehensive description of recent advances in experimental strategies to investigate the liver stage of malaria. These issues are discussed in the context of current challenges in the field to provide researchers with the technical tools that enable effective experimental approaches to study liver stage malaria.

  9. CIRCUIT2. 4. 2-Stage Classification Modeling

    SciTech Connect

    Wilde, R.A. ); Anderson, J.V. )

    1987-12-01

    CIRCUIT2.4 is used to design optimum two-stage classification configurations and operating conditions for energy conservation. It permits simulation of five basic grinding-classification circuits, including one single-stage and four two-stage classification arrangements. Hydrocyclones, spiral classifiers, and sieve band screens can be simulated, and the user may choose the combination of devices for the flowsheet simulation. In addition, the user may select from four classification modeling methods to achieve the goals of a simulation project using the most familiar concepts. Circuit performance is modeled based on classification parameters or equipment operating conditions. A modular approach was taken in designing the program, which allows future addition of other models with relatively minor changes.

  10. Imaging the earliest stages of Alzheimer's disease.

    PubMed

    Wu, William; Small, Scott A

    2006-12-01

    Historical progress in medicine can be charted along the lines of technical innovations that have visualized the invisible. One hundred years ago, Alois Alzheimer exploited newly developed histological stains to visualize his eponymonous disease in dead tissue under the microscope. Now, as we are entering the second century of Alzheimer's disease research, technical innovation has endowed us with a range of in vivo imaging techniques that promise to visualize Alzheimer' disease in living people. The earliest stage of Alzheimer's disease is characterized by cell-sickness, not cell-death, and can occur before the deposition of amyloid plaques or neurofibrillary tangles. In principle, 'functional' imaging techniques might be able to detect this early stage of the disease, a stage that was invisible to Alzheimer himself. Here, we will first define the neurobiological meaning of 'function' and then review the different approaches that measure brain dysfunction in Alzheimer' disease.

  11. Stage of Alcohol and Drug Use among Young Adults.

    ERIC Educational Resources Information Center

    Werch, Chudley E.; And Others

    1994-01-01

    This study examined stages of drug habit acquisition and change among college students, basing the proposed stages of drug use on the Multi-Component Motivational Stages prevention model. Surveys indicated the model helped explain the stages of substance use. The proportion of youths at each stage differed by type of drug. (SM)

  12. Low Noise Research Fan Stage Design

    NASA Technical Reports Server (NTRS)

    Hobbs, David E.; Neubert, Robert J.; Malmborg, Eric W.; Philbrick, Daniel H.; Spear, David A.

    1995-01-01

    This report describes the design of a Low Noise ADP Research Fan stage. The fan is a variable pitch design which is designed at the cruise pitch condition. Relative to the cruise setting, the blade is closed at takeoff and opened for reverse thrust operation. The fan stage is a split flow design with fan exit guide vanes and core stators. This fan stage design was combined with a nacelle and engine core duct to form a powered fan/nacelle, subscale model. This model is intended for use in aerodynamic performance, acoustic and structural testing in a wind tunnel. The model has a 22-inch outer fan diameter and a hub-to-top ratio of 0.426 which permits the use of existing NASA fan and cowl force balance designs and rig drive system. The design parameters were selected to permit valid acoustic and aerodynamic comparisons with the PW 17-inch rig previously tested under NASA contract. The fan stage design is described in detail. The results of the design axisymmetric analysis at aerodynamic design condition are included. The structural analysis of the fan rotor and attachment is described including the material selections and stress analysis. The blade and attachment are predicted to have adequate low cycle fatigue life, and an acceptable operating range without resonant stress or flutter. The stage was acoustically designed with airfoil counts in the fan exit guide vane and core stator to minimize noise. A fan-FEGV tone analysis developed separately under NASA contract was used to determine these airfoil counts. The fan stage design was matched to a nacelle design to form a fan/nacelle model for wind tunnel testing. The nacelle design was developed under a separate NASA contract. The nacelle was designed with an axisymmetric inlet, cowl and nozzle for convenience in testing and fabrication. Aerodynamic analysis of the nacelle confirmed the required performance at various aircraft operating conditions.

  13. Progress on Ares First Stage Propulsion

    NASA Technical Reports Server (NTRS)

    Priskos, Alex S.; Tiller, Bruce

    2008-01-01

    The mission of the National Aeronautics and Space Administration (NASA) is not simply to maintain its current position with the International Space Station and other space exploration endeavors, but to build a permanent outpost on the Moon and then travel on to explore ever more distant terrains. The Constellation Program will oversee the development of the crew capsule, launch vehicles, and other systems needed to achieve this mission. From this initiative will come two new launch vehicles: the Ares I and Ares V. The Ares I will be a human-rated vehicle, which will be used for crew transport; the Ares V, a cargo transport vehicle, will be the largest launch vehicle ever built. The Ares Projects team at Marshall Space Flight Center (MSFC) in Huntsville, Alabama is assigned with developing these two new vehicles. The Ares I vehicle will have an in-line, two-stage rocket configuration. The first stage will provide the thrust or propulsion component for the Ares rocket systems through the first two minutes of the mission. The First Stage Team is tasked with developing the propulsion system necessary to liftoff from the Earth and loft the entire Ares vehicle stack toward low-Earth orbit. Building on the legacy of the Space Shuttle and other NASA space exploration initiatives, the propulsion for the Ares I First Stage will be a Shuttle-derived reusable solid rocket motor. Progress to date by the First Stage Team has been robust and on schedule. This paper provides an update on the design and development of the Ares First Stage Propulsion system.

  14. Developmental stages of health education in HMOs.

    PubMed

    Vosen, B; Deeds, S G

    1981-01-01

    With no standards for comparison, expectations for health education programs and judgments of their success are subjective. Regardless of initial differences in variables such as starting point of the program, resource allotment, and organizational characteristics and structures, all health education programs have some similar goals and development processes. The goals are: the need to establish long-term relationships, gain visibility, and appeal to the dominant domains within the organization in order to survive. An empirical three-stage model is proposed as a generic development process. The stages, formation, action, and stabilization, propose more sophisticated and complex programmatic content evolving as the initial strategic organizational issues are resolved.

  15. Staged Reconstruction for a Severely Worn Dentition.

    PubMed

    Wilson, Christopher

    2016-09-01

    When patients are constrained financially to receive dental work, a staged approach can be an effective way for enabling treatment to proceed. In this case, a patient who had been in the practice for about 10 years and had a severely worn and eroded dentition finally opted to receive treatment in stages. A systematic approach was used to determine the proper postoperative position of the teeth. The subsequent treatment plan included the use of porcelain onlays and full-coverage crowns in the mandibular posterior along with provisional direct composite restorations in the maxillary dentition; the composites would be transitioned to porcelain crowns as the patient's finances would allow. PMID:27608200

  16. Developmental Stages in Dynamic Plant Growth Models

    NASA Astrophysics Data System (ADS)

    Maclean, Heather; Dochain, Denis; Waters, Geoff; Stasiak, Michael; Dixon, Mike; Van Der Straeten, Dominique

    2011-09-01

    During the growth of red beet plants in a closed environment plant growth chamber, a change in metabolism was observed (decreasing photosynthetic quotient) which was not predicted by a previously developed simple dynamic model of photosynthesis and respiration reactions. The incorporation of developmental stages into the model allowed for the representation of this change in metabolism without adding unnecessary complexity. Developmental stages were implemented by dividing the model into two successive sub-models with independent yields. The transition between the phases was detected based on online measurements. Results showed an accurate prediction of carbon dioxide and oxygen fluxes.

  17. Upper stage alternatives for the shuttle era

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

  18. Two-stage coal liquefaction process

    DOEpatents

    Skinner, Ronald W.; Tao, John C.; Znaimer, Samuel

    1985-01-01

    An improved SRC-I two-stage coal liquefaction process which improves the product slate is provided. Substantially all of the net yield of 650.degree.-850.degree. F. heavy distillate from the LC-Finer is combined with the SRC process solvent, substantially all of the net 400.degree.-650.degree. F. middle distillate from the SRC section is combined with the hydrocracker solvent in the LC-Finer, and the initial boiling point of the SRC process solvent is increased sufficiently high to produce a net yield of 650.degree.-850.degree. F. heavy distillate of zero for the two-stage liquefaction process.

  19. MRI staging of low rectal cancer.

    PubMed

    Shihab, Oliver C; Moran, Brendan J; Heald, Richard J; Quirke, Philip; Brown, Gina

    2009-03-01

    Low rectal tumours, especially those treated by abdominoperineal excision (APE), have a high rate of margin involvement when compared with tumours elsewhere in the rectum. Correct surgical management to minimise this rate of margin involvement is reliant on highly accurate imaging, which can be used to plan the planes of excision. In this article we describe the techniques for accurate magnetic resonance imaging (MRI) assessment and a novel staging system for low rectal tumours. Using this staging system it is possible for the radiologist to demonstrate accurately tumour-free planes for surgical excision of low rectal tumours. PMID:18810451

  20. Psychosexual Intervention in Patients With Stage I-III Gynecologic or Breast Cancer

    ClinicalTrials.gov

    2016-05-02

    Ovarian Sarcoma; Ovarian Stromal Cancer; Stage I Uterine Sarcoma; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Epithelial Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IA Primary Peritoneal Cavity Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Epithelial Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IB Primary Peritoneal Cavity Cancer; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Epithelial Cancer; Stage IC Ovarian Germ Cell Tumor; Stage IC Primary Peritoneal Cavity Cancer; Stage II Endometrial Carcinoma; Stage II Gestational Trophoblastic Tumor; Stage II Uterine Sarcoma; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Cervical Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Primary Peritoneal Cavity Cancer; Stage III Gestational Trophoblastic Tumor; Stage III Uterine Sarcoma; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IIIA Cervical Cancer; Stage IIIA Endometrial Carcinoma; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Cervical Cancer; Stage IIIB Endometrial Carcinoma; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Endometrial Carcinoma; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell

  1. Ares I Crew Launch Vehicle Upper Stage/Upper Stage Engine Element Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

    The Ares I upper stage is an integral part of the Constellation Program transportation system. The upper stage provides guidance, navigation and control (GN and C) for the second stage of ascent flight for the Ares I vehicle. The Saturn-derived J-2X upper stage engine will provide thrust and propulsive impulse for the second stage of ascent flight for the Ares I launch vehicle. Additionally, the upper stage is responsible for the avionics system of the the entire Ares I. This brief presentation highlights the requirements, design, progress and production of the upper stage. Additionally, test facilities to support J-2X development are discussed and an overview of the operational and manufacturing flows are provided. Building on the heritage of the Apollo and Space Shuttle Programs, the Ares I Us and USE teams are utilizing extensive lessons learned to place NASA and the US into another era of space exploration. The NASA, Boeing and PWR teams are integrated and working together to make progress designing and building the Ares I upper stage to minimize cost, technical and schedule risks.

  2. Treatment results in women with clinical stage I and pathologic stage II endometrial carcinoma.

    PubMed

    Jobsen, J J; Schutter, E M; Meerwaldt, J H; Van Der Palen, J; Van Der Sijde, R; Ten Cate, L N

    2001-01-01

    The aim of this study is to report survival and results of therapy and possible prognostic factors in women with pathologic stage II endometrial carcinoma. Forty-two patients with pathologic stage II endometrial carcinoma were treated at the department of Radiation Oncology of the Medisch Spectrum Twente between 1987 and 1998. All patients received external radiotherapy following standard surgical procedures and no adjuvant systemic therapy was given. From the 42 patients 21 had a pathologic stage IIA and 21 stage IIB. The median follow-up was 62 months. The overall recurrence rate was 21.5% (9/42). Seven patients had distant metastasis, of which three also had locoregional recurrence, vaginal vault and/or pelvic. The presence of myometrial invasion (> (1/2)) and/or lymph-angioinvasion showed a significant relation with distant metastasis (P = 0.017). Stage IIB showed more recurrences, 33% (7/21). There was a significant different 5-year disease specific survival for stage IIA and IIB, respectively, 95% and 74% (P = 0.0311). Patients with a differentiation grade 3 and stage IIB showed a significantly poorer (P = 0.003) 5-year survival of 48.6% (P = 0.003). Results obtained in the present series of patients are in accordance with the literature. The present treatment policy seems justified, except for patients with pathologic stage IIB and grade 3, in which a more aggressive treatment should be considered. PMID:11285033

  3. Treatment results in women with clinical stage I and pathologic stage II endometrial carcinoma.

    PubMed

    Jobsen, J J; Schutter, E M; Meerwaldt, J H; Van Der Palen, J; Van Der Sijde, R; Ten Cate, L N

    2001-01-01

    The aim of this study is to report survival and results of therapy and possible prognostic factors in women with pathologic stage II endometrial carcinoma. Forty-two patients with pathologic stage II endometrial carcinoma were treated at the department of Radiation Oncology of the Medisch Spectrum Twente between 1987 and 1998. All patients received external radiotherapy following standard surgical procedures and no adjuvant systemic therapy was given. From the 42 patients 21 had a pathologic stage IIA and 21 stage IIB. The median follow-up was 62 months. The overall recurrence rate was 21.5% (9/42). Seven patients had distant metastasis, of which three also had locoregional recurrence, vaginal vault and/or pelvic. The presence of myometrial invasion (> (1/2)) and/or lymph-angioinvasion showed a significant relation with distant metastasis (P = 0.017). Stage IIB showed more recurrences, 33% (7/21). There was a significant different 5-year disease specific survival for stage IIA and IIB, respectively, 95% and 74% (P = 0.0311). Patients with a differentiation grade 3 and stage IIB showed a significantly poorer (P = 0.003) 5-year survival of 48.6% (P = 0.003). Results obtained in the present series of patients are in accordance with the literature. The present treatment policy seems justified, except for patients with pathologic stage IIB and grade 3, in which a more aggressive treatment should be considered.

  4. Acetic acid effects on methanogens in the second stage of a two-stage anaerobic system.

    PubMed

    Xiao, Keke; Guo, Chenghong; Zhou, Yan; Maspolim, Yogananda; Ng, Wun-Jern

    2016-02-01

    This study reports on biomass tolerance towards high concentrations of acetic acid (HAc) within the system. Biomass from the second stage of a two-stage anaerobic sludge digestion system was used for this study. Microbial community analysis by 454 pyrosequencing highlighted hydrogenotrophic Methanomicrobiales was the predominant archaeal population in the second stage (>99% of the total archaeal community). Second stage biomass degraded HAc up to 4200 mg HAc L(-1) without observable lag phase. However, at HAc-shock loading of 7400 mg HAc L(-1), it showed a one day lag phase associated with decreased biomass activity. After stepwise HAc-acclimation over 27 d, the biomass degraded HAc of up to 8200 mg HAc L(-1) without observable lag phase. The dominance of Methanomicrobiales had remained unchanged in proportion - while the total archaeal population increased during acclimation. This study showed stepwise acclimation could be an approach to accommodate HAc accumulation and hence higher concentrations resulting from an enhanced first stage.

  5. Chemotherapy for Stage II Colon Cancer.

    PubMed

    Varghese, Anna

    2015-12-01

    The adjuvant treatment of patients with stage II colon cancer is an area of controversy in medical oncology. Adjuvant chemotherapy aims to eradicate micrometastatic disease present at the time of surgery, preventing the development of distant metastatic disease and thereby curing those patients of their cancer. National and international guidelines for the adjuvant treatment of stage II colon cancer recommend a range of treatment options from observation to chemotherapy with single-agent or combination regimens, depending on the presence or absence of high-risk features (poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, report of < 12 lymph nodes, bowel obstruction, localized perforation, or positive margins). In the one prospective study designed to address the role of adjuvant chemotherapy in stage II colon cancer, a small but statistically significant benefit in overall survival was seen for those patients who received adjuvant chemotherapy; however, multiple meta-analyses and retrospective subgroup analyses have called these findings into question. Though there may be a role for adjuvant chemotherapy in the treatment of patients with stage II colon cancer, its incremental benefit is small, at best, and comes with the risks of real and rarely fatal complications of chemotherapy. PMID:26648796

  6. Predicting Stages of Change in Battered Women

    ERIC Educational Resources Information Center

    Alexander, Pamela C.; Tracy, Allison; Radek, Megan; Koverola, Catherine

    2009-01-01

    Battered women's stages of change (SOCs) are examined in this study. First, confirmatory factor analysis and latent profile analysis were conducted on 754 battered women's responses on the Problems in Relationship Scale (Brown, 1998). Factor loadings were strong, and latent variable mixture modeling produces a two-class solution. Second,…

  7. Two stage sorption of sulfur compounds

    SciTech Connect

    Moore, W.E.

    1991-12-31

    A two stage method for reducing the sulfur content of exhaust gases is disclosed. Alkali- or alkaline-earth-based sorbent is totally or partially vaporized 10 and introduced into a sulfur-containing gas stream. The activated sorbent can be introduced in the reaction zone or the exhaust gases of a combustor or a gasifier. High efficiencies of sulfur removal can be achieved.

  8. Sequencing of Vocational Development Stages: Further Studies

    ERIC Educational Resources Information Center

    Hershenson, David B.; Lavery, Gerard J.

    1978-01-01

    Reports two studies supporting the prediction derived from Hershenson's life-stage vocational development model that average scores on Self-differentiation (worker self-concept and motivation) would exceed those on Competence (work habits, skills, and interpersonal relations), which in turn would exceed those on Independence (appropriateness and…

  9. Optimization, an Important Stage of Engineering Design

    ERIC Educational Resources Information Center

    Kelley, Todd R.

    2010-01-01

    A number of leaders in technology education have indicated that a major difference between the technological design process and the engineering design process is analysis and optimization. The analysis stage of the engineering design process is when mathematical models and scientific principles are employed to help the designer predict design…

  10. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Technological Requirements (MTR)? No. Placing hazardous remediation wastes into a staging pile does not constitute land disposal of hazardous wastes or create a unit that is subject to the minimum technological... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS...

  11. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Technological Requirements (MTR)? No. Placing hazardous remediation wastes into a staging pile does not constitute land disposal of hazardous wastes or create a unit that is subject to the minimum technological... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS...

  12. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Technological Requirements (MTR)? No. Placing hazardous remediation wastes into a staging pile does not constitute land disposal of hazardous wastes or create a unit that is subject to the minimum technological... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS...

  13. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Technological Requirements (MTR)? No. Placing hazardous remediation wastes into a staging pile does not constitute land disposal of hazardous wastes or create a unit that is subject to the minimum technological... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS...

  14. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Technological Requirements (MTR)? No. Placing hazardous remediation wastes into a staging pile does not constitute land disposal of hazardous wastes or create a unit that is subject to the minimum technological... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS...

  15. Major Stages of Development, 1966-1972.

    ERIC Educational Resources Information Center

    Oak Ridge Associated Universities, TN.

    This study describes four developmental stages of Training and Technology (TAT), a human resources development activity begun 7 years ago by the Oak Ridge Associated Universities for the U. S. Department of Labor. The first year's project, in 1966, surveyed manpower development and training in universities, industry, and government in 15 Southern…

  16. Two stage sorption of sulfur compounds

    DOEpatents

    Moore, William E.

    1992-01-01

    A two stage method for reducing the sulfur content of exhaust gases is disclosed. Alkali- or alkaline-earth-based sorbent is totally or partially vaporized and introduced into a sulfur-containing gas stream. The activated sorbent can be introduced in the reaction zone or the exhaust gases of a combustor or a gasifier. High efficiencies of sulfur removal can be achieved.

  17. Multi-stage separations based on dielectrophoresis

    DOEpatents

    Mariella, Jr., Raymond P.

    2004-07-13

    A system utilizing multi-stage traps based on dielectrophoresis. Traps with electrodes arranged transverse to the flow and traps with electrodes arranged parallel to the flow with combinations of direct current and alternating voltage are used to trap, concentrate, separate, and/or purify target particles.

  18. A First Language: The Early Stages.

    ERIC Educational Resources Information Center

    Brown, Roger

    This book focuses on the nature and development of knowledge concerning grammar and the meanings coded by grammar. This knowledge is inferred from performance, from sentences and the settings in which they are spoken, and from signs of comprehension or incomprehension of sentences by preschool children. The first two stages of linguistic…

  19. Staging "Swissness": Inter- and Intracultural Theatre Translation

    ERIC Educational Resources Information Center

    Wilkinson, Jane

    2005-01-01

    This paper examines the choice to translate plays from "Hochdeutsch" (the standard form of the German language) into local dialect in German-speaking Switzerland. It first looks at the creative process of translating for the amateur stage and then at the reasons behind the choice to translate. It argues that this choice reflects a desire to…

  20. Shuttle/Centaur Upper Stage Capability

    NASA Technical Reports Server (NTRS)

    Clark, H. J.

    1984-01-01

    A joint project to design, develop, procure, and produce Centaur upper stages for use with the Space Shuttle is discussed. A common Centaur G stage 6 meters (19.5 feet) in length is being jointly developed. A longer version designated Centaur G Prime is being developed by NASA to accomplish the Galileo and International Solar-Polar Mission flights in 1986. The Centaur G and G Prime will have the capability to place, respectively, approximately 4540 kilograms (10,000 pounds) and 5910 kilograms (13,000 pounds) into geosynchronous orbit from a standard Shuttle parking orbit of 278 kilometers (150 nautical miles) and Shuttle performance (lift) capability 29,500 kilograms (65,000 pounds). The advent of high energy upper stage capability in 1986 will permit space users and spacecraft developers to utilize spacecraft growth, stage combination concepts with storage modules, teleoperator systems, and other mission peculiar devices to satisfy complex mission demands. These capabilities should greatly enhance the usefulness of the space environment and stimulate mission planners toward conception of innovative means to meet ever increasing mission requirements.

  1. Development Stages and Curriculum: A Japanese Perspective.

    ERIC Educational Resources Information Center

    Abiko, Tadahiko

    2002-01-01

    Discusses contemporary psychologists' criticism of Jean Piaget's developmental theory; reviews research in brain science, psychology, history, and the experiences of teachers; proposes a new theory of developmental stages based on children's shifting interests; discuses implications of "shifting interest center theory" for school curriculum in…

  2. Behaviorism and the Stages of Scientific Activity

    ERIC Educational Resources Information Center

    Moore, J.

    2010-01-01

    Following from an earlier analysis by B. F. Skinner, the present article suggests that the verbal processes in science may usefully be viewed as following a three-stage progression. This progression starts with (a) identification of basic data, then moves to (b) description of relations among those data, and ultimately concludes with (c) the…

  3. Staged tendon grafts and soft tissue coverage

    PubMed Central

    Elliot, David

    2011-01-01

    The objective of the two-staged flexor tendon method is to improve the predictability of final results in difficult problems dealing with tendon reconstruction. This article reviews the evolution and benefits of this procedure. It also considers the use of the technique to help deal with problems requiring pulley and skin reconstruction simultaneously with re-constituting the flexor tendon system. PMID:22022043

  4. Puppets and Stages: Tools of Imaginative Play.

    ERIC Educational Resources Information Center

    Texas Child Care, 1996

    1996-01-01

    Asserts that puppets help children in storytelling and role playing, encouraging creativity and language development. Details types of puppets and how to construct them, including: (1) figure stick puppets; (2) paper plate puppets; and (3) garden glove puppets. Describes how to construct different puppet stages for performance. (BGC)

  5. Water-sensitivity of cotton growth stages

    Technology Transfer Automated Retrieval System (TEKTRAN)

    All irrigations during a season are not equal in terms of providing economic return on the money spent to irrigate cotton. This article provides a brief description of the effect of water stress on cotton during the different growth stages of the plant and the relative benefit of irrigating to relie...

  6. Treatment of early stage vocal cord carcinoma

    SciTech Connect

    Ayers, G.

    1989-03-01

    The cure rates for early stage vocal cord cancer are excellent with primary radiotherapy. Voice quality remains as good or becomes better than prior to treatment. For the local failures that do occur, surgical salvage will yield ultimate cure rates of about 95% for T1 and 90% for T2 tumors.

  7. Uprated OMS engine for upper stage propulsion

    NASA Technical Reports Server (NTRS)

    Boyd, William C.

    1986-01-01

    The results of a pre-development component demonstration program on the use of a gas generator-driven turbopump that increases the Space Shuttle's Orbital Maneuvering Engine (OME) operating pressure are given. Tests and analysis confirm the the capability of the concept to meet or exceed performance and life requirements. Storable propellant upper stage concepts are also discussed.

  8. One-stage model for color conversion.

    NASA Technical Reports Server (NTRS)

    Richards, W.

    1972-01-01

    Description of a one-stage approximation to the color-conversion model of Richards and Parks (1971). The modified model proposes three channels for color vision, each with different center-surround sensitivities. In its strongest form, the model predicts that the gain-setting control that alters the sensitivities of each channel is solely a function of achromatic contrast.

  9. Space Launch System Upper Stage Technology Assessment

    NASA Technical Reports Server (NTRS)

    Holladay, Jon; Hampton, Bryan; Monk, Timothy

    2014-01-01

    The Space Launch System (SLS) is envisioned as a heavy-lift vehicle that will provide the foundation for future beyond low-Earth orbit (LEO) exploration missions. Previous studies have been performed to determine the optimal configuration for the SLS and the applicability of commercial off-the-shelf in-space stages for Earth departure. Currently NASA is analyzing the concept of a Dual Use Upper Stage (DUUS) that will provide LEO insertion and Earth departure burns. This paper will explore candidate in-space stages based on the DUUS design for a wide range of beyond LEO missions. Mission payloads will range from small robotic systems up to human systems with deep space habitats and landers. Mission destinations will include cislunar space, Mars, Jupiter, and Saturn. Given these wide-ranging mission objectives, a vehicle-sizing tool has been developed to determine the size of an Earth departure stage based on the mission objectives. The tool calculates masses for all the major subsystems of the vehicle including propellant loads, avionics, power, engines, main propulsion system components, tanks, pressurization system and gases, primary structural elements, and secondary structural elements. The tool uses an iterative sizing algorithm to determine the resulting mass of the stage. Any input into one of the subsystem sizing routines or the mission parameters can be treated as a parametric sweep or as a distribution for use in Monte Carlo analysis. Taking these factors together allows for multi-variable, coupled analysis runs. To increase confidence in the tool, the results have been verified against two point-of-departure designs of the DUUS. The tool has also been verified against Apollo moon mission elements and other manned space systems. This paper will focus on trading key propulsion technologies including chemical, Nuclear Thermal Propulsion (NTP), and Solar Electric Propulsion (SEP). All of the key performance inputs and relationships will be presented and

  10. Ares I Upper Stage Parachute Drop Test

    NASA Technical Reports Server (NTRS)

    2006-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry parachute drop test is conducted at the Yuma, Arizona proving ground. The parachute tests demonstrated a three-stage deployment sequence that included the use of an Orbiter drag chute to properly stage the unfurling of the main chute. The parachute recovery system for Orion will be similar to the system used for Apollo command module landings and include two drogue, three pilot, and three main parachutes. (Highest resolution available)

  11. Ares I Upper Stage Parachute Drop Test

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry parachute drop test is conducted at the Yuma, Arizona proving ground. The parachute tests demonstrated a three-stage deployment sequence that included the use of an Orbiter drag chute to properly stage the unfurling of the main chute. The parachute recovery system for Orion will be similar to the system used for Apollo command module landings and include two drogue, three pilot, and three main parachutes. (Highest resolution available)

  12. Comparative myoanatomy of cycliophoran life cycle stages.

    PubMed

    Neves, Ricardo C; Cunha, Marina R; Funch, Peter; Kristensen, Reinhardt M; Wanninger, Andreas

    2010-05-01

    The metazoan phylum Cycliophora includes small cryptic epibionts that live attached to the mouthparts of clawed lobsters. The life cycle is complex, with alternating sexual and asexual generations, and involves several sessile and free-living stages. So far, the morphological and genetic characterization of cycliophorans has been unable to clarify the phylogenetic position of the phylum. In this study, we add new details on the muscular anatomy of the feeding stage, the attached Prometheus larva, the dwarf male, and the female of one of the two hitherto described species, Symbion pandora. The musculature of the feeding stage is composed of myofibers that run longitudinally in the buccal funnel (two fibers) and in the trunk (variable number of fibers). The mouth opening is lined by a myoepithelial ring musculature. A complex myoepithelial sphincter is situated proximal to the anus. In the attached Prometheus larva, three longitudinal sets of myofilaments run dorsally, laterally, and ventrally along the entire anterior-posterior body axis. The muscular architecture of the dwarf male is complex, especially close to the penis, in the posterior part of the body. An X-shaped muscle structure is found on the dorsal side, whereas on the ventral side, longitudinal muscles and a V-shaped muscle structure are present. These muscles are complemented by additional dorsoventral muscles. The mesodermal muscle fibers attach to the cuticle via the epidermis in all life cycle stages studied herein. The musculature of the female is similar to that of the Pandora larva of Symbion americanus and includes dorsoventral muscles and longitudinal muscles that run in the dorsal and ventral body region. Overall, our results reveal striking similarities in the muscular arrangement of the life cycle stages of both Symbion species. PMID:20024946

  13. Vaccine Therapy and Cyclophosphamide in Treating Patients With Stage II-III Breast or Stage II-IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2016-01-07

    Recurrent Breast Carcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IIA Breast Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Breast Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Breast Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Breast Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Breast Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  14. Method and system for dual resolution translation stage

    DOEpatents

    Halpin, John Michael

    2014-04-22

    A dual resolution translation stage includes a stage assembly operable to receive an optical element and a low resolution adjustment device mechanically coupled to the stage assembly. The dual resolution stage also includes an adjustable pivot block mechanically coupled to the stage assembly. The adjustable pivot block includes a pivot shaft. The dual resolution stage further includes a lever arm mechanically coupled to the adjustable pivot block. The lever arm is operable to pivot about the pivot shaft. The dual resolution stage additionally includes a high resolution adjustment device mechanically coupled to the lever arm and the stage assembly.

  15. Ares I First Stage Propulsion System Status

    NASA Technical Reports Server (NTRS)

    Priskos, Alex S.

    2010-01-01

    With the retirement of the Space Shuttle inevitable, the US is faced with the need to loft a reliable cost-effective, technologically viable solution to bring the nation s fleet of spacecraft back up to industry standard. It must not only support the International Space Station (ISS), it must also be capable of supporting human exploration beyond low Earth orbit (LEO). NASA created the Constellation Program to develop a new fleet including the launch vehicles, the spacecraft, and the mission architecture to meet those objectives. The Ares First Stage Team is tasked with developing a propulsion system capable of safely, dependably and repeatedly lofting that new fleet. To minimize technical risks and development costs, the Solid Rocket Boosters (SRBs) of Shuttle were used as a starting point in the design and production of a new first stage element. While the first stage will provide the foundation, the structural backbone, power, and control for launch, the new propulsive element will also provide a greater total impulse to loft a safer, more powerful, fleet of space flight vehicles. Substantial design and system upgrades were required to meet the mass and trajectory requisites of the new fleet. Noteworthy innovations and design features include new forward structures, new propellant grain geometry, a new internal insulation system, and a state-of-the art avionics system. Additional advances were in materials and composite structures development, case bond liners, and thermal protection systems. Significant progress has been made in the design, development and testing of the propulsion and avionics systems for the new first stage element. Challenges, such as those anticipated with thrust oscillation, have been better characterized, and are being effectively mitigated. The test firing of the first development motor (DM-1) was a success that validated much of the engineering development to date. Substantive data has been collected and analyzed, allowing the Ares

  16. Stages in the psychological resolution of schizophrenia

    PubMed Central

    Steggles, Gillian R. M.

    2015-01-01

    From the work of Dr. Michael Robbins in Massachusetts, USA, it is known that nine schizophrenic patients out of a series of 18, and a further schizophrenic patient, treated by him achieved positive outcomes using psychoanalytic methodology. Four of these had strikingly successful outcomes, for example completing their treatment without a need for further medication, and also becoming happily married or graduating at university. This paper aims to illustrate the stages identified by him through which this can be accomplished. Dr. Robbins’ Stages of Psychological Therapy of Schizophrenia are compared with Dr. Steggles’ detailed case study of a patient’s recovery from schizoaffective disorder. These two data sources are juxtaposed and compared. Dr. Robbins’ therapeutic stages are found to parallel exactly Dr. Steggles’ findings from her case study, which she summarized as her psychodynamic pentapointed cognitive construct (PPCC) model of her schizoaffective patient’s experience. Psychological therapy of schizophrenia is still in its early stages of development. However, Dr. Robbins’ psychoanalytic psychotherapeutic technique has given rise to positive outcomes in 10 of the 19 patients he treated, that is, his series of 18 patients together with a further patient; these 19 patients he gave full psychological treatment, i.e., usually four sessions per week. The Stages he identifies in his therapeutic process match perfectly the stages Dr. Steggles identified in her own patient’s healing mind. Not all schizophrenic patients are likely to be able to benefit from this psychological therapy. Females seem to be better able than males to respond to the treatment, and motivation is necessary for a successful outcome. It is not known how to identify precisely those patients who will be successful. But those patients who do benefit may counterbalance by their economic activity the healthcare costs of those who do not recover, as well as achieving benefit from

  17. VEGF Trap in Treating Patients With Recurrent Stage III or Stage IV Melanoma That Cannot Be Removed by Surgery

    ClinicalTrials.gov

    2015-02-02

    Ciliary Body and Choroid Melanoma, Medium/Large Size; Extraocular Extension Melanoma; Iris Melanoma; Metastatic Intraocular Melanoma; Recurrent Intraocular Melanoma; Recurrent Melanoma; Stage III Melanoma; Stage IV Melanoma

  18. Implant-based breast reconstruction following conservative mastectomy: one-stage vs. two-stage approach

    PubMed Central

    2016-01-01

    Conservative mastectomy with preservation of the nipple areolar complex is now considered a safe and effective technique in properly selected patients. Good candidates for this procedure include women with small to moderate breast volume having therapeutic or prophylactic mastectomy. Both autologous and prosthetic options are available; however prosthetic techniques are performed more frequently. Prosthetic approaches include immediate 1-stage (direct to implant) or 2-atge (tissue expander/implant) techniques. Delayed prosthetic reconstruction is also possible with conservative mastectomy. This manuscript will review the 1-stage and 2-stage methods with an emphasis on indication, surgical techniques, and outcomes. PMID:26855908

  19. Performance of two-stage fan having low-aspect-ratio first-stage rotor blading

    NASA Technical Reports Server (NTRS)

    Urasek, D. C.; Gorrell, W. T.; Cunnan, W. S.

    1979-01-01

    The NASA two stage fan was tested with a low aspect ratio first stage rotor having no midspan dampers. At design speed the fan achieved an adiabatic design efficiency of 0.846, and peak efficiencies for the first stage and rotor of 0.870 and 0.906, respectively. Peak efficiency occurred very close to the stall line. In an attempt to improve stall margin, the fan was retested with circumferentially grooved casing treatment and with a series of stator blade resets. Results showed no improvement in stall margin with casing treatment but increased to 8 percent with stator blade reset.

  20. Enhanced stage and stage variability on the lower Missouri River benchmarked by Lewis and Clark

    NASA Astrophysics Data System (ADS)

    Ehlmann, Bethany L.; Criss, Robert E.

    2006-11-01

    Data from the 1803 1806 Lewis and Clark expedition and nineteenth century stage records are used to quantitatively benchmark natural, premanagement hydrology of the lower Missouri River and assess the magnitude and timing of hydrologic change over nearly two centuries. Data show doubling in daily stage variability from the nineteenth century to 2005. Annual maximum stages have, at some sites, become more extreme, and their seasonality is less regular. Observed changes adversely affect riverine habitat and flood levels; their timing, beginning as early as 1900, suggests that channelization is the major driver.

  1. Second-stage turbine bucket airfoil

    DOEpatents

    Wang, John Zhiqiang; By, Robert Romany; Sims, Calvin L.; Hyde, Susan Marie

    2002-01-01

    The second-stage buckets have airfoil profiles substantially in accordance with Cartesian coordinate values of X, Y and Z set forth in inches in Table I wherein Z is a perpendicular distance from a plane normal to a radius of the turbine centerline and containing the X and Y values with the Z value commencing at zero in the X, Y plane at the radially innermost aerodynamic section of the airfoil and X and Y are coordinate values defining the airfoil profile at each distance Z. The X and Y values may be scaled as a function of the same constant or number to provide a scaled-up or scaled-down airfoil section for the bucket. The second-stage wheel has sixty buckets.

  2. Whole organism blood stage vaccines against malaria.

    PubMed

    Stanisic, Danielle I; Good, Michael F

    2015-12-22

    Despite a century of research focused on the development and implementation of effective control strategies, infection with the malaria parasite continues to result in significant morbidity and mortality worldwide. An effective malaria vaccine is considered by many to be the definitive solution. Yet, after decades of research, we are still without a vaccine that is capable of inducing robust, long lasting protection in naturally exposed individuals. Extensive sub-unit vaccine development focused on the blood stage of the malaria parasite has thus far yielded disappointing results. There is now a renewed focus on whole parasite vaccine strategies, particularly as they may overcome some of the inherent weaknesses deemed to be associated with the sub-unit approach. This review discusses the whole parasite vaccine strategy focusing on the blood stage of the malaria parasite, with an emphasis on recent advances and challenges in the development of killed and live attenuated vaccines.

  3. Centaur upper-stage rocket for shuttle

    NASA Astrophysics Data System (ADS)

    Bell, Peter M.

    A popular topic for discussion among those still hoping that the National Aeronautics and Space Administration's (NASA) space shuttle will be able to launch large scientific space probes from earth orbit is the matter of the so-called US, or upper-stage, rocket vehicle. Programs slated for the middle of the decade that include sending probes deep into space will not be possible without a very powerful upper-stage rocket, and thus there was a surge of optimism among space scientists and NASA officials this past September when Congress voted not to eliminate the big Centaur rocket from space shuttle's portion of the NASA 1983 fiscal year budget.Support for construction of the Centaur followed the Air Force's requirement for greater lifting power because of the shielding required to prevent contamination of certain classified payloads (Science, 1 October 1982). The large rocket will also be needed to place massive communications satellites into geosynchronous earth orbit.

  4. Nutraceutical use in late-stage cancer

    PubMed Central

    Morris, Jay; Brown, Vondina; Ellis, Jane; Logothetis, Britt; Weber, Rebecca

    2012-01-01

    Access to a wealth of information on the internet has led many cancer patients to use complementary methods as an adjunct to traditional therapy for cancer, with, and more often, without informing their primary caregiver. Of the common complementary modalities, the use of dietary supplements appears to be highly prevalent in patients in active treatment for cancer, and later in cancer survivors. Emerging research suggests that some plant-based agents may, indeed, impact late-stage cancer, influencing molecular processes corrupted by tumor cells to evade detection, expand clonally, and invade surrounding tissues. The intent of this article is to review some of the current science underpinning the use of nutraceuticals in the latter stages of cancer. PMID:20714787

  5. High Head Unshrouded Impeller Pump Stage Technology

    NASA Technical Reports Server (NTRS)

    Williams, Robert W.; Skelley, Stephen E.; Stewart, Eric T.; Droege, Alan R.; Prueger, George H.; Chen, Wei-Chung; Williams, Morgan; Turner, James E. (Technical Monitor)

    2000-01-01

    Objective to develop an unshrouded impeller design, which a meets the performance requirements of a 3-stage fuel pump with a 2-stage pump design, has been accomplished. Performance of the baseline unshrouded impeller has been experimentally verified. Unshrouded impeller trade study and final 6+6 unshrouded impeller configuration has been presented. Structurally viable, 6+6-impeller design concept has been produced. Based on results presented in this study, at a nominal 10% tip-clearance, the 6+6 impeller design would increase payload to orbit by almost 625 lbs. per engine. The RLV vehicle requires 7 engines, therefore, application of high head unshrouded technology would increase payload capability by as much as 4,375 lbs. per vehicle.

  6. Technologies of stage magic: Simulation and dissimulation.

    PubMed

    Smith, Wally

    2015-06-01

    The craft of stage magic is presented in this article as a site to study the interplay of people and technology. The focus is on conjuring in the 19th and early 20th centuries, a time when magicians eagerly appropriated new optical, mechanical and electrical technologies into their acts. Also at this time, a modern style of conjuring emerged, characterized by minimal apparatus and a natural manner of performance. Applying Lucy Suchman's perspective of human-machine reconfigurations, conjuring in this modern style is interpreted as an early form of simulation, coupled with techniques of dissimulation. Magicians simulated the presence of supernational agency for public audiences, while dissimulating the underlying methods and mechanisms. Dissimulation implies that the secret inner workings of apparatus were not simply concealed but were rendered absent. This, in turn, obscured the production of supernatural effects in the translation of agencies within an assembly of performers, assistants, apparatus, apparatus-builders, and so on. How this was achieved is investigated through an analysis of key instructional texts written by and for magicians working in the modern style. Techniques of dissimulation are identified in the design of apparatus for three stage illusions, and in the new naturalness of the performer's manner. To explore the significance of this picture of stage magic, and its reliance on techniques of dissimulation, a parallel is drawn between conjuring and recent performances of computerized life forms, especially those of social robotics. The paper concludes by considering what is revealed about the production of agency in stage magic's peculiar human-machine assemblies. PMID:26477195

  7. Ares I Upper Stage Subscale Engine Test

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. The launch vehicle's first stage is a single, five-segment reusable solid rocket booster derived from the Space Shuttle Program's reusable solid rocket motor that burns a specially formulated and shaped solid propellant called polybutadiene acrylonitrile (PBAN). The second or upper stage will be propelled by a J-2X main engine fueled with liquid oxygen and liquid hydrogen. This HD video image depicts a test firing of a 40k subscale J2X injector at MSFC's test stand 115. (Highest resolution available)

  8. Computer Program Predicts Turbine-Stage Performance

    NASA Technical Reports Server (NTRS)

    Boyle, Robert J.; Haas, Jeffrey E.; Katsanis, Theodore

    1988-01-01

    MTSBL updated version of flow-analysis programs MERIDL and TSONIC coupled to boundary-layer program BLAYER. Method uses quasi-three-dimensional, inviscid, stream-function flow analysis iteratively coupled to calculated losses so changes in losses result in changes in flow distribution. Manner effects both configuration on flow distribution and flow distribution on losses taken into account in prediction of performance of stage. Written in FORTRAN IV.

  9. Technologies of stage magic: Simulation and dissimulation.

    PubMed

    Smith, Wally

    2015-06-01

    The craft of stage magic is presented in this article as a site to study the interplay of people and technology. The focus is on conjuring in the 19th and early 20th centuries, a time when magicians eagerly appropriated new optical, mechanical and electrical technologies into their acts. Also at this time, a modern style of conjuring emerged, characterized by minimal apparatus and a natural manner of performance. Applying Lucy Suchman's perspective of human-machine reconfigurations, conjuring in this modern style is interpreted as an early form of simulation, coupled with techniques of dissimulation. Magicians simulated the presence of supernational agency for public audiences, while dissimulating the underlying methods and mechanisms. Dissimulation implies that the secret inner workings of apparatus were not simply concealed but were rendered absent. This, in turn, obscured the production of supernatural effects in the translation of agencies within an assembly of performers, assistants, apparatus, apparatus-builders, and so on. How this was achieved is investigated through an analysis of key instructional texts written by and for magicians working in the modern style. Techniques of dissimulation are identified in the design of apparatus for three stage illusions, and in the new naturalness of the performer's manner. To explore the significance of this picture of stage magic, and its reliance on techniques of dissimulation, a parallel is drawn between conjuring and recent performances of computerized life forms, especially those of social robotics. The paper concludes by considering what is revealed about the production of agency in stage magic's peculiar human-machine assemblies.

  10. The treatment of early stage ovarian cancer.

    PubMed

    Young, R C

    1995-10-01

    Approximately one third of women with ovarian cancer present with localized disease. A series of recent studies have identified a population of patients who require only comprehensive surgical staging for optimal results and another group that may benefit from adjuvant therapy. A series of national and international studies are evaluating a variety of adjuvant treatments in prospective randomized trials that may enhance long-term survival in poor-prognosis early ovarian cancer. PMID:7481865

  11. Multi-stage hydride-hydrogen compressor

    NASA Astrophysics Data System (ADS)

    Golben, P. M.

    A 4-stage metal hydride/hydrogen compressor that uses low temperature hot water (75 C) as its energy source has been built and tested. The compressor utilizes a new hydride heat exchanger technique that has achieved fast cycling time (with 20 C cooling water) on the order of 1 min. This refinement substantially decreases the size, weight and cost of the unit when compared to previous hydride compressors or even conventional mechanical diaphragm compressors.

  12. Inertial Upper Stage (IUS) software analysis

    NASA Technical Reports Server (NTRS)

    Grayson, W. L.; Nickel, C. E.; Rose, P. L.; Singh, R. P.

    1979-01-01

    The Inertial Upper Stage (IUS) System, an extension of the Space Transportation System (STS) operating regime to include higher orbits, orbital plane changes, geosynchronous orbits, and interplanetary trajectories is presented. The IUS software design, the IUS software interfaces with other systems, and the cost effectiveness in software verification are described. Tasks of the IUS discussed include: (1) design analysis; (2) validation requirements analysis; (3) interface analysis; and (4) requirements analysis.

  13. Staging Liver Fibrosis with Statistical Observers

    NASA Astrophysics Data System (ADS)

    Brand, Jonathan Frieman

    Chronic liver disease is a worldwide health problem, and hepatic fibrosis (HF) is one of the hallmarks of the disease. Pathology diagnosis of HF is based on textural change in the liver as a lobular collagen network that develops within portal triads. The scale of collagen lobules is characteristically on order of 1mm, which close to the resolution limit of in vivo Gd-enhanced MRI. In this work the methods to collect training and testing images for a Hotelling observer are covered. An observer based on local texture analysis is trained and tested using wet-tissue phantoms. The technique is used to optimize the MRI sequence based on task performance. The final method developed is a two stage model observer to classify fibrotic and healthy tissue in both phantoms and in vivo MRI images. The first stage observer tests for the presence of local texture. Test statistics from the first observer are used to train the second stage observer to globally sample the local observer results. A decision of the disease class is made for an entire MRI image slice using test statistics collected from the second observer. The techniques are tested on wet-tissue phantoms and in vivo clinical patient data.

  14. Status Report on Nuclear Stage Definition

    NASA Technical Reports Server (NTRS)

    Johnson, Paul G.; Harris, Ronald J.

    1970-01-01

    This status report on nuclear stage definition should convey the message that a comprehensive analysis is underway, embracing many vehicle concepts and the full range of expected RNS operations. Flexible use in the future space program is one objective; economy and ease of operations are also major goals. Not until details unfold in the several mission areas and in definitions of interrelated systems can the RNS studies be narrowed down to fewer alternatives. Consequently, the current phase of the NSSD study is emphasizing (1) in-space operations, especially as they are affected by aftercooling and the radiation environment of the stage, and (2) RNS concepts in which the unique features of nuclear propulsion are utilized or designed around. Studies to date indicate that significant benefits can be realized through use of an RNS in the missions of the 1980's. Tn the broader context of technology advancement and foundation-building for later decades, the development of a reusable nuclear stage is highly desirable. The next year's efforts will, we trust, bring us much nearer to a full understanding of the RNS and its role in the future space program.

  15. Suicide in the Early Stage of Schizophrenia.

    PubMed

    Ventriglio, Antonio; Gentile, Alessandro; Bonfitto, Iris; Stella, Eleonora; Mari, Massimo; Steardo, Luca; Bellomo, Antonello

    2016-01-01

    Suicide is a relevant leading cause of death among patients affected by schizophrenia. Even if suicidal ideation may be present in different stages of disease, some differences have been described between the risk of suicide in patients experiencing first episode of psychosis and those with long-term schizophrenia. It is particularly higher during the first year of illness and reaches a steady decline over the following years. Suicidal ideation and attempts may also be common among subjects with subthreshold psychotic experiences. Factors associated with the risk of suicide in the early phase of schizophrenia are previous suicidal attempts and social aspects: the lack of social support and stable relationships, social drift after the first episode, and social impairment. Also, several psychotic symptoms (suspiciousness, paranoid delusions, mental disintegration and agitation, negative symptoms, depression and hopelessness, and command hallucinations) and substance abuse are associated with higher risk of suicide. It has been described that perfectionism and good levels of insight among individuals who have recently developed psychotic symptoms are significantly associated with higher numbers of suicidal attempts. Moreover, recent evidences show that prefrontal cortex-based circuit dysfunction may be related to suicide in the early stage of schizophrenia. This narrative review summarizes available evidences on suicide in the early stage of schizophrenia and deals with issues to be further studied and discussed. PMID:27445872

  16. Immunity to erythrocytic stages of malarial parasites.

    PubMed

    Long, C A; Daly, T M; Kima, P; Srivastava, I

    1994-01-01

    In those individuals who live in endemic areas, immunity to malaria is slow to develop and stage-specific. The nature and antigenic specificity of this response, which may involve components of both cell-mediated and humoral immunity, is not well understood. Rodent models provide useful systems to explore the spectrum of host responses that may contribute to resolution of erythrocytic-stage infection or possibly to pathogenesis. Moreover, these models allow identification of plasmodial molecules that can induce different types of host responses. Two different mouse model systems, Plasmodium yoelii yoelii and P. chabaudi adami are presented. These have been selected because resolution of infection by P. yoelii yoelii has been shown to require B cell-dependent mechanisms, while control of acute P. chabaudi adami infection can be achieved by T cell-dependent mechanisms. A monoclonal antibody that provides passive protection to P. yoelii challenge infection has been shown to recognize the cysteine-rich, carboxyl-terminal region of the merozoite surface protein-1. This region, obtained in an appropriate configuration from recombinant Escherichia coli, can induce significant protective immune responses in naive mice. In contrast, cell-mediated immune mechanisms make a major contribution to resolution of asexual-stage P. chabaudi adami infection. An empirical approach using continuous flow electrophoresis has identified several low molecular weight plasmodial proteins that can induce partial protective responses in susceptible hosts. These observations are briefly discussed with respect to human malaria.

  17. Management of Stage IIIA Hodgkin's disease

    SciTech Connect

    Timothy, A.R.; Sutcliffe, S.B.J.; Lister, A.; Wrigley, P.F.M.; Jones, A.E.

    1980-02-01

    Forty patients with pathological Stage IIIA Hodgkin's disease were allocated to receive either total modal irradiation (TNI) or 6 cycles of chemotherapy with Nitrogen Mustard (Mustine), Vinblastine, Procarbazine and Prednisolone (MVPP) as initial treatment. The complete remission rate for both groups was 100%, with 5-year actuarial disease-free survival figures of 74 and 87% for TNI and MVPP respectively (median duration of follow-up= 48 months). Eighty-eight percent of TNI treated patients were alive at 5 years compared with 100% in the MVPP group. Three patients died, two who were treated with TNI and one who received MVPP. Treatment related morbidity included one patient with osteonecrosis and one with a second malignancy. Given the length of follow-up available, these results demonstrate no significant difference between TNI and MVPP for patients with Stage IIIA disease; it is unlikely that further patient entry into this particular study will allow any conclusion to be reached regarding the optimal form of management. We would recommend that individual disease characteristics within Stage IIIA be used as a basis for future treatment decisions with the understanding that further information regarding morbidity may become available with prolonged follow-up.

  18. Suicide in the Early Stage of Schizophrenia

    PubMed Central

    Ventriglio, Antonio; Gentile, Alessandro; Bonfitto, Iris; Stella, Eleonora; Mari, Massimo; Steardo, Luca; Bellomo, Antonello

    2016-01-01

    Suicide is a relevant leading cause of death among patients affected by schizophrenia. Even if suicidal ideation may be present in different stages of disease, some differences have been described between the risk of suicide in patients experiencing first episode of psychosis and those with long-term schizophrenia. It is particularly higher during the first year of illness and reaches a steady decline over the following years. Suicidal ideation and attempts may also be common among subjects with subthreshold psychotic experiences. Factors associated with the risk of suicide in the early phase of schizophrenia are previous suicidal attempts and social aspects: the lack of social support and stable relationships, social drift after the first episode, and social impairment. Also, several psychotic symptoms (suspiciousness, paranoid delusions, mental disintegration and agitation, negative symptoms, depression and hopelessness, and command hallucinations) and substance abuse are associated with higher risk of suicide. It has been described that perfectionism and good levels of insight among individuals who have recently developed psychotic symptoms are significantly associated with higher numbers of suicidal attempts. Moreover, recent evidences show that prefrontal cortex-based circuit dysfunction may be related to suicide in the early stage of schizophrenia. This narrative review summarizes available evidences on suicide in the early stage of schizophrenia and deals with issues to be further studied and discussed. PMID:27445872

  19. Intravital Microscopy for Identifying Tumor Vessels in Patients With Stage IA-IV Melanoma That is Being Removed by Surgery

    ClinicalTrials.gov

    2016-01-13

    Recurrent Melanoma; Stage IA Skin Melanoma; Stage IB Skin Melanoma; Stage IIA Skin Melanoma; Stage IIB Skin Melanoma; Stage IIC Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIB Skin Melanoma; Stage IIIC Skin Melanoma; Stage IV Skin Melanoma

  20. Evaluation of an Internet, Stage-Based Physical Activity Intervention.

    ERIC Educational Resources Information Center

    Hager, Ronald L.; Hardy, Aaron; Aldana, Steven G.; George, James D.

    2002-01-01

    Evaluated the impact of online, stage-based materials on exercise behavior and stage of readiness to change. College faculty participated in stage-based, action-message, or control groups. Occupational and leisure activity, 7-day physical activity, exercise self-efficacy, and stage of readiness to change were assessed at baseline and 6 weeks.…

  1. Multi-Stage Bunch Compressors for the International Linear Collider

    SciTech Connect

    Tenenbaum, P.; Raubenheimer, T.O.; Wolski, A.; /LBL, Berkeley

    2005-05-27

    We present bunch compressor designs for the International Linear Collider (ILC) which achieve a reduction in RMS bunch length from 6 mm to 0.3 mm via multiple stages of compression, with stages of acceleration inserted between the stages of compression. The key advantage of multi-stage compression is that the maximum RMS energy spread is reduced to approximately 1%, compared to over 3% for a single-stage design. Analytic and simulation studies of the multi-stage bunch compressors are presented, along with performance comparisons to a single-stage system. Parameters for extending the systems to a larger total compression factor are discussed.

  2. Simulation and Analyses of Stage Separation of Two-Stage Reusable Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Pamadi, Bandu N.; Neirynck, Thomas A.; Hotchko, Nathaniel J.; Tartabini, Paul V.; Scallion, William I.; Murphy, K. J.; Covell, Peter F.

    2007-01-01

    NASA has initiated the development of methodologies, techniques and tools needed for analysis and simulation of stage separation of next generation reusable launch vehicles. As a part of this activity, ConSep simulation tool is being developed which is a MATLAB-based front-and-back-end to the commercially available ADAMS(Registerd TradeMark) solver, an industry standard package for solving multi-body dynamic problems. This paper discusses the application of ConSep to the simulation and analysis of staging maneuvers of two-stage-to-orbit (TSTO) Bimese reusable launch vehicles, one staging at Mach 3 and the other at Mach 6. The proximity and isolated aerodynamic database were assembled using the data from wind tunnel tests conducted at NASA Langley Research Center. The effects of parametric variations in mass, inertia, flight path angle, altitude from their nominal values at staging were evaluated. Monte Carlo runs were performed for Mach 3 staging to evaluate the sensitivity to uncertainties in aerodynamic coefficients.

  3. Simulation and Analyses of Stage Separation Two-Stage Reusable Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Pamadi, Bandu N.; Neirynck, Thomas A.; Hotchko, Nathaniel J.; Tartabini, Paul V.; Scallion, William I.; Murphy, Kelly J.; Covell, Peter F.

    2005-01-01

    NASA has initiated the development of methodologies, techniques and tools needed for analysis and simulation of stage separation of next generation reusable launch vehicles. As a part of this activity, ConSep simulation tool is being developed which is a MATLAB-based front-and-back-end to the commercially available ADAMS(registered Trademark) solver, an industry standard package for solving multi-body dynamic problems. This paper discusses the application of ConSep to the simulation and analysis of staging maneuvers of two-stage-to-orbit (TSTO) Bimese reusable launch vehicles, one staging at Mach 3 and the other at Mach 6. The proximity and isolated aerodynamic database were assembled using the data from wind tunnel tests conducted at NASA Langley Research Center. The effects of parametric variations in mass, inertia, flight path angle, altitude from their nominal values at staging were evaluated. Monte Carlo runs were performed for Mach 3 staging to evaluate the sensitivity to uncertainties in aerodynamic coefficients.

  4. Results of the Utah-Arizona stage-by-stage migrations

    USGS Publications Warehouse

    Ellis, D.H.; Mellon, C.; Kinloch, M.; Dolbeare, T.; Ossi, D.P.

    2001-01-01

    In an effort to find a safer means of teaching cranes new migration routes, each year (in 1998 and 1999) we transported a group of greater sandhill cranes (Grus canadensis tabida) stage-by-stage, in a horse trailer, with stops for brief flights at about 30-km intervals, along a 1300-1400-km fall migration route from Fish Springs National Wildlife Refuge (Fish Springs) in west-central Utah to the vicinity of Gila Bend, Arizona. Thereafter, we released them into a wild flock of sandhill cranes. All stage-by-stage birds were hand-reared with both a plastic crane decoy (to encourage them to roost in water) and a costume-draped humanoid form (called a scare-eagle and used for its namesake purpose). When these 2 teaching aids were placed in water, our cranes readily roosted nearby. All but 4 of our cranes proved cooperative (i.e., catchable at each of the ca 25-36 stops) during the migration. All were efficiently released into a wild flock and experienced good survival. The stage-by-stage method proved to be a safe means of transporting cranes south and giving them experience along the route. Some cranes apparently learned their route from the limited experience afforded by releasing them at intervals, and the 1999 cranes have made repealed migrations to or near our chosen northern terminus. However, after 1 winter in our chosen area, the birds have moved elsewhere to winter.

  5. Multi-stage fuel cell system method and apparatus

    DOEpatents

    George, Thomas J.; Smith, William C.

    2000-01-01

    A high efficiency, multi-stage fuel cell system method and apparatus is provided. The fuel cell system is comprised of multiple fuel cell stages, whereby the temperatures of the fuel and oxidant gas streams and the percentage of fuel consumed in each stage are controlled to optimize fuel cell system efficiency. The stages are connected in a serial, flow-through arrangement such that the oxidant gas and fuel gas flowing through an upstream stage is conducted directly into the next adjacent downstream stage. The fuel cell stages are further arranged such that unspent fuel and oxidant laden gases too hot to continue within an upstream stage because of material constraints are conducted into a subsequent downstream stage which comprises a similar cell configuration, however, which is constructed from materials having a higher heat tolerance and designed to meet higher thermal demands. In addition, fuel is underutilized in each stage, resulting in a higher overall fuel cell system efficiency.

  6. Combination Chemotherapy With or Without Monoclonal Antibody Therapy in Treating Patients With Stage III or Stage IV Low-Grade Non-Hodgkin's Lymphoma

    ClinicalTrials.gov

    2013-02-26

    Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Small Lymphocytic Lymphoma

  7. Imatinib Mesylate in Treating Patients With Progressive, Refractory, or Recurrent Stage II or Stage III Testicular or Ovarian Cancer

    ClinicalTrials.gov

    2013-01-15

    Ovarian Dysgerminoma; Recurrent Malignant Testicular Germ Cell Tumor; Recurrent Ovarian Germ Cell Tumor; Stage II Malignant Testicular Germ Cell Tumor; Stage II Ovarian Germ Cell Tumor; Stage III Malignant Testicular Germ Cell Tumor; Stage III Ovarian Germ Cell Tumor; Testicular Seminoma

  8. Molecular Phenotyping in Predicting Response in Patients With Stage IB-III Esophageal Cancer Receiving Combination Chemotherapy

    ClinicalTrials.gov

    2015-12-18

    Stage IB Esophageal Adenocarcinoma; Stage IIA Esophageal Adenocarcinoma; Stage IIB Esophageal Adenocarcinoma; Stage IIIA Esophageal Adenocarcinoma; Stage IIIB Esophageal Adenocarcinoma; Stage IIIC Esophageal Adenocarcinoma

  9. Cross-stage immunity for malaria vaccine development.

    PubMed

    Nahrendorf, Wiebke; Scholzen, Anja; Sauerwein, Robert W; Langhorne, Jean

    2015-12-22

    A vaccine against malaria is urgently needed for control and eventual eradication. Different approaches are pursued to induce either sterile immunity directed against pre-erythrocytic parasites or to mimic naturally acquired immunity by controlling blood-stage parasite densities and disease severity. Pre-erythrocytic and blood-stage malaria vaccines are often seen as opposing tactics, but it is likely that they have to be combined into a multi-stage malaria vaccine to be optimally safe and effective. Since many antigenic targets are shared between liver- and blood-stage parasites, malaria vaccines have the potential to elicit cross-stage protection with immune mechanisms against both stages complementing and enhancing each other. Here we discuss evidence from pre-erythrocytic and blood-stage subunit and whole parasite vaccination approaches that show that protection against malaria is not necessarily stage-specific. Parasites arresting at late liver-stages especially, can induce powerful blood-stage immunity, and similarly exposure to blood-stage parasites can afford pre-erythrocytic immunity. The incorporation of a blood-stage component into a multi-stage malaria vaccine would hence not only combat breakthrough infections in the blood should the pre-erythrocytic component fail to induce sterile protection, but would also actively enhance the pre-erythrocytic potency of this vaccine. We therefore advocate that future studies should concentrate on the identification of cross-stage protective malaria antigens, which can empower multi-stage malaria vaccine development.

  10. Staged sacrectomy--an adaptive approach.

    PubMed

    Ramamurthy, Rajaraman; Bose, Jagadish Chandra; Muthusamy, Vimalakannan; Natarajan, Mayilvahanan; Kunjithapatham, Deiveegan

    2009-09-01

    Object Sacral tumors are commonly diagnosed late and therefore present at an advanced stage. The late presentation makes curative surgery technically demanding. Sacrectomy is fraught with a high local recurrence rate and potential complications: deep infection; substantial blood loss; large-bone and soft-tissue defects; bladder, bowel, and sexual dysfunction; spinopelvic nonunion; and gait disturbance. The aim of this study was to analyze the complications and morbidity of sacrectomy and the modifications meant to reduce the morbidity. Methods This is a retrospective study of the patients who underwent sacrectomy between February 1997 and September 2008 in the Department of Surgical Oncology, Government Royapettah Hospital, Kilpauk Medical College, in Chennai, Tamilnadu, India. Sacrectomy was performed using 1 of the following approaches: posterior approach, abdominolateral approach, or abdominosacral approach, either as sequential or staged operations. The morbidity rate after the sequential and staged abdominosacral approaches was analyzed. Functional assessment was made based on the Enneking functional scoring system. The results were analyzed and survival analysis was done using the Kaplan-Meier method (with SPSS software). Results Nineteen patients underwent sacrectomy, of which 12 operations were partial, 3 were subtotal, and 4 were total sacrectomy. Histological diagnosis included giant cell tumor, chordoma, chondroblastoma, adenocarcinoma of rectum, and retroperitoneal sarcoma. The giant cell tumor was the most common tumor in this series, followed by chordoma. The patients' mean age at diagnosis was 32 years. There were 10 male and 9 female patients. Fortyseven percent of patients had bowel and bladder disturbances postoperatively, and 57.89% of patients had wound complications. The median follow-up duration was 24 months (range 2-140 months). The 5-year overall survival rate was 70.4%, and the 5-year disease-free survival rate was 65% (based on the Kaplan

  11. Biomarkers and clinical staging in psychiatry

    PubMed Central

    McGorry, Patrick; Keshavan, Matcheri; Goldstone, Sherilyn; Amminger, Paul; Allott, Kelly; Berk, Michael; Lavoie, Suzie; Pantelis, Christos; Yung, Alison; Wood, Stephen; Hickie, Ian

    2014-01-01

    Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry. PMID:25273285

  12. Two-stage microbial community experimental design.

    PubMed

    Tickle, Timothy L; Segata, Nicola; Waldron, Levi; Weingart, Uri; Huttenhower, Curtis

    2013-12-01

    Microbial community samples can be efficiently surveyed in high throughput by sequencing markers such as the 16S ribosomal RNA gene. Often, a collection of samples is then selected for subsequent metagenomic, metabolomic or other follow-up. Two-stage study design has long been used in ecology but has not yet been studied in-depth for high-throughput microbial community investigations. To avoid ad hoc sample selection, we developed and validated several purposive sample selection methods for two-stage studies (that is, biological criteria) targeting differing types of microbial communities. These methods select follow-up samples from large community surveys, with criteria including samples typical of the initially surveyed population, targeting specific microbial clades or rare species, maximizing diversity, representing extreme or deviant communities, or identifying communities distinct or discriminating among environment or host phenotypes. The accuracies of each sampling technique and their influences on the characteristics of the resulting selected microbial community were evaluated using both simulated and experimental data. Specifically, all criteria were able to identify samples whose properties were accurately retained in 318 paired 16S amplicon and whole-community metagenomic (follow-up) samples from the Human Microbiome Project. Some selection criteria resulted in follow-up samples that were strongly non-representative of the original survey population; diversity maximization particularly undersampled community configurations. Only selection of intentionally representative samples minimized differences in the selected sample set from the original microbial survey. An implementation is provided as the microPITA (Microbiomes: Picking Interesting Taxa for Analysis) software for two-stage study design of microbial communities.

  13. Clinical presentation and staging of Hodgkin lymphoma.

    PubMed

    Gallamini, Andrea; Hutchings, Martin; Ramadan, Safaa

    2016-07-01

    In the present chapter the authors present a brief overview of the diagnostic methods proposed over time for Hodgkin lymphoma (HL) spread detection, moving from surgical procedures, through standard radiological and functional imaging techniques to the present state of the art for HL staging. The main body of the review will be dedicated to the recently published guidelines for lymphoma staging (including HL) agreed by the experts during the 12th International Congress for Malignant Lymphoma in Lugano. The recommendations of the panel on how to integrate flurodeoxyglucose positron emission tomography (FDG-PET) scan in the armamentarium of staging procedures will be presented and commented, with a special emphasis on the utility of special procedures, such as bone marrow trephine biopsy, which is deemed no longer needed in the PET era. While the HL diagnosis is straightforward in most cases, sometimes HL is a subtle disease, difficult to diagnose for the paucity of symptoms, the absence of physical findings, or for concomitant immunologic disorders: a compete overview of the common and rare patterns of HL clinical presentation will be also offered. The future perspective of PET scan use will be based on a operator-independent, quantitative readings of the scan thanks to a plethora of sophisticated dedicated software, which are now available, able to quantify every voxel captured by the tumor to display the metabolically active tumor volume. Moreover, new tracers are now available able to track the new pathways of cellular metabolism beside glycolysis such as amino acids or purine-analogues or specific oncoproteins; the preliminary, promising results will be reported. Preliminary results from other imaging techniques, such as diffusion-weighted magnetic resonance (DW-MRI) will be also reported. PMID:27496305

  14. Clonal genomic alterations in glioma malignancy stages.

    PubMed

    James, C D; Carlbom, E; Dumanski, J P; Hansen, M; Nordenskjold, M; Collins, V P; Cavenee, W K

    1988-10-01

    Comparison of constitutional and tumor genotypes at chromosomal loci defined by restriction fragment length alleles has proven useful in determining the genomic position and tissue specificity of recessive mutations that predispose to cancer (Hansen, M.F., and Cavenee, W.K. Cancer Res., 47:5518-5527, 1987). Here we have applied this approach to 53 unrelated patients with glial tumors of varying histological malignancy grade. Loss of constitutional heterozygosity for loci on chromosome 10 was observed in 28 of 29 tumors histologically classified as glioblastoma (malignancy grade IV) whereas no similar losses were observed in any of 22 gliomas of lower malignancy grade. Examination of restriction fragment length alleles on other chromosomes revealed that loss of sequences on chromosomes 13, 17, or 22 had occurred at nonrandom frequencies and in at least one instance of each malignancy grade of adult glioma. The tumors in which loss of constitutional heterozygosity was observed were composed of one or a mixture of glial cell subtypes displaying astrocytic, oligodendrocytic, and/or ependymal differentiation. These results demonstrate a close association of the loss of chromosome 10 sequences with the most malignant histological stage of glioma and that glioblastoma arises as the clonal expansion of an earlier staged precursor. Furthermore they suggest that glioblastoma is a common phenotypic and malignancy terminus for glial tumors of various cellular subtypes which is reached through a common molecular pathway. This approach which involves the identification of malignancy stage specific somatic losses of heterozygosity provides a genotypic, rather than phenotypic, analysis of tumor progression.

  15. Omega-3 Fatty Acid in Treating Patients With Stage I-III Breast Cancer

    ClinicalTrials.gov

    2016-03-17

    Ductal Breast Carcinoma in Situ; Lobular Breast Carcinoma in Situ; Male Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  16. Staging memory for massively parallel processor

    NASA Technical Reports Server (NTRS)

    Batcher, Kenneth E. (Inventor)

    1988-01-01

    The invention herein relates to a computer organization capable of rapidly processing extremely large volumes of data. A staging memory is provided having a main stager portion consisting of a large number of memory banks which are accessed in parallel to receive, store, and transfer data words simultaneous with each other. Substager portions interconnect with the main stager portion to match input and output data formats with the data format of the main stager portion. An address generator is coded for accessing the data banks for receiving or transferring the appropriate words. Input and output permutation networks arrange the lineal order of data into and out of the memory banks.

  17. Temporal variability in stage-discharge relationships

    NASA Astrophysics Data System (ADS)

    Guerrero, José-Luis; Westerberg, Ida K.; Halldin, Sven; Xu, Chong-Yu; Lundin, Lars-Christer

    2012-06-01

    SummaryAlthough discharge estimations are central for water management and hydropower, there are few studies on the variability and uncertainty of their basis; deriving discharge from stage heights through the use of a rating curve that depends on riverbed geometry. A large fraction of the world's river-discharge stations are presumably located in alluvial channels where riverbed characteristics may change over time because of erosion and sedimentation. This study was conducted to analyse and quantify the dynamic relationship between stage and discharge and to determine to what degree currently used methods are able to account for such variability. The study was carried out for six hydrometric stations in the upper Choluteca River basin, Honduras, where a set of unusually frequent stage-discharge data are available. The temporal variability and the uncertainty of the rating curve and its parameters were analysed through a Monte Carlo (MC) analysis on a moving window of data using the Generalised Likelihood Uncertainty Estimation (GLUE) methodology. Acceptable ranges for the values of the rating-curve parameters were determined from riverbed surveys at the six stations, and the sampling space was constrained according to those ranges, using three-dimensional alpha shapes. Temporal variability was analysed in three ways: (i) with annually updated rating curves (simulating Honduran practices), (ii) a rating curve for each time window, and (iii) a smoothed, continuous dynamic rating curve derived from the MC analysis. The temporal variability of the rating parameters translated into a high rating-curve variability. The variability could turn out as increasing or decreasing trends and/or cyclic behaviour. There was a tendency at all stations to a seasonal variability. The discharge at a given stage could vary by a factor of two or more. The quotient in discharge volumes estimated from dynamic and static rating curves varied between 0.5 and 1.5. The difference between

  18. Single stage rankine and cycle power plant

    SciTech Connect

    Closs, J.J.

    1981-10-13

    The specification describes a Rankine cycle power plant of the single stage type energized by gasified freon, the latter being derived from freon in the liquid state in a boiler provided in the form of a radio frequency heating cell adapted at low energy input to effect a rapid change of state from liquid freon at a given temperature and pressure to gaseous freon of relatively large volume, thereby to drive a Rankine cycle type of engine recognized in the prior art as a steam engine type of engine of the piston or turbine type.

  19. Late-stage sinking of plutons

    USGS Publications Warehouse

    Glazner, A.F.; Miller, D.M.

    1997-01-01

    Many granodiorite to diorite plutons in the Great Basin of western North America are surrounded by rim monoclines or anticlines that suggest relative downward movement of the plutons while wall rocks were hot and ductile. We propose that such plutons rise to a level of approximately neutral buoyancy and then founder as their densities increase ??? 40% during crystallization. Late-stage sinking of intermediate to mafic plutons should be common when wall rocks are rich in weak, low-density minerals such as quartz and calcite. Structures related to sinking will overprint those related to initial pluton emplacement and may be mistaken for regional tectonic structures.

  20. Epidemiology and Staging of Renal Cell Carcinoma

    PubMed Central

    Ridge, Carole A.; Pua, Bradley B.; Madoff, David C.

    2014-01-01

    Incidence and mortality trends attributed to kidney cancer exhibit marked regional variability, likely related to demographic, environmental, and genetic factors. Efforts to identify reversible factors, which lead to the development of renal cell carcinoma (RCC), have led not only to a greater understanding of the etiology of RCC but also the genetic and histologic characteristics of renal tumors. This article describes this evolution by discussing contemporary RCC incidence and mortality data, the risk factors for development of RCC, the histologic features, and anatomic and integrated staging systems that guide treatment. PMID:24596434

  1. Turbine nozzle stage having thermocouple guide tube

    DOEpatents

    Schotsch, Margaret Jones; Kirkpatrick, Francis Lawrence; Lapine, Eric Michael

    2002-01-01

    A guide tube is fixed adjacent opposite ends in outer and inner covers of a nozzle stage segment. The guide tube is serpentine in shape between the outer and inner covers and extends through a nozzle vane. An insert is disposed in the nozzle vane and has apertures to accommodate serpentine portions of the guide tube. Cooling steam is also supplied through chambers of the insert on opposite sides of a central insert chamber containing the guide tube. The opposite ends of the guide tube are fixed to sleeves, in turn fixed to the outer and inner covers.

  2. AMERICAN JOINT COMMITTEE ON CANCER ACCEPTANCE CRITERIA FOR INCLUSION OF RISK MODELS FOR INDIVIDUALIZED PROGNOSIS IN THE PRACTICE OF PRECISION MEDICINE

    PubMed Central

    Kattan, Michael W.; Hess, Kenneth R.; Amin, Mahul; Lu, Ying; Moons, Karel G; Gershenwald, Jeffrey E.; Gimotty, Phyllis A.; Guinney, Justin; Halabi, Susan; Lazar, Alexander J.; Mahar, Alyson L.; Patel, Tushar; Sargent, Daniel J.; Weiser, Martin R.; Compton, Carolyn

    2016-01-01

    The American Joint Committee on Cancer (AJCC) has increasingly recognized the need for more personalized probabilistic predictions than those delivered by ordinal staging systems, particularly through the use of accurate risk models or calculators. However, judging the quality and acceptability of a risk model is complex. The AJCC Precision Medicine Core conducted a two-day meeting to discuss characteristics necessary for a quality risk model in cancer patients. More specifically, the committee established inclusion and exclusion criteria necessary for a risk model to potentially be endorsed by the AJCC. This committee reviewed and discussed relevant literature before creating a checklist unique to this need of AJCC risk model endorsement. The committee identified 13 inclusion and 3 exclusion criteria for AJCC risk model endorsement in cancer. The emphasis centered on performance metrics, implementation clarity, and clinical relevance. The facilitation of personalized probabilistic predictions for cancer patients holds tremendous promise, and these criteria will hopefully greatly accelerate this process. Moreover, these criteria might be useful for a general audience when trying to judge the potential applicability of a published risk model in any clinical domain. PMID:26784705

  3. Optimization Strategies for Single-Stage, Multi-Stage and Continuous ADRs

    NASA Technical Reports Server (NTRS)

    Shirron, Peter J.

    2014-01-01

    Adiabatic Demagnetization Refrigerators (ADR) have many advantages that are prompting a resurgence in their use in spaceflight and laboratory applications. They are solid-state coolers capable of very high efficiency and very wide operating range. However, their low energy storage density translates to larger mass for a given cooling capacity than is possible with other refrigeration techniques. The interplay between refrigerant mass and other parameters such as magnetic field and heat transfer points in multi-stage ADRs gives rise to a wide parameter space for optimization. This paper first presents optimization strategies for single ADR stages, focusing primarily on obtaining the largest cooling capacity per stage mass, then discusses the optimization of multi-stage and continuous ADRs in the context of the coordinated heat transfer that must occur between stages. The goal for the latter is usually to obtain the largest cooling power per mass or volume, but there can also be many secondary objectives, such as limiting instantaneous heat rejection rates and producing intermediate temperatures for cooling of other instrument components.

  4. Acetic acid effects on methanogens in the second stage of a two-stage anaerobic system.

    PubMed

    Xiao, Keke; Guo, Chenghong; Zhou, Yan; Maspolim, Yogananda; Ng, Wun-Jern

    2016-02-01

    This study reports on biomass tolerance towards high concentrations of acetic acid (HAc) within the system. Biomass from the second stage of a two-stage anaerobic sludge digestion system was used for this study. Microbial community analysis by 454 pyrosequencing highlighted hydrogenotrophic Methanomicrobiales was the predominant archaeal population in the second stage (>99% of the total archaeal community). Second stage biomass degraded HAc up to 4200 mg HAc L(-1) without observable lag phase. However, at HAc-shock loading of 7400 mg HAc L(-1), it showed a one day lag phase associated with decreased biomass activity. After stepwise HAc-acclimation over 27 d, the biomass degraded HAc of up to 8200 mg HAc L(-1) without observable lag phase. The dominance of Methanomicrobiales had remained unchanged in proportion - while the total archaeal population increased during acclimation. This study showed stepwise acclimation could be an approach to accommodate HAc accumulation and hence higher concentrations resulting from an enhanced first stage. PMID:26498097

  5. Adaptive two-stage designs in phase II clinical trials.

    PubMed

    Banerjee, Anindita; Tsiatis, Anastasios A

    2006-10-15

    Two-stage designs have been widely used in phase II clinical trials. Such designs are desirable because they allow a decision to be made on whether a treatment is effective or not after the accumulation of the data at the end of each stage. Optimal fixed two-stage designs, where the sample size at each stage is fixed in advance, were proposed by Simon when the primary outcome is a binary response. This paper proposes an adaptive two-stage design which allows the sample size at the second stage to depend on the results at the first stage. Using a Bayesian decision-theoretic construct, we derive optimal adaptive two-stage designs; the optimality criterion being minimum expected sample size under the null hypothesis. Comparisons are made between Simon's two-stage fixed design and the new design with respect to this optimality criterion. PMID:16479547

  6. Diagnosis, disease stage, and distress of Chinese cancer patients

    PubMed Central

    Huang, Boyan; Chen, Huiping; Deng, Yaotiao; Yi, Tingwu; Wang, Yuqing

    2016-01-01

    Background The objective is to assess how cancer patients know about their diagnosis what they know about their real stage, and the relationship between cancer stage and psychological distress. Methods A questionnaire including the Distress Thermometer was delivered to 422 cancer inpatients. Multivariate logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results Most of patients (68.7%) knew the bad news immediately after diagnosis. Half of patients knew their diagnosis directly from medical reports. Nearly one third of patients were informed by doctors. Cancer stages, which patients believed, differed significantly from their real disease stages (P<0.001). Over half of patients did not know their real disease stages. Patients with stage I–III cancer were more likely to know their real disease stage than patients with stage IV cancer (P<0.001). Distress scores of cancer patients were determined by the real cancer stage (P=0.012), not the stage which patients believed. Conclusions Although most of participants knew the bad news immediately after diagnosis, less than half of them knew their real disease stage. Patient with stage I–III cancer was more likely to know the real disease stage and had a DT score <4 than patient with stage IV disease. PMID:27004220

  7. SLI Artist's Concept-Stage Separation

    NASA Technical Reports Server (NTRS)

    2002-01-01

    NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle during separation of stages. For SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first-generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado; a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

  8. Model of earlier stage of universe's evolution

    NASA Astrophysics Data System (ADS)

    Bronnikov, K. A.; Melnikov, V. N.

    1987-06-01

    A scenario of the evolution of the universe has been proposed on the basis of an open nonsingular model symmetric in time and consisting of four stages: (1) spontaneous breaking of the conformal symmetry in unified theories of the Weinberg-Salam type with gravitational background, assuming that only a conformal Higgs field and a gravitational field have nonzero averages in vacuum; (2) spontaneous breaking of the gauge symmetry of a Higgs field in a gravitational field; (3) generation of particles in a nonsteady gravitational field; (4) variation of the effective gravitational coupling. The model is initially cold and then becomes hot as particles are generated or phase transition occurs. The dynamics of this model and the corresponding earlier stage of evolution are determined by the time term in the Einstein equations, analysis and solution of which require that deviation of the scalar field from classical and a possible attendant effect on the polarization of vacuum be taken into account. The essential underlying feature of this model is the concept of evolution from a perfect vacuum and thus a cold state with subsequent expansion from a nonsingular state and expansion implied by the cosmological constant.

  9. Multiple stage multiple filter hydrate store

    DOEpatents

    Bjorkman, Jr., Harry K.

    1983-05-31

    An improved hydrate store for a metal halogen battery system is disclosed which employs a multiple stage, multiple filter means or separating the halogen hydrate from the liquid used in forming the hydrate. The filter means is constructed in the form of three separate sections which combine to substantially cover the interior surface of the store container. Exit conduit means is provided in association with the filter means for transmitting liquid passing through the filter means to a hydrate former subsystem. The hydrate former subsystem combines the halogen gas generated during the charging of the battery system with the liquid to form the hydrate in association with the store. Relief valve means is interposed in the exit conduit means for controlling the operation of the separate sections of the filter means, such that the liquid flow through the exit conduit means from each of the separate sections is controlled in a predetermined sequence. The three separate sections of the filter means operate in three discrete stages to provide a substantially uniform liquid flow to the hydrate former subsystem during the charging of the battery system. The separation of the liquid from the hydrate causes an increase in the density of the hydrate by concentrating the hydrate along the filter means.

  10. Hypertension in end-stage renal disease.

    PubMed

    Appleby, C; Foley, R N

    2002-03-01

    Chronic renal failure is common. Recent estimates from the United States suggest that one in 10 adults has an elevated serum creatinine. Hypertension and renal disease are intimately connected at many levels, and clearly accelerate each other s course. Hypertension is an almost universal feature of end-stage renal disease, a state of frightening cardiovascular risk. Surprisingly, most recent observational studies have shown an association between low blood pressure and increased mortality, a result that may engender therapeutic nihilism in the absence of large randomised trials. This observation may be due to reverse causality, as the age and cardiovascular comorbidity of patients reaching end-stage renal disease is considerable. When outcomes other than death are considered, especially progressive left ventricular hypertrophy, but also ischaemic heart disease and congestive heart failure, more predictable and expected associations are seen, with rising blood pressure appearing to be a deleterious parameter. Uraemia appears to be a state of premature senescence, and arterial rigidity, whose clinical corollary is wide pulse pressure, is a characteristic feature. Recent observational studies have focused on pulse pressure, rather than the traditional approach of analysing its components, systolic and diastolic blood pressure, in isolation. High pulse pressure appears to be a marker of short survival in dialysis patients, but disentangling this association from old age and pre-existing cardiovascular conditions is challenging. Remarkably, and regrettably, no large scale randomised controlled studies examining strategies that tackle the issue of hypertension in dialysis patients have yet to be initiated.

  11. Chromatin States Accurately Classify Cell Differentiation Stages

    PubMed Central

    Larson, Jessica L.; Yuan, Guo-Cheng

    2012-01-01

    Gene expression is controlled by the concerted interactions between transcription factors and chromatin regulators. While recent studies have identified global chromatin state changes across cell-types, it remains unclear to what extent these changes are co-regulated during cell-differentiation. Here we present a comprehensive computational analysis by assembling a large dataset containing genome-wide occupancy information of 5 histone modifications in 27 human cell lines (including 24 normal and 3 cancer cell lines) obtained from the public domain, followed by independent analysis at three different representations. We classified the differentiation stage of a cell-type based on its genome-wide pattern of chromatin states, and found that our method was able to identify normal cell lines with nearly 100% accuracy. We then applied our model to classify the cancer cell lines and found that each can be unequivocally classified as differentiated cells. The differences can be in part explained by the differential activities of three regulatory modules associated with embryonic stem cells. We also found that the “hotspot” genes, whose chromatin states change dynamically in accordance to the differentiation stage, are not randomly distributed across the genome but tend to be embedded in multi-gene chromatin domains, and that specialized gene clusters tend to be embedded in stably occupied domains. PMID:22363642

  12. A Stage Model of Stress and Disease.

    PubMed

    Cohen, Sheldon; Gianaros, Peter J; Manuck, Stephen B

    2016-07-01

    In this article, we argued that the term stress has served as a valuable heuristic, helping researchers to integrate traditions that illuminate different stages of the process linking stressful life events to disease. We provided a short history of three traditions in the study of stress: the epidemiological, psychological, and biological. The epidemiological tradition focuses on defining which circumstances and experiences are deemed stressful on the basis of consensual agreement that they constitute threats to social or physical well-being. The psychological tradition focuses on individuals' perceptions of the stress presented by life events on the basis of their appraisals of the threats posed and the availability of effective coping resources. The biological tradition focuses on brain-based perturbations of physiological systems that are otherwise essential for normal homeostatic regulation and metabolic control. The foci of these three traditions have informed elements of a stage model of disease, wherein events appraised as stressful are viewed as triggering affective states that in turn engender behavioral and biological responses having possible downstream implications for disease. PMID:27474134

  13. Concept of white light in stage lighting

    NASA Astrophysics Data System (ADS)

    Rinaldi, Mauricio R.

    2002-06-01

    In perceiving objects, generally we see them in a white light situation. But, actually, there is not an absolute white, in such a manner that the different light sources have a determined kind of white, what it is known as color temperature. Even the white light may be of different kinds (different color temperature), the individual mind tends to perceive it as the same kind of white, that is to say, there is in our mind a psychological function by which we operate an integration in the perception in order to do the object perceptually invariable. On the other hand, it is a common practice in stage lighting to use color light sources. It is a well known phenomenon that a color of light produces a change in the object color perception. However, when we go to theater, we see the objects as having their real color, even if the lighting is not white. In this paper the concept of white light in stage lighting is presented, showing its possibilities of aesthetical expression.

  14. Mapping mouse hemangioblast maturation from headfold stages

    PubMed Central

    Rhee, Jerry M.; Iannaccone, Philip M.

    2012-01-01

    The mouse posterior primitive streak at neural plate/headfold stages (NP/HF, ~7.5dpc–8dpc) represents an optimal window from which hemangioblasts can be isolated. We performed immunohistochemistry on this domain using established monoclonal antibodies for proteins that affect blood and endothelial fates. We demonstrate that HoxB4 and GATA1 are the first set of markers that segregate independently to endothelial or blood populations during NP/HF stages of mouse embryonic development. In a subset of cells, both proteins are co-expressed and immunoreactivities appear mutually excluded within nuclear spaces. We searched for this particular state at later sites of hematopoietic stem cell emergence, viz., the aorta-gonadmesonephros (AGM) and the fetal liver at 10.5–11.5dpc, and found that only a rare number of cells displayed this character. Based on this spatial-temporal argument, we propose that the earliest blood progenitors emerge either directly from the epiblast or through segregation within the allantoic core domain (ACD) through reduction of cell adhesion and pSmad1/5 nuclear signaling, followed by a stochastic decision toward a blood or endothelial fate that involves GATA1 and HoxB4, respectively. A third form in which binding distributions are balanced may represent a common condition shared by hemangioblasts and HSCs. We developed a heuristic model of hemangioblast maturation, in part, to be explicit about our assumptions. PMID:22426104

  15. Multiple stage multiple filter hydrate store

    DOEpatents

    Bjorkman, H.K. Jr.

    1983-05-31

    An improved hydrate store for a metal halogen battery system is disclosed which employs a multiple stage, multiple filter means for separating the halogen hydrate from the liquid used in forming the hydrate. The filter means is constructed in the form of three separate sections which combine to substantially cover the interior surface of the store container. Exit conduit means is provided in association with the filter means for transmitting liquid passing through the filter means to a hydrate former subsystem. The hydrate former subsystem combines the halogen gas generated during the charging of the battery system with the liquid to form the hydrate in association with the store. Relief valve means is interposed in the exit conduit means for controlling the operation of the separate sections of the filter means, such that the liquid flow through the exit conduit means from each of the separate sections is controlled in a predetermined sequence. The three separate sections of the filter means operate in three discrete stages to provide a substantially uniform liquid flow to the hydrate former subsystem during the charging of the battery system. The separation of the liquid from the hydrate causes an increase in the density of the hydrate by concentrating the hydrate along the filter means. 7 figs.

  16. Core compressor exit stage study, 2

    NASA Technical Reports Server (NTRS)

    Behlke, R. F.; Burdsall, E. A.; Canal, E., Jr.; Korn, N. D.

    1979-01-01

    A total of two three-stage compressors were designed and tested to determine the effects of aspect ratio on compressor performance. The first compressor was designed with an aspect ratio of 0.81; the other, with an aspect ratio of 1.22. Both compressors had a hub-tip ratio of 0.915, representative of the rear stages of a core compressor, and both were designed to achieve a 15.0% surge margin at design pressure ratios of 1.357 and 1.324, respectively, at a mean wheel speed of 167 m/sec. At design speed the 0.81 aspect ratio compressor achieved a pressure ratio of 1.346 at a corrected flow of 4.28 kg/sec and an adiabatic efficiency of 86.1%. The 1.22 aspect ratio design achieved a pressure ratio of 1.314 at 4.35 kg/sec flow and 87.0% adiabatic efficiency. Surge margin to peak efficiency was 24.0% with the lower aspect ratio blading, compared with 12.4% with the higher aspect ratio blading.

  17. Device for staged carbon monoxide oxidation

    DOEpatents

    Vanderborgh, Nicholas E.; Nguyen, Trung V.; Guante, Jr., Joseph

    1993-01-01

    A method and apparatus for selectively oxidizing carbon monoxide in a hydrogen rich feed stream. The method comprises mixing a feed stream consisting essentially of hydrogen, carbon dioxide, water and carbon monoxide with a first predetermined quantity of oxygen (air). The temperature of the mixed feed/oxygen stream is adjusted in a first the heat exchanger assembly (20) to a first temperature. The mixed feed/oxygen stream is sent to reaction chambers (30,32) having an oxidation catalyst contained therein. The carbon monoxide of the feed stream preferentially absorbs on the catalyst at the first temperature to react with the oxygen in the chambers (30,32) with minimal simultaneous reaction of the hydrogen to form an intermediate hydrogen rich process stream having a lower carbon monoxide content than the feed stream. The elevated outlet temperature of the process stream is carefully controlled in a second heat exchanger assembly (42) to a second temperature above the first temperature. The process stream is then mixed with a second predetermined quantity of oxygen (air). The carbon monoxide of the process stream preferentially reacts with the second quantity of oxygen in a second stage reaction chamber (56) with minimal simultaneous reaction of the hydrogen in the process stream. The reaction produces a hydrogen rich product stream having a lower carbon monoxide content than the process stream. The product stream is then cooled in a third heat exchanger assembly (72) to a third predetermined temperature. Three or more stages may be desirable, each with metered oxygen injection.

  18. Pubertal Stage and Brain Anatomy in Girls

    PubMed Central

    Blanton, Rebecca E.; Cooney, Rebecca E.; Joormann, Jutta; Eugène, Fanny; Glover, Gary H.; Gotlib, Ian H.

    2015-01-01

    Studies of puberty have focused primarily on changes in hormones and on observable physical bodily characteristics. Little is known, however, about the nature of the relation between pubertal status and brain physiology. This is particularly important given findings that have linked the onset of puberty with both changes in cognitive functioning and increases in the incidence of depression and anxiety. The present study examined relations between pubertal stage, as assessed by Tanner Staging, and brain anatomy in a sample of 54 girls aged 9 - 15 years. Brain morphometric analysis was conducted using high-resolution magnetic resonance imaging (MRI). The hippocampus and amygdala were manually traced on MRI scans in all participants. Stepwise regression analyses were conducted with total intracranial volume (ICV), age, and pubertal status as the predictor variables and hippocampus and amygdala volumes as outcome variables. Pubertal status was significantly associated with left amygdala volume, after controlling for both age and intracranial volume (ICV). In addition, puberty was related to right hippocampus and amygdala volumes, after controlling for ICV. In contrast, no significant associations were found between age and hippocampal and amygdala volumes after controlling for pubertal status and ICV. These findings highlight the importance of the relation between pubertal status and morphometry of the hippocampus and amygdala, and of limbic and subcortical structures that have been implicated in emotional and social behavior. PMID:22569152

  19. Two-Stage Modelling Of Random Phenomena

    NASA Astrophysics Data System (ADS)

    Barańska, Anna

    2015-12-01

    The main objective of this publication was to present a two-stage algorithm of modelling random phenomena, based on multidimensional function modelling, on the example of modelling the real estate market for the purpose of real estate valuation and estimation of model parameters of foundations vertical displacements. The first stage of the presented algorithm includes a selection of a suitable form of the function model. In the classical algorithms, based on function modelling, prediction of the dependent variable is its value obtained directly from the model. The better the model reflects a relationship between the independent variables and their effect on the dependent variable, the more reliable is the model value. In this paper, an algorithm has been proposed which comprises adjustment of the value obtained from the model with a random correction determined from the residuals of the model for these cases which, in a separate analysis, were considered to be the most similar to the object for which we want to model the dependent variable. The effect of applying the developed quantitative procedures for calculating the corrections and qualitative methods to assess the similarity on the final outcome of the prediction and its accuracy, was examined by statistical methods, mainly using appropriate parametric tests of significance. The idea of the presented algorithm has been designed so as to approximate the value of the dependent variable of the studied phenomenon to its value in reality and, at the same time, to have it "smoothed out" by a well fitted modelling function.

  20. Minuteman 3: Stage 3 propellant fire characterization

    SciTech Connect

    Diaz, J C

    1994-06-20

    We have completed an experimental program to diagnose and characterize the thermal environment of a solid rocket propellant fire burning in ambient atmospheric conditions. This work has been conducted as part of the Defense Nuclear Agency`s probabilistic risk assessment (PRA) of the Minuteman III (MMIII) weapon system. The goals of this study are two-fold; (1) to provide a description of a propellant fire in sufficient detail so as to allow system response models to predict the outcome of various hypothetical accident, scenarios and, (2) to identify diagnostics that could be used in a large-scale test fire of MMIII stage 3 motor. The study has been performed burning SRAM II and MMIII stage 3 propellant (ANB-3066), in chimneys ranging in size from 18 cm to 53 cm (twenty-one inches) in diameter. Several methods have been used to determine and confirm temperature measurements including thermometry, radiometry, and ultrasonic thermal sensing. Temperature profiles with peaks in excess of 2300{degree} C have been measured. Temperature measurements have been used in conjunction with inverse modeling to determine heat flux characteristics. The regression rate for ANB-3066 (under ambient conditions) has also been determined. Finally, at a very cursory level, we have studied the characteristics of aluminum oxide deposits as well as some materials responses to these fires. We have also addressed the initial efforts on development of diagnostics, problems encountered in controlling the burning of propellants, in taking radiometric measurements, and the survivability of materials in the fire.

  1. Single-stage fluidized-bed gasification

    NASA Astrophysics Data System (ADS)

    Lau, F. S.; Rue, D. M.; Weil, S. A.; Punwani, D. V.

    1982-04-01

    The single-stage fluidized-bed gasification process, in addition to being a simple system, maximizes gas production and allows the economic exploitation of small peat deposits. The objective of this gasification project is to conduct experiments in order to obtain data for designing a single-stage fluidized-bed gasifier, and to evaluate the economics of converting peat to synthesis gas and to SNG by this process. An existing high-temperature and high-pressure process development unit (PDU) was modified to permit the direct feeding of peat to the fluidized bed. Peat flows by gravity from the feed hopper through a 6-inch line to the screw-feeder conveyor. From there, it is fed to the bottom tee section of the reactor and transported into the gasification zone. Oxygen and steam are fed through a distributing ring into the reactor. Gasification reactions occur in the annulus formed by the reactor tube and a central standpipe. Peat ash is discharged from the reactor by overflowing into the standpipe and is collected in a solids receiver.

  2. Line-scanning, stage scanning confocal microscope

    NASA Astrophysics Data System (ADS)

    Carucci, John A.; Stevenson, Mary; Gareau, Daniel

    2016-03-01

    We created a line-scanning, stage scanning confocal microscope as part of a new procedure: video assisted micrographic surgery (VAMS). The need for rapid pathological assessment of the tissue on the surface of skin excisions very large since there are 3.5 million new skin cancers diagnosed annually in the United States. The new design presented here is a confocal microscope without any scanning optics. Instead, a line is focused in space and the sample, which is flattened, is physically translated such that the line scans across its face in a direction perpendicular to the line its self. The line is 6mm long and the stage is capable of scanning 50 mm, hence the field of view is quite large. The theoretical diffraction-limited resolution is 0.7um lateral and 3.7um axial. However, in this preliminary report, we present initial results that are a factor of 5-7 poorer in resolution. The results are encouraging because they demonstrate that the linear array detector measures sufficient signal from fluorescently labeled tissue and also demonstrate the large field of view achievable with VAMS.

  3. Complement Factor H Autoantibodies are Associated with Early Stage NSCLC

    PubMed Central

    Amornsiripanitch, Nita; Hong, Shaolin; Campa, Michael J.; Frank, Michael M.; Gottlin, Elizabeth B.; Patz, Edward F.

    2010-01-01

    Purpose In order to discover diagnostic biomarkers associated with early stage non-small cell lung cancer (NSCLC), we searched for autoantibodies preferentially present in stage I patients compared to patients with advanced stage disease. Here we describe an autoantibody against complement factor H (CFH) and its association with early stage NSCLC. Experimental Design Immunoblots were used to detect autoantibodies in the sera of stage I NSCLC patients. An autoantibody recognizing a 150 kDa protein was discovered and the protein was identified by mass spectrometry. The association of the autoantibody with early stage disease was suggested by the results of immunoblot analysis with sera from 28 stage I patients and 28 stage III/IV patients. This association was confirmed by protein microarray of sera from 125 NSCLC patients of all stages as well as 125 age, gender, and smoking history matched controls. Results The immunoreactive protein was identified as CFH. By immunoblot analysis, anti-CFH autoantibody was found in 50% of stage I NSCLC patients and 11% of late stage NSCLC patients (P=0.003). By protein microarray analysis, patients with stage I NSCLC had a significantly higher incidence of anti-CFH antibody than those with late stage NSCLC (P=0.0051). The percentage of sera with a positive level of CFH autoantibody was 30.4% in stage I, 21.1% in stage II, 12.5% in stage III, 7.4% in stage IV and 8.0% in the control group. Conclusions These findings suggest that in patients with NSCLC, CFH autoantibody is a molecular marker associated with early stage disease. PMID:20515868

  4. Vaccine Therapy in Treating Patients With Stage IIC-IV Melanoma

    ClinicalTrials.gov

    2014-05-20

    Ciliary Body and Choroid Melanoma, Medium/Large Size; Ciliary Body and Choroid Melanoma, Small Size; Extraocular Extension Melanoma; Iris Melanoma; Metastatic Intraocular Melanoma; Mucosal Melanoma; Recurrent Intraocular Melanoma; Recurrent Melanoma; Stage IIC Melanoma; Stage IIIA Intraocular Melanoma; Stage IIIA Melanoma; Stage IIIB Intraocular Melanoma; Stage IIIB Melanoma; Stage IIIC Intraocular Melanoma; Stage IIIC Melanoma; Stage IV Intraocular Melanoma; Stage IV Melanoma

  5. Small upper stage - An orbit enabling hydrazine propulsion stage for the small satellite community

    NASA Astrophysics Data System (ADS)

    Reitan, Thane

    1992-03-01

    The small upper stage (SUS) study aimed at creating a generic, low-cost propulsion stage design capable of being integrated to different launch vehicles (LVs) and providing a mission with an orbit transfer function to a variety of different small satellite missions is presented. The preliminary SUS design was developed taking into account the SUS specification requirements. The SUS design makes it possible to provide small satellites with several orbit transfer maneuvers from a LEO parking orbit, including Hohmann transfer, circularization, plane change, and deorbit. The propulsion system design encompasses a single delta V thruster, a single hydrazine propellant tank, and a pressurized nitrogen gas storage system. It is concluded that with the SUS generic design, the software and fuel loads are tailorable to enable a variety of different missions in a cost-effective manner. The SUS will eliminate the need for a custom propulsion stage for future small satellite missions.

  6. One-stage vs. three-stage repair in anorectal malformation with rectovestibular fistula

    PubMed Central

    Amanollahi, Omid; Ketabchian, Saman

    2016-01-01

    Background: Anorectal malformations (ARMs) disease is one of the congenital anomalies with an incidence of about 1 in 5000 neonate births, and treatment requires surgical intervention. Selecting the one- or three-step surgical procedure to treat the disease, especially in female neonates with rectovestibular fistula, is a subject of debate. This study aims to compare the advantages and disadvantages of these two methods. Materials and Methods: Forty female neonates with ARM and rectovestibular fistula between March 2011 and March 2013 were included in the study, and they were divided into two equal groups. Allocation of the first case was random, and all cases were then allocated alternatively (every other subject was assigned to a treatment group) until each group received 20 cases equally patients of study group underwent a one-stage posterior sagittal anorectoplasty (PSARP) and in control group patients underwent a three-stage operation (colostomy, PSARP, and closure of colostomy). The complications during and after the surgery were recorded in both groups, and the results were compared. Results: In the control group, only one case (5%) of wound infection and dehiscence was seen, whereas in the one-stage study group, six cases (30%) of wound infection and dehiscence were seen (P value = 0.046). However, regarding the incidence of other complications, such as iatrogenic vaginal injury as well as final recovery, no considerable differences were seen between the two groups. Conclusions: Despite more surgical site infections and dehiscence in the one-stage repair, but due to the numerous advantages compared to the three-stage method, which is more time-consuming, more costly, and causes more adverse effect on parents and children, performing the one-stage repair is recommended for this anomaly. PMID:27251519

  7. Dynamics of transition from stage-1 to stage-2 evaporation from porous media

    NASA Astrophysics Data System (ADS)

    Shokri, Nima; Shahraeeni, Ebrahim; Shahabdeen, Rumeena; Or, Dani

    2014-05-01

    The early stages of evaporation from porous media are marked by a relatively high and constant evaporation rate (the so-called stage-1 evaporation) sustained by capillary liquid flow from the porous medium interior. Following interruption of hydraulic connections at a certain drying front depth, the vaporization plane migrates below the surface leading to transition to stage-2 evaporation limited by vapour diffusion through the porous medium. The nature of the transition and the wide range of transition dynamics from stage-1 to stage-2 were studied using evaporation experiments from sand-filled Hele-Shaw cells (172x81x4 mm) with three mean particle sizes of 0.27, 0.46, and 0.84 mm. The initially water saturated cells were placed on digital balances (cell top exposed to air) to record evaporation rates. Experiments were conducted in an environmental chamber where the relative humidity and temperature could be varied and controlled accurately. The effects of grains size, ambient temperature and relative humidity (both affecting potential evaporation rates) on transition dynamics were systematically evaluated. The results illustrate the role of potential evaporation rate on transition duration and shape transcending the expected scaling with cumulative mass loss that defines the evaporative characteristic length. The transition becomes more abrupt at higher atmospheric demand perhaps due to enhanced role of viscous effects that accelerate pore disconnection. Pore size did not affect the shape of transition much except for the medium sand with prolonged transition (the exact pore size distribution needs to be examined). Interestingly the evaporation rate at the onset of stage 2 was not affected by atmospheric conditions (Shokri and Or, 2011).

  8. Situational variation in moral judgment: In a stage or on a stage?

    PubMed

    Carpendale, J I; Krebs, D L

    1992-04-01

    Two issues were examined in this study-the consistency of moral judgment across different types of dilemma and different social contexts, and the relationship between the structure (stage) of moral judgment and the content of moral decisions. Forty subjects were given two hypothetical dilemmas about business decisions and two standard Kohlberg dilemmas. Half the subjects directed their responses to a business audience, half to a philosophical audience. Responses to the moral dilemmas were scored in accordance with the Colby and Kohlberg (1987) scoring manual. Stage of moral reasoning was found to be significantly higher on the Kohlberg dilemmas than on the business dilemmas. A significant interaction between type of dilemma and audience was attributed to the tendency of subjects directing their responses to a business audience to interpret one of the business dilemmas in terms of the moral order of business, but for subjects directing their responses to a philosophy audience to treat it as a philosophical dilemma. The other business dilemma evoked uniformly low-level moral judgments. The amount of selfishness intrinsic in subjects' moral choices on the business dilemmas was significantly negatively correlated with moral maturity on the business dilemmas, but not with their moral maturity on Kohlberg's test. These results are interpreted as more consistent with models of moral development such as those advanced by C. G. Levine ([1979] "Stage Acquisition and Stage Use: An Appraisal of Stage Displacement Explanations of Variation in Moral Reasoning, " Human Development, Vol. 22, pp. 145-164), J. Rest ([1983] "Morality," in: P. H. Mussen [ed.], J. H. Flavell and E. Markman [Vol. eds.], Handbook of Child Psychology [Vol. 3, 4th ed.], John Wiley & Sons, New York), and R. Harré ([1984]) Personal Being: A Theory for Individual Psychology, Harvard University Press, Cambridge, Massachusetts), which posit a relatively wide range of within-person stage use and emphasize the

  9. [Complications of surgical stage of treatment in patients with cancer of cervix uteri stage IIB].

    PubMed

    Kryzhanivs'ka, A Ie

    2013-11-01

    The results of treatment of 127 patients, suffering cervix uteri cancer stage IIB in period of 1998 - 2012 yrs, were analyzed. Complications of surgical stage of the combined treatment have had occurred in 40.9% patients, including 40.5% patients, to whom neoadjuvant chemotherapy was conducted and in 41.5%--radiation therapy (RTH). The main postoperative complications--retroperitoneal lymphatic cysts--were revealed in 35.4% patients. The factors, raising the risk of postoperative complications occurrence, are following: the primary tumor spreading, metastatic affection of lymphatic nodes of pelvic cavity, preoperative conduction of RTH or chemotherapy.

  10. Method and apparatus for removing coarse unentrained char particles from the second stage of a two-stage coal gasifier

    DOEpatents

    Donath, Ernest E.

    1976-01-01

    A method and apparatus for removing oversized, unentrained char particles from a two-stage coal gasification process so as to prevent clogging or plugging of the communicating passage between the two gasification stages. In the first stage of the process, recycled process char passes upwardly while reacting with steam and oxygen to yield a first stage synthesis gas containing hydrogen and oxides of carbon. In the second stage, the synthesis gas passes upwardly with coal and steam which react to yield partially gasified char entrained in a second stage product gas containing methane, hydrogen, and oxides of carbon. Agglomerated char particles, which result from caking coal particles in the second stage and are too heavy to be entrained in the second stage product gas, are removed through an outlet in the bottom of the second stage, the particles being separated from smaller char particles by a counter-current of steam injected into the outlet.

  11. Single-stage experimental evaluation of low aspect ratio, highly loaded blading for compressors. Part 9: Stage F and stage G, volume 1

    NASA Technical Reports Server (NTRS)

    Cheatham, J. G.; Smith, J. D.; Wright, D. L.

    1976-01-01

    Two single-stage, 0.77 hub/tip ratio axial-flow compressors were tested to evaluate the effectiveness of low aspect ratio blading as a means of obtaining higher stage loadings. One compressor, designated Stage F, was comprised of circular arc blading with an aspect ratio of 0.9 for both the rotor and stator. This compressor was tested with uniform inlet flow, hub radial, tip radial, and 180 deg arc circumferential inlet distortion. The second compressor, designated Stage G, was comprised of multiple circular arc blading with an aspect ratio of 1.0 for both the rotor and stator. This compressor was tested with uniform inlet flow only. Design rotor tip speeds for Rotor F and Rotor G were 285 m/sec (934 ft/sec) and 327 m/sec (1,074 ft/sec) respectively. Both stages operated at high loading levels with adequate efficiency and operating range. The peak efficiencies and corresponding average stage diffusion factors for Stages F and G at design rotor speed were 86.4% and 84.1% and 0.59 and 0.55 respectively. The surge margin at peak efficiency for Stage F was 12.6% and the corresponding value for Stage G was 16.5%. Both stages experienced a loss in efficiency with increasing rotor speed; however, the multiple circular arc rotor delayed the characteristic loss in efficiency within increasing Mach number to higher Mach number.

  12. Upper Stage Engine Composite Nozzle Extensions

    NASA Technical Reports Server (NTRS)

    Valentine, Peter G.; Allen, Lee R.; Gradl, Paul R.; Greene, Sandra E.; Sullivan, Brian J.; Weller, Leslie J.; Koenig, John R.; Cuneo, Jacques C.; Thompson, James; Brown, Aaron; Shigley, John K.; Dovey, Henry N.; Roberts, Robert K.

    2015-01-01

    Carbon-carbon (C-C) composite nozzle extensions are of interest for use on a variety of launch vehicle upper stage engines and in-space propulsion systems. The C-C nozzle extension technology and test capabilities being developed are intended to support National Aeronautics and Space Administration (NASA) and United States Air Force (USAF) requirements, as well as broader industry needs. Recent and on-going efforts at the Marshall Space Flight Center (MSFC) are aimed at both (a) further developing the technology and databases for nozzle extensions fabricated from specific CC materials, and (b) developing and demonstrating low-cost capabilities for testing composite nozzle extensions. At present, materials development work is concentrating on developing a database for lyocell-based C-C that can be used for upper stage engine nozzle extension design, modeling, and analysis efforts. Lyocell-based C-C behaves in a manner similar to rayon-based CC, but does not have the environmental issues associated with the use of rayon. Future work will also further investigate technology and database gaps and needs for more-established polyacrylonitrile- (PAN-) based C-C's. As a low-cost means of being able to rapidly test and screen nozzle extension materials and structures, MSFC has recently established and demonstrated a test rig at MSFC's Test Stand (TS) 115 for testing subscale nozzle extensions with 3.5-inch inside diameters at the attachment plane. Test durations of up to 120 seconds have been demonstrated using oxygen/hydrogen propellants. Other propellant combinations, including the use of hydrocarbon fuels, can be used if desired. Another test capability being developed will allow the testing of larger nozzle extensions (13.5- inch inside diameters at the attachment plane) in environments more similar to those of actual oxygen/hydrogen upper stage engines. Two C-C nozzle extensions (one lyocell-based, one PAN-based) have been fabricated for testing with the larger

  13. Two-stage unilateral versus one-stage bilateral single-port sympathectomy for palmar and axillary hyperhidrosis†

    PubMed Central

    Ibrahim, Mohsen; Menna, Cecilia; Andreetti, Claudio; Ciccone, Anna Maria; D'Andrilli, Antonio; Maurizi, Giulio; Poggi, Camilla; Vanni, Camilla; Venuta, Federico; Rendina, Erino Angelo

    2013-01-01

    OBJECTIVES Video-assisted thoracoscopic sympathectomy is currently the best treatment for palmar and axillary hyperhidrosis. It can be performed through either one or two stages of surgery. This study aimed to evaluate the operative and postoperative results of two-stage unilateral vs one-stage bilateral thoracoscopic sympathectomy. METHODS From November 1995 to February 2011, 270 patients with severe palmar and/or axillary hyperhidrosis were recruited for this study. One hundred and thirty patients received one-stage bilateral, single-port video-assisted thoracoscopic sympathectomy (one-stage group) and 140, two-stage unilateral, single-port video-assisted thoracoscopic sympathectomy, with a mean time interval of 4 months between the procedures (two-stage group). RESULTS The mean postoperative follow-up period was 12.5 (range: 1–24 months). After surgery, hands and axillae of all patients were dry and warm. Sixteen (12%) patients of the one-stage group and 15 (11%) of the two-stage group suffered from mild/moderate pain (P = 0.8482). The mean operative time was 38 ± 5 min in the one-stage group and 39 ± 8 min in the two-stage group (P = 0.199). Pneumothorax occurred in 8 (6%) patients of the one-stage group and in 11 (8%) of the two-stage group. Compensatory sweating occurred in 25 (19%) patients of the one-stage group and in 6 (4%) of the two-stage group (P = 0.0001). No patients developed Horner's syndrome. CONCLUSIONS Both two-stage unilateral and one-stage bilateral single-port video-assisted thoracoscopic sympathectomies are effective, safe and minimally invasive procedures. Two-stage unilateral sympathectomy can be performed with a lower occurrence of compensatory sweating, improving permanently the quality of life in patients with palmar and axillary hyperhidrosis. PMID:23442937

  14. Progress on Ares First Stage Propulsion

    NASA Technical Reports Server (NTRS)

    Priskos, Alex S.; Williams, Thomas J.; Brasfield, Fred; Jacobs, Michael

    2008-01-01

    The National Aeronautics and Space Administration (NASA) Ares Projects Office (APO) is continuing to make progress toward the final design of the first stage propulsion system for the Ares I crew launch vehicle and the Ares V cargo launch vehicle. Ares I and Ares V will provide the space launch capabilities necessary to fulfill NASA's exploration strategy of sending human beings to the Moon, Mars, and beyond. As primary propulsion for both the Ares I and Ares V, the Space Shuttle-derived Reusable Solid Rocket Motor (RSRM) is one of the first and most important components to be tested. The first flight of Ares I, called Ares I-X, will occur in April 2009. The Ares I-X flight will use a combination of flight and simulation hardware to obtain data on controlling the long and narrow crew launch vehicle configuration.

  15. "Physics on Stage" Festival Video Now Available

    NASA Astrophysics Data System (ADS)

    2001-01-01

    ESO Video Clip 01/01 is issued on the web in conjunction with the release of an 18-min documentary video from the Science Festival of the "Physics On Stage" programme. This unique event took place during November 6-11, 2000, on the CERN premises at the French-Swiss border near Geneva, and formed part of the European Science and Technology Week 2000, an initiative by the European Commission to raise the public awareness of science in Europe. Physics On Stage and the Science Festival were jointly organised by CERN, ESA and ESO, in collaboration with the European Physical Society (EPS) and the European Association for Astronomy Education (EAAE) and national organisations in about 25 European countries. During this final phase of the yearlong Physics On Stage programme, more than 500 physics teachers, government officials and media representatives gathered at CERN to discuss different aspects of physics education. The meeting was particular timely in view of the current decline of interest in physics and technology by Europe's citizens, especially schoolchildren. It included spectacular demonstrations of new educational materials and methods. An 18-min video is now available that documents this event. It conveys the great enthusiasm of the many participants who spent an extremely fruitful week, meeting and exchanging information with colleagues from all over the continent. It shows the various types of activities that took place, from the central "fair" with national and organisational booths to the exciting performances and other dramatic presentations. Based of the outcome of 13 workshops that focussed on different subject matters, a series of very useful recommendations was passed at the final session. The Science Festival was also visited by several high-ranking officials, including the European Commissioner for Research, Phillipe Busquin. Full reports from the Festival will soon become available from the International Steering Committee..More information is

  16. [2-stage operative treatment of Dupuytren contracture].

    PubMed

    Nagay, B

    1985-05-01

    The incidence of Sudeck-like complications after surgery for Dupuytren's contracture is discussed. In a series of 209 operations for Dupuytren's contracture some complications were observed in 26 cases. In 12 patients these complications could not be precisely explained. In the author's opinion they may illustrate the creation of a nerve-irritating source within the operative field. In order to avoid these complications a two-stage operation was proposed, especially for severe contractures in elderly patients. A preliminary fasciotomy relieves most of symptoms of the disease and may also serve as a so-called tissue test for eventual more radical procedures. The observation of 42 patients with severe contractures so treated confirms the usefulness of the method. PMID:4007639

  17. Third-stage turbine bucket airfoil

    DOEpatents

    Pirolla, Peter Paul; Siden, Gunnar Leif; Humanchuk, David John; Brassfield, Steven Robert; Wilson, Paul Stuart

    2002-01-01

    The third-stage buckets have airfoil profiles substantially in accordance with Cartesian coordinate values of X, Y and Z set forth in inches in Table I wherein Z is a perpendicular distance from a plane normal to a radius of the turbine centerline and containing the X and Y values with the Z value commencing at zero in the X, Y plane at the radially innermost aerodynamic section of the airfoil and X and Y are coordinates defining the airfoil profile at each distance Z. The X, Y and Z values may be scaled as a function of the same constant or number to provide a scaled-up or scaled-down airfoil section for the bucket.

  18. Ariane-5 solid-propellant stage development

    NASA Astrophysics Data System (ADS)

    Gigou, Jacques

    1992-03-01

    The development status of the solid propellant engine (P230) of the Ariane-5 launcher is described. Large new industrial plants were built in Europe and Guiana for the development and manufacture of the solid-booster stage and are now operational. A product assurance policy, specific and common to the companies that are involved in the engine's development, was defined and will be implemented. The paper describes the production cycles for the charged segments, the igniter, and the nozzle for P230 engine, as well as the process of engine integration and testing. Consideration is also given to the engine thrust capability, the launcher flight control, and the interfaces. The the major engine development tests are described.

  19. Two-stage eutectic metal brushes

    SciTech Connect

    Hsu, John S

    2009-07-14

    A two-stage eutectic metal brush assembly having a slip ring rigidly coupled to a shaft, the slip ring being electrically coupled to first voltage polarity. At least one brush is rigidly coupled to a second ring and slidingly engaged to the slip ring. Eutectic metal at least partially fills an annulus between the second ring and a stationary ring. At least one conductor is rigidly coupled to the stationary ring and electrically coupled to a second voltage polarity. Electrical continuity is maintained between the first voltage polarity and the second voltage polarity. Periodic rotational motion is present between the stationary ring and the second ring. Periodic rotational motion is also present between the brush and the slip ring.

  20. Thrombosis in end-stage renal disease.

    PubMed

    Casserly, Liam F; Dember, Laura M

    2003-01-01

    Although renal failure has classically been associated with a bleeding tendency, thrombotic events are common among patients with end-stage renal disease (ESRD). A variety of thrombosis-favoring hematologic alterations have been demonstrated in these patients. In addition, "nontraditional" risk factors for thrombosis, such as hyperhomocysteinemia, endothelial dysfunction, inflammation, and malnutrition, are present in a significant proportion of chronic dialysis patients. Hemodialysis (HD) vascular access thrombosis, ischemic heart disease, and renal allograft thrombosis are well-recognized complications in these patients. Deep venous thrombosis and pulmonary embolism are viewed as rare in chronic dialysis patients, but recent studies suggest that this perception should be reconsidered. Several ESRD treatment factors such as recombinant erythropoietin (EPO) administration, dialyzer bioincompatibility, and calcineurin inhibitor administration may have prothrombotic effects. In this article we review the pathogenesis and clinical manifestations of thrombosis in ESRD and evaluate the evidence that chronic renal failure or its management predisposes to thrombotic events.

  1. Nuclear Cryogenic Propulsion Stage for Mars Exploration

    NASA Technical Reports Server (NTRS)

    Houts, M. G.; Borowski, S. K.; George, J. A.; Kim, T.; Emrich, W. J.; Hickman, R. R.; Broadway, J. W.; Gerrish, H. P.; Adams, R. B.

    2012-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP).

  2. Russian plans for lunar investiagtions. Stage 1

    NASA Astrophysics Data System (ADS)

    Zelenyi, L.; Mitrofanov, I.; Petrukovich, A.; Khartov, V.; Martynov, M.; Lukianchikov, A.

    2014-04-01

    Lunar Race of 60-ies and 70-ies between US and Soviet Union produced outstanding results for lunar science. For many technical reasons mostly near equatorial and mid-latitude Lunar regions were investigated at this glorious time. New epoch of Lunar investigations began at the late 90-ies. It gradually shaped the image of a new wet moon at least at the vicinity of its polar regions. Strong interest to the mechanisms of the formation of a near polar volatiles deposits, their migration and their composition (including the bisotope one) became the central theme of the Russian program of lunar investigations for next 10 years. Certainly the number of other outstanding scientific topics like the properties of Lunar dust, peculiarities of regolith interaction with the supersonic solar wind flow, characteristics of the Lunar magnetic and gravitational anomalies, etc., are planned to be studied both from the orbit and from the surface. First stage of the Russian Lunar Program consists of a four missions: Lunas 25, 26, 27, 28. (The numeration follows Lunar missions of a Soviet Epoch - last successful regolith sample delivery have been accomplished by Luna 24 in 1976). Luna 25 will land to the southern polar site, which would be the most suitable for engineering reasons and also interesting for the science. Second lander Luna 27 will have more sophisticated payload with the additional instruments in comparison with Luna 25. Luna 27 should be landed to the selected landing site at the vicinity of the South Pole, which could be the most promising for installation of the future Lunar Base. It is very important that Luna 27 will be equipped by the subsurface drill to get samples from the permafrost shallow subsurface (one attractive option now is that this drill will be provided by our ESA colleagues having the experience of designing and manufacturing of a similar drill for the Exomars project). The principal difference of the drilling at Luna 27 in comparison with the early

  3. "End-stage" pulmonary fibrosis in sarcoidosis.

    PubMed

    Teirstein, Alvin T; Morgenthau, Adam S

    2009-02-01

    Pulmonary fibrosis is an unusual "end stage" in patients with sarcoidosis. Fibrosis occurs in a minority of patients, and presents with a unique physiologic combination of airways dysfunction (obstruction) superimposed on the more common restrictive dysfunction. Imagin techniques are essential to the diagnosis, assessment and treatment of pulmonary fibrosis. Standard chest radiographs and CT scans may reveal streaks, bullae, cephalad retraction of the hilar areas, deviation of the trachea and tented diaphragm. Positive gallium and PET scans indicate residual reversible granulomatous disease and are important guides to therapy decisions. Treatment, usually with corticosteroids, is effective in those patients with positive scans, but fibrosis does not improve with any treatment. With severe functional impariment and patient disability, pulmonary hypertension and right heart failure may supervene for which the patient will require treatment. Oxygen, careful diuresis, sildenafil and bosentan may be salutary. These patients are candidates for lung transplantation. PMID:19170216

  4. Nuclear Cryogenic Propulsion Stage Affordable Development Strategy

    NASA Technical Reports Server (NTRS)

    Doughty, Glen E.; Gerrish, H. P.; Kenny, R. J.

    2014-01-01

    The development of nuclear power for space use in nuclear thermal propulsion (NTP) systems will involve significant expenditures of funds and require major technology development efforts. The development effort must be economically viable yet sufficient to validate the systems designed. Efforts are underway within the National Aeronautics and Space Administration's (NASA) Nuclear Cryogenic Propulsion Stage Project (NCPS) to study what a viable program would entail. The study will produce an integrated schedule, cost estimate and technology development plan. This will include the evaluation of various options for test facilities, types of testing and use of the engine, components, and technology developed. A "Human Rating" approach will also be developed and factored into the schedule, budget and technology development approach.

  5. Low energy stages - 'dogbone' muon RLA

    SciTech Connect

    Alex Bogacz

    2005-12-01

    A conceptual design of lower energy stages of muon accelerator is presented. The scheme is based on two superconducting, 200 MHz linacs: a single pass linear pre-accelerator followed by a multi-pass ''dogbone'' recirculating linac (RLA). In the presented scenario, acceleration starts after ionization cooling at 273 MeV/c and proceeds to 5 GeV, where the beam is injected into a complex of FFAG rings for further acceleration. The key conceptual issues are addressed and implemented in the overall acceleration scheme: capture, acceleration, transport and preservation of large phase space of fast decaying species. Beam transport of large-momentum-spread beams is facilitated through appropriate lattice design choices. The proposed linear optics for ''droplet'' return arcs optics is further supplemented with a sextupole correction to suppress chromatic effects contributing to the horizontal emittance dilution.

  6. Space shuttle (ATP configuration) abort staging investigation

    NASA Technical Reports Server (NTRS)

    Rampy, J. M.; Blackwell, K. L.; Allen, E. C., Jr.; Fossler, I.

    1973-01-01

    A wind tunnel test conducted in a 14-inch trisonic wind tunnel to determine the force and moment characteristics of the ATP Orbiter and modified ATP External Tank/SRB combination during abort staging conditions is discussed. Six component aerodynamic force and moment data were recorded for the orbiter and ET/SRB combination. Pitch polars were obtained for an angle of attack range from minus 10 to plus 10 degrees and orbiter incidence angles (orbiter relative to the ET/SRB combination) of 0 and 2 degrees. A limited amount of yaw data were obtained at 0 degree angle of attack and beta range from minus 10 to plus 10 degrees. In addition, orbiter pitch control effectiveness was determined at several grid points. These force and moment data were obtained for Mach numbers of 0.9, 1.2 and 2.0.

  7. Synthetic fuel aromaticity and staged combustion

    SciTech Connect

    Longanbach, J. R.; Chan, L. K.; Levy, A.

    1982-11-15

    Samples of middle and heavy SRC-II distillates were distilled into 50 C boiling point range fractions. These were characterized by measurements of their molecular weight, elemental analysis and basic nitrogen content and calculation of average molecular structures. The structures typically consisted of 1 to 3 aromatic rings fused to alicyclic rings with short, 1 to 3 carbon aliphatic side chains. The lower boiling fractions contained significant amounts (1 atom/molecule) of oxygen while the heavier fractions contained so few heteroatoms that they were essentially hydrocarbons. Laboratory scale oxidative-pyrolysis experiments were carried out at pyrolysis temperatures of 500 to 1100 C and oxygen concentrations from 0 to 100 percent of stoichiometry. Analysis of liquid products, collected in condensers cooled with liquid nitrogen showed that aromatization is a major reaction in the absence of oxygen. The oxygen-containing materials (phenolics) seem to be more resistant to thermal pyrolysis than unsubstituted aromatics. Nitrogen converts from basic to nonbasic forms at about 500 C. The nonbasic nitrogen is more stable and survives up to 700 C after which it is slowly removed. A recently constructed 50,000 Btu/hr staged combustor was used to study the chemistry of the nitrogen and aromatics. SRC II combustion was studied under fuel-rich, first-stage conditions at air/fuel ratios from 0.6 to 1.0 times stoichiometric. The chemistry of the fuel during combustion calls for further investigation in order to examine the mechanism by which HCN is evolved as a common intermediate for the formation of the nitrogen-containing gaseous combustion products. 25 references, 45 figures, 25 tables.

  8. Stages of educational development? Beeby revisited

    NASA Astrophysics Data System (ADS)

    Guthrie, Gerard

    1980-12-01

    Beeby's model of stages of educational change in developing countries has been accepted into the educational literature with remarkably little critical analysis. Though valuable for a large number of experiential insights, the author argues that the model has certain weaknesses which should restrict its application. The stages have a teleological bias and are not sufficiently distinct, nor do the labels used for them meet the formal requirements of measuring scales. Furthermore, the model overgeneralizes from the experience of British-tradition South Pacific school systems, and the equation of western teaching with good teaching is an unsupported view which may not be valid in many countries. The most fundamental problem is the lack of clear distinction between empirical issues and the ethical judgements implicit in the formulation. However, the model has a number of positive features well worth building upon, such as its focus on the qualitative aspects of teaching and on qualitative change, the realistic emphasis on the gradualism of such change in practice, and the identification of the teacher as the key change agent in the classroom — a fundamental point often overlooked by innovators. The continua of general and professional education which underlie the teaching styles provide useful hypotheses for empirical analysis of the relationship between teacher education and classroom teaching style, but the association of this education with certain types of teaching style needs careful examination. Stripped of its evaluative connotations, Beeby's interest in qualitative change was a valuable early attempt to move attention in developing countries from linear, quantitative expansion of existing systems to a consideration of what was actually being taught and how. The real lesson to be learned from his work is that education should be paying closer attention to its theoretical propositions.

  9. Next stages in HDR technology development

    SciTech Connect

    Duchane, D.V.

    1993-03-01

    Twenty years of research and development have brought HDR heat mining technology from the purely conceptual stage to the establishment of an engineering-scale heat mine at Fenton Hill, NM. In April 1992, a long-term flow test (LTFT) of the HDR reservoir at Fenton Hill was begun. The test was carried out under steady-state conditions on a continuous basis for four months, but a major equipment failure in late July forced a temporary suspension of operations. Even this short test provided valuable information and extremely encouraging results as summarized below: There was no indication of thermal drawdown of the reservoir. There was evidence of increasing access to hot rock with time. Water consumption was in the rangki of 10--12%. Measured pumping costs were $0.003 per kilowatt of energy produced. Temperature logs conducted in the reservoir production zone during and after the flow test confirmed the fact that there was no decline in the average temperature of the fluid being produced from the reservoir. In fact, tracer testing showed that the fluid was taking more indirect pathways and thus contacting a greater amount of hot rock as the test progressed. Water usage quickly dropped to a level of 10--15 gallons per minute, an amount equivalent to about 10--12% of the injected fluid volume. At a conversion rate of 10--15%, these would translate to effective ``fuel costs`` of 2--3{cents} per kilowatt hour of electricity production potential. The completion of the LTFT will set the stage for commercialization of HDR but will not bring HDR technology to maturity. Relatively samples extensions of the current technology may bring significant improvements in efficiency, and these should be rapidly investigated. In the longer run, advanced operational concepts could further improve the efficiency of HDR energy extraction and may even offer the possibility of cogeneration schemes which solve both energy and water problems throughout the world.

  10. Hidden Stages of Cognition Revealed in Patterns of Brain Activation.

    PubMed

    Anderson, John R; Pyke, Aryn A; Fincham, Jon M

    2016-09-01

    To advance cognitive theory, researchers must be able to parse the performance of a task into its significant mental stages. In this article, we describe a new method that uses functional MRI brain activation to identify when participants are engaged in different cognitive stages on individual trials. The method combines multivoxel pattern analysis to identify cognitive stages and hidden semi-Markov models to identify their durations. This method, applied to a problem-solving task, identified four distinct stages: encoding, planning, solving, and responding. We examined whether these stages corresponded to their ascribed functions by testing whether they are affected by appropriate factors. Planning-stage duration increased as the method for solving the problem became less obvious, whereas solving-stage duration increased as the number of calculations to produce the answer increased. Responding-stage duration increased with the difficulty of the motor actions required to produce the answer. PMID:27440808

  11. Early-Stage Breast Cancer Treatment Fact Sheet

    MedlinePlus

    ... breast cancer treatment fact sheet ePublications Early-stage breast cancer treatment fact sheet Print this fact sheet Early-stage breast cancer treatment fact sheet (PDF, 943 KB) Related information ...

  12. Two stage sorption type cryogenic refrigerator including heat regeneration system

    NASA Technical Reports Server (NTRS)

    Jones, Jack A. (Inventor); Wen, Liang-Chi (Inventor); Bard, Steven (Inventor)

    1989-01-01

    A lower stage chemisorption refrigeration system physically and functionally coupled to an upper stage physical adsorption refrigeration system is disclosed. Waste heat generated by the lower stage cycle is regenerated to fuel the upper stage cycle thereby greatly improving the energy efficiency of a two-stage sorption refrigerator. The two stages are joined by disposing a first pressurization chamber providing a high pressure flow of a first refrigerant for the lower stage refrigeration cycle within a second pressurization chamber providing a high pressure flow of a second refrigerant for the upper stage refrigeration cycle. The first pressurization chamber is separated from the second pressurization chamber by a gas-gap thermal switch which at times is filled with a thermoconductive fluid to allow conduction of heat from the first pressurization chamber to the second pressurization chamber.

  13. Stages in Learning New Technology: Naive Adult Email Users.

    ERIC Educational Resources Information Center

    Russell, Anne L.

    1995-01-01

    Identifies six stages adult learners pass through as they become confident using electronic mail. Understanding the stages of learning to use technology empowers the learner through the knowledge that feelings of tension and frustration will be overcome. (Author/AEF)

  14. 37 CFR 1.491 - National stage commencement and entry.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... national stage shall commence with the expiration of the applicable time limit under PCT Article 22 (1) or (2), or under PCT Article 39(1)(a). (b) An international application enters the national stage...

  15. A generic fast airbreathing first stage TSTO vehicle - RADIANCE

    NASA Astrophysics Data System (ADS)

    Wagner, Alain; Dufour, Alain

    1992-12-01

    A concept is considered that reducing the delta V to be provided by the second stage reduces its mass and, hence, may allow a down scaling of the first stage despite the higher staging Mach number. The concept is based on a two-stage-to-orbit vehicle called RADIANCE that stages at Mach 12 with an airbreathing first stage and a rocket-powered second stage. A fairing is provided to avoid aerodynamic interactions between the stages. RADIANCE takes off horizontally using an integral landing gear. The booster lands horizontally on a conventional runway. After having completed its orbital mission the orbiter returns through the atmosphere for an unpowered landing to the launch base. It is noted that RADIANCE hampered by the high drag losses inherently coupled with its booster size.

  16. 118. Stage basement. View, facing south, of the south hydraulic ...

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

    118. Stage basement. View, facing south, of the south hydraulic ram (type D) in the middle row. Photo was taken before the stage flooring was removed. - Auditorium Building, 430 South Michigan Avenue, Chicago, Cook County, IL

  17. 25. DETAIL OF TIE ROD REINFORCING BELOW WESTERNMOST MOVABLE STAGE ...

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

    25. DETAIL OF TIE ROD REINFORCING BELOW WESTERNMOST MOVABLE STAGE SECTION, LOWER LEVEL OF STAGE, LOOKING SOUTH. TAKEN FROM A POINT JUST SOUTH OF RAM IN IL-1007-24. - Auditorium Building, 430 South Michigan Avenue, Chicago, Cook County, IL

  18. Drama in the Key Stage 3 English Framework. Key Stage 3: National Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    Effective drama teaching improves the following student skills: speaking and listening, reading and writing through developing thinking, communication skills, and critical analysis. Drama is part of young people's core curriculum entitlement in the United Kingdom. It is included in the English Curriculum Orders and in the Key Stage 3 Framework for…

  19. Iterative learning control for synchronization of reticle stage and wafer stage in step-and-scan lithographic equipment

    NASA Astrophysics Data System (ADS)

    Li, Lan-lan; Hu, Song; Zhao, Li-xin; Ma, Ping

    2013-08-01

    Lithographic equipments are highly complex machines used to manufacture integrated circuits (ICs). To make larger ICs, a larger lens is required, which, however, is prohibitively expensive. The solution to this problem is to expose a chip not in one flash but in a scanning fashion. For step-and-scan lithographic equipment (wafer scanner), the image quality is decided by many factors, in which synchronization of reticle stage and wafer stage during exposure is a key one. In this paper, the principle of reticle stage and wafer stage was analyzed through investigating the structure of scanners, firstly. While scanning, the reticle stage and wafer stage should scan simultaneously at a high speed and the speed ratio is 1:4. Secondly, an iterative learning controller (ILC) for synchronization of reticle stage and wafer stage is presented. In the controller, a master-slave structure is used, with the wafer stage acting as the master, and the reticle stage as the slave. Since the scanning process of scanner is repetitive, ILC is used to improve tracking performance. A simple design procedure is presented which allows design of the ILC system for the reticle stage and wafer stage independently. Finally, performance of the algorithm is illustrated by simulated on the virtual stages (the reticle stage and wafer stage).The results of simulation experiments and theory analyzing demonstrate that using the proposed controller better synchronization performance can be obtained for the reticle stage and wafer stage in scanner. Theory analysis and experiment shows the method is reasonable and efficient.

  20. Proteomics of Secretory-Stage and Maturation-Stage Enamel of Genetically Distinct Mice.

    PubMed

    Charone, Senda; De Lima Leite, Aline; Peres-Buzalaf, Camila; Silva Fernandes, Mileni; Ferreira de Almeida, Lucas; Zardin Graeff, Marcia Sirlene; Cardoso de Oliveira, Rodrigo; Campanelli, Ana Paula; Groisman, Sonia; Whitford, Gary Milton; Everett, Eric T; Buzalaf, Marília Afonso Rabelo

    2016-01-01

    The mechanisms by which excessive ingestion of fluoride (F) during amelogenesis leads to dental fluorosis (DF) are still not precisely known. Inbred strains of mice vary in their susceptibility to develop DF, and therefore permit the investigation of underlying molecular events influencing DF severity. We employed a proteomic approach to characterize and evaluate changes in protein expression from secretory-stage and maturation-stage enamel in 2 strains of mice with different susceptibilities to DF (A/J, i.e. 'susceptible' and 129P3/J, i.e. 'resistant'). Weanling male and female susceptible and resistant mice fed a low-F diet were divided into 2 F-water treatment groups. They received water containing 0 (control) or 50 mg F/l for 6 weeks. Plasma and incisor enamel was analyzed for F content. For proteomic analysis, the enamel proteins extracted for each group were separated by 2-dimensional electrophoresis and subsequently characterized by liquid-chromatography electrospray-ionization quadrupole time-of-flight mass spectrometry. F data were analyzed by 2-way ANOVA and Bonferroni's test (p < 0.05). Resistant mice had significantly higher plasma and enamel F concentrations when compared with susceptible mice in the F-treated groups. The proteomic results for mice treated with 0 mg F/l revealed that during the secretory stage, resistant mice had a higher abundance of proteins than their susceptible counterparts, but this was reversed during the maturation stage. Treatment with F greatly increased the number of protein spots detected in both stages. Many proteins not previously described in enamel (e.g. type 1 collagen) as well as some uncharacterized proteins were identified. Our findings reveal new insights regarding amelogenesis and how genetic background and F affect this process. PMID:26820156

  1. Efficiency study comparing two helicopter planetary reduction stages

    NASA Technical Reports Server (NTRS)

    Krantz, Timothy L.; Handschuh, Robert F.

    1990-01-01

    A study was conducted to compare the efficiency of two helicopter transmission planetary reduction stages. Experimental measurements and analytical predictions were made. The analysis predicted and experiments verified that one planetary stage was a more efficient design due to the type of planet bearing used in the stage. The effects of torque, speed, lubricant type, and lubricant temperature on planetary efficiency are discussed.

  2. Research Productivity by Career Stage among Korean Academics

    ERIC Educational Resources Information Center

    Jung, Jisun

    2014-01-01

    This study explores Korean academics' changes in research productivity by career stage. Career stage in this study is defined as a specific cohort based on one's length of job experience, with those in the same stage sharing similar interests, values, needs, and tasks; it is categorized into fledglings, maturing academics, established…

  3. Super's Career Stages and the Decision to Change Careers.

    ERIC Educational Resources Information Center

    Smart, Roslyn; Peterson, Candida

    1997-01-01

    Australians (n=226) in one of four stages of a second career (contemplating, choosing a field, implementing, change completed) were compared with 81 nonchangers. Job satisfaction varied as a function of stage. Results supported Super's theory that career changers cycle through the full set of career stages a second time. (SK)

  4. Surgical decision making for stage IV adult acquired flatfoot disorder.

    PubMed

    Peterson, Kyle S; Hyer, Christopher F

    2014-07-01

    Adult acquired flatfoot deformity is a debilitating musculoskeletal condition affecting the lower extremity. Posterior tibial tendon dysfunction (PTTD) is the primary etiology for the development of a flatfoot deformity in an adult. PTTD is classified into 4 stages (with stage IV subdivided into stage IV-A and IV-B). This classification is described in detail in this article.

  5. Surgical decision making for stage IV adult acquired flatfoot disorder.

    PubMed

    Peterson, Kyle S; Hyer, Christopher F

    2014-07-01

    Adult acquired flatfoot deformity is a debilitating musculoskeletal condition affecting the lower extremity. Posterior tibial tendon dysfunction (PTTD) is the primary etiology for the development of a flatfoot deformity in an adult. PTTD is classified into 4 stages (with stage IV subdivided into stage IV-A and IV-B). This classification is described in detail in this article. PMID:24980933

  6. Megamelus bellicus (Hemiptera: Delphacidae): immature stages and biology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The immature stages of Megamelus bellicus Remes Lenicov & Sosa (Hemiptera:Delphacidae) are described, keyed and illustrated. The descritpion of each stage was based on 24-h hatched nymphs from the laboratory colony. The main characters that distinguish the various stages are body size, color, number...

  7. 42 CFR 441.40 - End-stage renal disease.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false End-stage renal disease. 441.40 Section 441.40... General Provisions § 441.40 End-stage renal disease. FFP in expenditures for services described in subpart A of part 440 is available for facility treatment of end-stage renal disease only if the...

  8. 42 CFR 441.40 - End-stage renal disease.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false End-stage renal disease. 441.40 Section 441.40... General Provisions § 441.40 End-stage renal disease. FFP in expenditures for services described in subpart A of part 440 is available for facility treatment of end-stage renal disease only if the...

  9. 42 CFR 441.40 - End-stage renal disease.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false End-stage renal disease. 441.40 Section 441.40... General Provisions § 441.40 End-stage renal disease. FFP in expenditures for services described in subpart A of part 440 is available for facility treatment of end-stage renal disease only if the...

  10. 42 CFR 441.40 - End-stage renal disease.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false End-stage renal disease. 441.40 Section 441.40... General Provisions § 441.40 End-stage renal disease. FFP in expenditures for services described in subpart A of part 440 is available for facility treatment of end-stage renal disease only if the...

  11. 42 CFR 441.40 - End-stage renal disease.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false End-stage renal disease. 441.40 Section 441.40... General Provisions § 441.40 End-stage renal disease. FFP in expenditures for services described in subpart A of part 440 is available for facility treatment of end-stage renal disease only if the...

  12. Stages of Identity Development and Problem Drinking in College Women.

    ERIC Educational Resources Information Center

    Schnur, Randi E.; MacDonald, Marian L.

    1988-01-01

    Deviation from age-appropriate identity-development stage and problem drinking was investigated in 75 undergraduate women (18-25 years old). Results indicate that younger subjects deviating from their age-appropriate identity stage differentiation and older subjects deviating from their age-appropriate stage of identity integration were likely to…

  13. Developmental Supervision: Reducing Teacher Stress at Different Career Stages.

    ERIC Educational Resources Information Center

    Burden, Paul R.

    Teachers have different job skills, knowledge, behaviors, attitudes, and concerns at different points in their careers. A number of these characteristics follow a regular developmental pattern. Three stages of teacher career development have been identified, with different developmental characteristics at each stage. In the survival stage, which…

  14. Questions and Answers for Transplant Candidates about Model for End-Stage Liver Disease (MELD) and Pediatric End-Stage ....

    MedlinePlus

    ... needs a liver transplant most urgently. The MELD (Model for End Stage Liver Disease) is used for ... and the PELD (Pediatric End Stage Liver Disease Model) is used for patients age 11 and younger. ...

  15. Plasmodium vivax trophozoite-stage proteomes

    PubMed Central

    Anderson, D.C.; Lapp, Stacey A.; Akinyi, Sheila; Meyer, Esmeralda V.S.; Barnwell, John W.; Korir-Morrison, Cindy; Galinski, Mary R.

    2015-01-01

    Plasmodium vivax is the causative infectious agent of 80–300 million annual cases of malaria. Many aspects of this parasite’s biology remain unknown. To further elucidate the interaction of P. vivax with its Saimiri boliviensis host, we obtained detailed proteomes of infected red blood cells, representing the trophozoite-enriched stage of development. Data from two of three biological replicate proteomes, emphasized here, were analyzed using five search engines, which enhanced identifications and resulted in the most comprehensive P. vivax proteomes to date, with 1375 P. vivax and 3209 S. boliviensis identified proteins. Ribosome subunit proteins were noted for both P. vivax and S. boliviensis, consistent with P. vivax’s known reticulocyte host–cell specificity. A majority of the host and pathogen proteins identified belong to specific functional categories, and several parasite gene families, while 33% of the P. vivax proteins have no reported function. Hemoglobin was significantly oxidized in both proteomes, and additional protein oxidation and nitration was detected in one of the two proteomes. Detailed analyses of these post-translational modifications are presented. The proteins identified here significantly expand the known P. vivax proteome and complexity of available host protein functionality underlying the host–parasite interactive biology, and reveal unsuspected oxidative modifications that may impact protein function. Biological significance Plasmodium vivax malaria is a serious neglected disease, causing an estimated 80 to 300 million cases annually in 95 countries. Infection can result in significant morbidity and possible death. P. vivax, unlike the much better-studied Plasmodium falciparum species, cannot be grown in long-term culture, has a dormant form in the liver called the hypnozoite stage, has a reticulocyte host–cell preference in the blood, and creates caveolae vesicle complexes at the surface of the infected reticulocyte

  16. Improving a stage forecasting Muskingum model by relating local stage and remote discharge

    NASA Astrophysics Data System (ADS)

    Barbetta, S.; Moramarco, T.; Melone, F.; Brocca, L.

    2009-04-01

    Following the parsimonious concept of parameters, simplified models for flood forecasting based only on flood routing have been developed for flood-prone sites located downstream of a gauged station and at a distance allowing an appropriate forecasting lead-time. In this context, the Muskingum model can be a useful tool. However, critical points in hydrological routing are the representation of lateral inflows contribution and the knowledge of stage-discharge relationships. As regards the former, O'Donnell (O'Donnell, T., 1985. A direct three-parameter Muskingum procedure incorporating lateral inflow, Hydrol. Sci. J., 30[4/12], 479-496) proposed a three-parameter Muskingum procedure assuming the lateral inflows proportional to the contribution entering upstream. Using this approach, Franchini and Lamberti (Franchini, M. & Lamberti, P., 1994. A flood routing Muskingum type simulation and forecasting model based on level data alone, Water Resour. Res., 30[7], 2183-2196) presented a simple model Muskingum type to provide forecast water levels at the downstream end by selecting a routing time interval and, hence, a forecasting lead-time allowing to express the forecast stage as a function of only observed quantities. Moramarco et al. (Moramarco, T., Barbetta, S., Melone, F. & Singh, V.P., 2006. A real-time stage Muskingum forecasting model for a site without rating curve, Hydrol. Sci. J., 51[1], 66-82) enhanced the modeling scheme incorporating a procedure for adapting the parameter linked to lateral inflows. This last model, called STAFOM (STAge FOrecasting Model), was also extended to a two connected river branches schematization in order to improve significantly the forecasting lead-time. The STAFOM model provided satisfactory results for most of the analysed flood events observed in different river reaches in the Upper-Middle Tiber River basin in Central Italy. However, the analysis highlighted that the stage forecast should be enhanced when sudden modifications

  17. Urinary Biomarkers at Early ADPKD Disease Stage

    PubMed Central

    Petzold, Katja; Poster, Diane; Krauer, Fabienne; Spanaus, Katharina; Andreisek, Gustav; Nguyen-Kim, Thi Dan Linh; Pavik, Ivana; Ho, Thien Anh; Serra, Andreas L.; Rotar, Laura

    2015-01-01

    Background Autosomal dominant polycystic kidney disease (ADPKD) is characterized by a decline in renal function at late disease stage when the majority of functional renal parenchyma is replaced by cystic tissue. Thus, kidney function, assessed by estimated glomerular filtration rate (eGFR) does not well represent disease burden in early disease. Here, we investigated various urinary markers for tubular injury and their association with disease burden in ADPKD patients at early disease course. Methods ADPKD patients between 18 and 40 years with an eGFR greater or equal to 70 ml per min per 1.73m2 were eligible for this cross-sectional study. Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule-1 (KIM-1), and Uromodulin (UMOD) were investigated by Enzyme-Linked Immunosorbent Assay. Clara Cell Protein 16 (CC16) was investigated by Latex Immuno Assay. Cryoscopy was performed to assess urine osmolality and Urinary Albumin-to-Creatinine Ratio (UACR) was calculated. The association and the predictive properties of the markers on eGFR and height adjusted total kidney volume (htTKV) was evaluated using multiple regression analysis, incorporating different control variables for adjustment. Internal bootstrapping validated the obtained results. Results In 139 ADPKD patients (age 31 ±7 years, mean eGFR of 93 ± 19 ml per min per 1.73 m2) the total kidney volume was negatively correlated with eGFR and UMOD and positive associated with age, UACR, KIM-1 and urine osmolality after adjustment for possible confounders. Urine osmolality and htTKV were also associated with eGFR, whereas no association of CC16, NGAL and UMOD with eGFR or htTKV was found. Conclusion UACR and urinary KIM-1 are independently associated with kidney size but not with renal function in our study population. Urine osmolality was associated with eGFR and kidney volume following adjustment for multiple confounders. Despite statistical significance, the clinical value of our

  18. Cumberland last stage blade failure investigation

    SciTech Connect

    Puri, A.; Lam, T.

    1995-12-31

    TVA`s Cumberland plant has two sister units which are rated 1,300 MW each, and have been in service since 1973. Five other units in the United States share the identical design and configuration as the Cumberland machines, and have a similar operating history. Relying on a cross compound design, these machines have an HP turbine and two LP turbines in line A, an IP turbine and two LP turbines in line B. The four double flow LP turbines are identical in design. The L-0 stage is comprised of 71 free standing blades, each of which measures 30 inches from hub to tip. On December 3, 1993, Unit 1 experienced an in-service catastrophic failure. Subsequent inspection revealed that blade {number_sign}35 in the L-0 stage, LP1 turbine end of A line had failed in the airfoil near the platform. The separation of blade {number_sign}35 caused a revere rotor unbalance which resulted in extensive consequential damage to all the components in the A line rotor train. To manage the forced outage and minimize the unit downtime the plant needed to establish (a) a list of immediate actions to restore the damaged unit and return it back into service and (b) the long term actions which should be taken to ensure the reliability of both the damaged machine and its sister unit. A key issue included within this decision making process was to identify the root cause of failure of blade {number_sign}35. By relying on the EPRI BLADE{trademark} program, TVA was able to initiate a technical investigation in parallel with the repair efforts being performed with the cooperation of the Original Equipment Manufacturers (OEM). Based on the technical detail generated in part with BLADE, and supplemented with a series of additional tests and studies, TVA was able to bring Unit 1 back into service and reduce the downtime by 58 days, and thereby save an estimated $25.55 million towards the purchase of replacement power.

  19. Structural analysis at aircraft conceptual design stage

    NASA Astrophysics Data System (ADS)

    Mansouri, Reza

    . Considering the strength and limitations of both methodologies, the question to be answered in this thesis is: How valuable and compatible are the classical analytical methods in today's conceptual design environment? And can these methods complement each other? To answer these questions, this thesis investigates the pros and cons of classical analytical structural analysis methods during the conceptual design stage through the following objectives: Illustrate structural design methodology of these methods within the framework of Aerospace Vehicle Design (AVD) lab's design lifecycle. Demonstrate the effectiveness of moment distribution method through four case studies. This will be done by considering and evaluating the strength and limitation of these methods. In order to objectively quantify the limitation and capabilities of the analytical method at the conceptual design stage, each case study becomes more complex than the one before.

  20. IUS/SPINSIM - INERTIAL UPPER STAGE SPIN STAGE SIX DEGREE OF FREEDOM SIMULATION

    NASA Technical Reports Server (NTRS)

    Dauro, V. A.

    1994-01-01

    IUS/SPINSIM was written to evaluate a proposed spinning third stage for the Inertial Upper Stage (IUS) Jupiter Mission. The third stage of the IUS was not to have altitude control during the solid motor burn for this mission. IUS was to be spun up about its principle thrust axis in the desired attitude prior to ignition of its solid motor. IUS/SPINSIM can also be used to evaluate the performance of other spinning stages that utilize a fixed burn motor. IUS/SPINSIM is a Six-Degree-of-Freedom simulation for exo-atmospheric flight of an IUS. It assumes the stage is released in orbit at or near its desired inertial attitude, and is spinning slowly. The code models three phases: a coast phase in which further spin-up may occur, a burn stage during which a solid rocket motor (SRM) burn injects the space craft into a transfer trajectory, and a final coast phase. IUS/SPINSIM takes into account the effects of the following: a reaction control system (RCS) spinning the vehicle; SRM thrust buildup, decay, and misalignment; changing mass, center of gravity, principle moments of inertia, cross products of inertia, time derivatives of inertia; jet damping moments; and an oblate gravity model. Numerical integration of the equations of motion using a Runge-Kutta fourth order integrator and small step sizes is used to track the vehicle's position, velocity, attitude and spin rates. Instead of using Euler angles or the Direction Cosine Matrix, Quarternions are used to model the attitude and spinning of the vehicle. This eliminates the renormalization difficulties associated with either of the other methods. Program input is taken from a file, and output is to a print file and a data file suitable for use in plotting. The IUS/SPINSIM is written in FORTRAN 77 for DEC VAX series computers running VMS. The standard distribution medium for this program is a 9track 1600 BPI magnetic tape in DEC VAX BACKUP format. It is also available on a TK50 tape cartridge in DEC VAX BACKUP format. This