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Sample records for ajcc tnm staging

  1. The impact of tumor deposits on colonic adenocarcinoma AJCC TNM staging and outcome.

    PubMed

    Jin, Ming; Roth, Rachel; Rock, Jonathan B; Washington, Mary Kay; Lehman, Amy; Frankel, Wendy L

    2015-01-01

    The definition of tumor deposits (TDs) in colonic adenocarcinoma has been modified in different editions of the AJCC/TNM staging system. Studies have shown that the presence of TD is associated with advanced tumor growth and poor prognosis. Most of these data were obtained in patients with simultaneous lymph node (LN) metastases. Reports focusing on the impact of TD in patients without LN metastasis are limited. We retrospectively restaged all right-sided colonic adenocarcinomas over a 10-year period using criteria from the fifth, sixth, and seventh AJCC edition. We compared the number of tumor nodule interpreted as LN and TD in each edition and evaluated the stage migration caused by TD definition change. We then assessed clinical significance of TD in the AJCC seventh edition by comparing 5-year overall survival of N1c patients versus other N category (N0, N1, N2) patients with similar T and M status. We showed that the average number of tumor nodules interpreted as LNs per case and the number of cases with positive LNs were significantly decreased with the seventh edition compared with fifth/sixth; however, numbers of cases with TDs and <12 LNs were significantly increased with the seventh edition compared with fifth/sixth. These changes, however, resulted in minimal effects on the final stage grouping. Our survival analysis showed that N1c patients had significantly worse survival compared with N0 patients. Although not statistically significant, the hazard ratios indicated that the N1c group might have worse survival than the N1 group and better survival than the N2 group. Therefore, we conclude that TDs predict patient outcome at least similarly to positive LNs.

  2. 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

  3. Serologic biomarkers of Epstein-Barr virus correlate with TNM classification according to the seventh edition of the UICC/AJCC staging system for nasopharyngeal carcinoma.

    PubMed

    Sun, Peng; Chen, Cui; Cheng, Yi-Kan; Zeng, Zhi-Jian; Chen, Xin-Lin; Liu, Li-Zhi; Gu, Mo-Fa

    2014-09-01

    This study aimed to investigate the association between Epstein-Barr virus (EBV)-related biomarkers and TNM classification according to the seventh edition of AJCC/UICC staging system for nasopharyngeal carcinoma. Serum VCA-IgA and EA-IgA titers and plasma EBV-DNA load were quantified at baseline in 779 patients; the rates of positivity and titers/load were compared by TNM classification. The VCA-IgA-positive rate was significantly associated with advanced N classification and stage; the EA-IgA-positive rate with advanced T and N classifications and stage; the EBV-DNA-positive rate with advanced T, N and M classifications and stage. The percentage of triple-positive patients was higher in patients with advanced TNM classification. The VCA-IgA titer and EA-IgA titer correlated positively with T classification, N classification and disease stage (1:117 in Stage I, 1:188.4 in Stage II, 1:231.12 in Stage III, 1:265.91 in Stage IV, and 1:18.34 in Stage I, 1:32.11 in Stage II, 1:34.77 in Stage III, 1:37.65 in Stage IV, respectively). EBV DNA load correlated positively with T, N and M classification and stage [median lg (EBV DNA): 0 (IQ range 0-1.85) in Stage I, 1.32 (0-3.51) in Stage II, 3.33 (0-4.30) in Stage III, 3.83 (2.85-4.71) in Stage IV]. Serum VCA-IgA/EA-IgA titers and plasma EBV DNA correlated strongly with TNM classification according to the seventh edition of the AJCC/UICC; however, plasma EBV DNA load could accurately predict metastatic disease. EBV serological biomarkers may enhance the accuracy of TNM staging and help to avoid excessive imaging examinations in routine evaluation.

  4. Ongoing problems concerning 7th TNM Staging System and Proposals for 8th TNM Staging System of Gastric Cancer

    PubMed Central

    Ureyen, Orhan; Meral, Ulvi Mehmet

    2016-01-01

    Because of different prognosis of gastric cancer patients with the same T and N stages, the impossibility of N3 staging in patients with fewer than 15 removed lymph nodes, and the presence of stage migration phenomenon, the 6th edition TNM Staging System for gastric cancer was updated to the 7th edition TNM staging system in 2009. Despite some opposing views, the superiority of the 7th edition TNM staging system compared to the 6th has been demonstrated in many studies. However, there are doubts about the 7th edition that it will reduce the stage migration phenomenon. The most important problem about the 7th TNM staging system is regarding subgroups N3a and N3b. The separation of N3 stage as N3a and N3b does not contribute to the TNM staging system. In conclusion, separate usage of N3a and N3b subgroups in the TNM staging system should be considered in the creation phase of the 8th edition. PMID:28053675

  5. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging.

    PubMed

    Amin, Mahul B; Greene, Frederick L; Edge, Stephen B; Compton, Carolyn C; Gershenwald, Jeffrey E; Brookland, Robert K; Meyer, Laura; Gress, Donna M; Byrd, David R; Winchester, David P

    2017-03-01

    The American Joint Committee on Cancer (AJCC) staging manual has become the benchmark for classifying patients with cancer, defining prognosis, and determining the best treatment approaches. Many view the primary role of the tumor, lymph node, metastasis (TNM) system as that of a standardized classification system for evaluating cancer at a population level in terms of the extent of disease, both at initial presentation and after surgical treatment, and the overall impact of improvements in cancer treatment. The rapid evolution of knowledge in cancer biology and the discovery and validation of biologic factors that predict cancer outcome and response to treatment with better accuracy have led some cancer experts to question the utility of a TNM-based approach in clinical care at an individualized patient level. In the Eighth Edition of the AJCC Cancer Staging Manual, the goal of including relevant, nonanatomic (including molecular) factors has been foremost, although changes are made only when there is strong evidence for inclusion. The editorial board viewed this iteration as a proactive effort to continue to build the important bridge from a "population-based" to a more "personalized" approach to patient classification, one that forms the conceptual framework and foundation of cancer staging in the era of precision molecular oncology. The AJCC promulgates best staging practices through each new edition in an effort to provide cancer care providers with a powerful, knowledge-based resource for the battle against cancer. In this commentary, the authors highlight the overall organizational and structural changes as well as "what's new" in the Eighth Edition. It is hoped that this information will provide the reader with a better understanding of the rationale behind the aggregate proposed changes and the exciting developments in the upcoming edition. CA Cancer J Clin 2017;67:93-99. © 2017 American Cancer Society.

  6. Comparison of the AJCC, MSTS, and Modified Spanier Systems for Clinical and Pathologic Staging of Osteosarcoma.

    PubMed

    Cates, Justin M M

    2017-03-01

    The prognostic performance of the 2 most commonly used staging systems for skeletal sarcoma (the American Joint Committee on Cancer [AJCC] and Musculoskeletal Tumor Society [MSTS] systems) have never been compared analytically. Another staging system originally proposed by Spanier has not yet been validated. Given the recent release of the 8th edition of the AJCC Cancer Staging Manual, this study was designed to directly compare these anatomic staging systems in a series of 153 high-grade, intramedullary osteosarcomas. Kaplan-Meier curves were plotted and pairwise comparisons between each stage category were performed. Predictive accuracy of each staging system for determining 5-year disease-free survival was evaluated by comparing areas under receiver-operating characteristic curves generated from logistic regression analysis. Multiple concordance indices were calculated using bootstrapping methods (200 replications). ρk and R were estimated as measures of the variation in survival outcomes explained by the regression models. The AJCC, MSTS, and a modified version of the Spanier staging systems showed similar discriminatory abilities and no significant differences in the levels of contrast between different tumor stages across staging systems. Addition of T-category information from each staging system contributed significant prognostic information compared with a Cox proportional hazard regression model consisting only of the presence or absence of metastatic disease as a measure of disease extent. Concordance indices and predictive accuracy for 5-year disease-free survival were not significantly different among the different staging systems either. Similar findings were observed after accounting for other important prognostic variables. Additional studies are necessary to determine performance parameters of each staging system for other types of skeletal sarcoma. Prognostic performance of osteosarcoma staging systems would also be improved by incorporating

  7. A nomogram improves AJCC stages for colorectal cancers by introducing CEA, modified lymph node ratio and negative lymph node count

    PubMed Central

    Zhang, Zhen-yu; Gao, Wei; Luo, Qi-feng; Yin, Xiao-wei; Basnet, Shiva; Dai, Zhen-ling; Ge, Hai-yan

    2016-01-01

    Lymph node stages (pN stages) are primary contributors to survival heterogeneity of the 7th AJCC staging system for colorectal cancer (CRC), indicating spaces for modifications. To implement the modifications, we selected eligible CRC patients from the Surveillance Epidemiology and End Results (SEER) database as participants in a training (n = 6675) and a test cohort (n = 6760), and verified tumor deposits to be metastatic lymph nodes to derive modified lymph node count (mLNC), lymph node ratio (mLNR), and positive lymph node count (mPLNC). After multivariate Cox regression analyses with forward stepwise elimination of the mLNC and mPLNC for the training cohort, a nomogram was constructed to predict overall survival (OS) via incorporating preoperative carcinoembryonic antigen, pT stages, negative lymph node count, mLNR and metastasis. Internal validations of the nomogram showed concordance indexes (c-index) of 0.750 (95% CI, 0.736–0.764) and 0.749 before and after corrections for overfitting. Serial performance evaluations indicated that the nomogram outperformed the AJCC stages (c-index = 0.725) with increased accuracy, net benefits, risk assessment ability, but comparable complexity and clinical validity. All the results were reproducible in the test cohort. In summary, the proposed nomogram may serve as an alternative to the AJCC stages. However, validations with longer follow-up periods are required. PMID:27941905

  8. TNM and Modified Dukes staging along with the demographic characteristics of patients with colorectal carcinoma

    PubMed Central

    Akkoca, Ayşe Neslin; Yanık, Serdar; Özdemir, Zeynep Tuğba; Cihan, Fatma Gökşin; Sayar, Süleyman; Cincin, Tarık Gandi; Çam, Akın; Özer, Cahit

    2014-01-01

    Aim: Colon adenocarcinoma, is the most common cancer in gastrointesinal system (GIS). The whole world is an important cause of morbidity and mortality. TNM and modified Dukes classification which has great importance in the diagnosis and treatment of Colorectal cancer (CRC). TNM and Modified Dukes classification results of histopathological examination and the demographic characteristics of patients and their relation were investigated. Materials and methods: Lower gastrointestinal operation results of 85 patients were examined accepted to clinical Pathology between January 1997-November 2013. Colon cancer had been diagnosed at 85 patients with pathology materials and staging was done according to the TNM and Modified Duke classification. The demographic characteristics of patients, differentiation grade, lymph node involvement, serous involvement were evaluated retrospectively. Results: In this study 37 patients (43.52%) were men and 48 (56.47%) were women. Ages of patients were between 19 and 87 with a mean age of 57.31 ± 15.31. Lymph node, differentiation, serosa involvement, Modified Dukes and TNM classification was assessed according to sex and age. TNM classification by sex was not statistically significant (p > 0.05). There was no statistically significant relationship between age and differentiation (p = 0.085). Value of differentiation increased towards from 1 to 3 inversely proportional to age. So young patients defined as well-differentiated at the conclusion. Negative relationship was evaluated between age and TNM Class variables. As a result, the relationship between age and TNM was not significant (p > 0.05). However, with increasing age the degree of staging was also found to increase. TNM classification was associated with the differentiation and it was significant (p = 0.043). Conclusion: Colon cancer, when contracted at an early stage, it is suitable for surgery and curative treatment can be done with minimal morbidity and mortality. However

  9. Prognostic significance and the role in TNM stage of extranodal metastasis within regional lymph nodes station in gastric carcinoma

    PubMed Central

    Chen, Xiao-Long; Zhao, Lin-Yong; Xue, Lian; Xu, Yu-Hui; Zhang, Wei-Han; Liu, Kai; Chen, Xin-Zu; Yang, Kun; Zhang, Bo; Chen, Zhi-Xin; Chen, Jia-Ping; Zhou, Zong-Guang; Hu, Jian-Kun

    2016-01-01

    The role of extranodal metastasis (ENM) in TNM stage in gastric carcinoma (GC) is controversial. This study was aimed to make a detailed investigation of the prognostic significance and the role in TNM stage of ENM in GC. The patients with primary GC, who underwent gastrectomy with curative intention in West China Hospital from January 2005 to December 2011, were retrospectively enrolled. The prognosis and clinicopathological traits were compared between ENM positive (ENMP) and negative (ENMN) groups in all patients, TNM I-II, III and IV stages, respectively. The significance of the number and the role in TNM stage of ENM were also assessed. In our study, 1457 patients were enrolled, with 1324 (90.9%) in ENMN group and 133 (9.1%) in ENMP group. ENMP group had significantly more advanced GC and worse prognosis (all p<0.05) than ENMN group in all patients, TNM I-II stages and TNM III stage. ENM>2 subgroup had remarkably larger tumor size (p=0.002) and more advanced N stage (p=0.016) than ENM=1-2 subgroup. The number of ENM was an independent prognostic factor in ENMP group (p=0.029). The prognosis of ENM>2 in TNM I-III stages was significantly worse than ENMN patients in TNM III stage. The C-index of TNM stage plus the number of ENM was significantly higher than that of current TNM stage alone (p=0.005). In conclusion, the patients in ENMP subgroup had more advanced GC and worse prognosis than those in ENMN subgroup. It might be more reasonable to categorize ENM>2 into TNM IV stage. PMID:27563811

  10. Correlation of CD24 expression with histological grading and TNM staging of retinoblastoma

    PubMed Central

    Ishaq, Syed Muhammad; Kehar, Shahnaz Imdad; Zafar, Shahid; Hasan, Syed Furqan Ul

    2016-01-01

    Objective: Correlation of CD24 expression with histological grading and TNM staging of retinoblastoma. Methods: This cross-sectional study was conducted in the Department of Pathology, BMSI, JPMC and NICH from 1st January 2009 to 31st December 2013. A total 68 diagnosed cases of retinoblastoma were selected for CD24 immuno staining. The data was analyzed by using SPSS version 22. Results: Out of 68 cases 7.35% showed grade 1 followed by 11.76% in G2, 26.47% in G3 and 54.41% in G4. Majority of cases i.e. 60.29% in stage IV followed by 19.11% in stage I, 10.29% each in stage II and stage III. CD24 immuno staining positivity was seen in majority of grade 3 and grade 4. In grade 3, 38.88% showed moderate and 22.22% strong immuno reaction. Amongst grade 4, 40.54% showed moderate and 13.51% strong positive. Variable immuno pattern was observed according to TNM staging. In stage I, 46.15% showed moderate and 7.69% strong positivity, while in stage II, 57.14% were negative for saining. In stage III, 42.85% were negative while 28.57% each showed moderate and strong staining. Majority of cases in stage IV i.e. 48.78% were negative for staining while 34.14%, 17.07% showed moderate and severe CD24 immuno staining. Conclusion: Majority of grade I retinoblastoma were in TNM stage I & II and mostly were immuno negative. Lymph node and distant metastatic cases were 75% in G4 and 25% in G3, all of them showed moderate to strong immunoreactivity. These results showed that CD24 expression may be a marker of poor prognosis in retinoblastoma. Whereas TNM staging of retinoblastomas with CD24 expression had varying pattern and showed no significant correlation between them. PMID:27022367

  11. Vitronectin and dermcidin serum levels predict the metastatic progression of AJCC I–II early‐stage melanoma

    PubMed Central

    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

    2016-01-01

    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

  12. Protein signatures correspond to survival outcomes of AJCC stage III melanoma patients

    PubMed Central

    Mactier, Swetlana; Kaufman, Kimberley L; Wang, Penghao; Crossett, Ben; Pupo, Gulietta M; Kohnke, Philippa L; Thompson, John F; Scolyer, Richard A; Yang, Jean Y; Mann, Graham J; Christopherson, Richard I

    2014-01-01

    Summary Outcomes for melanoma patients with stage III disease differ widely even within the same subcategory. Molecular signatures that more accurately predict prognosis are needed to stratify patients according to risk. Proteomic analyses were used to identify differentially abundant proteins in extracts of surgically excised samples from patients with stage IIIc melanoma lymph node metastases. Analysis of samples from patients with poor (n = 14, <1 yr) and good (n = 19, >4 yr) survival outcomes identified 84 proteins that were differentially abundant between prognostic groups. Subsequent selected reaction monitoring analysis verified 21 proteins as potential biomarkers for survival. Poor prognosis patients are characterized by increased levels of proteins involved in protein metabolism, nucleic acid metabolism, angiogenesis, deregulation of cellular energetics and methylation processes, and decreased levels of proteins involved in apoptosis and immune response. These proteins are able to classify stage IIIc patients into prognostic subgroups (P < 0.02). This is the first report of potential prognostic markers from stage III melanoma using proteomic analyses. Validation of these protein markers in larger patient cohorts should define protein signatures that enable better stratification of stage III melanoma patients. PMID:24995518

  13. Protein signatures correspond to survival outcomes of AJCC stage III melanoma patients.

    PubMed

    Mactier, Swetlana; Kaufman, Kimberley L; Wang, Penghao; Crossett, Ben; Pupo, Gulietta M; Kohnke, Philippa L; Thompson, John F; Scolyer, Richard A; Yang, Jean Y; Mann, Graham J; Christopherson, Richard I

    2014-11-01

    Outcomes for melanoma patients with stage III disease differ widely even within the same subcategory. Molecular signatures that more accurately predict prognosis are needed to stratify patients according to risk. Proteomic analyses were used to identify differentially abundant proteins in extracts of surgically excised samples from patients with stage IIIc melanoma lymph node metastases. Analysis of samples from patients with poor (n = 14, <1 yr) and good (n = 19, >4 yr) survival outcomes identified 84 proteins that were differentially abundant between prognostic groups. Subsequent selected reaction monitoring analysis verified 21 proteins as potential biomarkers for survival. Poor prognosis patients are characterized by increased levels of proteins involved in protein metabolism, nucleic acid metabolism, angiogenesis, deregulation of cellular energetics and methylation processes, and decreased levels of proteins involved in apoptosis and immune response. These proteins are able to classify stage IIIc patients into prognostic subgroups (P < 0.02). This is the first report of potential prognostic markers from stage III melanoma using proteomic analyses. Validation of these protein markers in larger patient cohorts should define protein signatures that enable better stratification of stage III melanoma patients.

  14. [The IASLC lung cancer staging project. Comparing the current 6(th) TNM edition with the proposed 7(th) edition].

    PubMed

    Carvalho, Lina; Cardoso, Edgar; Nunes, Henrique; Baptista, Victor; Gomes, Ana; Couceiro, Patrícia

    2009-01-01

    The future 7th edition of TNM classification for lung cancer will be published in 2009 and comprises the IASLC recommendations for TNM parameters. The general staging of lung cancer includes the new parameters: reclassification of tumours larger than 7 cm from T2 to T3; extra tumoral nodules will change their category to T3, T4 and M1 when in the same, ipsilateral or contralateral lobe, respectively; pleural effusion will be M1a. With these alterations, cases staged as IB - T2b N0 M0 will be IIA, cases staged IIB - T2a N1 M0 will be IIA and cases IIIB- T4 N0- -1 M0 will be IIIA. The 7(th) TNM edition recommendations were applied to 203 broncho -pulmonary carcinomas, concerning epidermoid carcinomas (83) and adenocarcinomas (120) registered in the archive of the Serviço de Anatomia Patológica of the Hospitais da Universidade de Coimbra - Portugal, previously submitted to surgical resection and lymph node excision. The following alterations will be kept as the application of the future 7(th) TNM edition: 20 cases in stage IB will move to stage IIA (17) and stage IIB (3); 18 cases will change from stage IIB to stage IIA (17) and 1 case to stage IIIA; 2 cases from stage IIIB will move to stage IV; 6 cases in stage IV will move to stage IIIA (5) and 1 case to stage IIIB. In this translational adaptation from 6th to 7th TNM staging, 51 out of the 203 analysed cases change their staging, corresponding to 25.1%.

  15. 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.

  16. A comparison of the prognostic value of preoperative inflammation-based scores and TNM stage in patients with gastric cancer

    PubMed Central

    Pan, Qun-Xiong; Su, Zi-Jian; Zhang, Jian-Hua; Wang, Chong-Ren; Ke, Shao-Ying

    2015-01-01

    Background People’s Republic of China is one of the countries with the highest incidence of gastric cancer, accounting for 45% of all new gastric cancer cases in the world. Therefore, strong prognostic markers are critical for the diagnosis and survival of Chinese patients suffering from gastric cancer. Recent studies have begun to unravel the mechanisms linking the host inflammatory response to tumor growth, invasion and metastasis in gastric cancers. Based on this relationship between inflammation and cancer progression, several inflammation-based scores have been demonstrated to have prognostic value in many types of malignant solid tumors. Objective To compare the prognostic value of inflammation-based prognostic scores and tumor node metastasis (TNM) stage in patients undergoing gastric cancer resection. Methods The inflammation-based prognostic scores were calculated for 207 patients with gastric cancer who underwent surgery. Glasgow prognostic score (GPS), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic nutritional index (PNI), and prognostic index (PI) were analyzed. Linear trend chi-square test, likelihood ratio chi-square test, and receiver operating characteristic were performed to compare the prognostic value of the selected scores and TNM stage. Results In univariate analysis, preoperative serum C-reactive protein (P<0.001), serum albumin (P<0.001), GPS (P<0.001), PLR (P=0.002), NLR (P<0.001), PI (P<0.001), PNI (P<0.001), and TNM stage (P<0.001) were significantly associated with both overall survival and disease-free survival of patients with gastric cancer. In multivariate analysis, GPS (P=0.024), NLR (P=0.012), PI (P=0.001), TNM stage (P<0.001), and degree of differentiation (P=0.002) were independent predictors of gastric cancer survival. GPS and TNM stage had a comparable prognostic value and higher linear trend chi-square value, likelihood ratio chi-square value, and larger area under the receiver operating

  17. The new TNM classification of lymph node metastasis minimises stage migration problems in gastric cancer patients

    PubMed Central

    de Manzoni, G; Verlato, G; Roviello, F; Morgagni, P; Di Leo, A; Saragoni, L; Marrelli, D; Kurihara, H; Pasini, F

    2002-01-01

    The present study aimed at investigating whether in gastric cancer patients stage migration occurs with extension of lymphadenectomy, when node metastases are staged according to the new pN classification (UICC 1997). The investigation involved 921 patients, who underwent R0 gastric resection for gastric cancer between 1988 and 1998 in three different Italian centres: Verona (n=236), Forlì (n=409), Siena (n=276). The relation among lymphadenectomy and pN category was assessed by Kendall's partial rank-order correlation coefficient, controlling for depth of tumour invasion. A direct evaluation of the Will Rogers phenomenon was accomplished in the Verona series, by comparing the number of positive nodes actually observed with the number of positive nodes which would have been retrieved by a less extended lymphadenectomy (D1). The number of positive nodes increased remarkably with the enlargement of lymphadenectomy, especially in pT2 patients (from 2.2±3.9 in D1 to 3.9±5.0 in D3) and in pT3/pT4 patients (from 5.1±5.9 in D1 to 11.3±12.6 in D3). Non-parametric statistics highlighted a weak (Kendall's partial T=0.128) but significant (P<0.001) correlation between pN category and extension of lymphadenectomy. In the direct analysis of the Verona series, 22 patients out of 230 (9.6%) migrated to a lower pN tier when ignoring positive nodes retrieved from the second and third level. This percentage increased to 39.1% (90 out of 230) when adopting the TNM 87 classification. In conclusion stage migration is of minor importance in gastric cancer patients, staged according to the new pN classification. British Journal of Cancer (2002) 87, 171–174. doi:10.1038/sj.bjc.6600432 www.bjcancer.com © 2002 Cancer Research UK PMID:12107838

  18. High expression of Wls is associated with lymph node metastasis and advanced TNM stage in gastric carcinomas.

    PubMed

    Zhang, Wei; Tao, Hong; Chen, Xiao; Sugimura, Haruhiko; Wang, Jiandong; Zhou, Ping

    2017-03-01

    The roles of Wnt protein in carcinogenesis have been well documented in human cancers. Wls is a key modulator for the secretion of Wnt protein. We previously found that Wls was aberrantly expressed in colorectal carcinomas. Studies have revealed that dysregulation of Wnt signal transduction plays an important role in gastric carcinoma. We hypothesized that Wls may play a role in the development and progression of gastric carcinoma. In this study, three gastric cancer cell lines MGC-803, SGC-7901, and AGS, and a set of gastric carcinoma tissue specimens were subjected to immunohistochemistry. The relationship between the expression of Wls and clinicopathological parameters was analyzed. Wls was negatively detected in MGC-803, positively detected in SGC-7901 and AGS cell lines. Wls was weakly expressed in 9.7% (15/154), moderately in 33.1% (51/154), and strongly in 57.1% (88/154) of tested gastric carcinoma specimens. High expression of Wls was positively associated with well and moderately differentiated tumors (P = 0.035, rs  = 0.170), lymph node metastasis (P = 0.001, rs  = 0.276), and advanced TNM stage (P = 0.006, rs  = 0.219). Our data suggest that Wls protein is related to tumor metastasis and advanced TNM stage, and may be used as a new marker for prognosis of gastric carcinoma.

  19. Expression and significance of S100P, CD147, and OCT4 in different prostate cancer tissue TNM stages.

    PubMed

    Wang, Q; Zhang, J G; Wang, W

    2015-06-18

    The aim of this project was to investigate the expression and significance of S100P, CD147, and OCT4 in prostate cancer tissue at different TNM stages. We enrolled 54 patients with prostate cancer, 40 with benign prostatic hyperplasia, and 20 subjects with normal prostates. S100P, CD147, and OCT4 were detected by immunohistochemistry. The positive rate of S100P detection was 18.52% in prostate cancer tissues, significantly lower than in normal and benign prostate hyperplasia tissues (P ˂ 0.05). The positive expression rate of CD147 and OCT4 were 100 and 77.38% in prostate cancer tissue, respectively, both markedly higher than in normal and benign prostate hyperplasia tissue (P ˂ 0.05). The positive rate of S100P in stage V was 0, which was significantly lower than in stages I (37.50%) and II (35.71%) (P ˂ 0.05). OCT4 expression in stages III (86.67%) and V (94.12%) was higher than in stage I (37.50%). The positive rate of S100P in patients with distant metastasis was 4%, which was significantly lower than that in patients without metastases (P ˂ 0.05). In contrast, the positive rate of OCT4 in patients with distant metastasis was 92%. S100P, CD147, and OCT4 expression in prostate cancer patients with different degrees of differentiation had no significant difference (P > 0.05). Overall, our results demonstrated that S100P expression in prostate cancer tissue was significantly decreased, whereas CD147 and OCT4 expression was increased. Their expression levels were closely associated with TNM stage and distant metastasis, but were not related to the degree of differentiation.

  20. 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

  1. TNM Staging Matched-pair Comparison of Surgery After Neoadjuvant Chemoradiotherapy, Surgery Alone and Definitive Chemoradiotherapy for Thoracic Esophageal Squamous Cell Carcinoma

    PubMed Central

    Liu, ShiLiang; Qiu, Bo; Luo, GuangYu; Liang, Ying; Zheng, YuZhen; Chen, ZhaoLin; Luo, KongJia; Xi, Mian; Liu, Qing; Hu, YongHong; Li, Qun; Fu, JianHua; Liu, MengZhong; Yang, Hong; Liu, Hui

    2017-01-01

    Introduction: We used the TNM staging matched-pair approach to compare the efficacies of surgery after neoadjuvant chemoradiotherapy (NCT), surgery alone and definitive chemoradiotherapy (CCRT) in patients with localized advanced thoracic esophageal squamous cell carcinoma (ESCC). Methods: A total of 642 patients with ESCC from previous studies were studied. Patients whose treatment involved NCT + surgery and surgery alone were compared with patients receiving CCRT. Prospensity score matched-pair comparison based on pre-treatment TNM staging was developed to assess the efficacies of these treatment options. Results: Prospensity score matched-pair comparison to control for bias generated a cohort of 274 patients who were eligible for comparison. The 3-year OS rate was 70.0% in the NCT + surgery group, compared to 51.7% in the surgery group (p=0.000) and 61.9% in the CCRT group (p=0.082). With the TNM staging matched-pair approach, the CCRT group had more upper thoracic ESCC patients (43/92, 46.7%), while the surgery group had more lower thoracic ESCC patients (37/92, 40.2%). The 3-year OS rates were comparable between the surgery alone group and CCRT group (p=0.109). Conclusions: NCT plus surgery was superior in OS to surgery alone or CCRT. The 3-year OS rates were comparable between the surgery alone group and CCRT group with TNM staging matched-pair approach. Further investigation is warranted to confirm these findings. PMID:28367248

  2. An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer

    PubMed Central

    Nixon, Iain J.; Wang, Laura Y.; Migliacci, Jocelyn C.; Eskander, Antoine; Campbell, Michael J.; Aniss, Ahmad; Morris, Lilah; Vaisman, Fernanda; Corbo, Rossana; Momesso, Denise; Vaisman, Mario; Carvalho, Andre; Learoyd, Diana; Leslie, William D.; Nason, Richard W.; Kuk, Deborah; Wreesmann, Volkert; Morris, Luc; Palmer, Frank L.; Ganly, Ian; Patel, Snehal G.; Singh, Bhuvanesh; Tuttle, R. Michael; Shaha, Ashok R.; Gönen, Mithat; Pathak, K. Alok; Shen, Wen T.; Sywak, Mark; Kowalski, Luis; Freeman, Jeremy; Perrier, Nancy; Shah, Jatin P.

    2016-01-01

    Background: Age is a critical factor in outcome for patients with well-differentiated thyroid cancer. Currently, age 45 years is used as a cutoff in staging, although there is increasing evidence to suggest this may be too low. The aim of this study was to assess the potential for changing the cut point for the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging system from 45 years to 55 years based on a combined international patient cohort supplied by individual institutions. Methods: A total of 9484 patients were included from 10 institutions. Tumor (T), nodes (N), and metastasis (M) data and age were provided for each patient. The group was stratified by AJCC/UICC stage using age 45 years and age 55 years as cutoffs. The Kaplan–Meier method was used to calculate outcomes for disease-specific survival (DSS). Concordance probability estimates (CPE) were calculated to compare the degree of concordance for each model. Results: Using age 45 years as a cutoff, 10-year DSS rates for stage I–IV were 99.7%, 97.3%, 96.6%, and 76.3%, respectively. Using age 55 years as a cutoff, 10-year DSS rates for stage I–IV were 99.5%, 94.7%, 94.1%, and 67.6%, respectively. The change resulted in 12% of patients being downstaged, and the downstaged group had a 10-year DSS of 97.6%. The change resulted in an increase in CPE from 0.90 to 0.92. Conclusions: A change in the cutoff age in the current AJCC/UICC staging system from 45 years to 55 years would lead to a downstaging of 12% of patients, and would improve the statistical validity of the model. Such a change would be clinically relevant for thousands of patients worldwide by preventing overstaging of patients with low-risk disease while providing a more realistic estimate of prognosis for those who remain high risk. PMID:26914539

  3. Phosphohistone-H3 (PHH3) is prognostic relevant in Merkel cell carcinomas but Merkel cell polyomavirus is a more powerful prognostic factor than AJCC clinical stage, PHH3, Ki-67 or mitotic indices.

    PubMed

    Iwasaki, Takeshi; Matsushita, Michiko; Nonaka, Daisuke; Kato, Masako; Nagata, Keiko; Murakami, Ichiro; Hayashi, Kazuhiko

    2015-08-01

    Merkel cell carcinomas (MCCs) associated with Merkel cell polyomavirus (MCPyV) have better prognosis than those without MCPyV. The relationship between mitotic index (MI) and MCC outcome has remained elusive because of the difficulty in differentiating mitotic cells from apoptotic ones. We evaluated the role of phosphohistone-H3 (PHH3) (Ser10), a new mitotic count biomarker, in MCPyV-positive or -negative MCC patients, and assessed its prognostic value in comparison to Ki-67 labeling index or MI using hematoxylin and eosin (HE) staining. We compared the prognostic value of PHH3 mitotic index with that of MI by HE in 19 MCPyV-positive and 9 MCPyV-negative MCC patients. PHH3-positive immunoreactivity was mostly observed in mitotic figures. Multivariate analysis significantly showed that MCPyV status (HR, 0.004; 95% CI 0.0003-0.058) and the American Joint Committee of Cancer (AJCC) stage (HR, 5.02; 95% CI 1.23-20.51) were observed as significantly independent prognostic factors for OS. PHH3-positive cell counts/10 HPF was a slightly significant independent prognostic factor for OS (HR, 4.96; 95% CI 0.93-26.55). PHH3-positive MI and MCPyV status in MCC patients are useful in prognostication, although MCPyV-infection is a more powerful prognostic factor in MCCs than the AJCC scheme on proliferation or mitotic indices.

  4. Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy

    SciTech Connect

    Chan, Alexander K.P. . E-mail: alexc@cancerboard.ab.ca; Wong, Alfred; Jenken, Daryl; Heine, John; Buie, Donald; Johnson, Douglas

    2005-03-01

    Purpose: To evaluate the prognostic value of the posttreatment TNM stage as a predictor of outcome in locally advanced rectal cancers treated with preoperative chemotherapy and radiotherapy. Methods and materials: Between 1993 and 2000, 128 patients with tethered (103) or fixed (25) rectal cancers were treated with 50 Gy preoperative pelvic radiotherapy and two cycles of concurrent 5-fluorouracil infusion (20 mg/kg/d) and leucovorin (200 mg/m{sup 2}/d) chemotherapy on Days 1-4 and 22-25 and a single bolus mitomycin C injection (8 mg/m{sup 2}) on Day 1. Of the 128 patients, 111 had Stage T3 and 17 Stage T4 according to the rectal ultrasound or CT findings and clinical evaluation. All 128 patients underwent surgery 8 weeks after chemoradiotherapy. Postoperatively, the disease stage was determined according to the surgical and pathologic findings using the American Joint Committee on Cancer TNM staging system. Results: Of the 128 patients, 32 had postchemoradiotherapy (pCR) Stage 0 (T0N0M0), 37 pCR Stage I, 26 pCR Stage II, 28 pCR Stage III, and 5 pCR Stage IV disease. Of the 128 patients, 79 had pCR Stage T0-T2, 35 pCR Stage T3, and 14 pCR Stage T4. The rate of T stage downstaging was 66% (84 of 128). Of the 128 patients, 25% achieved a pathologic complete response, and 31 (24%) had positive nodal disease. Lymphovascular or perineural invasion was found in 13 patients (10%). The 5-year disease-specific survival rate was 97% for pCR Stage 0, 88% for pCR Stage I, 74% for pCR Stage II, 44% for pCR Stage III, and 0% for pCR Stage IV (p = 0.0000059). The 5-year relapse-free survival rate was 97% for pCR Stage 0, 80% for pCR Stage I, 72% for pCR Stage II, 42% for pCR Stage III, and 0% for pCR Stage IV (p < 0.000001). In univariate analysis, the pretreatment tumor status (fixed vs. tethered tumors), the pCR TNM stage, T stage downstaging, pathologic T4 tumors, node-positive disease after chemoradiotherapy, and lymphovascular or perineural invasion were statistically

  5. [TNM classification of breast cancer: changes and comments on the 7th edition].

    PubMed

    Sinn, H-P; Helmchen, B; Wittekind, C H

    2010-09-01

    The 7th edition of the TNM classification includes only minor changes in the main TNM categories for breast cancer. Only ductal and lobular carcinoma in situ (DCIS, LCIS), and isolated Paget's disease of the nipple are classified as pTis, but not precursor lesions such as atypical ductal or lobular hyperplasia (ADH, ALH). AJCC emphasizes that microscopic measurement is the most accurate and preferred method to determine pT in small invasive cancers and stresses the importance of strict adherence to criteria for T4 cancers. For better distinction from micrometastases in regional lymph nodes, small clusters of cells not greater than 0.2 mm, or nonconfluent or nearly confluent clusters of cells not exceeding 200 cells in a single histologic lymph node cross section are classified as isolated tumour cells (pN0(i+)). The pN classification has otherwise remained unchanged. In the setting of patients having received neoadjuvant therapy, ypT1-ypT3 is based on the total extent of viable tumour cells, irrespective of tumour regression. Stage I breast tumours have been subdivided into Stage IA and Stage IB; Stage IB includes small tumours (TI) with lymph node micrometastases (N1mi). These changes and clarifications will contribute to maintaining the clinical and prognostic relevance of TNM in breast cancer.

  6. The use of rapid and cost-effective blood-based biomarkers in combination with tumour TNM stage for individual head and neck cancer patient treatment selection.

    PubMed

    Laytragoon Lewin, Nongnit; Lewin, Freddi; Andersson, Bengt-Åke; Löfgren, Sture; Rutqvist, Lars Erik

    2017-04-01

    Head and neck (H&N) cancer is an aggressive disease and the incidence has increased in younger population worldwide. Tumour TNM staging is the main basis for treatment decision despite significant variation in clinical outcome. Survival time of these patients has marginally improved during the last 30 years. Various biomarkers with cumbersome analysis, high cost, time consumption and requirement of special laboratory facilities have been investigated. However, none of these biomarkers have been shown to be suitable to use for individual H&N cancer patient treatment selection in the clinic. For practical use in clinical settings, the given biomarkers must be simple to analyse, rapid, cost effective and available in routine laboratories. With this intension, we suggested the combination of standard TNM staging and biomarkers associated with inflammation such as neutrophils, neutrophil to lymphocyte ratio, plasma C-reactive protein or plasma tumour necrosis factor alpha (TNFa) and single-nucleotide polymorphism in TNFa rs1800629 using blood-based analysis. The optimal treatment outcome of H&N cancer by using combination of TNM stage and these blood-based biomarkers for individual patient selection need further investigation.

  7. Lymph node ratio-based staging system as an alternative to the current TNM staging system to assess outcome in adenocarcinoma of the esophagogastric junction after surgical resection

    PubMed Central

    Chen, Chuangui; Gao, Yongyin; Xiao, Xiangming; Tang, Peng; Duan, Xiaofeng; Yang, Mingjian; Jiang, Hongjing; Yu, Zhentao

    2016-01-01

    This study aimed to assess the prognostic value of the hypothetical tumor-N-ratio (rN)-metastasis (TrNM) staging system in adenocarcinoma of the esophagogastric junction (AEG). The clinical data of 387 AEG patients who received surgical resection were retrospectively reviewed. The optimal cut-off point of rN was calculated by the best cut-off approach using log-rank test. Kaplan-Meier plots and Cox regressions model were applied for univariate and multivariate survival analyses. A TrNM staging system based on rN was proposed. The discriminating ability of each staging was evaluated by using an adjusted hazard ratio (HR) and a −2log likelihood. The prediction accuracy of the model was assessed by using the area under the curve (AUC) and the Harrell's C-index. The number of examined lymph nodes (LNs) was correlated with metastatic LNs (r = 0.322, P < 0.001) but not with rN (r = 0.098, P > 0.05). The optimal cut-points of rN were calculated as 0, 0~0.3, 0.3~0.6, and 0.6~1.0. Univariate analysis revealed that pN and rN classifications significantly influenced patients’ RFS and OS (P < 0.001). Multivariate analysis adjusted for significant factors revealed that rN was recognized as an independent risk factor. A larger HR, a smaller −2log likelihood and a larger prediction accuracy were obtained for rN and the modified TrNM staging system. Taken together, our study demonstrates that the proposed N-ratio-based TrNM staging system is more reliable than the TNM staging system in evaluating prognosis of AEG patients after curative resection. PMID:27517157

  8. Lymph node ratio-based staging system as an alternative to the current TNM staging system to assess outcome in adenocarcinoma of the esophagogastric junction after surgical resection.

    PubMed

    Zhang, Hongdian; Shang, Xiaobin; Chen, Chuangui; Gao, Yongyin; Xiao, Xiangming; Tang, Peng; Duan, Xiaofeng; Yang, Mingjian; Jiang, Hongjing; Yu, Zhentao

    2016-11-08

    This study aimed to assess the prognostic value of the hypothetical tumor-N-ratio (rN)-metastasis (TrNM) staging system in adenocarcinoma of the esophagogastric junction (AEG). The clinical data of 387 AEG patients who received surgical resection were retrospectively reviewed. The optimal cut-off point of rN was calculated by the best cut-off approach using log-rank test. Kaplan-Meier plots and Cox regressions model were applied for univariate and multivariate survival analyses. A TrNM staging system based on rN was proposed. The discriminating ability of each staging was evaluated by using an adjusted hazard ratio (HR) and a -2log likelihood. The prediction accuracy of the model was assessed by using the area under the curve (AUC) and the Harrell's C-index. The number of examined lymph nodes (LNs) was correlated with metastatic LNs (r = 0.322, P < 0.001) but not with rN (r = 0.098, P > 0.05). The optimal cut-points of rN were calculated as 0, 0~0.3, 0.3~0.6, and 0.6~1.0. Univariate analysis revealed that pN and rN classifications significantly influenced patients' RFS and OS (P < 0.001). Multivariate analysis adjusted for significant factors revealed that rN was recognized as an independent risk factor. A larger HR, a smaller -2log likelihood and a larger prediction accuracy were obtained for rN and the modified TrNM staging system. Taken together, our study demonstrates that the proposed N-ratio-based TrNM staging system is more reliable than the TNM staging system in evaluating prognosis of AEG patients after curative resection.

  9. 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

  10. Tumor deposits counted as positive lymph nodes in TNM staging for advanced colorectal cancer: a retrospective multicenter study

    PubMed Central

    Li, Jun; Yang, Shengke; Hu, Junjie; Liu, Hao; Du, Feng; Yin, Jie; Liu, Sai; Li, Ci; Xing, Shasha; Yuan, Jiatian; Lv, Bo; Fan, Jun; Leng, Shusheng; Zhang, Xin; Wang, Bing

    2016-01-01

    We investigated the possibility of counting tumor deposits (TDs) as positive lymph nodes (pLNs) in the pN category and evaluated its prognostic value for colorectal cancer (CRC) patients. A new pN category (npN category) was calculated using the numbers of pLNs plus TDs. The npN category included 4 tiers: npN1a (1 tumor node), npN1b (2-3 tumor nodes), npN2a (4-6 tumor nodes), and npN2b (≥7 tumor nodes). We identified 4,121 locally advanced CRC patients, including 717 (11.02%) cases with TDs. Univariate and multivariate analyses were performed to evaluate the disease-free and overall survival (DFS and OS) for npN and pN categories. Multivariate analysis showed that the npN and pN categories were both independent prognostic factors for DFS (HR 1.614, 95% CI 1.541 to 1.673; HR 1.604, 95% CI 1.533 to 1.679) and OS (HR 1.633, 95% CI 1.550 to 1.720; HR 1.470, 95% CI 1.410 to 1.532). However, the npN category was superior to the pN category by Harrell's C statistic. We conclude that it is thus feasible to consider TDs as positive lymph nodes in the pN category when evaluating the prognoses of CRC patients, and the npN category is potentially superior to the TNM (7th edition) pN category for predicting DFS and OS among advanced CRC patients. PMID:26934317

  11. 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

  12. 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.

  13. 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.

  14. 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. PMID:27789963

  15. ACTOplus Met XR in Treating Patients With Stage I-IV Oral Cavity or Oropharynx Cancer Undergoing Definitive Treatment

    ClinicalTrials.gov

    2017-04-10

    Oral Cavity Neoplasm; Oropharyngeal Neoplasm; Stage I Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage I Oropharyngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage II Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage II Oropharyngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Oropharyngeal Squamous Cell Carcinoma AJCC v7

  16. [The new TNM classification in lung cancer].

    PubMed

    Wrona, Anna; Jassem, Jacek

    2010-01-01

    This paper presents the new TNM classification in lung cancer and its history. Seventh edition of tumor, node, metastasis (TNM) classification in lung cancer has been published by the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC) at the beginning of 2009. The changes were based upon the results of the international project of the International Association for the Study of Lung Cancer (IASLC). The database included 81.495 patients from the entire world (68.463 with non-small cell lung cancer and 13.032 with small cell lung cancer) treated with various modalities between 1990 and 2000. The collected data were validated internally and externally. The tumor size was considered of prognostic relevance: T1 tumors were subdivided into T1a (≤ 2 cm) and T1b (〉 2 cm - ≤ 3 cm), T2 tumors into T2a (〉 3 cm - ≤ 5 cm) and T2b (〉 5 cm - ≤ 7 cm), and T2 tumors 〉 7 cm were reclassified as T3. Tumors with the additional nodules in the same lobe as the primary tumor were classified as T3, those with additional nodules in another ipsilateral lobe - as T4. There were no changes in N category. In the M category, M1 was subclassified into M1a (contralateral lung nodules and pleural dissemination) and M1b (distant metastasis). Large T2 tumors (T2bN0M0) were upstaged from IB to IIA, small T2 tumors (T2aN1M0) were downstaged from the IIB to IIA and T4N0-N1M0 - from IIIB to IIIA. The TNM classification was also recommended for small cell lung cancer instead of previously used categories of limited and extensive disease.

  17. [Adjuvant chemotherapy for non-small cell lung carcinoma Stage IA p-T1N0M0. A changed "scenario" after the 2009 7th edition of TNM staging system].

    PubMed

    Salvati, Franco; Combi, Giampiero

    2013-04-01

    More than a decade has elapsed since the earliest reports about the relevant influence of vascular invasion on the outcome of patients with completely resected NSCLC at stage IApT1N0M0,but just after the approved seventh edition of TNM Classification 2009 for non-small cell lung cancer the importance concerning these issues has been put in its true perspective as correlated also to therapeutic features. The main evidences emerged with regard to studies published during the last ten years are reviewed. On the basis of these evidences a new "scenario" has dawned: the adjuvant chemotherapy for non-small cell lung cancer patients Stage IA with poor prognostic factor vessel invasion should be reconsidered as recommended or at least not-contraindicated.

  18. Prognostic Discrepancy of the 6th and 7th UICC N Classification for Lymph Node Staging in Gastric Cancer Patients after Curative Resection

    PubMed Central

    Oh, Sung Jin; Suh, Byoung Jo; Park, Jong Kwon; Oh, Sung Don; Yu, Hang Jong

    2017-01-01

    Background The validity of N classification of the 7th edition of the American Joint Committee on Cancer/Union Internationale contre le Cancer (AJCC/UICC) tumor-node-metastasis (TNM) staging system is still under debate. The purpose of this study was to evaluate the prognostic efficacy of the 7th edition of the AJCC/UICC TNM staging system (focusing on N stage), in comparison with the 6th edition, at a single Eastern institution. Methods We analyzed 1,435 patients with gastric cancer who underwent curative resection performed from September 1998 to August 2003 at the Memorial Jin-Pok Kim Korea Gastric Cancer Center. We analyzed the survival rate of the patients according to the AJCC/UICC 6th and 7th editions, and compared each stage, focusing on N stage. Results Significant differences in the 5-year survival rates were observed between the 6th and the 7th AJCC/UICC staging system. In the 6th edition staging system, the Kaplan-Meier curves discriminated each N stage significantly. In contrast, there was no difference in terms of survival curves for N stage according to the 7th edition, especially between N1 and N2: the Kaplan-Meier plots of survival curves between N1 (77.0%) and N2 (78.1%) stages overlapped significantly (p < 0.05). Conclusion Although the 7th UICC staging system is a more detailed and sophisticated system in the T category, there was no prognostic significance between the pN1 and pN2 stages according to our data. Therefore, we suggest establishing a new UICC staging system taking into consideration the application of the N stage. PMID:28203165

  19. 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

  20. The anatomy of the TNM for colon cancer

    PubMed Central

    Hueman, Matthew T.; Chen, Dechang; Patel, Jigar A.; Wang, Huan; Schwartz, Arnold M.

    2017-01-01

    Background To visualize the anatomy as revealed by dendrograms of the tumor, lymph node, and metastasis (TNM) staging system for colon cancer and compare it with the Dukes’ system. Methods A hierarchical clustering algorithm generated tree-structured dendrograms that stratified patients according to survival only. The dendrograms were constructed with the same prognostic variables used for the TNM. Because combinations of prognostic factors were stratified only on survival, additional factors of any number and type could be integrated into the TNM without changing the TNM categories. Results The algorithm provided a step-by-step visualization of the TNM and the Dukes’ system for colon cancer. Dendrograms and associated 5-year survival rates were generated for the T category only, the N category only, the T, N combination, and combinations of the T, N, and M, and the T, N, M with histological grade. Dendrograms revealed visual differences between the structure of TNM and the Dukes’ system of staging. Dendrograms also revealed how variations in prognostic factors changed survival. By cutting dendrograms along their dissimilarity axis, multiple prognostic subgroups could be created for colon cancer that may reflect outcomes that are more accurate to estimate. Conclusions Dendrograms provide a new way to view cancer patient staging. They reveal a visual step-by-step hierarchical relationship between survival rates and combinations of prognostic variables. The dendrograms also revealed fundamental differences between the TNM and the Dukes system of staging. By stratifying on survival only, additional factors including molecular factors can be added to the TNM, because it classifies patients according to survival rates only and not according to pre-set rules of prognostic factors and stage groups. The clinical implications of stratifying only survival are discussed. PMID:28280604

  1. 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

  2. LAPTM4B-35, a Cancer-Related Gene, Is Associated with Poor Prognosis in TNM Stages I-III Gastric Cancer Patients

    PubMed Central

    Wu, Xiaojiang; Zhang, Lianhai; Xing, Xiaofang; Wang, Xiaohong; Hu, Ying; Du, Hong; Li, Lin; Li, Shen; Zhou, Rouli; Wen, Xian-Zi; Ji, Jia-Fu

    2015-01-01

    Background Lysosome-associated transmembrane protein 4β-35 (LAPTM4B-35), a member of the mammalian 4-tetratransmembrane spanning protein superfamily, has been reported to be overexpressed in several cancers. However the expression of LAPTM4B-35 and its role in the progression of gastric cancer (GC) remains unknown. The aim of this study was to investigate LAPTM4B-35 expression in GC, its potential relevance to clinicopathologic parameters and role of LAPTM4B-35 during gastric carcinogenesis. Methods In the present study, paraffin-embedded specimens with GC (n = 240, including 180 paired specimens) and 24 paired fresh frozen tissues were analyzed. qRT-PCR and immunohistochemistry (IHC) were used to analyze the expression of LAPTM4B-35 in GC. The effects of LAPTM4B-35 on GC cell proliferation, migration and invasion were determined by overexpression and knockdown assays. Results IHC showed that LAPTM4B-35 was expressed in 68.3% (123/180) of GC tissues, while in 16.1% (29/180) of their paired adjacent noncancerous gastric tissues (P = 0.000). LAPTM4B-35 mRNA levels in GC tissues were also significantly elevated when compared with their paired adjacent noncancerous tissues (P = 0.017). Overexpression of LAPTM4B-35 was significantly associated with degree of differentiation, depth of invasion, lymphovascular invasion and lymph node metastasis (P<0.05). Kaplan-Meier survival curves revealed that patients with LAPTM4B-35 expression had a significant decrease in overall survival (OS) in stages I-III GC patients (P = 0.006). Multivariate analysis showed high expression of LAPTM4B-35 was an independent prognostic factor for OS in stage I-III GC patients (P = 0.025). Conclusion These findings indicate that LAPTM4B-35 overexpression may be related to GC progression and poor prognosis, and thus may serve as a new prediction marker of prognosis in GC patients. PMID:25849595

  3. 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

  4. Prostate cancer - major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.

    PubMed

    Buyyounouski, Mark K; Choyke, Peter L; McKenney, Jesse K; Sartor, Oliver; Sandler, Howard M; Amin, Mahul B; Kattan, Michael W; Lin, Daniel W

    2017-02-21

    Answer questions and earn CME/CNE The eighth edition of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) Staging Manual has been updated and improved to ensure the highest degree of clinical relevance and to improve its utility for patient evaluation and clinical research. Major changes include: 1) pathologically organ-confined disease is now considered pT2 and is no longer subclassified by extent of involvement or laterality, 2) tumor grading now includes both the Gleason score (as in the seventh edition criteria) and the grade group (introduced in the eighth edition criteria), 3) prognostic stage group III includes select, organ-confined disease based on prostate-specific antigen and Gleason/grade group status, and 4) 2 statistical prediction models are included in the staging manual. The AJCC will continue to critically analyze emerging prostate cancer biomarkers and tools for their ability to prognosticate and guide treatment decision making with the highest level of accuracy and confidence for patients and physicians. CA Cancer J Clin 2017. © 2017 American Cancer Society.

  5. Pancreatic Ductal Adenocarcinoma is Spread to the Peripancreatic Soft Tissue in the Majority of Resected Cases, Rendering the AJCC T-Stage Protocol (7th Edition) Inapplicable and Insignificant: A Size-Based Staging System (pT1: ≤2, pT2: >2–≤4, pT3: >4 cm) is More Valid and Clinically Relevant

    PubMed Central

    Saka, Burcu; Balci, Serdar; Basturk, Olca; Bagci, Pelin; Postlewait, Lauren M.; Maithel, Shishir; Knight, Jessica; El-Rayes, Bassel; Kooby, David; Sarmiento, Juan; Muraki, Takashi; Oliva, Irma; Bandyopadhyay, Sudeshna; Akkas, Gizem; Goodman, Michael; Reid, Michelle D.; Krasinskas, Alyssa; Everett, Rhonda; Adsay, Volkan

    2016-01-01

    Background Most studies have failed to identify any prognostic value of the current T-stage protocol for pancreatic ductal adenocarcinoma (PDAC) by the American Joint Committee on Cancer and the Union for International Cancer Control unless some grouping was performed. Methods To document the parameters included in this T-stage protocol, 223 consecutive pancreatoduodenectomy specimens with PDAC were processed by a uniform grossing protocol. Results Peripancreatic soft tissue (PST) involvement, the main pT3 parameter, was found to be inapplicable and irreproducible due to lack of a true capsule in the pancreas and variability in the amount and distribution of adipose tissue. Furthermore, 91 % of the cases showed carcinoma in the adipose tissue, presumably representing the PST, and thus were classified as pT3. An additional 4.5 % were qualified as pT3 due to extension into adjacent sites. The T-stage defined as such was not found to have any correlation with survival (p = 0.4). A revised T-stage protocol was devised that defined pT1 as 2 cm or smaller, pT2 as >2–4 cm, and pT3 as larger than 4 cm. This revised protocol was tested in 757 consecutive PDACs. The median and 3-year survival rates of this size-based protocol were 26, 18, 13 months, and 40 %, 26 %, 20 %, respectively (p < 0.0001). The association between higher T-stage and shorter survival persisted in N0 cases and in multivariate modeling. Analysis of the Surveillance, Epidemiology, and End Results database also confirmed the survival differences (p < 0.0001). Conclusions This study showed that resected PDACs are already spread to various surfaces of the pancreas, leaving only about 4 % of PDACs to truly qualify as pT1/T2, and that the current T-stage protocol does not have any prognostic correlation. In contrast, as shown previously in many studies, size is an important prognosticator, and a size-based T-stage protocol is more applicable and has prognostic value in PDAC. PMID:26832882

  6. 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.

  7. 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.

  8. [Changes in the TNM classification of head and neck tumors].

    PubMed

    Weber, A; Schmid, K W; Tannapfel, A; Wittekind, C

    2010-09-01

    Only minor modifications were introduced in the classification of squamous cell carcinomas of the oro- and hypopharynx, namely in the definition of some T and N categories. A new TNM classification has been introduced for mucosal melanoma of the head and neck. Some proposals for ramification of the T1 categories of thyroid tumours have been adopted from the TNM Supplement, unfortunately not those proposed for the T3 categories. The new TNM classification of Merkel cell carcinomas, which frequently occur in the head and neck region, is also discussed.

  9. [New TNM classification of malignant lung tumors 2009 from a pathology perspective].

    PubMed

    Fisseler-Eckhoff, A

    2009-12-01

    Based on the IASLC multicenter data collected worldwide on 81495 patients diagnosed or registered with lung cancer between 1990 and 2000, the T, N, and M descriptors were analyzed and recommendations for changes in the seventh edition of the TNM classification were proposed on the basis of differences in survival. This new TNM classification replaces the old UICC classification and the staging system according to C. Mountain 1997. The changes principally affect the T and M classifications. For the T component, tumor size was found to have prognostic relevance and its analysis led to recommendations to subclassify T1 into T1a and T1b, and T2 tumors into T2a and T2b and to reclassify T2 tumor>7 cm into T3 tumors. In the M category, M1 was recommended to be subclassified into M1a (contralateral lung nodules and pleural dissemination) and M1b (distant metastasis). There is no change in the N category. The proposed changes for the new stage grouping are to upstage T2b N0 M0 from stage IB to stage IIA and to downstage T2a N1 M0 from stage IIB to stage IIA and T4 N0-N1 M0 from stage IIIB to stage IIIA. The particulars of the new classification are discussed in the context of practice-relevant aspects from a pathology perspective view.

  10. [A comparison between 3.0 T MRI and histopathology for preoperative T staging of potentially resectable esophageal cancer].

    PubMed

    Wang, Z Q; Zhang, F G; Guo, J; Zhang, H K; Qin, J J; Zhao, Y; Ding, Z D; Zhang, Z X; Zhang, J B; Yuan, J H; Li, H L; Qu, J R

    2017-03-21

    Objective: To explore the value of 3.0 T MRI using multiple sequences (star VIBE+ BLADE) in evaluating the preoperative T staging for potentially resectable esophageal cancer (EC). Methods: Between April 2015 and March 2016, a total of 66 consecutive patients with endoscopically proven resectable EC underwent 3.0T MRI in the Affiliated Cancer Hospital of Zhengzhou University.Two independent readers were assigned a T staging on MRI according to the 7th edition of UICC-AJCC TNM Classification, the results of preoperative T staging were compared and analyzed with post-operative pathologic confirmation. Results: The MRI T staging of two readers were highly consistent with histopathological findings, and the sensitivity, specificity and accuracy of preoperative T staging MR imaging were also very high. Conclusion: 3.0 T MRI using multiple sequences is with high accuracy for patients of potentially resectable EC in T staging. The staging accuracy of T1, T2 and T3 is better than that of T4a. 3.0T MRI using multiple sequences could be used as a noninvasive imaging method for pre-operative T staging of EC.

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

    ClinicalTrials.gov

    2016-11-14

    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

  12. 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

  13. [New TNM classification of malignant lung tumours].

    PubMed

    Wohlschläger, J; Wittekind, C; Theegarten, D

    2010-09-01

    The staging system for lung tumours is now recommended for the classification of both non-small-cell and small-cell lung cancer as well as for carcinoid tumours of the lung. The T classifications have been redefined: T1 has been subclassified as T1a (≤ 2 cm in size) and T1b (> 2-3 cm in size). T2 has been subclassified as T2a (> 3-5 cm in size) and T2b (> 5-7 cm in size). T2 (> 7 cm in size) has been reclassified as T3. Multiple tumour nodules in the same lobe have been reclassified from T4 to T3. Multiple tumour nodules in the same lung but a different lobe have been reclassified from M1 to T4. No changes have been made in the N classification. The M classification has been redefined: M1 has been subdivided into M1a and M1b. Malignant pleural and pericardial effusions have been reclassified from T4 to M1a. Separate tumour nodules in the contralateral lung have been reclassified from T4 to M1a. M1b designates distant metastasis.

  14. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual.

    PubMed

    Lydiatt, William M; Patel, Snehal G; O'Sullivan, Brian; Brandwein, Margaret S; Ridge, John A; Migliacci, Jocelyn C; Loomis, Ashley M; Shah, Jatin P

    2017-03-01

    Answer questions and earn CME/CNE The recently released eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, introduces significant modifications from the prior seventh edition. This article details several of the most significant modifications, and the rationale for the revisions, to alert the reader to evolution of the field. The most significant update creates a separate staging algorithm for high-risk human papillomavirus-associated cancer of the oropharynx, distinguishing it from oropharyngeal cancer with other causes. Other modifications include: the reorganizing of skin cancer (other than melanoma and Merkel cell carcinoma) from a general chapter for the entire body to a head and neck-specific cutaneous malignancies chapter; division of cancer of the pharynx into 3 separate chapters; changes to the tumor (T) categories for oral cavity, skin, and nasopharynx; and the addition of extranodal cancer extension to lymph node category (N) in all but the viral-related cancers and mucosal melanoma. The Head and Neck Task Force worked with colleagues around the world to derive a staging system that reflects ongoing changes in head and neck oncology; it remains user friendly and consistent with the traditional tumor, lymph node, metastasis (TNM) staging paradigm. CA Cancer J Clin 2017;67:122-137. © 2017 American Cancer Society.

  15. Staging of intrahepatic cholangiocarcinoma

    PubMed Central

    Ronnekleiv-Kelly, Sean M.

    2017-01-01

    Intrahepatic cholangiocarcinoma (ICC) comprises approximately 5−30% of primary liver tumors, however it has been increasing over the last several decades. Up to and including the 6th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) edition staging system, ICC was staged the same as hepatocellular carcinoma. In the 7th edition AJCC/UICC manual, the staging system of ICC was revised such that a distinct classification was proposed. Pathologic features for prognosis included vascular invasion, tumor multiplicity, local extension, periductal infiltration and lymph nodal metastasis. Over the last decade, as the incidence of ICC has increased and surgery for this indication has become more common, more data has been published on the prognostic factors associated with long-term survival. PMID:28261593

  16. Therapy and prognosis of testicular carcinomas in relation to TNM classification.

    PubMed

    Batata, M A; Chu, F C; Hilaris, B S; Papantoniou, P A; Whitmore, W F; Golbey, R B

    1982-08-01

    Eight-hundred and thirty-one patients with testicular carcinomas, either teratocarcinoma (405), embryonal carcinoma (406) or pure choriocarcinoma (20), treated mainly at our center from 1950 to 1976, were clinicopathologically staged according to the TNM Classification. The cancer was confined to the body of testis alone (T1 N0 M0) or extended to paratesticular structures (T2-4 N0 M0) in 37% of all patients. Para-aortic lymph nodes were found involved (N1-3) in 33% and juxtaregional lymph nodes (N4) in 9% of patients; distant metastases were detected initially in the lung alone (M1) and other distant organs (M2) in 21% of the patients. Postorchiectomy treatment was retroperitoneal lymphadenectomy with or without regional-juxtaregional irradiation and systemic chemotherapy in 470 patients; the other 361 patients received external irradiation and/or adjuvant chemotherapy. Survival determined at 5 years was 58% in teratocarcinoma cases, 41% in embryonal carcinoma cases and 0% in pure choriocarcinoma cases. Rates of 5-year survival according to the TNM staging were 81% for T1 N0 M0 tumors, 58% for T2-4 N0 M0 tumors, 44% for N1-3 M0 tumors, 33% for N4 M0 tumors and 10% for N0-4 M1 or 2 tumors. In patients who underwent lymphadenectomy with or without external irradiation, the 5-year survival rates with and without adjuvant chemotherapy, respectively, were 96% and 86% for T1 N0 M0 tumors, 100% and 60% for T2-4 N0 M0 tumors, 66% and 42% for N1-3 M0 tumors, 54% and 40% for N4 M0 tumors and 38% and 0% for N0-4 M1 tumors. In patients treated by external irradiation alone or following lymphadenectomy the rates of 5-year survival with versus without adjuvant chemotherapy were 100% versus 66% for T1-4 N0 M0 tumors, 44% versus 18% for N1-3 M0 tumors, 41% versus 22% for N4 M0 tumors and 3% versus 4% for N0-4 M1-2 tumors.

  17. CD45RO+ Memory T Lymphocytes — a Candidate Marker for TNM-Immunoscore in Squamous Non–Small Cell Lung Cancer1

    PubMed Central

    Paulsen, Erna-Elise; Kilvaer, Thomas; Khanehkenari, Mehrdad Rakaee; Maurseth, Ramona Johansen; Al-Saad, Samer; Hald, Sigurd M.; Al-Shibli, Khalid; Andersen, Sigve; Richardsen, Elin; Busund, Lill-Tove; Bremnes, Roy; Donnem, Tom

    2015-01-01

    Tumor-infiltrating lymphocytes (TILs) are vital in limiting cancer progression and may supplement the TNM classification. CD45RO+ memory TILs show major prognostic impact in various malignancies but have not been extensively explored in non–small cell lung cancer (NSCLC). In this study, we aimed to evaluate their potential in a NSCLC TNM-Immunoscore. Tissue microarrays were constructed from tumor tissue samples from two cohorts including in total 536 patients (University Hospital of North Norway, n = 285; Nordland Hospital, n = 251) with primary resected stage I to IIIA NSCLC. The density of CD45RO+ and CD8+ TILs in tumor epithelial and stromal compartments of the tumors was evaluated by immunohistochemistry. In univariate analyses, intraepithelial CD45RO+ TIL density (T-CD45RO) was a significant prognostic factor for disease-specific survival (P = .007), limited to the squamous cell carcinoma (SCC) histology subgroup (P < .001), where it was significant in both cohorts (University Hospital of North Norway, P = .003; Nordland Hospital, P = .022). Combining T-CD45RO and stromal CD8+ TIL density (S-CD8) increased the prognostic impact in SCC (P < .001) and showed a significant impact within all pathological stages (I, P = .025; II, P < .001; III, P = .001). In the multivariate analysis, T-CD45RO was an independent positive prognostic factor for SCC (hazard ratio 2.65, 95% confidence interval 1.64-4.28, P < .001), and in combination with S-CD8, the prognostic impact increased vastly (high + high versus low + low: hazard ratio 6.50, 95% confidence interval 3.54-11.91, P < .001). In conclusion, T-CD45RO was an independent prognostic factor for SCC NSCLC. When combined with S-CD8, the prognostic impact increased and was significant within each pathological stage. We propose CD45RO as a candidate marker for TNM-Immunoscore in SCC NSCLC. PMID:26678911

  18. The degree of extramural spread of T3 rectal cancer: a plea to the UICC and AJCC.

    PubMed

    Zinicola, R; Pedrazzi, G; Haboubi, N; Nicholls, R J

    2017-03-01

    The above article, published online on 15 July 2016 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor-in-Chief, Neil Mortensen, and John Wiley & Sons Limited. After acceptance the authors were made aware of a contribution to a prior publication of the UICC, TNM Supplement: A commentary on uniform use, 4th Edition, ed. C. Wittekind (Wiley, 2012), p. 195, which renders the central argument of their article invalid. They have therefore asked for it to be withdrawn. A modified version of the paper was published in the January 2017 issue (volume 19; issue 1) with the title "The degree of extramural spread of T3 rectal cancer: an appeal to the American Joint Committee on Cancer".

  19. [Evaluation of American Joint Commission on Cancer(8(th) edition) and Japanese Pancreas Society(7(th) edition)changes for T and N staging in patients with pancreatic adenocarcinoma].

    PubMed

    Yang, Y M

    2017-01-01

    Accurate staging for cancer is the basis for clinical practice, individualized treatment strategy, and prognosis determination.Recently, the T and N staging systems for pancreatic adenocarcinoma were updated by both American Joint Commission on Cancer(AJCC)8(th) edition and Japanese Pancreas Society 7(th) edition, in which more objective parameters were applied.When a large number of patients within the test set were staged, AJCC 8(th) edition has showed more reproducible and helped to predict the patient prognosis more accurately.

  20. MR imaging in staging of bone tumors

    PubMed Central

    Ehara, Shigeru

    2006-01-01

    For staging of bone tumors, TNM and Enneking’s systems are used with some differences. Magnetic resonance imaging is particularly useful for defining the extent of high-grade tumors, including transcortical and intertrabecular infiltration and periosteal extension. The concepts of compartment and curative surgical margins are important for bone tumor staging. PMID:17098647

  1. Quantitative Analysis of Phase Composition of Alloy TNM-B1 based on TiAl(γ) Titanium Aluminide

    NASA Astrophysics Data System (ADS)

    Belov, N. A.; Chupakhin, I. S.

    2014-01-01

    The Thermo-Calc software is used to design isothermal and polythermal sections of the Ti - Al - Nb - Mo system as applied to a standard TNM-B1 γ-alloy based on TiAl intermetallic. It is shown that the use of special softwares is an effective tool for substantial lowering of the volume of experimental studies.

  2. [Postoperative results under the new stage classification of lung cancer: the additional reports for those of JACS in 1996].

    PubMed

    Shirakusa, T

    2000-10-01

    This time, in 3008 lung cancer patients, the postoperative results were analyzed under the new stage grouping of TNM classification. All of those patients underwent the operation in 1989, and the 5 year-survival rates had beeb surveyed in 1996 by JACS (The Japanese Association for Chest Surgery). Under the new TNM classification established in 1996 worldwidey, T3N0M0 was transferred from IIIA to IIB. This report is the additional one in the focus of the results accompanied with the change of TNM classification.

  3. Recommendations for Updating T and N Staging Systems for Nasopharyngeal Carcinoma in the Era of Intensity-Modulated Radiotherapy

    PubMed Central

    Liang, Zhong-Guo; Chen, Xiao-Qian; Niu, Zhi-Jie; Chen, Kai-Hua; Li, Ling; Qu, Song; Su, Fang; Zhao, Wei; Li, Ye; Pan, Xin-Bin; Zhu, Xiao-Dong

    2016-01-01

    Objective The aim of this study was to compare the 2008 Chinese and the 7th edition of the American Joint Committee on Cancer (AJCC) staging systems for nasopharyngeal carcinoma and to provide proposals for updating T and N staging systems of the present staging system. Methods Between January 2007 and December 2012, a cohort of 752 patients with biopsy-proven, newly diagnosed, non-metastatic nasopharyngeal carcinoma who were treated with intensity-modulated radiotherapy were retrospectively analysed. Prognoses were compared by T stage, N stage, and clinical stage according to the two staging systems for overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). Results In terms of both the T and N staging systems, the two current staging systems were comparable in predicting OS. The T classification of the 2008 Chinese staging system was better in predicting LRFS, while the N classification of the 7th edition AJCC staging system was superior in predicting DMFS. In the modern era of intensity-modulated radiotherapy, the staging system should be updated by down-staging the current stage T2 to T1, and it might be rational to merge subcategories N1 and N2. Conclusions The two current staging systems each had advantages in predicting prognosis. It seems reasonable to downstage T2 to T1 and to merge N1 and N2. PMID:27973544

  4. F-18-fluoro-2-deoxyglucose positron emission tomography (PET) and PET/computed tomography imaging in primary staging of patients with malignant melanoma: a systematic review

    PubMed Central

    2012-01-01

    Purpose The aim of this systematic review was to systematically assess the potential patient-relevant benefit (primary aim) and diagnostic and prognostic accuracy (secondary aim) of positron emission tomography (PET) and PET/computed tomography (CT) in primary staging of malignant melanoma. This systematic review updates the previous evidence for PET(/CT) in malignant melanoma. Materials and methods For the first aim, randomized controlled trials (RCTs) investigating patient-relevant outcomes and comparing PET and PET(/CT) with each other or with conventional imaging were considered. For the secondary aim, a review of reviews was conducted, which was amended by an update search for primary studies. MEDLINE, EMBASE and four databases of the Cochrane Library were searched. The risk of bias was assessed using a modified QUADAS tool. Results No RCTs investigating the patient-relevant benefit of PET(/CT) and no prognostic accuracy studies were found. Seventeen diagnostic accuracy studies of varying quality were identified. For patients with American Joint Committee on Cancer (AJCC) stages I and II, sensitivity mostly ranged from 0 to 67%. Specificity ranged from 77 to 100%. For AJCC stages III and IV, sensitivity ranged from 68 to 87% and specificity from 92 to 98%. Conclusion There is currently no evidence of a patient-relevant benefit of PET(/CT) in the primary staging of malignant melanoma. RCTs investigating patient-relevant outcomes are therefore required. The diagnostic accuracy of PET(/CT) appears to increase with higher AJCC stages. PMID:23237499

  5. Incorporation of alpha-fetoprotein(AFP) into subclassification of BCLC C stage hepatocellular carcinoma according to a 5-year survival analysis based on the SEER database

    PubMed Central

    Yin, Li; Wu, Jing; Du, Ming-yu; Ding, Kai; Huang, Teng; He, Xia

    2016-01-01

    Purpose To evaluate the effect of serum alpha-fetoprotein(AFP) on prognosis of patients with hepatocellular carcinoma (HCC) and put forward a proposal to modify BCLC staging system and the recommended treatment of patients with stage C. Results AFP positive was an independent poor prognostic factor of HCC. Race, pathological grade, T stage, M stage were also regarded to be significant predicted factors for poorer prognosis. When combining AFP status with AJCC stage, patients with A1 disease had a worse prognosis compared with those with A0 disease within each stage. Patients with A1 disease of each T/N stage had a worse prognosis than patients with A0 disease of the respective stage, and the prognosis of patients with A1 disease with lower T stages was worse or similar to that of patients with A0 disease of higher T stages. Materials and Methods We performed a retrospective study of all patients histologically diagnosed HCC from January 1, 2004, through December 31, 2008, from the SEER database. Conclusions AFP can be used as a subclassification index to modify the AJCC staging system of HCC. Since BCLC stage is the most widely used staging system, we recommend routine pre-treatment AFP testing as standard of care in HCC and incorporate AFP status into the BCLC staging system to modify the recommended treatment of patients with stage C. PMID:27835609

  6. 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.

  7. The science behind the 7th edition Tumour, Node, Metastasis staging system for lung cancer.

    PubMed

    Marshall, Henry M; Leong, Steven C; Bowman, Rayleen V; Yang, Ian A; Fong, Kwun M

    2012-02-01

    The Tumour, Node, Metastasis (TNM) system for classifying lung cancer is the cornerstone of modern lung cancer treatment and underpins comparative research; yet is continuously evolving through updated revisions. The recently published Union for International Cancer Control 7th Edition TNM Classification for lung cancer addresses many of its predecessor's shortcomings and has been subject to rigorous evidence-based methodology. It is based on a retrospective analysis of over 80 000 lung cancer patients treated between 1990 and 2000 carried out by the International Association for the Study of Lung Cancer. The dataset was truly international and included patients treated by all modalities. Extensive internal and external validation of the findings has ensured that the recommendations are robust and generalizable. For the first time, a single classification system has been shown to be applicable not only to non-small cell lung cancer, but also to be of prognostic significance in small cell lung cancer and bronchopulmonary carcinoid tumours. We review the history of the Union for International Cancer Control TNM staging system, the changes in the most recent 7th edition and the strength of the scientific basis motivating these changes. Limitations of the current staging edition are explored, post-publication independent validation studies are reviewed, and the future of TNM staging for lung cancer is discussed.

  8. A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems

    PubMed Central

    Katai, Hitoshi; Seto, Yasuyuki; Fukagawa, Takeo; Okumura, Yasuhiro; Kim, Dong Wook; Kim, Hyoung-Il; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon

    2016-01-01

    Although changing a lymph node staging system from an anatomically based system to a numerically based system in gastric cancer offers better prognostic performance, several problems can arise: it does not offer information on the anatomical extent of disease and cannot represent the extent of lymph node dissection. The purpose of this study was to discover an alternative lymph node staging system for gastric cancer. Data from 6025 patients who underwent gastrectomy for primary gastric cancer between January 2000 and December 2010 were reviewed. The lymph node groups were reclassified into lesser-curvature, greater-curvature, and extra-perigastric groups. Presence of any metastatic lymph node in one group was considered positive. Lymph node groups were further stratified into four (new N0–new N3) according to the number of positive lymph node groups. Survival outcomes with this new N staging were compared with those of the current TNM system. For validation, two centers in Japan (large center, n = 3443; medium center, n = 560) were invited. Even among the same pN stages, the more advanced new N stage showed worse prognosis, indicating that the anatomical extent of metastatic lymph nodes is important. The prognostic performance of the new staging system was as good as that of the current TNM system for overall advanced gastric cancer as well as lymph node—positive gastric cancer (Harrell C-index was 0.799, 0.726, and 0.703 in current TNM and 0.799, 0.727, and 0.703 in new TNM stage). Validation sets supported these outcomes. The new N staging system demonstrated prognostic performance equal to that of the current TNM system and could thus be used as an alternative. PMID:26967161

  9. Deriving stage at diagnosis from multiple population-based sources: colorectal and lung cancer in England

    PubMed Central

    Benitez-Majano, S; Fowler, H; Maringe, C; Di Girolamo, C; Rachet, B

    2016-01-01

    Background: Stage at diagnosis is a strong predictor of cancer survival. Differences in stage distributions and stage-specific management help explain geographic differences in cancer outcomes. Stage information is thus essential to improve policies for cancer control. Despite recent progress, stage information is often incomplete. Data collection methods and definition of stage categories are rarely reported. These inconsistencies may result in assigning conflicting stage for single tumours and confound the interpretation of international comparisons and temporal trends of stage-specific cancer outcomes. We propose an algorithm that uses multiple routine, population-based data sources to obtain the most complete and reliable stage information possible. Methods: Our hierarchical approach derives a single stage category per tumour prioritising information deemed of best quality from multiple data sets and various individual components of tumour stage. It incorporates rules from the Union for International Cancer Control TNM classification of malignant tumours. The algorithm is illustrated for colorectal and lung cancer in England. We linked the cancer-specific Clinical Audit data (collected from clinical multi-disciplinary teams) to national cancer registry data. We prioritise stage variables from the Clinical Audit and added information from the registry when needed. We compared stage distribution and stage-specific net survival using two sets of definitions of summary stage with contrasting levels of assumptions for dealing with missing individual TNM components. This exercise extends a previous algorithm we developed for international comparisons of stage-specific survival. Results: Between 2008 and 2012, 163 915 primary colorectal cancer cases and 168 158 primary lung cancer cases were diagnosed in adults in England. Using the most restrictive definition of summary stage (valid information on all individual TNM components), colorectal cancer stage

  10. Tumor Staging and HPV-Related Oropharyngeal Cancer.

    PubMed

    Wittekindt, Claus; Klussmann, Jens Peter

    The current TNM staging for oropharyngeal cancer (OSCC) was designed empirically for non-HPV-related disease. Emerging evidence suggests it is unsuited for Human papillomavirus (HPV)-related OSCC. Patients with HPV-positive tumors have improved prognosis, despite presenting at advanced stages. These shortcomings of the current staging system have been identified in single- and multi-institutional trials. Patients with HPV related OSCC typically present with advanced N-stages leading to higher stage groupings. A rarity of stages I and II therefore represents the nature of HPV-related OSCC. Concerning prognosis of the patients, N-category and extracapsular spread seem to be of minor importance, whereas advanced T-stages result in unfavourable outcome. Anatomical staging therefore has been implied into different proposals to prognostic risk classifications in HPV-related disease as an additive compound. Prognostic risk groupings are further enhanced by incorporating non-anatomical factors. To summarize, it can be suggested that the current TNM system alone has little prognostic value in HPV-related OSCC.

  11. Differential blood-based diagnosis between benign prostatic hyperplasia and prostate cancer: miRNA as source for biomarkers independent of PSA level, Gleason score, or TNM status.

    PubMed

    Leidinger, Petra; Hart, Martin; Backes, Christina; Rheinheimer, Stefanie; Keck, Bastian; Wullich, Bernd; Keller, Andreas; Meese, Eckart

    2016-08-01

    Since the benefit of prostate-specific antigen (PSA) screening remains controversial, new non-invasive biomarkers for prostate carcinoma (PCa) are still required. There is evidence that microRNAs (miRNAs) in whole peripheral blood can separate patients with localized prostate cancer from healthy individuals. However, the potential of blood-based miRNAs for the differential diagnosis of PCa and benign prostatic hyperplasia (BPH) has not been tested. We compared the miRNome from blood of PCa and BPH patients and further investigated the influence of the tumor volume, tumor-node-metastasis (TNM) classification, Gleason score, pretreatment risk status, and the pretreatment PSA value on the miRNA pattern. By microarray approach, we identified seven miRNAs that were significantly deregulated in PCa patients compared to BPH patients. Using quantitative real time PCR (qRT-PCR), we confirmed downregulation of hsa-miR-221* (now hsa-miR-221-5p) and hsa-miR-708* (now hsa-miR-708-3p) in PCa compared to BPH. Clinical parameters like PSA level, Gleason score, or TNM status seem to have only limited impact on the overall abundance of miRNAs in patients' blood, suggesting a no influence of these factors on the expression of deregulated miRNAs.

  12. 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.

  13. A Study of 358 Cases of Locally Advanced Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiation Therapy: Improving the Seventh Edition of the American Joint Committee on Cancer T-Staging System

    PubMed Central

    Zhou, Qin; He, Yuxiang; Zhao, Yajie; Wang, Yin; Kuang, Weilu

    2017-01-01

    To evaluate the rationality and limitations of the seventh edition of the American Joint Committee on Cancer (the 7th AJCC edition) T-staging system for locally advanced nasopharyngeal carcinoma (NPC). The prognosis of 358 patients with stage T3/T4 NPC treated with intensity-modulated radiotherapy (IMRT) was analyzed with the Kaplan–Meier method or the log-rank test. The 7th AJCC staging system of NPC has some limitations in that the T category is neither the significant factor in OS/LRFS nor the independent prognostic factor in OS/LRFS/DMFS/DFS (P > 0.05). After adjustment by anatomic structures, univariate analysis has shown that the adjusted-T category has statistical significance between T3 and T4 for OS (86.4% and 71.3%, P = 0.002), LRFS (97% and 90.9%, P = 0.048), DMFS (90.9% and 77.2%, P = 0.001), and DFS (86.2% and 67.5%, P = 0.000), and multivariate analysis has shown that the adjusted-T category is an independent prognostic factor for OS/DMFS/DFS (with the exception of LRFS). Then, GTV-P was taken into consideration. Multivariate analysis showed that these nT categories serve as suitable independent prognostic factors for OS/DMFS/DFS (P < 0.001) and LRFS (HR = 3.131; 95% CI, 1.090–8.990; P = 0.043). The 7th AJCC staging system has limitations and should be improved by including the modifications suggested, such as anatomic structures and tumor volume adjustment. PMID:28265567

  14. Glycoprotein 130 is associated with adverse postoperative clinical outcomes of patients with late-stage non-metastatic gastric cancer

    PubMed Central

    Cao, Yifan; Zhang, Heng; Liu, Hao; Lin, Chao; Li, Ruochen; Wu, Songyang; He, Hongyong; Li, He; Xu, Jiejie

    2016-01-01

    The interaction of glycoprotein 130 (gp130) with the cytokines of Interleukin-6 (IL-6) family has proved to play a crucial part in several cancers. Our current study is designed to discover the clinical prognostic significance of gp130 in non-metastatic gastric cancer. We examined intratumoral gp130 expression in retrospectively enrolled 370 gastric cancer patients who underwent radical gastrectomy with standard D2 lymphadenectomy at Zhongshan Hospital of Fudan University during 2007 and 2008 by immunohistochemical staining. The expression of gp130 was significantly correlated with T classification, N classification and TNM stage (P = 0.003, P < 0.001 and P < 0.001, respectively; T, N, TNM refers to Tumor Invasion, Regional lymph node metastasis and Tumor Node Metastasis, respectively). Elevated intratumoral gp130 expression implied unfavourable overall survival (OS) (P < 0.001) and disease-free survival (DFS) (P < 0.001), respectively. Furthermore, among TNM II and III gp130-high patients, those who were treated with 5-fluorouracil (5-FU) based adjuvant chemotherapy had better OS (P < 0.001). The generated nomogram performed well in predicting the 3- and 5-year OS of gastric cancer patients. The incorporation of gp130 into contemporary TNM staging system would be of great significance to improve the current individual risk stratification. These findings contribute to better clinical management for those patients who would benefit from adjuvant chemotherapy. PMID:27917904

  15. 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

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

    PubMed Central

    Kang, Min; Zhou, Pingting; Wei, Tingting; Zhao, Tingting; Long, Jianxiong; Li, Guisheng; Yan, Haolin; Feng, Guosheng; Liu, Meilian; Zhu, Jinxian; Wang, Rensheng

    2017-01-01

    Purpose: This prospective multicentric study aimed to establish a new clinical T staging standard for nasopharyngeal carcinoma (NPC) based on intensity-modulated radiotherapy (IMRT). Methods and materials: Between January 2006 and December 2009, four hundred and ninety-two NPC patients undergoing IMRT were staged according to the seventh edition of the UICC/AJCC staging system. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to compare survival differences. Results: The 5-year overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMSF) rates were 80.5%, 78.6%, 94.1%, and 84.3%, respectively. Univariate and multivariate analyses showed that the invasion of the nasal cavity, parapharyngeal space, oropharynx, skull base, internal pterygoid muscle, external pterygoid muscle, paranasal sinus, infratemporal fossa, orbit, cranial nerves, cavernous sinus, and intracalvarium were independent prognostic factors (P<0.05). According to the results of risk variety and survival curves, we suggest that the new T staging system for NPC based on magnetic resonance imaging and intensity modulated radiation therapy can be classified as T1 (nasopharynx, nasal cavity, parapharyngeal space, oropharynx, skull base and internal pterygoid muscle) and T2 (external pterygoid muscle, paranasal sinus, infratemporal fossa, orbit, cranial nerves, cavernous sinus and intracalvarium). Compared to the seventh edition of UICC/AJCC staging system, our new recommended staging system performs better in risk difference and distribution balance. Furthermore, the differences between the substages of 5-year curves of LRFS, DMFS and OS were all statistically significant in our new recommended staging system. Conclusions: Our new recommended staging system is more adaptable to IMRT and can predict the prognosis of NPC patient in a more objective and accurate manner.

  17. 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.

  18. The IASLC Mesothelioma Staging Project: Improving Staging of a Rare Disease Through International Participation.

    PubMed

    Pass, Harvey; Giroux, Dorothy; Kennedy, Catherine; Ruffini, Enrico; Cangir, Ayten K; Rice, David; Asamura, Hisao; Waller, David; Edwards, John; Weder, Walter; Hoffmann, Hans; van Meerbeeck, Jan P; Nowak, Anna; Rusch, Valerie W

    2016-12-01

    For nearly 40 years, there was no generally accepted staging system for malignant pleural mesothelioma. In 1994, members of the International Mesothelioma Interest Group, in collaboration with the International Association for the Study of Lung Cancer, proposed a TNM staging system based on analyses of outcomes in retrospective surgical series and small clinical trials. Subsequently accepted by the American Joint Commission on Cancer and the Union for International Cancer Control for the sixth editions of their staging manuals, this system has since been the international staging standard. However, it has significant limitations, particularly with respect to clinical staging and to the categories for lymph node staging. Here we provide an overview of the development of the International Association for the Study of Lung Cancer malignant pleural mesothelioma staging database, which was designed to address these limitations through the development of a large international data set. Analyses of this database, described in papers linked to this overview, are being used to inform revisions in the eighth editions of the American Joint Commission on Cancer and Union for International Cancer Control staging systems.

  19. Evaluation of the prognostic value of Okuda, Cancer of the Liver Italian Program, and Japan Integrated Staging systems for hepatocellular carcinoma patients undergoing radiotherapy

    SciTech Connect

    Seong, Jinsil . E-mail: jsseong@yumc.yonsei.ac.kr; Shim, Su Jung; Lee, Ik Jae; Han, Kwang Hyub; Chon, Chae Yoon; Ahn, Sang Hoon

    2007-03-15

    Purpose: The purpose of this study was to compare the validity of staging systems, as well as to identify the staging system with the best prognostic value, in hepatocellular carcinoma (HCC) patients treated with radiotherapy. Methods and Materials: From 1992 to 2003, a total of 305 patients undergoing radiotherapy for HCC were evaluated retrospectively. All patients were classified before radiation therapy by the following systems: tumor-node-metastasis (TNM), Okuda, Cancer of the Liver Italian Program (CLIP), and Japan Integrated Staging (JIS) score. Cumulative survival rates were obtained using the Kaplan-Meier method, and were statistically compared using the log-rank test. Results: Median survival time was 11 months. The 1-, 2-, 3-, 4-, and 5-year survival rates were 45.1%, 24.5%, 14.7%, 10.3%, and 6.4%, respectively. Significant differences in survival were observed between all TNM stages, between CLIP scores 2, 3 and 5, 6, as well as between JIS scores 1, 2, and 2, 3. Conclusions: Among the systems studied, the TNM staging approach appeared to be the best predictor of prognosis. Staging systems that reflect liver disease status (Okuda stage, CLIP, and JIS score) showed limitations in stratifying patients undergoing radiotherapy into different prognostic groups.

  20. 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

  1. [Update to the recommendations for management of melanoma stages I to III].

    PubMed

    Guillot, B; Dalac, S; Denis, M G; Dupuy, A; Emile, J-F; De La Fouchardière, A; Hindie, E; Jouary, T; Lassau, N; Mirabel, X; Piperno Neumann, S; De Raucourt, S; Vanwijck, R

    2016-10-01

    As knowledge continues to develop, regular updates are necessary concerning recommendations for practice. The recommendations for the management of melanoma stages I to III were drawn up in 2005. At the request of the Société Française de Dermatologie, they have now been updated using the methodology for recommendations proposed by the Haute Autorité de Santé. In practice, the principal recommendations are as follows: for staging, it is recommended that the 7th edition of AJCC be used. The maximum excision margins have been reduced to 2cm. Regarding adjuvant therapy, the place of interferon has been reduced and no validated emerging medication has yet been identified. Radiotherapy may be considered for patients in stage III at high risk of relapse. The sentinel lymph node technique remains an option. Initial examination includes routine ultrasound as of stage II, with other examinations being optional in stages IIC and III. A shorter strict follow-up period (3years) is recommended for patients, but with greater emphasis on imaging.

  2. 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.

  3. Vorinostat and Azacitidine in Treating Patients With Locally Recurrent or Metastatic Nasopharyngeal Cancer or Nasal Natural Killer T-Cell Lymphoma

    ClinicalTrials.gov

    2017-04-10

    Adult Nasal Type Extranodal NK/T-Cell Lymphoma; Recurrent Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Recurrent Nasopharyngeal Undifferentiated Carcinoma; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IV Nasopharyngeal Undifferentiated Carcinoma AJCC v7

  4. Nodal staging of colorectal carcinomas and sentinel nodes

    PubMed Central

    Cserni, G

    2003-01-01

    This review surveys the staging systems used for the classification of colorectal carcinomas, including the TNM system, and focuses on the assessment of the nodal stage of the disease. It reviews the quantitative requirements for a regional metastatic work up, and some qualitative features of lymph nodes that may help in the selection of positive and negative lymph nodes. Identification of the sentinel lymph nodes (those lymph nodes that have direct drainage from the primary tumour site) is one such qualitative feature that is claimed to allow the upstaging of colorectal carcinomas via an oriented, enhanced pathological work up. Current evidence in favour of a change in the requisite of assessing as may lymph nodes as is possible, and concentrating the efforts on only a selected number of lymph nodes, is weak. PMID:12719450

  5. Preoperative staging of primary breast cancer. A multicentric study.

    PubMed

    Ciatto, S; Pacini, P; Azzini, V; Neri, A; Jannini, A; Gosso, P; Molino, A; Capelli, M C; di Costanzo, F; Pucciatti, M A

    1988-03-01

    This article reports on a consecutive series of 3627 breast cancer (BC) patients undergoing preoperative staging by chest x-ray (CXR), bone x-ray (BXR) or bone scintigraphy (BS), and liver ecography (LE) or liver scintigraphy (LS). The detection rate (DR) of preclinical asymptomatic distant metastases depended on the T and N category (TNM classification system), and was very low (CXR: 0.30%, BXR: 0.64%, BS: 0.90%, LE: 0.24%, LS: 0.23%). The sensitivity, determined after a 6-month follow-up, was below 0.50% for all tests. The highest value (0.48%) was recorded for BS, which also had the lowest specificity (0.95%). The entire preoperative staging policy using the studied tests seems questionable due to poor sensitivity and an extremely low DR of distant metastases.

  6. Impact of tumour volume on prediction of progression-free survival in sinonasal cancer

    PubMed Central

    Hennersdorf, Florian; Mauz, Paul-Stefan; Adam, Patrick; Welz, Stefan; Sievert, Anne; Ernemann, Ulrike; Bisdas, Sotirios

    2015-01-01

    Background The present study aimed to analyse potential prognostic factors, with emphasis on tumour volume, in determining progression free survival (PFS) for malignancies of the nasal cavity and the paranasal sinuses. Patients and methods Retrospective analysis of 106 patients with primary sinonasal malignancies treated and followed-up between March 2006 and October 2012. Possible predictive parameters for PFS were entered into univariate and multivariate Cox regression analysis. Kaplan-Meier curve analysis included age, sex, baseline tumour volume (based on MR imaging), histology type, TNM stage and prognostic groups according to the American Joint Committee on Cancer (AJCC) classification. Receiver operating characteristic (ROC) curve analysis concerning the predictive value of tumour volume for recurrence was also conducted. Results The main histological subgroup consisted of epithelial tumours (77%). The majority of the patients (68%) showed advanced tumour burden (AJCC stage III–IV). Lymph node involvement was present in 18 cases. The mean tumour volume was 26.6 ± 21.2 cm3. The median PFS for all patients was 24.9 months (range: 2.5–84.5 months). The ROC curve analysis for the tumour volume showed 58.1% sensitivity and 75.4% specificity for predicting recurrence. Tumour volume, AJCC staging, T- and N- stage were significant predictors in the univariate analysis. Positive lymph node status and tumour volume remained significant and independent predictors in the multivariate analysis. Conclusions Radiological tumour volume proofed to be a statistically reliable predictor of PFS. In the multivariate analysis, T-, N- and overall AJCC staging did not show significant prognostic value. PMID:26401135

  7. Oestrogen receptors, nodes and stage as predictors of post-recurrence survival in 457 breast cancer patients.

    PubMed Central

    Shek, L. L.; Godolphin, W.; Spinelli, J. J.

    1987-01-01

    The relationship to survival after first recurrence of oestrogen receptor (ER), nodal status and TNM stage at diagnosis, and treatment for advanced disease was studied in 457 females whose primary breast cancer was diagnosed in 1975 to 1981. Receptor concentration was the most important predictor of post-recurrence survival, with some additional information conveyed by nodal status. ER predicted survival after recurrence independently of nodal status, clinical stage or mode of therapy. Response to endocrine therapy is only a facet of the generally favourable prognosis of ER positive patients, rather than the sole explanation. PMID:3435707

  8. 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 ...

  9. 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

  10. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score).

    PubMed

    Kudo, Masatoshi; Chung, Hobyung; Osaki, Yukio

    2003-01-01

    A clinical staging system for cancer patients provides guidance for patient assessment and making therapeutic decisions. It is useful in deciding whether to treat a patient aggressively, and in avoiding the overtreatment of patients who would not tolerate the treatment or patients whose life expectancy rules out any chance of treatment. Clinical staging is also an essential tool for comparison between groups in therapeutic trials and for comparison between different studies. The current classifications most commonly used for hepatocellular carcinoma (HCC) are the Okuda stages, the Child-Pugh staging system, tumor node metastasis (TNM) staging, and the Cancer of the Liver Italian Program (CLIP) score. Among these, the CLIP score is currently the most commonly used integrated staging score, including both tumor stage and liver disease stage. Although the CLIP score has been well validated by many authors in terms of its prognostic value in HCC patients, this score has some problems and limitations when applied to currently diagnosed HCC patients, who are diagnosed in the early stage of disease. First, the CLIP score can discriminate score 0- to 3-patient populations, but it is not able to discriminate score 4- to 6-patient groups. Second, the definition of tumor morphology in the best prognostic group is too advanced, i.e., uninodular and a tumor extent of less than 50% of the liver. As a result, the prognosis of the CLIP system best prognostic group is not so good. In other words, this system cannot identify the best prognostic group who would benefit from curative and aggressive treatment. Third, nearly 80% of the patient population is classified as having a CLIP score of 0-2, as confirmed by many studies, which shows poor stratification ability. In contrast, a new staging system based on the Liver Cancer Study Group of Japan (LCSGJ), the Japan Integrated Staging (JIS) score is currently proposed in Japan. This staging system combines Child-Pugh grade (grade A

  11. [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。.

  12. Stage Posts

    ERIC Educational Resources Information Center

    Soulsby, Jim

    2004-01-01

    Uncertainty about identity and the future is occurring at a stage of life when people do question what they have achieved and what they still want to achieve. The notion of midlife crisis has been in existence for some time but recently its occurrence has coincided with opportunities to take early retirement or redundancy. This has meant that the…

  13. An improved prognostic model for stage T1a and T1b prostate cancer by assessments of cancer extent

    PubMed Central

    Rajab, Ramzi; Fisher, Gabrielle; Kattan, Michael W; Foster, Christopher S; Møller, Henrik; Oliver, Tim; Reuter, Victor; Scardino, Peter T; Cuzick, Jack; Berney, Daniel M

    2013-01-01

    Treatment decisions on prostate cancer diagnosed by trans-urethral resection (TURP) of the prostate are difficult. The current TNM staging system for pT1 prostate cancer has not been re-evaluated for 25 years. Our objective was to optimise the predictive power of tumor extent measurements in TURP of the prostate specimens. A total of 914 patients diagnosed by TURP of the prostate between 1990 and 1996, managed conservatively were identified. The clinical end point was death from prostate cancer. Diagnostic serum prostate-specific antigen (PSA) and contemporary Gleason grading was available. Cancer extent was measured by the percentage of chips infiltrated by cancer. Death rates were compared by univariate and multivariate proportional hazards models, including baseline PSA and Gleason score. The percentage of positive chips was highly predictive of prostate cancer death when assessed as a continuous variable or as a grouped variable on the basis of and including the quintiles, quartiles, tertiles and median groups. In the univariate model, the most informative variable was a four group-split (≤ 10%, >10–25%, > 25–75% and > 75%); (HR = 2.08, 95% CI = 1.8–2.4, P < 0.0001). The same was true in a multivariate model (ΔX2 (1 d.f.) = 15.0, P = 0.0001). The current cutoff used by TNM (< = 5%) was sub-optimal (ΔX2 (1 d.f.) = 4.8, P = 0.023). The current TNM staging results in substantial loss of information. Staging by a four-group subdivision would substantially improve prognostication in patients with early stage disease and also may help to refine management decisions in patients who would do well with conservative treatments. PMID:20834240

  14. Factors related to late stage diagnosis of oral squamous cell carcinoma

    PubMed Central

    Vázquez-Mahía, Inés; Seoane, Juan; Varela-Centelles, Pablo; Tomás, Inmaculada; López-Cedrún, José-Luis

    2012-01-01

    Aims: To identify factors related to advanced-stage diagnosis of oral cancer to disclose high-risk groups and facilitate early detection strategies. Study design: An ambispective cohort study on 88 consecutive patients treated from January 1998 to December 2003. Inclusion criteria: pathological diagnosis of OSCC (primary tumour) at any oral site and suffering from a tumour at any TNM stage. Variables considered: age, gender, smoking history, alcohol usage, tumour site, macroscopic pattern of the lesion, co-existing precancerous lesion, degree of differentiation, diagnostic delay and TNM stage. Results: A total of 88 patients (mean age 60±11.3; 65.9% males) entered the study. Most patients (54.5%) suffered no delayed diagnosis and 45.5% of the carcinomas were diagnosed at early stages (I-II). The most frequent clinical lesions were ulcers (70.5%). Most cases were well- and moderately-differentiated (91%). Univariate analyses revealed strong associations between advanced stages and moderate-poor differentiation (OR=4.2; 95%CI=1.6-10.9) or tumour site (floor of the mouth (OR=3.6; 95%CI=1.2-11.1); gingivae (OR=8.8; 95%CI=2.0-38.2); and retromolar trigone (OR=8.8; 95%CI=1.5-49.1)). Regression analysis recognised the site of the tumour and the degree of differentiation as significantly associated to high risk of late-stage diagnosis. Conclusions: Screening programmes designed to detect asymptomatic oral cancers should be prioritized. Educational interventions on the population and on the professionals should include a sound knowledge of the disease presentation, specifically on sites like floor of the mouth, gingivae and retromolar trigone. More studies are needed in order to analyse the part of tumour biology on the extension of the disease at the time of diagnosis. Key words: Oral cancer, advanced-stage, diagnosis, cohort study. PMID:21743390

  15. Adjuvant Chemotherapy for Stage II Right- and Left-Sided Colon Cancer: Analysis of SEER-Medicare Data

    PubMed Central

    Weiss, Jennifer M.; Schumacher, Jessica; Allen, Glenn O.; Neuman, Heather; Lange, Erin O’Connor; LoConte, Noelle K.; Greenberg, Caprice C.; Smith, Maureen A.

    2014-01-01

    Purpose Survival benefit from adjuvant chemotherapy is established for stage III colon cancer; however, uncertainty exists for stage II patients. Tumor heterogeneity, specifically microsatellite instability (MSI) which is more common in right-sided cancers, may be the reason for this observation. We examined the relationship between adjuvant chemotherapy and overall 5-year mortality for stage II colon cancer by location (right- versus left-side) as a surrogate for MSI. Methods Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified Medicare beneficiaries from 1992 to 2005 with AJCC stage II (n=23,578) and III (n=17,148) primary adenocarcinoma of the colon who underwent surgery for curative intent. Overall 5-year mortality was examined with Kaplan-Meier survival analysis and Cox proportional hazards regression with propensity score weighting. Results Eighteen percent (n=2,941) of stage II patients with right-sided cancer and 22% (n=1,693) with left-sided cancer received adjuvant chemotherapy. After adjustment, overall 5-year survival benefit from chemotherapy was observed only for stage III patients (right-sided: HR 0.64; 95% CI, 0.59–0.68, p<0.001 and left-sided: HR 0.61; 95% CI, 0.56–0.68, p<0.001). No survival benefit was observed for stage II patients with either right-sided (HR 0.97; 95% CI, 0.87–1.09, p=0.64) or left-sided cancer (HR 0.97; 95% CI, 0.84–1.12, p=0.68). Conclusions Among Medicare patients with stage II colon cancer, a substantial number receive adjuvant chemotherapy. Adjuvant chemotherapy did not improve overall 5-year survival for either right- or left-sided colon cancers. Our results reinforce existing guidelines and should be considered in treatment algorithms for older adults with stage II colon cancer. PMID:24643898

  16. Contribution of diffusion weighted MRI to diagnosis and staging in gastric tumors and comparison with multi-detector computed tomography

    PubMed Central

    Fatih Özbay, Mehmet; Çallı, İskan; Doğan, Erkan; Çelik, Sebahattin; Batur, Abdussamet; Bora, Aydın; Yavuz, Alpaslan; Bulut, Mehmet Deniz; Özgökçe, Mesut; Çetin Kotan, Mehmet

    2017-01-01

    Abstract Background Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy

  17. Correlation of serum levo-fucose levels as a biomarker with tumor node metastasis staging in oral cancer patients

    PubMed Central

    Manchil, P. Redwin Dhas; Joy, E. Tatu; Kiran, M. Shashi; Sherubin, J. Eugenia; Khan, M. Farakath; Aravind, B. S.

    2016-01-01

    Background: oral cancer is a result of disordered cellular behavior initiated by various stimuli which is characterized by the alteration of serum glycoproteins consisting of different monosaccharides. One of these is levo-fucose (L-fucose), a methyl pentose. Elevated levels of protein-bound fucose have been reported in various malignancies. Aim: The present study attempted to correlate levels of serum L-fucose as a biomarker with the various tumor node metastasis (TNM) stages of oral cancer. Methodology: The study was carried out on 90 subjects consisting of 30 healthy controls and 60 histopathologically proven oral squamous cell carcinoma (OSCC) cases. The serum fucose level estimation was done based on the method adopted by Winzler. Statistical analysis included independent sample's t-test, one-way ANOVA test, Karl–Pearson correlation test, and Tukey's HSD post hoc test to evaluate the significance and variability of values between groups. Results: Significant elevation in serum fucose levels was noticed among OSCC patients when compared with the controls and a progressive ascent of L-fucose levels were noted as the stage of severity increased. Serum fucose levels were independent of histopathological grading, age, and sex. Conclusion: Serum L-fucose levels were increased in OSCC patients, and a positive correlation was observed between serum L-fucose levels and TNM staging of OSCC. Thus, serum L-fucose can be used as an effective diagnostic and prognostic biomarker in OSCC patients. PMID:27829767

  18. Developing and Implementing the AJCC Prognostic System for Breast Cancer.

    DTIC Science & Technology

    1997-08-01

    patients by outcome. A measure of discriminative accuracy is being created to assess the accuracy of the artificial neural networks ’ predictions. We are...and Systems in Oncology. Kluwer Academic Publishers, in preparation. Burke HB (ed). Artificial Neural Networks in Medicine. Kluwer Academic Publishers...429-437. Burke HB, Goodman PH, Rosen DB, Henson DE, Weinstein JN, Harrell Jr. FE, Marks JR, Winchester DP, Bostwick DG. Artificial neural networks improve

  19. Incorporation of perineural invasion of gastric carcinoma into the 7th edition tumor-node-metastasis staging system.

    PubMed

    Jiang, Nan; Deng, Jing-Yu; Liu, Yong; Ke, Bin; Liu, Hong-Gen; Liang, Han

    2014-09-01

    The aim of this study was to determine the prognostic value of perineural invasion (PNI) in patients with gastric cancer who underwent curative resection. We retrospectively analyzed 518 patients who had undergone curative gastrectomy. Paraffin sections of surgical specimens from all patients were stained with hematoxylin and eosin. PNI was defined when carcinoma cells infiltrated into the perineurium or neural fascicles. Patients with PNI had a significantly larger tumors (≥5.0 cm), lymphatic venous invasion (positive), deeper tumor invasion (T4), more number of lymph node metastases (N3), and higher tumor stage (III). Regarding survival, multivariate analysis showed that PNI emerged as an independent prognostic factor for survival (hazard ratio (HR) = 1.901, P < 0.001). We incorporated the PNI into the 7th edition tumor-node-metastasis (TNM) staging system. Comparing with the 7th edition staging system, the redefinition of TPNI stage had higher -2loglikelihood value (-2loglikelihood = 3,492.259) and lower HR and 95 % confidence interval (CI) (HR = 1.955, 95 % CI = 1.630-2.343); redefinition of NPNI and TNMIIIPNI stage both had lower -2loglikelihood value (-2loglikelihood = 3,306.608; -2loglikelihood = 2,535.151) and higher HR and 95 % CI (HR = 1.879, 95 % CI = 1.720-2.053; HR = 2.268, 95 % CI = 1.900-2.707), which represented the optimum prognostic stratification, together with better homogeneity, discriminatory ability. Our results showed that the frequency of PNI was high in patients with gastric cancer who underwent curative gastrectomy and the proportion of PNI positivity increased with progression and clinical stage of disease. PNI may be useful in detecting patients who had poor prognosis after curative resection in gastric cancer and it should be incorporated into TNM staging.

  20. Microsatellite instability & survival in patients with stage II/III colorectal carcinoma

    PubMed Central

    Srdjan, Markovic; Jadranka, Antic; Ivan, Dimitrijevic; Branimir, Zogovic; Daniela, Bojic; Petar, Svorcan; Velimir, Markovic; Zoran, Krivokapic

    2016-01-01

    Background & objectives: The two key aspects associated with the microsatellite instability (MSI) as genetic phenomenon in colorectal cancer (CRC) are better survival prognosis, and the varying response to 5-fluorouracil (5-FU)-based chemotherapy. This study was undertaken to measure the survival of surgically treated patients with stages II and III CRC based on the MSI status, the postoperative 5-FU treatment as well as clinical and histological data. Methods: A total of 125 consecutive patients with stages II and III (American Joint Committee on Cancer, AJCC staging) primary CRCs, were followed prospectively for a median time of 31 months (January 2006 to December 2009). All patients were assessed, operated and clinically followed. Tumour samples were obtained for cytopathological verification and MSI grading. Results: Of the 125 patients, 21 (20%) had high MSI (MSI-H), and 101 patients (80%) had MSI-L or MSS (low frequency MSI or stable MSI). Patients with MSS CRC were more likely to have recurrent disease (P=0.03; OR=3.2; CI 95% 1-10.2) compared to those with MSI-H CRC. Multi- and univariate Cox regression analysis failed to show a difference between MSI-H and MSS groups with respect to disease-free, disease-specific and overall survival. However, the disease-free survival was significantly lower in patients with MSI-H CRC treated by adjuvant 5-FU therapy (P=0.03). Interpretation & conclusions: MSI-H CRCs had a lower recurrence rate, but the prognosis was worse following adjuvant 5-FU therapy. PMID:27748284

  1. Stages and Behaviors

    MedlinePlus

    ... Stages Early-Stage Caregiving Middle-Stage Caregiving Late-Stage Caregiving Understand Behaviors Aggression | Agitation Confusion | Depression Hallucinations | Suspicion Sleep Issues and Sundowning Repetition | Wandering Get Help 24/ ...

  2. Ovarian Cancer Stage II

    MedlinePlus

    ... Download Title: Ovarian Cancer Stage II Description: Three-panel drawing of stage IIA, IIB, and stage II primary peritoneal cancer; the first panel (stage IIA) shows cancer inside both ovaries that ...

  3. 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 ...

  4. Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines.

    PubMed

    Gupta, Sumit; Aitken, Joanne F; Bartels, Ute; Brierley, James; Dolendo, Mae; Friedrich, Paola; Fuentes-Alabi, Soad; Garrido, Claudia P; Gatta, Gemma; Gospodarowicz, Mary; Gross, Thomas; Howard, Scott C; Molyneux, Elizabeth; Moreno, Florencia; Pole, Jason D; Pritchard-Jones, Kathy; Ramirez, Oscar; Ries, Lynn A G; Rodriguez-Galindo, Carlos; Shin, Hee Young; Steliarova-Foucher, Eva; Sung, Lillian; Supriyadi, Eddy; Swaminathan, Rajaraman; Torode, Julie; Vora, Tushar; Kutluk, Tezer; Frazier, A Lindsay

    2016-04-01

    Population-based cancer registries generate estimates of incidence and survival that are essential for cancer surveillance, research, and control strategies. Although data on cancer stage allow meaningful assessments of changes in cancer incidence and outcomes, stage is not recorded by most population-based cancer registries. The main method of staging adult cancers is the TNM classification. The criteria for staging paediatric cancers, however, vary by diagnosis, have evolved over time, and sometimes vary by cooperative trial group. Consistency in the collection of staging data has therefore been challenging for population-based cancer registries. We assembled key experts and stakeholders (oncologists, cancer registrars, epidemiologists) and used a modified Delphi approach to establish principles for paediatric cancer stage collection. In this Review, we make recommendations on which staging systems should be adopted by population-based cancer registries for the major childhood cancers, including adaptations for low-income countries. Wide adoption of these guidelines in registries will ease international comparative incidence and outcome studies.

  5. Superiority of lymph node ratio-based staging system for prognostic prediction in 2575 patients with gastric cancer: validation analysis in a large single center

    PubMed Central

    Jia, Lu-Yu; Chen, Xiao-Long; Zhang, Wei-Han; Chen, Xin-Zu; Yang, Kun; Liu, Kai; Wang, Yi-Gao; Xue, Lian; Zhang, Bo; Chen, Zhi-Xin; Chen, Jia-Ping; Zhou, Zong-Guang; Hu, Jian-Kun

    2016-01-01

    This study aimed to evaluate the prognostic significance of node ratio (Nr), the ratio of metastatic to retrieved lymph nodes, and to investigate whether a modified staging system based on Nr can improve prognostic ability for gastric cancer patients following gastrectomy. A total of 2572 patients were randomly divided into training set and validation set, and the cutoff points for Nr were produced using X-tile. The relationships between Nr and other clinicopathologic factors were analyzed, while survival prognostic discriminatory ability and accuracy were compared among different staging systems by AIC and C-index in R program. Patients were categorized into four groups as follows: Nr0, Nr1: 0.00–0.15, Nr2: 0.15–0.40 and Nr3: > 0.40. Nr was significantly associated with clinicopathologic factors including macroscopic type, tumor differentiation, lymphovascular invasion, perineural invasion, tumor size, T stage, N stage and TNM stage. Besides, for all patients, Nr and TNrM staging system showed a smaller AIC and a larger C-index than that of N and TNM staging system, respectively. Moreover, in subgroup analysis for patients with retrieved lymph nodes < 15, Nr was demonstrated to have a smaller AIC and a larger C-index than N staging system. Furthermore, in validation analysis, Nr, categorized by our cutoff points, showed a larger C-index and a smaller AIC value than those produced in previous studies. Nr could be considered as a reliable prognostic factor, even in patients with insufficient (< 15) retrieved lymph nodes, and TNrM staging system may improve the prognostic discriminatory ability and accuracy for gastric cancer patients undergoing radical gastrectomy. PMID:27363014

  6. Chemotherapy With or Without Bevacizumab in Treating Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2017-04-12

    Recurrent Hypopharyngeal Squamous Cell Carcinoma; Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Recurrent Salivary Gland Carcinoma; Salivary Gland Squamous Cell Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage IV Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IV Major Salivary Gland Cancer AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma; Stage IVA Laryngeal Verrucous Carcinoma; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Major Salivary Gland Cancer AJCC v7; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVA Oral Cavity Verrucous Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma; Stage IVB Laryngeal Verrucous Carcinoma; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Major Salivary Gland Cancer AJCC v7; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVB Oral Cavity Verrucous Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Laryngeal Squamous Cell Carcinoma; Stage IVC Laryngeal Verrucous Carcinoma; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Major Salivary Gland Cancer AJCC v7; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVC Oral Cavity Verrucous Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma AJCC v7; Tongue Carcinoma; Untreated Metastatic Squamous Cell Carcinoma to Neck With Occult Primary

  7. PET/CT surveillance detects asymptomatic recurrences in stage IIIB and IIIC melanoma patients: a prospective cohort study.

    PubMed

    Madu, Max F; Timmerman, Pieter; Wouters, Michel W J M; van der Hiel, Bernies; van der Hage, Jos A; van Akkooi, Alexander C J

    2017-02-20

    AJCC stage IIIB and IIIC melanoma patients are at risk for disease relapse or progression. The advent of effective systemic therapies has made curative treatment of progressive disease a possibility. As resection of oligometastatic disease can confer a survival benefit and as immunotherapy is possibly most effective in a low tumor load setting, there is a likely benefit to early detection of progression. The aim of this pilot study was to evaluate a PET/computed tomography (CT) surveillance schedule for resected stage IIIB and IIIC melanoma. From 1-2015, stage IIIB and IIIC melanoma patients at our institution underwent 6-monthly surveillance with PET/CT, together with 3-monthly S100B assessment. When symptoms or elevated S100B were detected, an additional PET/CT was performed. Descriptive statistics were used to evaluate outcomes for this surveillance schedule. Fifty-one patients were followed up, 27 patients developed a recurrence before surveillance imaging, five were detected by an elevated S100B, and one patient was not scanned according to protocol. Eighteen patients were included. Thirty-two scans were acquired. Eleven relapses were suspected on PET/CT. Ten scans were true positive, one case was false positive, and one case was false negative. All recurrences detected by PET/CT were asymptomatic at that time, with a normal range of S100B. The number of scans needed to find one asymptomatic relapse was 3.6. PET/CT surveillance imaging seems to be an effective strategy for detecting asymptomatic recurrence in stage IIIB and IIIC melanoma patients in the first year after complete surgical resection.

  8. Ovarian Cancer Stage I

    MedlinePlus

    ... Three-panel drawing of stage IA, IB, and IC; the first panel (stage IA) shows cancer inside ... cancer inside both ovaries. The third panel (stage IC) shows cancer inside both ovaries, and one ovary ...

  9. Cervical Cancer Stage IIIA

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View / ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; ...

  10. Cervical Cancer Stage IIIB

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIB Add to My Pictures View / ... 1425x1326 View Download Large: 2850x2651 View Download Title: Cervical Cancer Stage IIIB Description: Stage IIIB cervical cancer; ...

  11. Cervical Cancer Stage IVB

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View / ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; ...

  12. Cervical Cancer Stage IVA

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View / ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; ...

  13. International trial of adjuvant therapy in high risk stage I non-squamous cell carcinoma identified by a 14-gene prognostic signature.

    PubMed

    Kratz, Johannes R; Mann, Michael J; Jablons, David M

    2013-06-01

    There is widespread agreement amongst clinical oncologists that more refined risk-stratification in early-stage lung cancer patients beyond conventional TNM staging is needed. Over the past decade, a number of molecular prognostic signatures have been designed to meet this need by correlating patterns in the differences in gene expression or modification to patient prognosis. Unfortunately, the majority of proposed signatures are not amenable to practical widespread implementation or have not yet undergone large-scale, rigorous clinical validation. A practical 14-gene prognostic signature that has undergone large-scale blinded independent validation is now ready for widespread clinical use. An international clinical trial is underway that has been designed to document the precise degree of benefit derived from adjuvant therapy in high-risk stage I patients identified by the 14-gene prognostic assay.

  14. Immunoprofiling as a predictor of patient's response to cancer therapy-promises and challenges.

    PubMed

    Bethmann, Daniel; Feng, Zipei; Fox, Bernard A

    2017-02-18

    Immune cell infiltration is common to many tumors and has been recognized by pathologists for more than 100 years. The application of digital imaging and objective assessment software allowed a concise determination of the type and quantity of immune cells and their location relative to the tumor and, in the case of colon cancer, characterized overall survival better than AJCC TNM staging. Subsequently, expression of PD-L1, by 50% or more tumor cells, identified NSCLC patients with double the response rate to anti-PD-1. Soon, automated staining methods will improve reproducibility of multiplex staining and allow for CLIA standards so that multiplex staining can be used to make clinical decisions. Ultimately, machine-learning algorithms will help interpret data from tissue images and lead to improved delivery of precision medicine.

  15. 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

  16. 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.

  17. 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

  18. Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy

    SciTech Connect

    Li, Wen-Fei; Sun, Ying; Mao, Yan-Ping; Chen, Lei; Chen, Yuan-Yuan; Chen, Mo; Liu, Li-Zhi; Lin, Ai-Hua; Li, Li; Ma, Jun

    2013-06-01

    Purpose: To propose a lymph node (N) staging system for nasopharyngeal carcinoma (NPC) based on the International Consensus Guidelines for lymph node (LN) levels and MRI-determined nodal variables. Methods and Materials: The MRI scans and medical records of 749 NPC patients receiving intensity modulated radiation therapy with or without chemotherapy were retrospectively reviewed. The prognostic significance of nodal level, laterality, maximal axial diameter, extracapsular spread, necrosis, and Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) size criteria were analyzed. Results: Nodal level and laterality were the only independent prognostic factors for distant failure and disease failure in multivariate analysis. Compared with unilateral levels Ib, II, III, and/or Va involvement (hazard ratio [HR] 1), retropharyngeal lymph node involvement alone had a similar prognostic value (HR 0.71; 95% confidence interval [CI] 0.43-1.17; P=.17), whereas bilateral levels Ib, II, III, and/or Va involvement (HR 1.65; 95% CI 1.06-2.58; P=.03) and levels IV, Vb, and/or supraclavicular fossa involvement (HR 3.47; 95% CI 1.92-6.29; P<.01) both significantly increased the HR for distant failure. Thus we propose that the N category criteria could be revised as follows: N0, no regional LN metastasis; N1, retropharyngeal lymph node involvement, and/or unilateral levels Ib, II, III, and/or Va involvement; N2, bilateral levels Ib, II, III, and/or Va involvement; N3, levels IV, Vb, and/or supraclavicular fossa involvement. Compared with the 7th edition of the UICC/AJCC criteria, the proposed N staging system provides a more satisfactory distinction between the HRs for regional failure, distant failure, and disease failure in each N category. Conclusions: The proposed N staging system defined by the International Consensus Guidelines and laterality is predictive and practical. However, because of no measurements of the maximal nodal diameter on MRI slices

  19. 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.

  20. Ages and Stages: Teen

    MedlinePlus

    ... Pediatrician Ages & Stages Prenatal Baby Toddler Preschool Gradeschool Teen Dating & Sex Fitness Nutrition Driving Safety School Substance Abuse Young Adult Healthy Children > Ages & Stages > Teen Teen Article Body Adolescence can be a rough ...

  1. Breast cancer staging

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000911.htm Breast cancer staging To use the sharing features on this ... Once your health care team knows you have breast cancer , they will do more tests to stage it. ...

  2. 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 ...

  3. Stages of Gallbladder Cancer

    MedlinePlus

    ... Serosal (outer) layer. Between these layers is supporting connective tissue . Primary gallbladder cancer starts in the inner layer ... has spread beyond the muscle layer to the connective tissue around the muscle. Stage IIIA In stage IIIA , ...

  4. Stages of Endometrial Cancer

    MedlinePlus

    ... Stage II endometrial cancer. Cancer has spread into connective tissue of the cervix, but has not spread outside ... uterus. In stage II , cancer has spread into connective tissue of the cervix , but has not spread outside ...

  5. Pancreatic Cancer Stage 3

    MedlinePlus

    ... 3 Description: Stage III pancreatic cancer; drawing shows cancer in the pancreas, common hepatic artery, and portal vein. Also shown ... and superior mesenteric artery. Stage III pancreatic cancer. Cancer ... near the pancreas. These include the superior mesenteric artery, celiac axis, ...

  6. Cervical Cancer Stage IB

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View / ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 ...

  7. Cervical Cancer Stage IA

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View / ... 1500x1200 View Download Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 ...

  8. 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)

  9. 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 ...

  10. 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 ...

  11. Brain metastasis is predetermined in early stages of cutaneous melanoma by CD44v6 expression through epigenetic regulation of the spliceosome.

    PubMed

    Marzese, Diego M; Liu, Michelle; Huynh, Jamie L; Hirose, Hajime; Donovan, Nicholas C; Huynh, Kelly T; Kiyohara, Eiji; Chong, Kelly; Cheng, David; Tanaka, Ryo; Wang, Jinhua; Morton, Donald L; Barkhoudarian, Garni; Kelly, Daniel F; Hoon, Dave S B

    2015-01-01

    Melanoma brain metastasis (MBM) is frequent and has a very poor prognosis with no current predictive factors or therapeutic molecular targets. Our study unravels the molecular alterations of cell-surface glycoprotein CD44 variants during melanoma progression to MBM. High expression of CD44 splicing variant 6 (CD44v6) in primary melanoma (PRM) and regional lymph node metastases from AJCC Stage IIIC patients significantly predicts MBM development. The expression of CD44v6 also enhances the migration of MBM cells by hyaluronic acid and hepatocyte growth factor exposure. Additionally, CD44v6-positive MBM migration is reduced by blocking with a CD44v6-specific monoclonal antibody or knocking down CD44v6 by siRNA. ESRP1 and ESRP2 splicing factors correlate with CD44v6 expression in PRM, and ESRP1 knockdown significantly decreases CD44v6 expression. However, an epigenetic silencing of ESRP1 is observed in metastatic melanoma, specifically in MBM. In advanced melanomas, CD44v6 expression correlates with PTBP1 and U2AF2 splicing factors, and PTBP1 knockdown significantly decreases CD44v6 expression. Overall, these findings open a new avenue for understanding the high affinity of melanoma to progress to MBM, suggesting CD44v6 as a potential MBM-specific factor with theranostic utility for stratifying patients.

  12. 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.

  13. 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

  14. Three stage rocket vehicle with parallel staging

    NASA Technical Reports Server (NTRS)

    Marshall, W. R. (Inventor)

    1984-01-01

    A three stage rocket vehicle has a large forward propellant tank and a small aft propellant tank axially aligned. Secured to the rear end of the aft propellant tank is an engine mount structure carrying rocket engines. Offset and secured to the propellant tanks is a payload structure. The propellants from the large forward tank are fed into the aft propellant tank. This arrangement enables the vehicle to parallel stage its use of engines and components and results in significant payload capability. The design and components fully utilize existing space shuttle elements and tooling.

  15. 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.

  16. 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.

  17. "High Stage" Organizing.

    ERIC Educational Resources Information Center

    Torbert, William R.

    Although a psychological theory of stages of transformation in human development currently exists, organizational researchers have yet to elaborate and test any theory of organizational transformation of comparable elegance. According to the organizational stage theory being developed since 1974 by William Torbert, bureaucratic organization, which…

  18. The clinicopathologic relevance and prognostic value of tumor deposits and the applicability of N1c category in rectal cancer with preoperative radiotherapy

    PubMed Central

    He, Ming-ming; Luo, Hui-yan; Wang, Feng-hua; Zhang, Dong-sheng; Li, Yu-hong; Xu, Rui-hua

    2016-01-01

    The clinicopathologic relevance and prognostic value of tumor deposits in colorectal cancer has been widely demonstrated. However, there are still debates in the prognostic value of tumor deposits and the applicability of N1c category in rectal cancer with preoperative radiotherapy. In this study, rectal cancer with preoperative radiotherapy followed by resection of primary tumors registered in Surveillance, Epidemiology and End Results (SEER) database from 2010-2012 were analyzed. There were 4,813 cases eligible for this study, and tumor deposits were found in 514 (10.7%) cases. The presence of tumor deposits was significantly associated with some aggressive characteristics, including poorer tumor differentiation, more advanced ypT category, ypN category and ypTNM stage, distant metastasis, elevated carcinoembryonic antigen, higher positive rates of circumferential resection margin and perineural invasion (all P < = 0.001). Tumor deposit was also an independent negative prognostic factor for cancer-specific survival in rectal cancer with preoperative radiotherapy (adjusted HR and 95% CI: 2.25 (1.51 – 3.35)). N1c category had significant worse survival compared with N0 category (adjusted HR and 95% CI: 2.41 (1.24 – 4.69)). In conclusion, tumor deposit was a significant and independent prognostic factor, and the N1c category by the 7th edition of AJCC/TNM staging system was applicable in rectal cancer with preoperative radiotherapy. PMID:27655707

  19. Early stage colon cancer.

    PubMed

    Freeman, Hugh James

    2013-12-14

    Evidence has now accumulated that colonoscopy and removal of polyps, especially during screening and surveillance programs, is effective in overall risk reduction for colon cancer. After resection of malignant pedunculated colon polyps or early stage colon cancers, long-term repeated surveillance programs can also lead to detection and removal of asymptomatic high risk advanced adenomas and new early stage metachronous cancers. Early stage colon cancer can be defined as disease that appears to have been completely resected with no subsequent evidence of involvement of adjacent organs, lymph nodes or distant sites. This differs from the clinical setting of an apparent "curative" resection later pathologically upstaged following detection of malignant cells extending into adjacent organs, peritoneum, lymph nodes or other distant sites, including liver. This highly selected early stage colon cancer group remains at high risk for subsequent colon polyps and metachronous colon cancer. Precise staging is important, not only for assessing the need for adjuvant chemotherapy, but also for patient selection for continued surveillance. With advanced stages of colon cancer and a more guarded outlook, repeated surveillance should be limited. In future, novel imaging technologies (e.g., confocal endomicroscopy), coupled with increased pathological recognition of high risk markers for lymph node involvement (e.g., "tumor budding") should lead to improved staging and clinical care.

  20. 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.

  1. Stage T3a renal cell carcinoma: staging accuracy of CT for sinus fat, perinephric fat or renal vein invasion

    PubMed Central

    Sokhi, H K; Mok, W Y

    2015-01-01

    Objective: To study the accuracy of CT for staging T3a (TNM 2009) renal cell carcinoma (RCC). Methods: Unenhanced and nephrographic phase CT studies of 117 patients (male:female = 82:35; age range, 21–86 years) with T1–T3a RCC were independently reviewed by 2 readers. The presence of sinus or perinephric fat, or renal vein invasion and tumour characteristics were noted. Results: Median (range) tumour size was 5.5 (0.9–19.0) cm; and 46 (39%), 16 (14%) and 55 (47%) tumours were pT1, pT2 and pT3a RCC, respectively. The sensitivity/specificity for sinus fat, perinephric fat and renal vein invasion were 71/79%, 83/76% and 59/93% (Reader 1) and 88/71%, 68/72% and 69/91% (Reader 2) with κ = 0.41, 0.43 and 0.61, respectively. Sinus fat invasion was seen in 47/55 (85%) cases with T3a RCC vs 16/55 (29%) and 33/55 (60%) for perinephric fat and renal vein invasion. Tumour necrosis, irregularity of tumour edge and direct tumour contact with perirenal fascia or sinus fat increased the odds of local invasion [odds ratio (OR), 2.5–3.7; p < 0.05; κ = 0.42–0.61]. Stage T3a tumours were centrally located (OR, 3.9; p = 0.0009). Conclusion: Stage T3a RCC was identified with a sensitivity of 59–88% and specificity of 71–93% (κ = 0.41–0.61). Sinus fat invasion was the most common invasive feature. Advances in knowledge: Centrally situated renal tumours with an irregular tumour edge, inseparable from sinus structures or the perirenal fascia and CT features of tumour necrosis should alert the reader to the possibility of Stage T3a RCC (OR, 2.5–3.9). PMID:25410425

  2. 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.

  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. 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 ...

  5. 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.

  6. Stages of Pregnancy

    MedlinePlus

    ... three stages. Expand all | Collapse all First trimester (week 1–week 12) During the first trimester your body undergoes ... is different, so is each pregnancy. Second trimester (week 13–week 28) Most women find the second ...

  7. 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.

  8. [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?

  9. Interleukin-6 stimulates aerobic glycolysis by regulating PFKFB3 at early stage of colorectal cancer.

    PubMed

    Han, Jun; Meng, Qingyang; Xi, Qiulei; Zhang, Yongxian; Zhuang, Qiulin; Han, Yusong; Jiang, Yi; Ding, Qiurong; Wu, Guohao

    2016-01-01

    Chronic inflammation is a well-known etiological factor for colorectal cancer (CRC) and cancer cells are known to preferentially metabolize glucose through aerobic glycolysis. However, the connection between chronic inflammation and aerobic glycolysis in the development of CRC is largely unexplored. The present study investigated whether interleukin-6 (IL-6), a pro-inflammatory cytokine, promotes the development of CRC by regulating the aerobic glycolysis and the underlying molecular mechanisms. In colitis-associated CRC mouse, anti-IL-6 receptor antibody treatment reduced the incidence of CRC and decreased the expression of key genes in aerobic glycolysis, whereas the plasma concentrations of glucose and lactate were not affected. Consistently, IL-6 treatment stimulated aerobic glycolysis, upregulated key genes in aerobic glycolysis and promoted cell proliferation and migration in SW480 and SW1116 CRC cells. 6-phoshofructo-2-kinase/fructose-2,6-bisphosphatase-3 (PFKFB3) was the most downregulated gene by anti-IL-6 receptor antibody in colorectal adenoma tissues. Further analysis in human samples revealed overexpression of PFKFB3 in colorectal adenoma and adenocarcinoma tissues, which was also associated with lymph node metastasis, intravascular cancer embolus and TNM stage. In addition, the effect of IL-6 on CRC cells can be abolished by knocking down PRKFB3 through siRNA transfection. Our data suggest that chronic inflammation promotes the development of CRC by stimulating aerobic glycolysis and IL-6 is functioning, at least partly, through regulating PFKFB3 at early stage of CRC.

  10. 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

  11. 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.

  12. 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

  13. Reading Aloud: Discrete Stage(s) Redux

    PubMed Central

    Robidoux, Serje; Besner, Derek

    2017-01-01

    Interactive activation accounts of processing have had a broad and deep influence on cognitive psychology, particularly so in the context of computational accounts of reading aloud at the single word level. Here we address the issue of whether such a framework can simulate the joint effects of stimulus quality and word frequency (which have been shown to produce both additive and interactive effects depending on the context). We extend previous work on this question by considering an alternative implementation of a stimulus quality manipulation, and the role of interactive activation. Simulations with a version of the Dual Route Cascaded model (a model with interactive activation dynamics along the lexical route) demonstrate that the model is unable to simulate the entire pattern seen in human performance. We discuss how a hybrid interactive activation model that includes some context dependent staged processing could accommodate these data. PMID:28289395

  14. 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.

  15. The degree of extramural spread of T3 rectal cancer: an appeal to the American Joint Committee on Cancer.

    PubMed

    Zinicola, R; Pedrazzi, G; Haboubi, N; Nicholls, R J

    2017-01-01

    The T3 category of the TNM classification includes over 60% of all rectal tumours and encompasses the greatest variance in cancer-specific end-points than any other T category. The most recent edition of the cancer staging handbook of the American Joint Committee on Cancer (AJCC) dated 2010 does not divide T3 tumours into subgroups which reflect cancer-specific outcome more sensitively. The original aim of the present study was to review the literature to assess the influence of the degree of extramural extent of T3 rectal cancer on local recurrence and survival. An article written by the authors was accepted for publication but was withdrawn immediately after they became aware of the publication of the 4th edition of the TNM Supplement by the Union for International Cancer Control dated 2012, which was not accessible by the search system used. This article dealt with the subdivision of the T3 category although this was not included in the most up-to-date AJCC guidelines and was stated to be 'entirely optional'. Medline, PubMed and Cochrane Library searches were performed to identify all studies that investigated the degree of extramural spread and its relationship to survival and local recurrence. Twenty-two studies were identified of which 12 assessed the degree of histopathological extramural spread measured in millimetres. In 18 of the 22 studies the degree of extramural spread was a statistically significant prognostic factor for survival and local recurrence. Analysis of the studies indicated that the subdivision of category T3 rectal cancer into two subgroups of extramural spread ≤ 5 mm or more than 5 mm resulted in markedly different survival and local recurrence rates. The data were insufficient to allow validation of any greater subdivision. Measurement of the extent of extramural spread by MRI before any treatment agreed with the histopathological measurement in the surgical specimen to within 1 mm. The extent of extramural spread in T3 rectal

  16. 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.

  17. 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…

  18. 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.

  19. 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. ...

  20. 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…

  1. Full analysis of the prostatic urethra at the time of radical cystoprostatectomy for bladder cancer: impact on final disease stage.

    PubMed

    Varinot, Justine; Camparo, Philippe; Roupret, Morgan; Bitker, Marc Olivier; Capron, Fréderique; Cussenot, Olivier; Witjes, J Alfred; Compérat, Eva

    2009-11-01

    Prostate involvement is a major prognostic element in urothelium carcinoma staging after radical cystoprostatectomy (RCP) for muscle invasive bladder cancer. While appropriate pTNM stage is necessary for adequate treatment, no standard procedure exists up to now for macroscopic sampling of the prostate in RCP in daily practice. We therefore propose a protocol where examination of the whole prostatic urethra (PU) is possible, without using whole mount sections. From 2008 to June 2009, RCP were sampled according to a macroscopic protocol permitting the whole length and the underlying stroma of PU to be visualized. Data were compared with our series or RCP from 2000-2007, when the PU was evaluated with a more simple protocol. One hundred and one specimens were examined between 2000-2007, 25 until June 2009. In the latter series, we found pT4 bladder cancer in 36% versus 21%, Cis in the PU in 28% versus 14%, and additional prostate cancer was seen in 44% compared with 13% (p = 0.0004) in the 2008-2009 group versus the 2000-2007 group, respectively. Our proposed protocol better detects prostate involvement by bladder cancer, therefore providing a better final stage of the patients. We propose a macroscopic protocol where the whole PU and the underlying stroma can be examined without the use of whole mount sections. Data are similar to those published in the recent literature, where whole mount sections were used. This protocol also permits better detection of concomitant prostate carcinomas.

  2. Staged treatment of pilon fractures

    PubMed Central

    Deivaraju, Chenthuran; Vlasak, Richard; Sadasivan, Kalia

    2015-01-01

    Aim To evaluate outcomes following staged anterolateral plating of pilon fractures. Methods Over a 5 year period, patients with pilon fractures received four treatment regimens (staged anterolateral plating, staged medial plating, definitive external fixation, early total care). We defined five outcomes (reduction, soft tissue complications, infection, non-union, malunion) and assessed the outcome of fractures treated by these interventions. Results Staged anterolateral plating or staged medial plating achieved comparable reduction and soft tissue complications. Staged medial plating had higher infection rates, malunion and non-union rates. Conclusions Staged anterolateral plating is superior to staged medial plating in the management of pilon fractures. PMID:26719618

  3. 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.

  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. Rituximab and Oblimersen in Treating Patients With Stage II, Stage III, or Stage IV Follicular Non-Hodgkin's Lymphoma

    ClinicalTrials.gov

    2013-01-04

    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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. Methylation of WNT target genes AXIN2 and DKK1 as robust biomarkers for recurrence prediction in stage II colon cancer.

    PubMed

    Kandimalla, R; Linnekamp, J F; van Hooff, S; Castells, A; Llor, X; Andreu, M; Jover, R; Goel, A; Medema, J P

    2017-04-03

    Stage II colon cancer (CC) still remains a clinical challenge with patient stratification for adjuvant therapy (AT) largely relying on clinical parameters. Prognostic biomarkers are urgently needed for better stratification. Previously, we have shown that WNT target genes AXIN2, DKK1, APCDD1, ASCL2 and LGR5 are silenced by DNA methylation and could serve as prognostic markers in stage II CC patients using methylation-specific PCR. Here, we have extended our discovery cohort AMC90-AJCC-II (N=65) and methylation was analyzed by quantitative pyrosequencing. Subsequently, we validated the results in an independent EPICOLON1 CC cohort (N=79). Methylation of WNT target genes is negatively correlated to mRNA expression. A combination of AXIN2 and DKK1 methylation significantly predicted recurrences in univariate (area under the curve (AUC)=0.83, confidence interval (CI): 0.72-0.94, P<0.0001) analysis in stage II microsatellite stable (MSS) CC patients. This two marker combination showed an AUC of 0.80 (CI: 0.68-0.91, P<0.0001) in the EPICOLON1 validation cohort. Multivariate analysis in the Academic Medical Center (AMC) cohort revealed that both WNT target gene methylation and consensus molecular subtype 4 (CMS4) are significantly associated with poor recurrence-free survival (hazard ratio (HR)methylation: 3.84, 95% CI: 1.14-12.43; HRCMS4: 3.73, 95% CI: 1.22-11.48). CMS4 subtype tumors with WNT target methylation showed worse prognosis. Combining WNT target gene methylation and CMS4 subtype lead to an AUC of 0.89 (0.791-0.982, P<0.0001) for recurrence prediction. Notably, we observed that methylation of DKK1 is high in BRAF mutant and CIMP (CpG island methylator phenotype)-positive cancers, whereas AXIN2 methylation appears to be associated with CMS4. Methylation of AXIN2 and DKK1 were found to be robust markers for recurrence prediction in stage II MSS CC patients. Further validation of these findings in a randomized and prospective manner could pave a way to identify

  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. Metastatic lymph node ratio demonstrates better prognostic stratification than pN staging in patients with esophageal squamous cell carcinoma after esophagectomy

    PubMed Central

    Zhang, Hongdian; Liang, Huagang; Gao, Yongyin; Shang, Xiaobin; Gong, Lei; Ma, Zhao; Sun, Ke; Tang, Peng; Yu, Zhentao

    2016-01-01

    This study aimed to evaluate the prognostic significance of lymph node ratio (LNR) by establishing a hypothetical tumor-ratio-metastasis (TRM) staging system in patients with esophageal squamous cell carcinoma (ESCC). The records of 387 ESCC patients receiving curative esophagectomy were retrospectively investigated. The optimal cut-point for LNR was assessed via the best cut-off approach. Potential prognostic parameters were identified through univariate and multivariate analyses. A novel LNR-based TRM stage was proposed. The prognostic discriminatory ability and prediction accuracy of each system were determined using hazard ratio (HR), Akaike information criterion (AIC), concordance index (C-index), and area under the receiver operating characteristic curve (AUC). The optimal cut-points of LNR were set at 0, 0~0.2, 0.2~0.4, and 0.4~1.0. Multivariate Cox analysis indicated that the LNR category was an independent risk factor of overall survival (P < 0.001). The calibration curves for the probability of 3- and 5-year survival showed good consistency between nomogram prediction and actual observation. The LNR category and TRM stage yielded a larger HR, a smaller AIC, a larger C-index, and a larger AUC than the N category and TNM stage did. In summary, the proposed LNR category was superior to the conventional N category in predicting the prognosis of ESCC patients. PMID:27941828

  14. Waste glass melting stages

    SciTech Connect

    Anderson, L.D.; Dennis, T.; Elliott, M.L.; Hrma, P.

    1993-04-01

    Three different simulated nuclear waste glass feeds, consisting of dried waste and glass frit, were heat treated for 1 hour in a gradient furnace at temperatures ranging from approximately 600[degrees]C--1000[degrees]C. Simulated melter feeds from the Hanford Waste Vitrification Plant (HWVP), the Defense Waste Processing Facility (DWPF), and Kernforschungszentrum Karlsruhe (KfK) in Germany were used. The samples were thin-sectioned and examined by optical microscopy to investigate the stages of the conversion from feed to glass. Various phenomena were seen, such as frit softening, bubble formation, foaming, bubble motion and removal, convective mixing, and homogenization. Behavior of different feeds was similar, although the degree of gas generation and melt homogenization varied.

  15. Waste glass melting stages

    SciTech Connect

    Anderson, L.D.; Dennis, T.; Elliott, M.L.; Hrma, P.

    1993-04-01

    Three different simulated nuclear waste glass feeds, consisting of dried waste and glass frit, were heat treated for 1 hour in a gradient furnace at temperatures ranging from approximately 600{degrees}C--1000{degrees}C. Simulated melter feeds from the Hanford Waste Vitrification Plant (HWVP), the Defense Waste Processing Facility (DWPF), and Kernforschungszentrum Karlsruhe (KfK) in Germany were used. The samples were thin-sectioned and examined by optical microscopy to investigate the stages of the conversion from feed to glass. Various phenomena were seen, such as frit softening, bubble formation, foaming, bubble motion and removal, convective mixing, and homogenization. Behavior of different feeds was similar, although the degree of gas generation and melt homogenization varied.

  16. How Are Myelodysplastic Syndromes Staged?

    MedlinePlus

    ... Syndromes Early Detection, Diagnosis, and Staging How Are Myelodysplastic Syndromes Scored? Doctors often group cancers into different stages ... Ask Your Doctor About Myelodysplastic Syndromes? More In Myelodysplastic Syndromes About Myelodysplastic Syndromes Causes, Risk Factors, and Prevention ...

  17. 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 ...

  18. 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 ...

  19. How Is Ovarian Cancer Staged?

    MedlinePlus

    ... recent FIGO staging. Stages of ovarian and fallopian tube cancer Once a patient's T, N, and M ... only within the ovary (or ovaries) or fallopian tube(s). It has not spread to organs and tissues ...

  20. The principles of cancer staging

    PubMed Central

    Brierley, James; Gospodarowicz, Mary; O’Sullivan, Brian

    2016-01-01

    The anatomic disease extent or tumour stage of a cancer at diagnosis as a determinant of prognosis is discussed. The importance of cancer stage in individual patient prognosis and determination of treatment is reviewed as well as its value in research and cancer control activities. The conflict between the need for stability of cancer stage definitions over time and the need to evolve with advances in medicine are examined. The ecancer elearning modules on Cancer Stage are introduced. PMID:28101141

  1. Stage measurement at gaging stations

    USGS Publications Warehouse

    Buchanan, Thomas J.; Somers, William P.

    1968-01-01

    Continuous measurements of stream stage are used in determining records of stream discharge. In addition a record of stream stage is useful in itself, as in designing structures affected by stream elevation or in planning the use of flood plains. This report describes instruments and structures commonly used in obtaining a record of stream stage.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. Does tumor size improve the accuracy of prognostic prediction in patients with esophageal squamous cell carcinoma after surgical resection?

    PubMed Central

    Gao, Yongyin; Shang, Xiaobin; Gong, Lei; Ma, Zhao; Yang, Mingjian; Jiang, Hongjing; Zhan, Zhongli; Meng, Bin; Yu, Zhentao

    2016-01-01

    This study aimed to investigate whether the inclusion of tumor size could improve the prognostic accuracy in patients with esophageal squamous cell cancer (ESCC). A total of 387 patients with ESCC who underwent curative resection were enrolled in this analysis. The patients were categorized into small-sized tumors (SSTs) and large-sized tumors (LSTs) using an appropriate cut-off point for tumor size. Kaplan–Meier survival curve and log–rank test were used to evaluate the prognostic value of tumor size. A Cox regression model was adopted for multivariate analysis. Their accuracy was compared based on the presence or absence of tumor size. Using 3.5 cm as the optimal cut-off point, 228 and 159 patients presented with LSTs (≥ 3.5 cm) and SSTs (< 3.5 cm), respectively. The patients with LSTs had significantly worse prognoses than patients with SSTs (23.9% vs. 43.2%, P < 0.001). Multivariate analysis revealed that tumor size, histological type, invasion depth, and lymph node metastasis were independent predictors of overall survival. The addition of tumor size to the AJCC TNM staging improved the predictive accuracy of the 5-year survival rate by 3.9%. Further study showed that tumor size and T stage were independent predictors of the prognosis of node-negative patients, and the combination of tumor size and T stage improved the predictive accuracy by 3.7%. In conclusion, tumor size is indeed a simple and practical prognostic factor in patients with ESCC. It can be used to improve the prognostic accuracy of the current TNM staging, especially for patients with node-negative disease. PMID:27579613

  7. Advanced two-stage compressor program design of inlet stage

    NASA Technical Reports Server (NTRS)

    Bryce, C. A.; Paine, C. J.; Mccutcheon, A. R. S.; Tu, R. K.; Perrone, G. L.

    1973-01-01

    The aerodynamic design of an inlet stage for a two-stage, 10/1 pressure ratio, 2 lb/sec flow rate compressor is discussed. Initially a performance comparison was conducted for an axial, mixed flow and centrifugal second stage. A modified mixed flow configuration with tandem rotors and tandem stators was selected for the inlet stage. The term conical flow compressor was coined to describe a particular type of mixed flow compressor configuration which utilizes axial flow type blading and an increase in radius to increase the work input potential. Design details of the conical flow compressor are described.

  8. Recent technological and application developments in computed tomography and magnetic resonance imaging for improved pulmonary nodule detection and lung cancer staging

    PubMed Central

    Sieren, Jessica C.; Ohno, Yoshiharu; Koyama, Hisanobu; Sugimura, Kazuro; McLennan, Geoffrey

    2010-01-01

    This review compares the emerging technologies and approaches in the application of magnetic resonance (MR) and computed tomography (CT) imaging for the assessment of pulmonary nodules and staging of malignant findings. Included in this review is a brief definition of pulmonary nodules and an introduction to the challenges faced. We have highlighted the current status of both MR and CT for the early detection of lung nodules. Developments are detailed in this review for the management of pulmonary nodules using advanced imaging, including; dynamic imaging studies, dual energy CT, computer aided detection and diagnosis, and imaging assisted nodule biopsy approaches which have improved lung nodule detection and diagnosis rates. Recent advancements linking in-vivo imaging to corresponding histological pathology are also highlighted. In-vivo imaging plays a pivotal role in the clinical staging of pulmonary nodules through TNM assessment. While CT and PET/CT are currently the most commonly clinically employed modalities for pulmonary nodule staging, studies are presented which highlight the augmentative potential of MR. PMID:21105140

  9. 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.

  10. Multi-stage complex contagions.

    PubMed

    Melnik, Sergey; Ward, Jonathan A; Gleeson, James P; Porter, Mason A

    2013-03-01

    The spread of ideas across a social network can be studied using complex contagion models, in which agents are activated by contact with multiple activated neighbors. The investigation of complex contagions can provide crucial insights into social influence and behavior-adoption cascades on networks. In this paper, we introduce a model of a multi-stage complex contagion on networks. Agents at different stages-which could, for example, represent differing levels of support for a social movement or differing levels of commitment to a certain product or idea-exert different amounts of influence on their neighbors. We demonstrate that the presence of even one additional stage introduces novel dynamical behavior, including interplay between multiple cascades, which cannot occur in single-stage contagion models. We find that cascades-and hence collective action-can be driven not only by high-stage influencers but also by low-stage influencers.

  11. Staged membrane oxidation reactor system

    DOEpatents

    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.

  12. Staged membrane oxidation reactor system

    DOEpatents

    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.

  13. 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.

  14. 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

  15. Ares I Upper Stage Element

    NASA Technical Reports Server (NTRS)

    Chojnacki, Kent

    2009-01-01

    This slide presentation reviews the elements that make up the Ares I launch vehicle, with particular attention devoted to the upper stage of the vehicle. The upper stage elememnts, a lunar mission profile, and the upper stage objectives are reviewed. The work that Marshall Space Flight Center is doing is highlighted: work on the full scale welding process, the vertical milling machining, and the thermal protection system.

  16. Staging of neoplasms. Volume 7

    SciTech Connect

    Glazer, G.M.

    1986-01-01

    This book is divided into ten chapters. The first, an overview of the importance of staging, is followed by separate chapters on computed tomographic (CT) evaluation of lymph node metastases; metastatic disease to the thorax; staging of laryngeal, hypopharyngeal, esophageal, non-small cell lung, and renal carcinoma; and pediatric abdominal malignancies. CT staging of lymphomas is dealt with in a separate chapter. The final chapter summarizes initial experiences with staging of neoplasms by magnetic resonance (MR) imaging. Other neoplasms, such as pelvic, pancreatic, and gastrointestinal, are not discussed in depth. The book concludes with ten case studies, most of which deal with pelvic and gastrointestinal malignancies.

  17. 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

  18. Second stage gasifier in staged gasification and integrated process

    DOEpatents

    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.

  19. 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…

  20. 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…

  1. 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.

  2. Lernpunkt Deutsch--Stage 1.

    ERIC Educational Resources Information Center

    Theil, Elvira

    1997-01-01

    Evaluates the first stage of "Lernpunkt Deutsch," a new three-stage German course designed for upper elementary and early secondary school. Describes the publisher's package of materials and the appropriateness of the course, utility of the different package elements, format of the materials, and assesses whether the course provides pedagogically…

  3. Multi-stage complex contagions

    NASA Astrophysics Data System (ADS)

    Melnik, Sergey; Ward, Jonathan A.; Gleeson, James P.; Porter, Mason A.

    2013-03-01

    The spread of ideas across a social network can be studied using complex contagion models, in which agents are activated by contact with multiple activated neighbors. The investigation of complex contagions can provide crucial insights into social influence and behavior-adoption cascades on networks. In this paper, we introduce a model of a multi-stage complex contagion on networks. Agents at different stages—which could, for example, represent differing levels of support for a social movement or differing levels of commitment to a certain product or idea—exert different amounts of influence on their neighbors. We demonstrate that the presence of even one additional stage introduces novel dynamical behavior, including interplay between multiple cascades, which cannot occur in single-stage contagion models. We find that cascades—and hence collective action—can be driven not only by high-stage influencers but also by low-stage influencers.

  4. Ares I Upper Stage Overview

    NASA Technical Reports Server (NTRS)

    Verhage, Marc

    2007-01-01

    The Upper Stage Element of NASA's Ares I Crew Launch Vehicle (CLV) is a "clean-sheet" approach that is being designed and developed in-house, with Element management at MSFC. The Upper Stage Element concept is a self-supporting cylindrical structure, approximately 84' long and 18' in diameter. While the First Stage Solid Rocket Booster (SRB) design has changed since the CLV inception, the Upper Stage Element design has remained essentially a clean-sheet design approach. A clean-sheet upper stage design does offer many advantages: a design for increased reliability; built-in evolvability to allow for commonality/growth without major redesign; incorporation of state-of-the-art materials and hardware; and incorporation of design, fabrication, and test techniques and processes to facilitate a more operable system.

  5. 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.

  6. A lymph node ratio of 10% is predictive of survival in stage III colon cancer: a French regional study.

    PubMed

    Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel; Panis, Xavier; Foncelle, Pierre Henri; de Fresnoy, Hugues; Leroux, Fabien; Vaneslander, Pierre; Ghighi, Caroline; Regimbeau, Jean-Marc

    2014-01-01

    Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between "good prognosis" and "poor prognosis" colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P=0.06) and a significant correlation between the LNR group and 3-year DFS (P=0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P=0.02) and DFS (P=0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff.

  7. A Lymph Node Ratio of 10% Is Predictive of Survival in Stage III Colon Cancer: A French Regional Study

    PubMed Central

    Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel; Panis, Xavier; Foncelle, Pierre Henri; de Fresnoy, Hugues; Leroux, Fabien; Vaneslander, Pierre; Ghighi, Caroline; Regimbeau, Jean-Marc

    2014-01-01

    Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between “good prognosis” and “poor prognosis” colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P = 0.06) and a significant correlation between the LNR group and 3-year DFS (P = 0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P = 0.02) and DFS (P = 0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff. PMID:25058763

  8. 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.

  9. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases.

    PubMed

    D'Elia, F; Zingarelli, A; Palli, D; Grani, M

    2000-01-01

    The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400-600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99% in early and advanced gastric cancer, respectively, with overall detection rate of 96% (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78%. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20% (3 of 15) and 87% (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3-pT4 vs pT1-pT2) was 93, 90, and 91.6%, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87%, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5% and specificity of 99 %. The sensitivity of peritoneal involvement was 30% when ascites or peritoneal nodules were absent. Our findings show that dynamic CTcan play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients.

  10. 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)

  11. Neuroblastoma: diagnostic imaging and staging

    SciTech Connect

    Stark, D.D.; Moss, A.A.; Brasch, R.C.; deLorimier, A.A.; Albin, A.R.; London, D.A.; Gooding, C.A.

    1983-07-01

    Results of computed tomography (CT), scintigraphy, excretory urography, and other imaging tests used to diagnose and stage 38 cases of neuroblastoma prior to treatment were reviewed. Findings of these examinations were correlated with clinical data, laboratory data, results of biopsy, and surgical findings. CT was the most sensitive single test (100%) for the detection and delineation of the primary tumor. Calcifications that suggested the histologic diagnosis of neuroblastoma were present in 79% of the cases. Rim calcifications, the most specific pattern for neuroblastoma, were identified in 29% of all cases. CT alone accurately staged 82% of cases; when complemented by bone marrow biopsy, staging accuracy was 97%. CT alone was more accurate than any combination of imaging tests that excluded CT. An algorithm using CT is presented for the diagnosis and staging of neuroblastoma at reduced cost and with increased efficiency.

  12. Five Developmental Stages of Spelling.

    ERIC Educational Resources Information Center

    Gentry, J. Richard

    1984-01-01

    Precommunicative, semiphonetic, phonetic, transitional, and correct spelling are the developmental stages in the acquisition of spelling competency. Samples of children's early spelling patterns are presented. A system for classifying early spelling strategy is outlined. (DF)

  13. 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.

  14. 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.

  15. Minuteman 3, stage 3 surveillance

    NASA Astrophysics Data System (ADS)

    Davis, R.; Porter, L. C., Jr.

    1986-01-01

    The program effort during this reporting period consisted of laboratory testing of both the Morton Thiokol, Inc./ASPC Minuteman 3 Third Stage Surveillance components and material samples. In addition, bondline aging testing and analysis using samples from previously dissected motors were accomplished. In support of the program, all flight and static tests, for both First and Third Stage Minuteman motors, were reviewed and tabulated for incorporation into reliability and motor historical records.

  16. 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.

  17. Antemortem Prediction of Braak Stage

    PubMed Central

    Carlson, Jesper O. E.; Gatz, Margaret; Pedersen, Nancy L.; Graff, Caroline; Nennesmo, Inger; Lindström, Anna-Karin; Gerritsen, Lotte

    2015-01-01

    We examined the extent to which tauopathy distribution, as determined by Braak staging, might be predicted by various risk factors in older individuals. The Swedish Twin Registry provided extensive information on neuropsychological function, lifestyle and cardiovascular risk factors of 128 patients for whom autopsy data including Braak staging were available. Logistic regression was used to develop a prognostic model that targeted discrimination between Braak stages 0-II vs. III-VI. The analysis showed that Braak stage III-VI was significantly predicted by having one or more APOE ε4 alleles, older age, high total cholesterol, absence of diabetes and cardiovascular disease, and poorer scores on the Wechsler Adult Intelligence Score Information test, verbal fluency, and recognition memory but better verbal recall. The algorithm predicted Braak stage III-VI well (receiver-operating characteristic area under curve: 0.897; 95% CI: 0.842-0.951). Using a cut-off of 50% risk or more, the sensitivity was 85%, the specificity was 70%, and the negative predictive value was 69%. This study demonstrates that tauopathy distribution can be accurately predicted using a combination of antemortem patient data. These results provide further insight into tauopathy development and AD-related disease mechanisms and suggest a prognostic model that predicts the spread of neurofibrillary tangles above the transentorhinal stage. PMID:26469248

  18. 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.

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

    PubMed Central

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

    2016-01-01

    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. PMID:25936599

  20. 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.

  1. FGFR4 Arg388 allele correlates with tumour thickness and FGFR4 protein expression with survival of melanoma patients.

    PubMed

    Streit, S; Mestel, D S; Schmidt, M; Ullrich, A; Berking, C

    2006-06-19

    A single nucleotide polymorphism in the gene for FGFR4 (-Arg388) has been associated with progression in various types of human cancer. Although fibroblast growth factors (FGFs) belong to the most important growth factors in melanoma, expression of FGF receptor subtype 4 has not been investigated yet. In this study, the protein expression of this receptor was analysed in 137 melanoma tissues of different progression stages by immunohistochemistry. FGFR4 protein was expressed in 45% of the specimens and correlated with pTNM tumour stages (UICC, P = 0.023 and AJCC, P = 0.046), presence of microulceration (P = 0.009), tumour vascularity (P = 0.001), metastases (P = 0.025), number of primary tumours (P = 0.022), overall survival (P = 0.047) and disease-free survival (P = 0.024). Furthermore, FGFR4 Arg388 polymorphism was analysed in 185 melanoma patients by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The Arg388 allele was detected in 45% of the melanoma patients and was significantly associated with tumour thickness (by Clark's level of invasion (P = 0.004) and by Breslow in mm (P = 0.02)) and the tumour subtype nodular melanoma (P = 0.002). However, there was no correlation of the FGFR4 Arg388 allele with overall and disease-free survival. In conclusion, the Arg388 genotype and the protein expression of FGFR4 may be potential markers for progression of melanoma.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. Mars Science Laboratory's Descent Stage

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This portion of NASA's Mars Science Laboratory, called the descent stage, does its main work during the final few minutes before touchdown on Mars.

    The descent stage will provide rocket-powered deceleration for a phase of the arrival at Mars after the phases using the heat shield and parachute. When it nears the surface, the descent stage will lower the rover on a bridle the rest of the way to the ground.

    The Mars Science Laboratory spacecraft is being assembled and tested for launch in 2011.

    This image was taken at NASA's Jet Propulsion Laboratory, Pasadena, Calif., which manages the Mars Science Laboratory Mission for NASA's Science Mission Directorate, Washington. JPL is a division of the California Institute of Technology.

  7. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... existing permit (for example, RAP), closure plan, or order be modified to allow me to use a staging pile? (1) To modify a permit, other than a RAP, to incorporate a staging pile or staging pile operating... under § 270.42 of this chapter. (2) To modify a RAP to incorporate a staging pile or staging...

  8. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... existing permit (for example, RAP), closure plan, or order be modified to allow me to use a staging pile? (1) To modify a permit, other than a RAP, to incorporate a staging pile or staging pile operating... under § 270.42 of this chapter. (2) To modify a RAP to incorporate a staging pile or staging...

  9. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... existing permit (for example, RAP), closure plan, or order be modified to allow me to use a staging pile? (1) To modify a permit, other than a RAP, to incorporate a staging pile or staging pile operating... under § 270.42 of this chapter. (2) To modify a RAP to incorporate a staging pile or staging...

  10. 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.

  11. Screening for Breast Cancer: Staging and Treatment

    MedlinePlus

    ... page please turn JavaScript on. Feature: Screening For Breast Cancer Staging and Treatment Past Issues / Summer 2014 Table of Contents Staging The extent (stage) of breast cancer needs to be determined to help choose the ...

  12. 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,…

  13. 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.

  14. 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…

  15. Stages of neuronal network formation

    NASA Astrophysics Data System (ADS)

    Woiterski, Lydia; Claudepierre, Thomas; Luxenhofer, Robert; Jordan, Rainer; Käs, Josef A.

    2013-02-01

    Graph theoretical approaches have become a powerful tool for investigating the architecture and dynamics of complex networks. The topology of network graphs revealed small-world properties for very different real systems among these neuronal networks. In this study, we observed the early development of mouse retinal ganglion cell (RGC) networks in vitro using time-lapse video microscopy. By means of a time-resolved graph theoretical analysis of the connectivity, shortest path length and the edge length, we were able to discover the different stages during the network formation. Starting from single cells, at the first stage neurons connected to each other ending up in a network with maximum complexity. In the further course, we observed a simplification of the network which manifested in a change of relevant network parameters such as the minimization of the path length. Moreover, we found that RGC networks self-organized as small-world networks at both stages; however, the optimization occurred only in the second stage.

  16. The Early Stages of Interlanguage.

    ERIC Educational Resources Information Center

    Schumann, John

    The stages of interlanguage, the speech of beginning second language learners as they progress toward second language fluency, are described. Examples are drawn from the speech of Spanish speaking students of English as a second language. The continuum of interlanguage development from native language forms to target language forms includes three…

  17. 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.

  18. Operation of staged membrane oxidation reactor systems

    SciTech Connect

    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.

  19. Growth stage estimation. [crop calendars

    NASA Technical Reports Server (NTRS)

    Whitehead, V. S.; Phinney, D. E.; Crea, W. E. (Principal Investigator)

    1979-01-01

    Of the three candidate approaches to adjustment of the crop calendar to account for year-to-year weather differences, the Robertson triquadratic unit, a function of a nonlinear function of maximum and minimum temperature and day length, best described the rate of phenological development of wheat. The adjustable crop calendar (ACC) as implemented for LACIE is used to calculate the daily increment of development through six physiological stages of growth. Topics covered include dormancy modeling, the spring restart model, spring wheat starter model, winter starter model, winter wheat starter model, inclusion of the moisture variable, and display of crop stage estimation results. Assessment of the ACC accuracy over the period of LACIE operation indicates that the adjustable crop calendars used provided more accurate information than would have been available using historical norms. The models performed best under the conditions from which they were derived (Canadian spring wheat) and most poorly for the dwarf varieties and Southern Hemisphere applications.

  20. Sleep stages, memory and learning.

    PubMed

    Dotto, L

    1996-04-15

    Learning and memory can be impaired by sleep loss during specific vulnerable "windows" for several days after new tasks have been learned. Different types of tasks are differentially vulnerable to the loss of different stages of sleep. Memory required to perform cognitive procedural tasks is affected by the loss of rapid-eye-movement (REM) sleep on the first night after learning occurs and again on the third night after learning. REM-sleep deprivation on the second night after learning does not produce memory deficits. Declarative memory, which is used for the recall of specific facts, is not similarly affected by REM-sleep loss. The learning of procedural motor tasks, including those required in many sports, is impaired by the loss of stage 2 sleep, which occurs primarily in the early hours of the morning. These findings have implications for the academic and athletic performance of students and for anyone whose work involves ongoing learning and demands high standards of performance.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Stages of motor skill learning.

    PubMed

    Luft, Andreas R; Buitrago, Manuel M

    2005-12-01

    Successful learning of a motor skill requires repetitive training. Once the skill is mastered, it can be remembered for a long period of time. The durable memory makes motor skill learning an interesting paradigm for the study of learning and memory mechanisms. To gain better understanding, one scientific approach is to dissect the process into stages and to study these as well as their interactions. This article covers the growing evidence that motor skill learning advances through stages, in which different storage mechanisms predominate. The acquisition phase is characterized by fast (within session) and slow learning (between sessions). For a short period following the initial training sessions, the skill is labile to interference by other skills and by protein synthesis inhibition, indicating that consolidation processes occur during rest periods between training sessions. During training as well as rest periods, activation in different brain regions changes dynamically. Evidence for stages in motor skill learning is provided by experiments using behavioral, electrophysiological, functional imaging, and cellular/molecular methods.

  6. 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…

  7. 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.

  8. 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.

  9. 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

  10. Pretreatment lymphocyte to monocyte ratio as a predictor of prognosis in patients with early-stage triple-negative breast cancer.

    PubMed

    He, Juanjuan; Lv, Pengwei; Yang, Xue; Chen, Yanli; Liu, Chao; Qiu, Xinguang

    2016-07-01

    Recent studies have shown that the lymphocyte to monocyte ratio (LMR) is a useful prognostic factor in various cancers. The purpose of the current study was to investigate the association between pretreatment LMR, disease-free survival (DFS), and overall survival (OS) in patients with early-stage (I to III) triple-negative breast cancer (TNBC). Pretreatment LMR with corresponding clinical features from 230 TNBC patients was noted. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimal cutoff values for LMR, lymphocyte, and monocyte counts. The difference between variables was calculated using chi-square tests. The Kaplan-Meier method and univariate and multivariate Cox regression models were applied to assess OS and DFS. Based on the ROC analysis, the optimal cutoff point for LMR was 4.7. Associations between high LMR (≥4.7) and significantly small tumor size (P = 0.005) and TNM stage (P = 0.013) were found, although there was no significant association for other clinical pathological factors. In the multivariate analysis, LMR was a significant predictive factor for both OS (hazard ratio [HR] = 0.42; 95 % confidence interval [CI], 0.19-0.95; P < 0.001) and DFS (HR = 0.40; 95 % CI, 0.20-0.79; P < 0.001). In addition, the predictive values of the OS and DFS were also observed for absolute counts of lymphocytes (P < 0.001) and monocytes (P < 0.001). Our study suggests that pretreatment LMR may be a predictive factor for long-term survival in patients with early-stage TNBC.

  11. Two stage coal gasification plant

    SciTech Connect

    Shoebotham, N.M.

    1984-06-26

    This invention relates to a two stage coal gasification plant which comprises a gasifier 1 and a predistillation retort 2. The gasifier has a plurality of gas extraction outlets 4 located in the periphery thereof which feed into a manifold 5 from where a percentage of the gas from the gasifier is extracted. Gas from the predistillation retort is extracted through an outlet near the top of the retort. An agitator 8 is provided for agitation of the coal in the agglomeration zone. The agitator is preferably automatically controlled by means of a temperature sensing device 10 located on an arm thereof.

  12. 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.

  13. Elizabethan madness: on London's stage.

    PubMed

    Dalby, J T

    1997-12-01

    During the reign of Elizabeth I (1558-1603) a renaissance of both literary and political history occurred. The stage was transformed from primitive echoes of the morality plays to a vibrant and diverse exploration of human endeavor and man's place in the universe. The titanic literary figure of Shakespeare today veils a group of friends and challengers whose pens strove for the same goal. The depiction of madness was ubiquitous during plays of this time and reflection on the views of this group of men gives us a more reliable insight into mental illness then and today.

  14. Composites for Exploration Upper Stage

    NASA Technical Reports Server (NTRS)

    Fikes, J. C.; Jackson, J. R.; Richardson, S. W.; Thomas, A. D.; Mann, T. O.; Miller, S. G.

    2016-01-01

    The Composites for Exploration Upper Stage (CEUS) was a 3-year, level III project within the Technology Demonstration Missions program of the NASA Space Technology Mission Directorate. Studies have shown that composites provide important programmatic enhancements, including reduced weight to increase capability and accelerated expansion of exploration and science mission objectives. The CEUS project was focused on technologies that best advanced innovation, infusion, and broad applications for the inclusion of composites on future large human-rated launch vehicles and spacecraft. The benefits included near- and far-term opportunities for infusion (NASA, industry/commercial, Department of Defense), demonstrated critical technologies and technically implementable evolvable innovations, and sustained Agency experience. The initial scope of the project was to advance technologies for large composite structures applicable to the Space Launch System (SLS) Exploration Upper Stage (EUS) by focusing on the affordability and technical performance of the EUS forward and aft skirts. The project was tasked to develop and demonstrate critical composite technologies with a focus on full-scale materials, design, manufacturing, and test using NASA in-house capabilities. This would have demonstrated a major advancement in confidence and matured the large-scale composite technology to a Technology Readiness Level 6. This project would, therefore, have bridged the gap for providing composite application to SLS upgrades, enabling future exploration missions.

  15. A 10-year follow-up of treatment outcomes in patients with early stage breast cancer and clinically negative axillary nodes treated with tangential breast irradiation following sentinel lymph node dissection or axillary clearance.

    PubMed

    Wernicke, A Gabriella; Goodman, Robert L; Turner, Bruce C; Komarnicky, Lydia T; Curran, Walter J; Christos, Paul J; Khan, Imraan; Vandris, Katherine; Parashar, Bhupesh; Nori, Dattatreyudu; Chao, K S Clifford

    2011-02-01

    We compare long-term outcomes in patients with node negative early stage breast cancer treated with breast radiotherapy (RT) without the axillary RT field after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). We hypothesize that though tangential RT was delivered to the breast tissue, it at least partially sterilized occult axillary nodal metastases thus providing low nodal failure rates. Between 1995 and 2001, 265 patients with AJCC stages I-II breast cancer were treated with lumpectomy and either SLND (cohort SLND) or SLND and ALND (cohort ALND). Median follow-up was 9.9 years (range 8.3-15.3 years). RT was administered to the whole breast to the median dose of 48.2 Gy (range 46.0-50.4 Gy) plus boost without axillary RT. Chi-square tests were employed in comparing outcomes of two groups for axillary and supraclavicular failure rates, ipsilateral in-breast tumor recurrence (IBTR), distant metastases (DM), and chronic complications. Progression-free survival (PFS) was compared using log-rank test. There were 136/265 (51%) and 129/265 (49%) patients in the SLND and ALND cohorts, respectively. The median number of axillary lymph nodes assessed was 2 (range 1-5) in cohort SLND and 18 (range 7-36) in cohort ALND (P < 0.0001). Incidence of AFR and SFR in both cohorts was 0%. The rates of IBTR and DM in both cohorts were not significantly different. Median PFS in the SLND cohort is 14.6 years and 10-year PFS is 88.2%. Median PFS in the ALND group is 15.0 years and 10-year PFS is 85.7%. At a 10-year follow-up chronic lymphedema occurred in 5/108 (4.6%) and 40/115 (34.8%) in cohorts SLND and ALND, respectively (P = 0.0001). This study provides mature evidence that patients with negative nodes, treated with tangential breast RT and SLND alone, experience low AFR or SFR. Our findings, while awaiting mature long-term data from NSABP B-32, support that in patients with negative axillary nodal status such treatment provides excellent

  16. Two stage indirect evaporative cooling system

    SciTech Connect

    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.

  17. 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).

  18. 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.

  19. 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.

  20. Staged treatment of lymphedema praecox

    PubMed Central

    Tilley, A. R.; Douglas, L. G.

    1974-01-01

    Lymphedema of the lower extremities poses a challenging problem in management. Gross deformities may be encountered in patients with filarial infestation. This degree of involvement is rare in native North Americans suffering from primary lymphedema. A case is presented of a patient with changes similar to those seen in filariasis, due to several episodes of acute lymphangitis over a period of years. The involved tissue was excised and the defects skin-grafted, employing a modified Charles procedure. The magnitude of the excision was such that it was carried out in three widely spaced stages. The result was satisfactory from a functional viewpoint, and also represented a marked cosmetic improvement. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4590797

  1. Treatment Options by Stage (Endometrial Cancer)

    MedlinePlus

    ... Stage II endometrial cancer. Cancer has spread into connective tissue of the cervix, but has not spread outside ... uterus. In stage II , cancer has spread into connective tissue of the cervix , but has not spread outside ...

  2. Survival by Stage of Soft Tissue Sarcoma

    MedlinePlus

    ... Detection, Diagnosis, and Staging Survival by Stage of Soft Tissue Sarcoma Survival rates are often used by ... Your Doctor About Soft Tissue Sarcomas? More In Soft Tissue Sarcoma About Soft Tissue Sarcoma Causes, Risk ...

  3. Revised FIGO staging system for endometrial cancer.

    PubMed

    Lewin, Sharyn N

    2011-06-01

    In 1988 the International Federation of Gynecologists and Obstetricians (FIGO) developed a surgical staging system for endometrial cancer. The FIGO staging system was recently revised in 2009 to reflect our growing understanding of the natural history of endometrial cancer. In this review, we describe the revised 2009 FIGO staging system for tumors of the uterine corpus and examine the effect of the new changes in the staging criteria.

  4. Two Stage Gear Tooth Dynamics Program

    DTIC Science & Technology

    1989-08-01

    cordi - tions and associated iteration prooedure become more complex. This is due to both the increased number of components and to the time for a...solved for each stage in the two stage solution . There are (3 + ntrrber of planets) degrees of freedom fcr eacb stage plus two degrees of freedom...should be devised. It should be noted that this is not minor task. In general, each stage plus an input or output shaft will have 2 times (4 + number

  5. Staging of primary malignancies of bone.

    PubMed

    Heck, Robert K; Peabody, Terrance D; Simon, Michael A

    2006-01-01

    Staging of bone sarcomas is the process whereby patients are evaluated with regard to histology, as well as the local and distant extent, of disease. Bone sarcomas are staged based on grade, size, and the presence and location of metastases. The system is designed to help stratify patients according to known risk factors. Proper staging helps define the prognosis for patients and helps guide their treatment. Furthermore, staging allows meaningful comparisons to be done among groups of patients.

  6. [Develpment of sleep stages in childhood].

    PubMed

    Geib, Lorena Teresinha Consalter

    2007-01-01

    With the perspective of describing some aspects of the ontogenesis and organization of the sleep stages during the first year of life, a literature review was carried out to assess the physiological and behavioral alterations controlled by changes occurring during sleep at this developmental stage. In addition, based on the sleep preceding theory the stages of differentiation, classification and time organization of sleep stages are presented, aiming at the favorable management of environmental events that affect the organization of infant sleep.

  7. Two-Stage Series-Resonant Inverter

    NASA Technical Reports Server (NTRS)

    Stuart, Thomas A.

    1994-01-01

    Two-stage inverter includes variable-frequency, voltage-regulating first stage and fixed-frequency second stage. Lightweight circuit provides regulated power and is invulnerable to output short circuits. Does not require large capacitor across ac bus, like parallel resonant designs. Particularly suitable for use in ac-power-distribution system of aircraft.

  8. 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

  9. 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

  10. Primary adenosquamous carcinoma of the esophagus: an analysis of 39 cases

    PubMed Central

    Ni, Peng-Zhi; Yang, Yu-Shang; Hu, Wei-Peng; Wang, Wen-Ping; Yuan, Yong

    2016-01-01

    Background Adenosquamous carcinoma (ASC) of the esophagus is an uncommon type of malignant esophageal neoplasm containing both squamous cell carcinoma (SCC) and adenocacinoma (AC) components. The aim of this study was to explore the clinical characteristics and prognosis of esophageal ASC. Methods A retrospective review of esophageal ASC patients who underwent transthoracic esophagectomy with lymphadenectomy in our hospital from July 2007 to April 2014. Results A total of 39 (1.0%) esophageal ASC patients among 3855 patients with esophageal cancers were collected to analyze. There were 34 men and 5 women with a median age of 61.0 years (range from 39–85). Median follow-up time was 30.0 months and median survival time was 44.4 months. The 1-, 3- and 5-year overall survival rates were 82.1%, 51.6% and 37.5%, respectively. Compared to esophageal SCC and AC, there were no significant difference in survive time (P=0.616). Thirty five (92.1%) of the 38 patients who underwent preoperative endoscopic biopsy were misdiagnosed, mostly as SCC. Fifteen patients (38.5%) were found to have lymph node metastasis. Thirty two patients (82.1%) had a poorly differentiated or undifferentiated tumor. According to the 2009 American Joint Committee on Cancer (AJCC) staging system for esophageal squamous cell carcinoma, 3 patients were at Stage I, 21 patients at Stage II and 15 patients at Stage III. In univariate analysis, pT stage, lymph node metastasis and pTNM Stage significantly influenced survive time. In multivariate analysis, however, only lymph node metastasis (P=0.003; 95% CI: 1.626–10.972) was found to be the independent prognostic factor. Conclusions Primary ASC of the esophagus is a rare disease with difficultly to be histologically confirmed by endoscopic biopsy. The prognosis of esophageal ASC was no worse than esophageal SCC and AC. Lymph node metastasis is the most influent prognostic factor. The TNM staging system of esophageal SCC is applicable for esophageal ASC

  11. 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

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

    ClinicalTrials.gov

    2017-02-17

    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

  13. 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.

  14. Two stage turbine for rockets

    NASA Technical Reports Server (NTRS)

    Veres, Joseph P.

    1993-01-01

    The aerodynamic design and rig test evaluation of a small counter-rotating turbine system is described. The advanced turbine airfoils were designed and tested by Pratt & Whitney. The technology represented by this turbine is being developed for a turbopump to be used in an advanced upper stage rocket engine. The advanced engine will use a hydrogen expander cycle and achieve high performance through efficient combustion of hydrogen/oxygen propellants, high combustion pressure, and high area ratio exhaust nozzle expansion. Engine performance goals require that the turbopump drive turbines achieve high efficiency at low gas flow rates. The low mass flow rates and high operating pressures result in very small airfoil heights and diameters. The high efficiency and small size requirements present a challenging turbine design problem. The shrouded axial turbine blades are 50 percent reaction with a maximum thickness to chord ratio near 1. At 6 deg from the tangential direction, the nozzle and blade exit flow angles are well below the traditional design minimum limits. The blade turning angle of 160 deg also exceeds the maximum limits used in traditional turbine designs.

  15. 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.

  16. 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.

  17. Saturn V S-IVB (Third) Stage

    NASA Technical Reports Server (NTRS)

    1967-01-01

    After the S-II (second) stage dropped away, the S-IVB (third) stage ignited and burned for about two minutes to place itself and the Apollo spacecraft into the desired Earth orbit. At the proper time during this Earth parking orbit, the S-IVB stage was re-ignited to speed the Apollo spacecraft to escape velocity, injecting it and the astronauts into a moon trajectory. Developed and manufactured by the Douglas Aircraft Company in Huntington, California, the S-IVB stage measures about 21.5 feet in diameter, about 58 feet in length and is powered by a single 200,000-pound-thrust J-2 engine with a re-start capability. The S-IVB stage was also used on the second stage of the Saturn IB launch vehicle. The fully-assembled S-IVB (third) stage for the AS-503 (Apollo 8 mission) launch vehicle is pictured in the Douglas' vertical checkout building.

  18. 14 CFR 91.859 - Modification to meet Stage 3 or Stage 4 noise levels.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 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....

  19. 14 CFR 91.859 - Modification to meet Stage 3 or Stage 4 noise levels.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 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....

  20. 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....

  1. 14 CFR 91.859 - Modification to meet Stage 3 or Stage 4 noise levels.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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....

  2. 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....

  3. 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.

  4. A Hypereosinophilic Syndrome with Cardiac Involvement from Thrombotic Stage to Fibrotic Stage

    PubMed Central

    Kim, Nam Kyun; Kim, Chang-Yeon; Kim, Jae Hee; Jang, Se Yong; Bae, Myung Hwan; Lee, Jang Hoon; Yang, Dong Heon; Park, Hun Sik; Cho, Yongkeun

    2015-01-01

    Cardiac involvement is a major cause of morbidity and mortality in hypereosinophilic syndrome (HES). It is classified into 3 stages by the degree of eosinophils-mediated heart injury; acute necrotic stage, thrombotic stage, and fibrotic stage. Nonetheless, definitive evidence that each patient passes sequentially through these stages is lacking. We present a case of 48-year-old male patient with dyspnea and peripheral edema who underwent valve replacement surgery due to severe mitral regurgitation. After the valve replacement, HES with cardiac involvement in the thrombotic stage was diagnosed. In the follow-up study, the patient progressed into fibrotic stage of HES. PMID:26140152

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. SERUM SOLUBLE B7x IS ELEVATED IN RENAL CELL CARCINOMA PATIENTS AND IS ASSOCIATED WITH ADVANCED STAGE

    PubMed Central

    Thompson, R. Houston; Zang, Xingxing; Lohse, Christine M.; Leibovich, Bradley C.; Slovin, Susan F.; Reuter, Victor E.; Cheville, John C.; Blute, Michael L.; Russo, Paul; Kwon, Eugene D.; Allison, James P.

    2008-01-01

    B7x is the newest member of the B7-CD28 family and is thought to dampen immune responses via negative costimulation. Tumor expression of B7x was recently described in renal cell carcinoma (RCC) and was associated with poor outcome. We developed an assay to detect serum soluble B7x (sB7x) and investigated 101 patients with clear cell RCC who underwent nephrectomy between 2003 and 2007. For controls, we obtained serum from 101 sex-matched blood donors within the same age range. Following an Enzyme-Linked Immunosorbent Assay for sB7x, detectable levels (>0.1ng/ml) of sB7x were observed in 53 RCC patients compared with 18 controls (pTNM stage I–IV RCC were 6.6, 10.3, 14.5, and 43.3ng/mL, respectively (p=0.012). In this first evaluation of sB7x in RCC, we demonstrate that RCC patients are more likely to have detectable sB7x compared with controls and higher sB7x levels correlate with advanced tumor stage. These early results merit further investigation of this serum marker for potential diagnostic and prognostic purposes. PMID:18676826

  11. Induction Charge Detector with Multiple Sensing Stages

    NASA Technical Reports Server (NTRS)

    Gamero-Castano, Manuel

    2008-01-01

    An induction charge detector with multiple sensing stages has been conceived for use in characterizing sprayed droplets, dust particles, large ionized molecules, and the like. Like related prior single-stage devices, each stage yields a measurement of the electric charge and the time of flight of the particle. In effect, an n-stage sensor yields n independent sets of such measurements from the same particle. The benefit of doing this is to increase the effective signal-to-noise ratio and thereby lower the charge-detection limit and the standard error of the charge measurement.

  12. Technology and staging effects on two-stage-to-orbit systems

    NASA Technical Reports Server (NTRS)

    Wilhite, Alan W.

    1991-01-01

    Horizontal takeoff and landing two-stage systems with an airbreathing first stage and rocket second stage are evaluated for staging Mach numbers that range from 5 to 14. All systems are evaluated with advanced technologies being developed in the NASP Program and sized to the same mission requirements. With these advanced technologies, the two-stage systems are heavier than the single stage. The weights of the two-stage systems are closely related to staging. Using a rocket on the first stage to accelerate from the turboramjet limit of Mach 6 to Mach 10 signiificantly decreases dry weight as compared to the Mach 6-staged system. The optimum dry weight staging Mach number for the scramjet two-stage system is Mach 12. At a 40 percent weight growth (current technology level), the scramjet two-stage systems are half the weight and less sensitive to weight changes than the single stage, but still require substantial technology development in the areas of inlets, nozzles, ramjet propulsion, active cooling, and high-temperature structures.

  13. 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

  14. Stages of Small-Group Development Revisited

    ERIC Educational Resources Information Center

    Tuckman, Bruce W.; Jensen, Mary Ann C.

    1977-01-01

    This review examines published research on small-group development done in the last ten years that would constitute an empirical test of Tuckman's hypothesis that groups go through the stages of "forming,""storming,""norming," and "performing." A fifth stage, "adjourning," was added to the…

  15. Second-Stage Music Teachers' Professional Identities

    ERIC Educational Resources Information Center

    Draves, Tami J.

    2013-01-01

    The purpose of this case study research was to explore the professional identities of second-stage music teachers, or those in years 4-10 of teaching, focusing primarily on how their identities were sustained or neglected. Participants were two second stage music educators teaching in middle school (grades 6-8) music classrooms and taught…

  16. 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…

  17. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... than two years, except when the Director grants an operating term extension under paragraph (i) of this section (entitled “May I receive an operating extension for a staging pile?”). You must measure the two... date when you first placed remediation waste into the staging pile for the life of the permit,...

  18. 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…

  19. Adolescent and Parent: Interaction between Developmental Stages.

    ERIC Educational Resources Information Center

    Smith, Barbara

    1976-01-01

    The focus of this newsletter is on the interaction between two major developmental stages: adolescence and middle age. Research and theories about each stage are presented separately, followed by a discussion of how the two occur within the family structure. This discussion may be useful to teachers, counselors, employers, or researchers working…

  20. Developmental Stages in the Conceptualization of Marriage

    ERIC Educational Resources Information Center

    Tamashiro, Roy T.

    1978-01-01

    "Marriage" is treated as a mental concept that evolves in a developmental sequence of four qualitatively distinct stages: Magical, Idealized Conventional, Individualistic, and Affirmational. Each stage is illustrated with excerpts from Ingmar Bergman's Scenes From a Marriage. Some applications for marriage counselors are suggested. (Author)

  1. Stage IV work hardening in cubic metals

    SciTech Connect

    Rollett, A.D.; Kocks, U.F.; Doherty, R.D.

    1986-01-01

    The work hardening of fcc metals at large strains is discussed with reference to the linear stress-strain behavior often observed at large strains and known as Stage IV. The experimental evidence shows that Stage IV is a work hardening phenomenon that is found quite generally, even in pure fcc metals subjected to homogeneous deformation. A simple model for Stage IV in pure metals is presented, based on the accumulation of dislocation debris. Experiments are described for large strain torsion tests on four aluminum alloys. The level and extent of Stage IV scaled with the saturation stress that would represent the end of Stage III in the absence of a Stage IV. Reversing the torsion after large prestrains produced transient reductions in the work hardening. The strain rate sensitivity was also measured before and during the transient and found not to vary significantly. The microstructure observed at large strains in an Mg alloy suggest that Stage IV can occur in the absence of microband formation. Previous proposals for the cause of Stage IV are reviewed and found to be not supported by recent experimental data.

  2. 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.

  3. 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;…

  4. Stage Separation CFD Tool Development and Evaluation

    NASA Technical Reports Server (NTRS)

    Droege, Alan; Gomez, Reynaldo; Wang, Ten-See

    2002-01-01

    This viewgraph presentation evaluates CFD (Computational Fluid Dynamics) tools for solving stage separation problems. The demonstration and validation of the tools is for a second generation RLV (Reusable Launch Vehicle) stage separation. The flow solvers are: Cart3D; Overflow/Overflow-D; Unic.

  5. Protective immunity to liver-stage malaria

    PubMed Central

    Holz, Lauren E; Fernandez-Ruiz, Daniel; Heath, William R

    2016-01-01

    Despite decades of research and recent clinical trials, an efficacious long-lasting preventative vaccine for malaria remains elusive. This parasite infects mammals via mosquito bites, progressing through several stages including the relatively short asymptomatic liver stage followed by the more persistent cyclic blood stage, the latter of which is responsible for all disease symptoms. As the liver acts as a bottleneck to blood-stage infection, it represents a potential site for parasite and disease control. In this review, we discuss immunity to liver-stage malaria. It is hoped that the knowledge gained from animal models of malaria immunity will translate into a more powerful and effective vaccine to reduce this global health problem. PMID:27867517

  6. Protective immunity to liver-stage malaria.

    PubMed

    Holz, Lauren E; Fernandez-Ruiz, Daniel; Heath, William R

    2016-10-01

    Despite decades of research and recent clinical trials, an efficacious long-lasting preventative vaccine for malaria remains elusive. This parasite infects mammals via mosquito bites, progressing through several stages including the relatively short asymptomatic liver stage followed by the more persistent cyclic blood stage, the latter of which is responsible for all disease symptoms. As the liver acts as a bottleneck to blood-stage infection, it represents a potential site for parasite and disease control. In this review, we discuss immunity to liver-stage malaria. It is hoped that the knowledge gained from animal models of malaria immunity will translate into a more powerful and effective vaccine to reduce this global health problem.

  7. 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.

  8. 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.

  9. 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

  10. H2AK119Ub1 and H3K27Me3 in molecular staging for survival prediction of patients with pancreatic ductal adenocarcinoma

    PubMed Central

    Zhan, Qian; Zhu, Yi; Chen, Hao; Deng, Xiaxing; Hou, Zhaoyuan; Shen, Baiyong; Chen, Yanling; Peng, Chenghong

    2014-01-01

    Polycomb group (PcG) proteins Ring1B and EZH2, which have been characterized as catalyzing the two epigenetic modifications H2AK119 monoubiquitination (H2AK119Ub1) and H3K27 trimethylation (H3K27Me3), are well-known epigenetic silencers implicated in embryonic development and tumorigenesis. However, the status of polycomb-associated histone modifications and their clinical implications in pancreatic cancer remain unclear. Here, we performed immunohistochemistry on tissue microarrays (TMAs) containing 80 pairs of human pancreatic cancer specimens to assess the expression levels of Ring1B, H2AK119Ub1, EZH2, and H3K27Me3 in tumors. More than 50% of the tumor cells showed a high expression of H2AK119Ub1, Ring1B, and EZH2, whereas more than 50% of the tumor cells showed a low level of H3K27Me3. Different expression patterns of H2AK119Ub1 and H3K27Me3 in tumors were negatively correlated (r = −0.247, P = 0.027). Both H2AK119Ub1 and H3K27Me3 independently predicted the clinical prognosis. In particular, a combinatorial pattern of elevated H2AK119Ub1 and decreased H3K27Me3 in tumors was significantly correlated with a poorer prognosis. Furthermore, compared to the tumor, lymph node, metastasis (TNM) staging system, histone modifications can discriminate the survival difference more accurately, especially for patients with stage I or stage II tumors. Simultaneous silencing of Ring1B and EZH2 via shRNA depleted H2AK119Ub1 and H3K27Me3 in the pancreatic cancer cells PanC1 and AsPC1, enhanced HOX gene derepression, and inhibited tumor cell growth in vitro and in tumor xenograft models. These results demonstrated that H2AK119Ub1 and H3K27Me3 cooperate in tumors and are associated with the clinical prognosis in combinatorial patterns. We have proposed that epigenetic modifications may serve as discriminatory biomarkers for molecular staging of pancreatic cancer. PMID:25431952

  11. 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.

  12. Impact of gender and primary tumor location on outcome of patients with cutaneous melanoma.

    PubMed

    S, Voinea; A, Blidaru; E, Panaitescu; A, Sandru

    2016-01-01

    Background. The survival of patients with cutaneous malignant melanoma (MM) depends on multiple factors whose role is continuously updated, as the molecular mechanisms underlying the disease progression are understood. This study intended to assess whether the patient's gender and tumor location affect the disease outcome. Methods. Between 2008 and 2012, 155 patients with cutaneous MM underwent various types of surgeries in our clinic. Patients were staged according to the 2009 TNM classification. There were 90 women and 65 men. Primary tumors were located as it follows head and neck region - 4.5%, limbs - 50.7% and trunk - 44.8%. The disease free and overall survival rates (DFS, OS) were estimated by using the Kaplan-Meier method. Results. Metastases developed in 52.3% of the males and 31.1% of the females (p=0.008). In univariate analysis, distant metastasis risk was significantly higher in men (p = 0.0472 for stage II patients and p = 0.0288 for stage III). In multivariate analysis, male gender almost doubled the risk of relapse (p = 0.044) and death (p = 0.022). Consequently, DFS and OS were significantly higher among females. Primary tumor location seemed to influence the melanoma spreading ability. Half of the trunk MM developed metastases while only a third of limbs MM did. The association between MM location and the recurrence risk was not random (p = 0.033). Conclusions. The patient gender represents an independent prognostic factor for both relapse and death. Although trunk MM had a significantly higher risk of metastasis than limbs MM, the location per se was not an independent prognostic factor for survival (p = 0.078). Abbreviations: MM = malignant melanoma, DFS = disease free survival, OS = overall survival, p = p value, AJCC = American Joint Commission on Cancer, CI = confidence interval.

  13. 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.

  14. Age, stage and senescence in plants

    PubMed Central

    Caswell, Hal; Salguero-Gómez, Roberto

    2013-01-01

    1. Senescence (an increase in the mortality rate or force of mortality, or a decrease in fertility, with increasing age) is a widespread phenomenon. Theories about the evolution of senescence have long focused on the age trajectories of the selection gradients on mortality and fertility. In purely age-classified models, these selection gradients are non-increasing with age, implying that traits expressed early in life have a greater impact on fitness than traits expressed later in life. This pattern leads inevitably to the evolution of senescence if there are trade-offs between early and late performance. 2. It has long been suspected that the stage- or size-dependent demography typical of plants might change these conclusions. In this paper, we develop a model that includes both stage- and age-dependence and derive the age-dependent, stage-dependent and age×stage-dependent selection gradients on mortality and fertility. 3. We applied this model to stage-classified population projection matrices for 36 species of plants, from a wide variety of growth forms (from mosses to trees) and habitats. 4. We found that the age-specific selection gradients within a life cycle stage can exhibit increases with age (we call these contra-senescent selection gradients). In later stages, often large size classes in plant demography, the duration of these contra-senescent gradients can exceed the life expectancy by several fold. 5. Synthesis. The interaction of age- and stage-dependence in plants leads to selection pressures on senescence fundamentally different from those found in previous, age-classified theories. This result may explain the observation that large plants seem less subject to senescence than most kinds of animals. The methods presented here can lead to improved analysis of both age-dependent and stage-dependent demographic properties of plant populations. PMID:23741075

  15. Assessment of Stage 35 With APNASA

    NASA Technical Reports Server (NTRS)

    Celestina, Mark L.; Mulac, Richard

    2009-01-01

    An assessment of APNASA was conducted at NASA Glenn Research Center under the Fundamental Aeronautics Program to determine their predictive capabilities. The geometry selected for this study was Stage 35 which is a single stage transonic compressor. A speedline at 100% speed was generated and compared to experimental data at 100% speed for two turbulence models. Performance of the stage at 100% speed and profiles of several key aerodynamic parameters are compared to the survey data downstream of the stator in this report. In addition, hub leakage was modeled and compared to solutions without leakage and the available experimental data.

  16. 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.

  17. 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.

  18. Aurora-A signaling is activated in advanced stage of squamous cell carcinoma of head and neck cancer and requires osteopontin to stimulate invasive behavior

    PubMed Central

    Su, Li-Jen; Chuang, Hui-Ching; Shiu, Li-Yen; Huang, Chao-Cheng; Fang, Fu-Min; Yu, Chun-Chieh; Su, Huei-Ting; Chen, Chang-Han

    2014-01-01

    The clinical significances, cellular effects, and molecular mechanisms by which Aurora-A mediate its invasive effects in HNSCC are still unclear. Here, we found that Aurora-A expression is significantly higher in tumor tissues on 14-microarray of HNSCC in Oncomine-databases. The activity of Aurora-A was not only found in HNSCC specimens, but also significantly correlated with advanced-T-classification, positive-N-classification, TNM-stage and the poor 5-year survival rate. HNSCC-microarray profile showed that osteopontin and Aurora-A exhibited positive correlation. Stimulation of HNC cells with osteopontin results in an increase in Aurora-A expression where localized at the centrosome. Functionally, Aurora-A had the abilities to stimulate cell motility in HNC cells through increase ERK1/2 activity under osteopontin stimulation. Conversely, depletion of Aurora-A expression by siRNAs suppressed ERK1/2 activity as well as inhibition of cell invasiveness. Treatment with anti-CD44 antibodies in HNC cells not only caused a decrease of mRNA/protein of Aurora-A and ERK1/2 activity upon osteopontin stimulation, but also affected the abilities of Aurora-A-elicited cell motility. Finally, immunohistochemical/Western-blotting analysis of human aggressive HNSCC specimens showed a significant positively correlation between osteopontin-Aurora-A and ERK1/2. These findings suggest that Aurora-A is not only an important prognostic factor but also a new therapeutic target in the osteopontin/CD44/ERK pathway for HNSCC treatment. PMID:24810160

  19. 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…

  20. 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.

  1. 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.

  2. 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.

  3. Shielded multi-stage EMI noise filter

    SciTech Connect

    Kisner, Roger Allen; Fugate, David Lee

    2016-11-08

    Electromagnetic interference (EMI) noise filter embodiments and methods for filtering are provided herein. EMI noise filters include multiple signal exclusion enclosures. The multiple signal exclusion enclosures contain filter circuit stages. The signal exclusion enclosures can attenuate noise generated external to the enclosures and/or isolate noise currents generated by the corresponding filter circuits within the enclosures. In certain embodiments, an output of one filter circuit stage is connected to an input of the next filter circuit stage. The multiple signal exclusion enclosures can be chambers formed using conductive partitions to divide an outer signal exclusion enclosure. EMI noise filters can also include mechanisms to maintain the components of the filter circuit stages at a consistent temperature. For example, a metal base plate can distribute heat among filter components, and an insulating material can be positioned inside signal exclusion enclosures.

  4. Low-level waste feed staging plan

    SciTech Connect

    Certa, P.J.; Grams, W.H.; McConville, C.M.; L. W. Shelton, L.W.; Slaathaug, E.J., Westinghouse Hanford

    1996-08-12

    The `Preliminary Low-Level Waste Feed Staging Plan` was updated to reflect the latest requirement in the Tank Waste Remediation Privatization Request for Proposals (RFP) and amendments. The updated plan develops the sequence and transfer schedule for retrieval of DST supernate by the management and integration contractor and delivery of the staged supernate to the private low-activity waste contractors for treatment. Two DSTs are allocated as intermediate staging tanks. A transfer system conflict analysis provides part of the basis for determining transfer system upgrade requirements to support both low-activity and high-level waste feed delivery. The intermediate staging tank architecture and retrieval system equipment are provided as a planning basis until design requirements documents are prepared. The actions needed to successfully implement the plan are identified. These include resolution of safety issues and changes to the feed envelope limits, minimum order quantities, and desired batch sizes.

  5. Two stage surgical procedure for root coverage.

    PubMed

    George, Anjana Mary; Rajesh, K S; Hegde, Shashikanth; Kumar, Arun

    2012-07-01

    Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva.

  6. How Are Gastrointestinal Stromal Tumors Staged?

    MedlinePlus

    ... The cancer has spread to nearby lymph nodes. M categories for GIST M0: The cancer has not ... lungs). Stage grouping Once the T, N, and M categories have been determined, this information is combined, ...

  7. Treating Male Breast Cancer by Stage

    MedlinePlus

    ... Men Treating Breast Cancer in Men Treatment of Breast Cancer in Men, by Stage Because there have been ... Doctor About Breast Cancer in Men? More In Breast Cancer In Men About Breast Cancer in Men Causes, ...

  8. 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.

  9. 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.

  10. 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.

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

    ClinicalTrials.gov

    2017-01-18

    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

  12. Cardiac Rehabilitation Program in Improving Cardiorespiratory Fitness in Stage 0-III Breast Cancer Survivors

    ClinicalTrials.gov

    2017-01-30

    Cancer Survivor; Stage 0 Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  13. 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

  14. Behaviorism and the stages of scientific activity.

    PubMed

    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.

  15. Evaluation of stage acoustics in Seoul Arts Center Concert Hall by measuring stage support.

    PubMed

    Jeon, Jin Yong; Barron, Michael

    2005-01-01

    Stage acoustics is an important characteristic for concert halls, both for the acoustic quality on stage and for the audience. However, relatively little research has been conducted into the question. This study was based on the investigation of an actual concert hall stage, that of the Seoul Arts Center Concert Hall in Korea. The stage acoustics was evaluated in the actual hall, and with two models: a 1:25 scale model and a computer model. The study was based on the stage support parameter ST1 proposed by Gade as a measure of support for individual performers [Acustica 65, 193-203 (1989)]. The variation of support was measured on the empty stage of the actual hall and in the two models. The effect of musicians on stage, the effect of moving the orchestra, the effect of ceiling height and of stage-wall profile were also investigated. Conclusions are drawn both relating to the Seoul Concert Hall stage and stages in general.

  16. 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.

  17. ROR1 is a novel prognostic biomarker in patients with lung adenocarcinoma

    PubMed Central

    Zheng, Yu-Zhu; Ma, Rui; Zhou, Jian-Kang; Guo, Cheng-Lin; Wang, Yong-Sheng; Li, Zheng-Guang; Liu, Lun-Xu; Peng, Yong

    2016-01-01

    Currently, there is no reliable biomarker to clinically predict the prognosis of lung adenocarcinoma (ADC). The receptor-tyrosine-kinase like orphan receptor 1 (ROR1) is reported to be overexpressed and associated with poor prognosis in several tumors. This study aimed to examine the expression of ROR1 and evaluate its prognostic significance in human lung ADC patients. In this present study, Western blot analysis and immunohistochemistry were performed to characterize expression of ROR1 protein in lung ADC patients. The results revealed that ROR1 protein expression was significantly higher in lung ADC tissues than that in their adjacent non-tumor tissues. Patients at advanced stages and those with positive lymph node metastasis expressed higher level of ROR1 (P < 0.001). Moreover, Chi-square test showed that ROR1 expression was correlated to gender (P = 0.028), the 7th edition of the American Joint Committee on Cancer tumor-node-metastasis (AJCC TNM) staging system and lymph node metastasis (P < 0.001). Kaplan-Meier survival analysis indicated an association of high ROR1 expression with worse overall survival (OS) in lung ADC patients (P < 0.001). Multivariate COX regression analysis further confirmed that ROR1 is an independent prognostic predictor (P < 0.001, HR = 4.114, 95% CI: 2.513–6.375) for OS. Therefore, ROR1 expression significantly correlates with malignant attributes of lung ADC and it may serve as a novel prognostic marker in lung ADC patients. PMID:27830754

  18. 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.

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

    SciTech Connect

    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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. Advanced staged combustion system for power generation

    SciTech Connect

    Rehmat, A.; Goyal, A.

    1993-12-31

    To respond to the increasing market need for a new generation of plants with a substantial improvement in efficiency and a reduction in capital cost, the Institute of Gas Technology has developed an advanced staged, fluidized-bed combustion system concept. The staged fluidized-bed partial combustor produces the fuel gas at about 1500 F. The fuel gas, after particulate removal, is directed to a gas turbine followed by a steam cycle. Adequate sulfur capture and solids waste stabilization are attained by separating calcination, carbonization, and gasification/combustion steps in the staged fluidized beds. Intermediate gas cooling is avoided during the process to maximize the power production. The coal-to-electricity conversion efficiency of the system approaches 49 percent, which exceeds the efficiencies of the other emerging technologies.

  5. STAGING OF FUEL CELLS - PHASE II

    SciTech Connect

    Per Onnerud; Suresh Sriramulu

    2002-08-29

    TIAX has executed a laboratory-based development program aiming at the improvement of stationary fuel cell systems. The two-year long development program resulted in an improved understanding of staged fuel cells and inorganic proton conductors through evaluation of results from a number of laboratory tasks: (1) Development of a fuel cell modeling tool--Multi-scale model was developed, capable of analyzing the effects of materials and operating conditions; and this model allowed studying various ''what-if'' conditions for hypothetically staged fuel cells; (2) Study of new high temperature proton conductor--TIAX discovery of a new class of sulfonated inorganics capable of conducting protons when exposed to water; and study involved synthesis and conductivity measurements of novel compounds up to 140 C; (3) Electrochemical fuel cell measurements--the feasibility of staged fuel cells was tested in TIAX's fuel cell laboratories experimental design was based on results from modeling.

  6. 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.

  7. Neural networks predict tomato maturity stage

    NASA Astrophysics Data System (ADS)

    Hahn, Federico

    1999-03-01

    Almost 40% of the total horticultural produce exported from Mexico the USA is tomato, and quality is fundamental for maintaining the market. Many fruits packed at the green-mature stage do not mature towards a red color as they were harvested before achieving its physiological maturity. Tomato gassed for advancing maturation does not respond on those fruits, and repacking is necessary at terminal markets, causing losses to the producer. Tomato spectral signatures are different on each maturity stage and tomato size was poorly correlated against peak wavelengths. A back-propagation neural network was used to predict tomato maturity using reflectance ratios as inputs. Higher success rates were achieved on tomato maturity stage recognition with neural networks than with discriminant analysis.

  8. 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.

  9. 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.

  10. The three stages of magma ocean cooling

    NASA Technical Reports Server (NTRS)

    Warren, Paul H.

    1992-01-01

    Models of magma ocean (MO) cooling and crystallization can provide important constraints on MO plausibility for a given planet, on the origin of long term, stable crusts, and even on the origin of the solar system. Assuming the MO is initially extensive enough to have a mostly molten surface, its first stage of cooling is an era of radiative heat loss from the surface, with extremely rapid convection below, and no conductive layer in between. The development of the chill crust starts the second stage of MO cooling. Heat loss is now limited by conduction through the crust. The third stage of cooling starts when the near surface MO evolves compositionally to the point of saturation with feldspar. At this point, the cooling rate again precipitously diminishes, the rate of crustal thickness growth as a function of temperature suddenly increases. More work on incorporating chemical constraints into the evolving physical models of MO solidification would be worthwhile.

  11. 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.

  12. Prediction of stage transitions in fruit and vegetable intake.

    PubMed

    Wiedemann, Amelie U; Lippke, Sonia; Reuter, Tabea; Schüz, Benjamin; Ziegelmann, Jochen P; Schwarzer, Ralf

    2009-08-01

    Stage theories propose that individuals pass through different stages on their way toward behavior change. The present study examines stage-specific prediction patterns of social-cognitive variables (risk perception, outcome expectancies, perceived self-efficacy, action planning and social support) regarding transitions between the three stages of the Health Action Process Approach (HAPA; preintention, intention and action stage). In an online study (n = 494) on fruit and vegetable intake, social-cognitive variables and stages were assessed at baseline and stage transitions 4 weeks later. Transitions between the preintention, intention and action stage were predicted by social-cognitive variables using binary and multinomial logistic regression analyses. Stage-specific prediction patterns emerged for stage progression and stage regression. Outcome expectancies predicted progression from the preintention stage, whereas social support predicted progression to the action stage. Low levels of planning were associated with relapse to the preintention and the intention stage. Self-efficacy emerged as a universal predictor of stage transitions. Findings support not only the usefulness of the stage construct for describing health behavior change but also the validity of the HAPA variables as predictors of stage transitions. Stage-matched interventions targeting the variables identified as stage-specific predictors might support stage progression toward the goal behavior.

  13. The larval stages of the sea urchin, Strongylocentrotus purpuratus.

    PubMed

    Smith, M Meighan; Cruz Smith, Luisa; Cameron, R Andrew; Urry, Lisa A

    2008-06-01

    The adult body plan of Strongylocentrotus purpuratus is established within the imaginal rudiment during the larval stages. To facilitate the study of these stages, we have defined a larval staging scheme, which consists of seven stages: Stage I, four-arm stage; Stage II, eight-arm stage; Stage III, vestibular invagination stage; Stage IV, rudiment initiation stage; Stage V, pentagonal disc stage; Stage VI, advanced rudiment stage; and Stage VI, tube-foot protrusion stage. Each stage is characterized by significant morphological features observed for the first time at that stage. This scheme is intended as a guide for determining the degree of larval development, and for identifying larval and adult structures. Larval anatomy was visualized using light and confocal microscopy as required on living material, whole mount fixed specimens, and serial sections. Antibody staining to localize specific gene products was also used. Detailed analysis of these data has furthered our understanding of the morphogenesis of the rudiment, and has suggested provocative questions regarding the molecular basis for these events. We intend this work to be of use to investigators studying gene expression and morphogenesis in postembryonic larvae.

  14. 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.

  15. 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.

  16. Ares I First Stage: Powering Exploration

    NASA Technical Reports Server (NTRS)

    Tiller, Bruce K.; Priskos, Alex S.

    2008-01-01

    he 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 presentation provides an overview and update on the design and development of the Ares I First Stage Propulsion system.

  17. The thesis of stages fourteen years later

    NASA Astrophysics Data System (ADS)

    Beeby, C. E.

    1980-12-01

    The author indicates the changes and additions he would make to his book ` The Quality of Education in Developing Countries' (1966) if he were re-writing it in 1980. He would make clearer that his primary interest is in a continuum of change, the process of growth of a school system, and that the `stages' are only a convenient non-mathematical artifact to make the thesis more useful to administrators and planners. In the light of more recent developments and experiences, he now gives new stress to the pluralism of objectives at the stage of Meaning, and discusses the political, social, cultural and financial reasons why a country may choose not to take the difficult step from stage III to stage IV. Recent forms of alternative education, particularly those embodying plans for lifelong education, offer some hope of bypassing his thesis of stages. More consideration is given to constraints other than that of teacher qualification, though the difficulty of changing the skills, habits, attitudes and purposes in the teaching profession remain the chief obstacle to qualitative growth. Particular attention is paid to `crash' programmes where processes that are, by their very nature, successive are compressed into simultaneous or almost simultaneous ones. Some implications of the thesis of stages for teacher training are briefly dealt with. Regarding the application of the thesis to secondary education, he maintains that a better model of growth would be one based on the capacity of secondary education to respond to the changing economic and social demands of the community. Finally, he suggests three methods of testing his hypotheses and pleads that more consideration be given to building up a body of educational, theory based on the experience of developing countries over the past three decades.

  18. All the World’s a Stage

    DTIC Science & Technology

    1994-01-01

    RELEASE ; DISTRIBUTION IS UNLIMITED 13. ABSTRACT (Maximum 200 words) Sic& fA,5e~ if 94-19142 94 6 22 08C 14. SUBJECT TERMS 1S. NUMBER OF PAGES ALL...ESSAY WRITING CONTEST ENTRY ALL THE WORLD’S A STAGE by Valeuie A. Elbow Accesion Fr Liutenant Colonel, USAF NTIS CRA&I- DTIC TAB U-announCed...8217•.•..:.;:.’’. ABSTRACT "TITLE: All The World’s A Stage AUTHOR: Valerie A. Elbow, Lieutenant Colonel, USAF The relationship between government officials and the

  19. Saturn V S-IC (First) Stage

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This cutaway illustration shows the Saturn V S-IC (first) stage with detailed callouts of the components. The S-IC Stage is 138 feet long and 33 feet in diameter, producing 7,500,000 pounds of thrust through five F-1 engines that are powered by liquid oxygen and kerosene. Four of the engines are mounted on an outer ring and gimbal for control purposes. The fifth engine is rigidly mounted in the center. When ignited, the roar produced by the five engines equals the sound of 8,000,000 hi-fi sets.

  20. 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.

  1. S-IB Stage Entering Point Barrow

    NASA Technical Reports Server (NTRS)

    1968-01-01

    The Saturn 1B first stage (S-IB) enters the NASA barge Point Barrow, in March 1968. The Marshall Space Flight Center (MSFC) utilized a number of water transportation craft to transport the Saturn stages to-and-from the manufacturing facilities and test sites, as well as delivery to the Kennedy Space Center for launch. Developed by the Marshall Space Flight Center and built by the Chrysler Corporation at Michoud Assembly Facility (MAF), the S-IB utilized the eight H-1 engines and each produced 200,000 pounds of thrust, a combined thrust of 1,600,000 pounds.

  2. Reliability and reproducibility of Kienbock's disease staging.

    PubMed

    Goeminne, S; Degreef, I; De Smet, L

    2010-09-01

    We evaluated the interobserver reliability and intraobserver reproducibility of the Lichtman et al. classification for Kienböck's disease by getting four observers with different experience to look at 70 sets of wrist radiographs at different points in time. These observers staged each set of radiographs. Paired comparisons of the observations identified an agreement in 63% of cases and a mean weighted kappa coefficient of 0.64 confirming interobserver reliability. The stage of the involved lunate was reproduced in 78% of the observations with a mean weighted kappa coefficient of 0.81 showing intraobserver reproducibility. This classification for Kienböck's disease has good reliability and reproducibility.

  3. 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.

  4. Saturn V S-IC (First) Stage

    NASA Technical Reports Server (NTRS)

    1967-01-01

    This illustration shows a cutaway drawing with callouts of the major components for the S-IC (first) stage of the Saturn V launch vehicle. The S-IC stage is 138 feet long and 33 feet in diameter, producing more than 7,500,000 pounds of thrust through five F-1 engines powered by liquid oxygen and kerosene. Four of the engines are mounted on an outer ring and gimball for control purposes. The fifth engine is rigidly mounted in the center. When ignited, the roar produced by the five engines equals the sound of 8,000,000 hi-fi sets.

  5. Saturn V S-IC (First) Stage

    NASA Technical Reports Server (NTRS)

    1968-01-01

    This is a cutaway view of the Saturn V first stage, known as the S-IC, detailing the five F-1 engines and fuel cells. The S-IC stage is 138 feet long and 33 feet in diameter, producing more than 7,500,000 pounds of thrust through the five F-1 engines that are powered by liquid oxygen and kerosene. Four of the engines are mounted on an outer ring and gimbal for control purposes. The fifth engine is rigidly mounted in the center. When ignited, the roar produced by the five engines equals the sound of 8,000,000 hi-fi sets.

  6. 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.

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

    ClinicalTrials.gov

    2017-04-12

    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

  8. 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.

  9. Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis.

    PubMed

    Jamshidy, Ladan; Mozaffari, Hamid Reza; Faraji, Payam; Sharifi, Roohollah

    2016-01-01

    Introduction. One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods. A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results. The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion. The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique.

  10. 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.

  11. How orchestra members influence stage acoustic parameters on five different concert hall stages and orchestra pits.

    PubMed

    Wenmaekers, R H C; Hak, C C J M; Hornikx, M C J

    2016-12-01

    Stage acoustic parameters aim to quantify the amount of sound energy reflected by the stage and hall boundaries and the energy decay over time. In this research, the effect of orchestra presence on parameter values is investigated. The orchestra is simulated by dressed mannequins, which have been compared with humans with respect to acoustic properties. Impulse response measurements were performed in a concert hall, a theatre, a rehearsal room, and in two orchestra pits. Conditions were empty stage floors, stage floors with music stands and chairs only, and floors occupied by the mannequin orchestra. Results show that the direct and reflected sound levels and the energy decay are significantly affected by the orchestra compared to an empty stage or a stage with chairs and stands only. Both the direct sound and early reflected sound levels are reduced by the orchestra with the distance. The late reflected sound level is reduced considerably more than can be expected based on Barron's revised theory. It can be concluded that measurements on a stage without the orchestra being present results in significant differences. A practical method is presented to perform a "musician friendly" stage acoustic measurement with a real orchestra.

  12. Exit Stage Left (And Right): Getting Your Chorus on and off the Stage

    ERIC Educational Resources Information Center

    Van Hoven, Scott

    2004-01-01

    A key element of a well-received performance is the efficient flow of performers on and off the stage. This important detail is often neglected until the last minute, with results that are, to say the least, unpredictable. While moving a large number of students on and off the stage will always take time, slow movement and ragged appearance while…

  13. Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis

    PubMed Central

    Jamshidy, Ladan; Faraji, Payam; Sharifi, Roohollah

    2016-01-01

    Introduction. One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods. A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results. The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion. The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique. PMID:28003824

  14. An actuarial approach to comparing early stage and late stage lung cancer mortality and survival.

    PubMed

    Goldberg, Sara W; Mulshine, James L; Hagstrom, Dale; Pyenson, Bruce S

    2010-02-01

    Comparing the mortality characteristics of different cohorts is an essential process in the life insurance industry. Pseudodisease, lead-time bias, and length bias, which are critical to determining the value of cancer screening, have close analogues in life insurance company management, including the temporal impact of underwriting. Ratios of all-cause mortality rates for cancer cohorts relative to standard population mortality rates can provide insights into early stage and late stage mortality differences, differences by age, sex, race, and histology, and allow modeling of biases associated with early stage detection or screening protocols. The Surveillance, Epidemiology and End Results (SEER) data set has characteristics that allow efficient application of actuarial techniques. We show the mortality burden associated with treated early stage lung cancer and that identifying all lung cancers at early stage could reduce US lung cancer deaths by over 70,000 per year.

  15. 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.

  16. 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.

  17. Capacitor blocks for linear transformer driver stages.

    PubMed

    Kovalchuk, B M; Kharlov, A V; Kumpyak, E V; Smorudov, G V; Zherlitsyn, A A

    2014-01-01

    In the Linear Transformer Driver (LTD) technology, the low inductance energy storage components and switches are directly incorporated into the individual cavities (named stages) to generate a fast output voltage pulse, which is added along a vacuum coaxial line like in an inductive voltage adder. LTD stages with air insulation were recently developed, where air is used both as insulation in a primary side of the stages and as working gas in the LTD spark gap switches. A custom designed unit, referred to as a capacitor block, was developed for use as a main structural element of the transformer stages. The capacitor block incorporates two capacitors GA 35426 (40 nF, 100 kV) and multichannel multigap gas switch. Several modifications of the capacitor blocks were developed and tested on the life time and self breakdown probability. Blocks were tested both as separate units and in an assembly of capacitive module, consisting of five capacitor blocks. This paper presents detailed design of capacitor blocks, description of operation regimes, numerical simulation of electric field in the switches, and test results.

  18. 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…

  19. 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...

  20. Staged description of the Finkelstein test.

    PubMed

    Dawson, Courtney; Mudgal, Chaitanya S

    2010-09-01

    We have revisited the original description of the Finkelstein test and review the reasons for its subsequent erroneous description. We have also outlined a staged description of this test, which we have found to be reliable and minimally painful for the diagnosis of de Quervain's tendonitis within our clinical practice.

  1. Hodgkin's lymphoma--patient's assessment and staging.

    PubMed

    Gospodarowicz, Mary K

    2009-01-01

    Hodgkin's lymphoma is one of the most curable malignancies today. But treatment is associated with significant toxicity. The objective of high-quality management is to minimize treatment exposure while maximizing cure of disease. Principles of cancer staging and patient's assessment taxonomy are important to improve communication. An orderly patient evaluation and systematic recording of disease extent using the Ann Arbor classification forms the basis for treatment decision, response assessment, and clinical trials. The practice of staging in Hodgkin's lymphoma evolved over the past 40 years from clinical examination and plain imaging to modern anatomic and functional imaging. Although useful in the past, staging laparotomy, lymphangiograms, and Gallium scintigraphy have now been abandoned. Computerized tomography combined with 2-[18F]fluoro-2-deoxyglucose-positron emission tomography form the basis for anatomic disease extent assessment. Although patients' evaluation and staging at diagnosis are important, the management of Hodgkin's lymphoma involves a complex series of algorithms requiring interim and overall response assessment, careful follow-up, repeat assessment, and salvage management of recurrent disease.

  2. 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…

  3. 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,…

  4. Liquid biopsy in early stage lung cancer

    PubMed Central

    Pérez-Ramírez, Cristina; Robles, Ana I.; Molina, Miguel Ángel; Faus-Dáder, María José; Calleja-Hernández, Miguel Ángel

    2016-01-01

    Lung cancer is the leading cause of cancer-associated deaths worldwide. Surgery is the standard treatment for early-stage non-small cell lung cancer (NSCLC). However, 30% to 80% of these patients will die within 5 yearS of diagnosis. Circulating cell-free DNA (cfDNA) harbors pathologic characteristics of the original tumor, such as gene mutations or epigenetic alterations. Analysis of cfDNA has revolutionized the clinical care of advanced lung cancer patients undergoing targeted therapies. However, the low concentration of cfDNA in the blood of early-stage NSCLC patients has hampered its use for management of early disease. Continuing development of more specific and sensitive techniques for detection and analysis of cfDNA will soon enable its leverage in early stage and, perhaps, even screening settings. Therefore, cfDNA analysis may become a tool used for routine NSCLC diagnosis and for monitoring tumor burden, as well as for identifying hidden residual disease. In this review, we will focus on the current evidence of cfDNA in patients with early-stage NSCLC, new and upcoming approaches to identify circulating-tumor biomarkers, their clinical applications and future directions. PMID:27826533

  5. 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.

  6. 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.

  7. Staged Turbojet Engine Would Emit Less NO

    NASA Technical Reports Server (NTRS)

    Craig, R. A.; Pritchard, H. O.

    1982-01-01

    New turbojet-engine concept could reduce nitric oxide emissions to a level from one-fifteenth to as little as one three-hundredth that of conventional units. Multiple-stage combustor could overcome flame instability problems associated with previous low-flame-temperature systems. It operates in a relatively-simple adiabatic mode without elaborate fuel-flow and air circulation patterns.,

  8. Educational Gymnastics--Stages of Content Development.

    ERIC Educational Resources Information Center

    Nilges, Lynda M.

    1997-01-01

    Educational gymnastics uses a problem-solving approach to accommodate multiple correct solutions to open-ended movement problems in gymnastics. A four-stage framework is outlined to help teachers systematically increase and decrease task difficulty in educational gymnastics. Answers to common questions about educational gymnastics are provided.…

  9. Staged tendon grafts and soft tissue coverage.

    PubMed

    Elliot, David

    2011-05-01

    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.

  10. 40 CFR 264.554 - Staging piles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operations as long as they are intended to prepare the wastes for subsequent management or treatment. (2) (b... 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...

  11. Capacitor blocks for linear transformer driver stages

    NASA Astrophysics Data System (ADS)

    Kovalchuk, B. M.; Kharlov, A. V.; Kumpyak, E. V.; Smorudov, G. V.; Zherlitsyn, A. A.

    2014-01-01

    In the Linear Transformer Driver (LTD) technology, the low inductance energy storage components and switches are directly incorporated into the individual cavities (named stages) to generate a fast output voltage pulse, which is added along a vacuum coaxial line like in an inductive voltage adder. LTD stages with air insulation were recently developed, where air is used both as insulation in a primary side of the stages and as working gas in the LTD spark gap switches. A custom designed unit, referred to as a capacitor block, was developed for use as a main structural element of the transformer stages. The capacitor block incorporates two capacitors GA 35426 (40 nF, 100 kV) and multichannel multigap gas switch. Several modifications of the capacitor blocks were developed and tested on the life time and self breakdown probability. Blocks were tested both as separate units and in an assembly of capacitive module, consisting of five capacitor blocks. This paper presents detailed design of capacitor blocks, description of operation regimes, numerical simulation of electric field in the switches, and test results.

  12. Systemic Therapies for Late-stage Melanoma

    PubMed Central

    Hashim, Peter W.; Friedlander, Philip

    2016-01-01

    Late-stage melanoma is associated with high morbidity and mortality. Classic treatment methods relied on cytotoxic chemotherapy, which is limited by low response rates and significant adverse effects. Recent advances in immunogenetics have led to the advent of important new systemictreatments.Thisarticle reviews the latest therapy options for advanced melanoma. PMID:27847547

  13. Stepwise two-stage sample size adaptation.

    PubMed

    Wan, Hong; Ellenberg, Susan S; Anderson, Keaven M

    2015-01-15

    Several adaptive design methods have been proposed to reestimate sample size using the observed treatment effect after an initial stage of a clinical trial while preserving the overall type I error at the time of the final analysis. One unfortunate property of the algorithms used in some methods is that they can be inverted to reveal the exact treatment effect at the interim analysis. We propose using a step function with an inverted U-shape of observed treatment difference for sample size reestimation to lessen the information on treatment effect revealed. This will be referred to as stepwise two-stage sample size adaptation. This method applies calculation methods used for group sequential designs. We minimize expected sample size among a class of these designs and compare efficiency with the fully optimized two-stage design, optimal two-stage group sequential design, and designs based on promising conditional power. The trade-off between efficiency versus the improved blinding of the interim treatment effect will be discussed.

  14. 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…

  15. 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…

  16. MM2 LRSLA Testing Stage III Propellant.

    DTIC Science & Technology

    1983-04-01

    tested Grain 70 data. This is the oldest CYR third stage pro- pellant in the OOALC inventory having been cast in June 1960. Motor serial numbers, lot ... numbers , cast dates and plot symbols are shown below. Motor S/N Lot Number Cast Date Symbol Grain 70 SR-47-60 Jun 60 0 0031064 SR-56-62 21 Oct 62

  17. The staging system: Display and edit module

    NASA Technical Reports Server (NTRS)

    Edwards, E.; Bernier, L.

    1976-01-01

    The Display and Edit (D and E) Module described is one of six major modules being developed for the STAGING (STructural Analysis through Generalized INteractive Graphics) System. Several remarks are included concerning the computer environment and the architecture of the data base. The utility of this module is emphasized.

  18. Erikson Psychosocial Stage Inventory: A Factor Analysis

    ERIC Educational Resources Information Center

    Gray, Mary McPhail; And Others

    1986-01-01

    The 72-item Erikson Psychosocial Stage Inventory (EPSI) was factor analyzed for a group of 534 university freshmen and sophomore students. Seven factors emerged, which were labeled Initiative, Industry, Identity, Friendship, Dating, Goal Clarity, and Self-Confidence. Item's representing Erikson's factors, Trust and Autonomy, were dispersed across…

  19. Two-Stage Passive Vibration Isolator

    NASA Technical Reports Server (NTRS)

    Goullioud, Renaud; Gursel, Yekta; Neville, Timothy; Bronowicki, Allen J.; Platus, David; MacDonald, Rhonda

    2008-01-01

    The design and testing of a structural system were implemented to hold the optics of the planned Space Interferometry Mission (SIM) at positions and orientations characterized by vibrational translation and rotation errors of no more than a few nanometers or a few milliarcseconds, respectively. Much of the effort was devoted to a test bed for verifying the predicted behavior of a vibration- isolation structural subsystem working together with an active control system for positioning and orienting the SIM optics. There was considerable emphasis on the vibration-isolation subsystem, which was passive and comprised two stages. The main sources of vibration were six reaction wheels in an assembly denoted the "backpack." The first vibration-isolation stage consisted of hexapod isolator mounts - one for each reaction wheel - characterized by a natural vibration frequency of 10 Hz. The second stage was a set of three beams, disposed between the backpack and the structure that held the SIM optics, that were flexured such that they transmitted only bending loads, with a natural vibrational frequency and damping of about 5 Hz and 4 percent, respectively. Preliminary test results were presented and characterized as demonstrating the effectiveness of the two-stage vibration-isolation design.

  20. 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…

  1. Strategies in late stage cervix carcinoma

    SciTech Connect

    Krochak, R.

    1986-03-01

    Stage IIB-IV squamous cell carcinoma of the cervix when treated by irradiation has a significant failure rate. Causes of pelvic and distant failure are discussed. New techniques employed to improve local control and decrease distant metastasis are presented. Data on morbidity, mortality, and survival will be reviewed with respect to these new strategies employed.

  2. Clinical manifestations and stages of Rett syndrome.

    PubMed

    Hagberg, Bengt

    2002-01-01

    The presentation and clinical diagnosis of Rett syndrome at various ages and stages are reviewed. In addition to the classical form, variability in phenotype between different atypical Rett forms is given. Obligatory, supportive, and differential diagnostic criteria are summarized. Long-term follow-up findings in ageing Rett women are addressed.

  3. 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

  4. Dosimetric accuracy of a staged radiosurgery treatment

    NASA Astrophysics Data System (ADS)

    Cernica, George; de Boer, Steven F.; Diaz, Aidnag; Fenstermaker, Robert A.; Podgorsak, Matthew B.

    2005-05-01

    For large cerebral arteriovenous malformations (AVMs), the efficacy of radiosurgery is limited since the large doses necessary to produce obliteration may increase the risk of radiation necrosis to unacceptable levels. An alternative is to stage the radiosurgery procedure over multiple stages (usually two), effectively irradiating a smaller volume of the AVM nidus with a therapeutic dose during each session. The difference between coordinate systems defined by sequential stereotactic frame placements can be represented by a translation and a rotation. A unique transformation can be determined based on the coordinates of several fiducial markers fixed to the skull and imaged in each stereotactic coordinate system. Using this transformation matrix, isocentre coordinates from the first stage can be displayed in the coordinate system of subsequent stages allowing computation of a combined dose distribution covering the entire AVM. The accuracy of this approach was tested on an anthropomorphic head phantom and was verified dosimetrically. Subtle defects in the phantom were used as control points, and 2 mm diameter steel balls attached to the surface were used as fiducial markers and reference points. CT images (2 mm thick) were acquired. Using a transformation matrix developed with two frame placements, the predicted locations of control and reference points had an average error of 0.6 mm near the fiducial markers and 1.0 mm near the control points. Dose distributions in a staged treatment approach were accurately calculated using the transformation matrix. This approach is simple, fast and accurate. Errors were small and clinically acceptable for Gamma Knife radiosurgery. Accuracy can be improved by reducing the CT slice thickness.

  5. Tumor progression stage: specific losses of heterozygosity.

    PubMed

    Cavenee, W K

    1989-01-01

    The development of human cancer is generally thought to entail a series of events that cause a progressively more malignant phenotype. This hypothesis predicts that tumor cells of the ultimate stage will carry each of the events, cells of the penultimate stage will carry each of the events less the last one and so on. That is to say, a dissection of the pathway form a normal cell to a fully malignant tumor may be viewed as the unraveling of a nested set of aberrations. In experiments designed to elucidate these events, we have compared genotypic combinations at genomic loci defined by restriction endonuclease recognition site variation in normal and tumor tissues from patients with various forms and stages of cancer. The first step, inherited predisposition, is best described for retinoblastoma in which a recessive mutation of a locus residing in the 13q14 region of the genome is unmasked by aberrant, but specific, mitotic chromosomal segregation. A similar mechanism involving the distal short arm of chromosome 17 is apparent in astrocytic tumors and the event is shared by cells in each malignancy stage. This is distinct from a loss of heterozygosity for loci on chromosome 10 which is restricted to the ultimate stage, glioblastoma multiforme. Further, this approach has has been extended to a wide variety of human cancers and shown to be generally applicable. The results suggest a genetic approach to defining degrees of tumor progression and a means for determining the genomic locations of genes involved in the pathway as a prelude to their molecular isolation and characterization. They have provided a molecular genetic-based oncology with clinical utility in differential pathology, in disease groupings for therapeutic purposes and in prenatal identification of latent disease carriers.

  6. Initial Staging of Hodgkin’s Disease

    PubMed Central

    Chiaravalloti, Agostino; Danieli, Roberta; Caracciolo, Cristiana Ragano; Travascio, Laura; Cantonetti, Maria; Gallamini, Andrea; Guazzaroni, Manlio; Orlacchio, Antonio; Simonetti, Giovanni; Schillaci, Orazio

    2014-01-01

    Abstract The objective of this study was to compare the diagnostic accuracy of positron emission tomography/low-dose computed tomography (PET/ldCT) versus the same technique implemented by contrast-enhanced computed tomography (ceCT) in staging Hodgkin’s disease (HD). Forty patients (18 men and 22 women, mean age 30 ± 9.6) with biopsy-proven HD underwent a PET/ldCT study for initial staging including an unenhanced low-dose computed tomography for attenuation correction with positron emission tomography acquisition and a ceCT, performed at the end of the PET/ldCT scan, in the same exam session. A detailed datasheet was generated for illness locations for separate imaging modality comparison and then merged in order to compare the separate imaging method results (PET/ldCT and ceCT) versus merged results positron emission tomography/contrast-enhanced computed tomography (PET/ceCT). The nodal and extranodal lesions detected by each technique were then compared with follow-up data that served as the reference standard. No significant differences were found at staging between PET/ldCT and PET/ceCT in our series. One hundred and eighty four stations of nodal involvement have been found with no differences in both modalities. Extranodal involvement was identified in 26 sites by PET/ldCT and in 28 by PET/ceCT. We did not find significant differences concerning the stage (Ann Arbor). Our study shows a good concordance and conjunction between PET/ldCT and ceCT in both nodal and extranodal sites in the initial staging of HD, suggesting that PET/ldCT could suffice in most of these patients. PMID:25121354

  7. Three-stage combustion demonstration projects update

    SciTech Connect

    Ashworth, B.; Zawadzki, E.; Murrell, F.; Shroyer, D.; Gallenbach, T.

    2000-07-01

    The Ashworth Combustor is a pulverized coal-fired system that reduces the three major air pollutants (NO{sub x}, SO{sub 2} and particulate) associated with coal combustion. A 50 million Btu/hr combustion system will be retrofitted to a stoker boiler at the Lincoln Development Center in Lincoln, Illinois. Startup and testing re scheduled for mid 2000. With this technology, a two-stage slagging combustor is used with furnace over-fire air (the third stage). Pulverized coal/limestone are fired/calcined in the combustor. limestone (lime) is added to flux the slag and capture sulfur in a molten slag eutectic as a non-leaching calcium sulfide. Beside deep NO{sub x} reduction, 70%+SO{sub 2} and 70 to 80% particulate reductions are projected for the Ashworth Combustor. ClearStack, the Illinois Department of Commerce and Community Affairs Office of Coal Development and Marketing and the Ohio Coal Development Office (OCDO) are sponsoring the Ashworth Combustor demonstration. The Stage3Cyclone is a simple retrofit to cyclone-fired boilers to reduce NO{sub x} emissions to low levels. The existing cyclone barrels are used as the first stage of combustion and the conventional cyclone feed coal size (-1/4 inch) is used. Limestone is added to flux the coal ash. Second stage air is added in the furnace at the re-entrant throat level followed by over-fire air (OFA) injection in the upper part of the furnace. The technique is to be demonstrated on a southern Illinois Power Cooperative 33 MWe cyclone-fired unit in Marion, Illinois. Funding arrangements are being made and testing is projected for late 2000.

  8. 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)

  9. 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)

  10. 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

    2016-10-10

    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

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. Pressurization of whole element canister during staging

    SciTech Connect

    Huang, F.F.

    1998-01-27

    An analytical model was developed to estimate the buildup of gas pressure for a single outer element in a hot cell test container for a post cold vacuum drying staging/storage test. This model considers various sources of gas generation and gas consumption as a function of time. In a canister containing spent nuclear fuel, hydrogen is generated from the reactions of uranium with free water or hydrated water, hydride decomposition, and radiolysis. The canister pressurization model predicts a stable pressure and a peak temperature during staging, with an assumption that a fuel element contains 40 gm of corrosion products and a decay heat of 2.07 or 1.06 Watts. Calculations were also performed on constant temperature tests for fuel elements containing varied amounts of sludge tested at 150, 125, 105, and 85 C. The pressurization model will be used to evaluate test results obtained from post-drying testing on whole fuel elements.

  19. Stage dependent nutritional regulation of transgenerational longevity

    PubMed Central

    Roussou, Ilianna G.; Savakis, Charalambos; Tavernarakis, Nektarios; Metaxakis, Athanasios

    2016-01-01

    BACKGROUND: Statistical analyses in human populations have associated limited food availability during development with increased longevity of next generations. In support, recent findings in Caenorhabditis elegans revealed nutritional effects on transgenerational longevity. OBJECTIVES: In this study we tested the effect of nutrition on longevity of future generations in Drosophila and whether this is sex-specific. METHODS: We reared male larvae and adults of Drosophila under different food conditions and performed lifespan analyses in F2 generation. RESULTS: Grandsons of males which experienced starvation through larval stages were long-lived and grandsons of well fed larvae were short lived, in two Drosophila strains. In one strain, the nutritional effect on transgenerational longevity was transmitted through male line. Interestingly, we find that dietary restriction in adult males is the main nutritional condition affecting lifespan of grandsons. CONCLUSIONS: Our findings suggest that nutritional regulation of transgenerational longevity is evolutionarily conserved and developmental stage – dependent in Drosophila. PMID:28035341

  20. Features of Intermetallic Alloy TNM-B1 High-Temperature Oxidation

    NASA Astrophysics Data System (ADS)

    Smyslov, A. M.; Bybin, A. A.; Dautov, S. S.

    2016-09-01

    Features of intermetallic alloy based on titanium aluminide high-temperature oxidation at 800 - 850°C are studied. A mathematical dependence is obtained for oxidation rate on test duration. The structure and composition of an oxide layer formed during high-temperature oxidation are studied. It is shown that under operating conditions at the maximum working temperatures the intermetallic alloy exhibits low heat resistance.

  1. Ecology of Postlarval Stages of Chigger Mites.

    DTIC Science & Technology

    1985-12-05

    as the principle species for study because it has the widest geographic range of all American species encompassing both tropical and temperate...Daniel, M. 1958. The seasonal dynamics of the infestation of small mammals by chigger larvae in a lowland forest of periodically inundated area. Vest. Cs...the soil surface in tropical areas, especially during the wet season. Nadchatram (1970) collected postlarval stages of chiggers (Leptotrombidium

  2. 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.

  3. 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.

  4. 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.

  5. Two-Stage Free Electron Laser Research.

    DTIC Science & Technology

    1984-10-24

    Ctmetenar an reverse ode It ne*eey aud identify fo black nmber) Free electron laser, two-stage free electron laser, quasioptical cavity, helical ...of very high intensity (_10 W/cm ). A quasioptical cavity concept has been developed to produce such a field. A helical wiggler is needed to excite...the TE waveguide mode in this cavity. Work is described on the development of a pfmanent magnet helical wiggler for this system. Off-axis electron

  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.

  7. Cellular effector mechanisms against Plasmodium liver stages.

    PubMed

    Frevert, Ute; Nardin, Elizabeth

    2008-10-01

    Advances in our understanding of the molecular and cell biology of the malaria parasite have led to new vaccine development efforts resulting in a pipeline of over 40 candidates undergoing clinical phase I-III trials. Vaccine-induced CD4+ and CD8+ T cells specific for pre-erythrocytic stage antigens have been found to express cytolytic and multi-cytokine effector functions that support a key role for these T cells within the hepatic environment. However, little is known of the cellular interactions that occur during the effector phase in which the intracellular hepatic stage of the parasite is targeted and destroyed. This review focuses on cell biological aspects of the interaction between malaria-specific effector cells and the various antigen-presenting cells that are known to exist within the liver, including hepatocytes, dendritic cells, Kupffer cells, stellate cells and sinusoidal endothelia. Considering the unique immune properties of the liver, it is conceivable that these different hepatic antigen-presenting cells fulfil distinct but complementary roles during the effector phase against Plasmodium liver stages.

  8. 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.

  9. 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

  10. 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.

  11. Integration of Life-Stage Physiologically Based ...

    EPA Pesticide Factsheets

    A Life-stage Physiologically-Based Pharmacokinetic (PBPK) model was developed to include descriptions of several life-stage events such as pregnancy, fetal development, the neonate and child growth. The overall modeling strategy was used for in vitro to in vivo (IVIVE) extrapolation to help contextualize activity in ToxCast assays that were mapped to an adverse outcome pathway (AOP) for embryonic vascular disruption. Using life-stage PBPK models, we estimated maternal exposures that would yield fetal blood levels equivalent to in vitro activity from ToxCast assays with critical vascular signaling targets. The resulting in vivo dose estimates were then compared to life-time exposures using literature data or exposure models (SHEDS-LITE) to derive AOP-based Margins of Exposure (ME). This computational framework was applied to a list of five chemicals with varying activity against the putative Vascular Disruption AOP. The idea of linking biological information related to toxicity (using AOPs), high throughput in vitro data (ToxCast), and age-varying physiological and biochemical information to estimate AOP-based MEs is novel and can be used to help regulators in realistically assessing chemicals based on toxicity, dosimetry, and real-life exposures. Developing fetuses and infants are especially sensitive to toxicity caused by exposure to xenobiotics. The time and dose to which a developing target tissue is exposed during pregnancy or via lactation after birth are c

  12. Polymorphic crystals selected in the nucleation stage

    NASA Astrophysics Data System (ADS)

    Zhang, Hui-Jun; Peng, Shu-Ming; Zhou, Xiao-Song; Ju, Xin

    2014-08-01

    Molecular dynamics simulations are used to explore the atomic mechanism of formation of polymorphic crystals. Cooling the Lennard-Jones systems, we observe that the system almost always evolves into a polymorphic crystal with either fivefold-symmetric stacking faults or single-direction stacking faults. The detailed analysis reveals that such an evolution depends on the configuration of fcc/hcp concomitance in the nucleation stage. A defect-induced model is then introduced to illustrate these two evolution routes. Through calculating the formation energies of the defective critical nuclei, we find that the polymorphic crystals seem to be determined by their critical nuclei, in which the relatively lower formation energy ensures the preponderance of the fivefold-symmetric cluster. Before the nucleation, we observe that thermal fluctuations prefer hcp-like particles over fcc-like ones while in the nucleation and growth stage this preference reverses. Notably, an extended step rule of Ostwald is seemingly suitable to characterise the growth process because of the temporary hcp layers appearing among fcc layers in the growth stage. Although the crystalline cluster with single-direction stacking faults has higher growth rate and structural order than its competitor, the component (fcc and hcp) proportion of the final crystals is almost always constant regardless of the polymorphic type. Our finding renews the understanding of the polymorphism of crystals, and possibly draws more attention of people intending to control the polymorphic structures through nucleation.

  13. Mindfulness Meditation or Survivorship Education in Improving Behavioral Symptoms in Younger Stage 0-III Breast Cancer Survivors (Pathways to Wellness)

    ClinicalTrials.gov

    2017-03-21

    Cancer Survivor; Early-Stage Breast Carcinoma; Stage 0 Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  14. 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

  15. Stage Effects on Stalling and Recovery of a High-Speed 10-Stage Axial- Flow Compressor

    DTIC Science & Technology

    1990-06-01

    17.7 Test compressor sixth stage characteristics 78.5% design corrected speed 347 17.8 Test compressor seventh stage characteristics 78.5% design...Figure 17.6 Test compressor fifth stage characteristics 78.5% design corrected speed 347 6TH STAGE PRESSURE CHARACTERISTIC 78.5% DESIGN CORRECTED SPEED...Vr) II 4 374 0 w0 -uU- M 4J 6 0 , 110 0 0 ’ 0 W0 wW LU $4 $4 w -j X 0W w) 4)O rl 0 4) Cd - 0 ) o--i0 0 r-4 - x 4) 0-H 04r fT~..I W 4 04 WEJ 0 0 0

  16. Performance of two-stage fan with larger dampers on first-stage rotor

    NASA Technical Reports Server (NTRS)

    Urasek, D. C.; Cunnan, W. S.; Stevans, W.

    1979-01-01

    The performance of a two stage, high pressure-ratio fan, having large, part-span vibration dampers on the first stage rotor is presented and compared with an identical aerodynamically designed fan having smaller dampers. Comparisons of the data for the two damper configurations show that with increased damper size: (1) very high losses in the damper region reduced overall efficiency of first stage rotor by approximately 3 points, (2) the overall performance of each blade row, downstream of the damper was not significantly altered, although appreciable differences in the radial distributions of various performance parameters were noted, and (3) the lower performance of the first stage rotor decreased the overall fan efficiency more than 1 percentage point.

  17. A comparison study of staging systems for bone sarcomas.

    PubMed

    Heck, Robert K; Stacy, G Scott; Flaherty, Michael J; Montag, Anthony G; Peabody, Terrance D; Simon, Michael A

    2003-10-01

    A retrospective study of 250 patients treated at one institution was done to evaluate the prognostic significance of the new American Joint Committee on Cancer staging system compared with the Musculoskeletal Tumor Society staging system for patients with sarcomas of bone. Regarding the Musculoskeletal Tumor Society system, there were significant differences in survival among patients with Stage I, Stage II, and Stage III disease. There were no significant differences between patients with Stages I-A and I-B disease, nor between patients with Stages II-A and II-B disease. Similarly, regarding the new American Joint Committee on Cancer staging system, there were significant differences among patients with Stage I, Stage II, and Stage IV disease. No significant differences were seen between patients with Stages I-A and I-B disease, between patients with Stages II-A and II-B disease, nor between patients with Stages IV-A and IV-B disease. A significant advantage in the ability to predict prognosis for one staging system over the other staging system was not shown with the relatively small number of patients in this study.

  18. Two-stage/single-stage reversible pump-turbine with supplying pump

    SciTech Connect

    Brcar, A.

    1980-08-12

    In a hydroelectric facility, a vertically mounted rotatable shaft is connected to a motor-generator and carries a pumpturbine with a supplying pump disposed below and immersed in water, the supplying pump disengaging from the shaft when the pump-turbine is driving the motor-generator and engaging the shaft when the motor-generator is driving the pump-turbine and supplying pump, thereby providing a two-stage pumping mode and a single-stage generating mode.

  19. Supersonic Air-Breathing Stage For Commercial Launch Rocket

    NASA Technical Reports Server (NTRS)

    Martin, James A.

    1993-01-01

    Concept proposed to expand use of air-breathing, reusable stages to put more payload into orbit at less cost. Stage with supersonic air-breathing engines added to carry expendable stages from subsonic airplane to supersonic velocity. Carry payload to orbit. Expendable stages and payload placed in front of supersonic air-breathing stage. After releasing expendable stages, remotely piloted supersonic air-breathing stage returns to takeoff site and land for reuse. New concept extends use of low-cost reusable hardware and increases payload delivered from B-52.

  20. [Comparison research on two-stage sequencing batch MBR and one-stage MBR].

    PubMed

    Yuan, Xin-Yan; Shen, Heng-Gen; Sun, Lei; Wang, Lin; Li, Shi-Feng

    2011-01-01

    Aiming at resolving problems in MBR operation, like low nitrogen and phosphorous removal efficiency, severe membrane fouling and etc, comparison research on two-stage sequencing batch MBR (TSBMBR) and one-stage aerobic MBR has been done in this paper. The results indicated that TSBMBR owned advantages of SBR in removing nitrogen and phosphorous, which could make up the deficiency of traditional one-stage aerobic MBR in nitrogen and phosphorous removal. During steady operation period, effluent average NH4(+) -N, TN and TP concentration is 2.83, 12.20, 0.42 mg/L, which could reach domestic scenic environment use. From membrane fouling control point of view, TSBMBR has lower SMP in supernatant, specific trans-membrane flux deduction rate, membrane fouling resistant than one-stage aerobic MBR. The sedimentation and gel layer resistant of TSBMBR was only 6.5% and 33.12% of one-stage aerobic MBR. Besides high efficiency in removing nitrogen and phosphorous, TSBMBR could effectively reduce sedimentation and gel layer pollution on membrane surface. Comparing with one-stage MBR, TSBMBR could operate with higher trans-membrane flux, lower membrane fouling rate and better pollutants removal effects.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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

    ClinicalTrials.gov

    2013-02-26

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

  6. 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

  7. 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

  8. 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.

  9. Gamma-Secretase/Notch Signalling Pathway Inhibitor RO4929097, Paclitaxel, and Carboplatin Before Surgery in Treating Patients With Stage II or Stage III Triple-Negative Breast Cancer

    ClinicalTrials.gov

    2015-09-03

    Estrogen Receptor Negative; HER2/Neu Negative; Progesterone Receptor Negative; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-Negative Breast Carcinoma

  10. 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.

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

    ClinicalTrials.gov

    2017-03-13

    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

  12. Two-Stage Reduction Of Dynamical Models

    NASA Technical Reports Server (NTRS)

    Lee, Allan Y.; Tsuha, Walter S.

    1993-01-01

    No longer necessary to solve eigenvalue problems of high order. Component-mode projection-and-assembly model-reduction (COMPARE) method provides approximation of dynamics of vibrations of complicated, multiple flexible bodies by use of mathematical models of reduced order. Incorporates component-mode synthesis (CMS) method and enhanced projection-and-assembly (EP&A) method, described in "Enhanced Method of Reduction of Dynamical Models" (NPO-18402), providing for somewhat simplified two-stage process in which order of applicable mathematical models reduced. Reduced-order models used to design algorithms of control systems to suppress vibrations or otherwise control structure.

  13. A 10-stage reconnection demonstration launcher

    SciTech Connect

    Cnare, E.C.; Widner, M.M.; Duggin, B.W.

    1989-01-01

    A small-scale, 10-stage cylindrical reconnection launcher has been designed, fabricated, and tested. Ten-gram projectiles are accelerated from rest to 317 m/s through the 0.44 m launcher assembly with a projectile kinetic energy to capacitor stored energy efficiency of 9%. Comparison of test results and computer code predictions will be presented. Results of these studies have substantiated launcher scaling at small size and have provided a useful test bed for launcher components and diagnostics. 5 refs., 6 figs.

  14. A 10-stage reconnection demonstration launcher

    SciTech Connect

    Cnare, E.G.; Widner, M.M.; Duggins, B.W. )

    1991-01-01

    This paper reports on a small-scale, 10-stage cylindrical reconnection launcher that has been designed, fabricated, and tested. Ten-gram projectiles are accelerated from rest to 317 m/s through the 0.44 m launcher assembly with a projectile kinetic energy to capacitor stored energy efficiency of 9%. Comparison of test results and computer code predictions are presented. Results of these studies have substantiated launcher scaling at small size and have provided a useful test bed for launcher components and diagnostics.

  15. 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

  16. 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.

  17. N staging: the role of the pathologist

    PubMed Central

    Biondi, Alberto; Ricci, Riccardo

    2017-01-01

    Gastric cancer is the second cause of cancer-related mortality worldwide. Metastases, including lymph nodes ones, heavily influence the prognosis of this disease. The pathological detection of positive lymph nodes is pivotal for an optimal prognostication and clinical management of affected individuals. Several factors influence the pathological investigation of surgical specimens, ultimately affecting the number of retrieved lymph nodes and, with it, the reliability of N staging. The pathologist plays a central role in optimizing this process. Factors influencing lymph node retrieval and analysis will be herein reviewed, together with the procedures adopted for an optimal pathological analysis of lymph nodes in gastric cancer. PMID:28275742

  18. 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.

  19. Mars Observer/Transfer Orbit Stage (TOS)

    NASA Technical Reports Server (NTRS)

    1992-01-01

    In the Payload Hazardous Servicing Facility, the integrated Mars Observer/Transfer Orbit Stage (TOS) payload is ready for encapsulation in the Titan III nose fairing. The TOS booster maiden flight was dedicated to Thomas O. Paine, a former NASA administrator who strongly supported interplanetary exploration and was an early backer of the TOS program. Launched September 25, 1992 from the Kennedy Space Flight Center aboard a Titan III rocket and the TOS, the Mars Observer spacecraft was to be the first U.S. spacecraft to study Mars since the Viking missions 18 years prior. Unfortunately, the Mars Observer spacecraft fell silent just 3 days prior to entering orbit around Mars.

  20. Study on acute recent stage pancreatitis

    PubMed Central

    Feng, Ye-Chen; Wang, Min; Zhu, Feng; Qin, Ren-Yi

    2014-01-01

    Acute pancreatitis (AP) is an inflammatory disease of the pancreas which involves the pancreas and surrounding tissue, and systemic inflammation with a characteristic systemic increase of vascular permeability and increased risk of multiple organ dysfunction. Currently, the pathogenesis of AP is fuzzy, and the diagnosis and treatment need to be standardized. Nevertheless, increased knowledge of AP may achieve more thorough understanding of the pathogenesis. The use of further advanced diagnostic tools and superior treatment, potentially will help clinicians to manage AP at an appropriate stage. However, in view of the multi factorial disease and the complex clinical manifestations, the management of patients with AP is also remaining areas for improvement. PMID:25473166

  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. The influence of magnetic field strength in ionization stage on ion transport between two stages of a double stage Hall thruster

    SciTech Connect

    Yu Daren; Song Maojiang; Li Hong; Liu Hui; Han Ke

    2012-11-15

    It is futile for a double stage Hall thruster to design a special ionization stage if the ionized ions cannot enter the acceleration stage. Based on this viewpoint, the ion transport under different magnetic field strengths in the ionization stage is investigated, and the physical mechanisms affecting the ion transport are analyzed in this paper. With a combined experimental and particle-in-cell simulation study, it is found that the ion transport between two stages is chiefly affected by the potential well, the potential barrier, and the potential drop at the bottom of potential well. With the increase of magnetic field strength in the ionization stage, there is larger plasma density caused by larger potential well. Furthermore, the potential barrier near the intermediate electrode declines first and then rises up while the potential drop at the bottom of potential well rises up first and then declines as the magnetic field strength increases in the ionization stage. Consequently, both the ion current entering the acceleration stage and the total ion current ejected from the thruster rise up first and then decline as the magnetic field strength increases in the ionization stage. Therefore, there is an optimal magnetic field strength in the ionization stage to guide the ion transport between two stages.

  3. A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

    PubMed Central

    Hegde, Gautham; Hegde, Nanditha; Kumar, Anil; Keshavaraj

    2014-01-01

    Objective: 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. Materials and Methods: A total of 160 periapical radiographs, 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 and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity. PMID:25210386

  4. 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.

  5. Optimization strategies for single-stage, multi-stage and continuous ADRs

    NASA Astrophysics Data System (ADS)

    Shirron, Peter

    2014-07-01

    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.

  6. Metering Gas Strut for Separating Rocket Stages

    NASA Technical Reports Server (NTRS)

    Floyd, Brian

    2010-01-01

    A proposed gas strut system would separate a liquid-fueled second rocket stage from a solid-fueled first stage using an array of pre-charged struts. The strut would be a piston-and-cylinder mechanism containing a compressed gas. Adiabatic expansion of the gas would drive the extension of the strut. The strut is designed to produce a force-versus-time profile, chosen to prevent agitation of the liquid fuel, in which the force would increase from an initial low value to a peak value, then decay toward the end of the stroke. The strut would include a piston chamber and a storage chamber. The piston chamber would initially contain gas at a low pressure to provide the initial low separation force. The storage chamber would contain gas at a higher pressure. The piston would include a longitudinal metering rod containing an array of small holes, sized to restrict the flow gas between the chambers, that would initially not be exposed to the interior of the piston chamber. During subsequent expansion, the piston motion would open more of the metering holes between the storage and piston chambers, thereby increasing the flow of gas into the piston chamber to produce the desired buildup of force.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. A Staged Reading of the Play: Reykjavik

    NASA Astrophysics Data System (ADS)

    2017-01-01

    Reykjavik is the capital of Iceland, an island country located about 500 miles northwest of Scotland in the North Atlantic. In 1986 Mikhail Gorbachev, the Chairman of the Politburo of the Soviet Union and General Secretary of the Soviet Communist Party, invited Ronald Reagan, the President of the United States, to meet with him. The play Reykjavik is a dramatic reconstruction of the two-day summit meeting during which the world leaders almost reached agreement on the total abolition of their countries' nuclear weapons. The play uses the actual transcripts of the Reykjavik meeting as well as the memoirs of both Reagan and Gorbachev. Join us for a dramatic staged reading of Reykjavik and find out how close the two superpowers, the Soviet Union and the United States, came to eliminating their nuclear weapons. He playwright is Richard Rhodes, the Pulitzer Prize-winning author of 24 books. He has written his first play, and it spins off of his research into the history of nuclear weapons. The staged reading is performed by the Washington based Tonic Theater Company: http://www.tonictheater.org/[tonictheater.org]. After the performance, the play director and actors as well as experts on nuclear disarmament will be available for a talk-back discussion of the play with the audience. Produced by Brian Schwartz, Brooklyn College and the Graduate Center of the City University of New York and Gregory Mack of the APS Washington office.

  15. Pubertal stages 1980 of Stockholm schoolchildren.

    PubMed

    Lindgren, G

    1996-11-01

    In March 1980 a cross-sectional study of the pubertal developmental of a sample of Stockholm schoolchildren was conducted. Breast development (B1-B5), pubic hair (PH1-PH5) and axillary hair (AH1-AH3) were rated in 138 girls, and genitalia development (G1-G5), pubic hair (PH1-PH5) and axillary hair (AH1-AH3) were rated in 116 boys according to the Tanner method. The girls' and the boys' ratings were done by one female and one male medically qualified expert respectively. When relating social class to age of pubertal stage no significant differences were found. Median ages for entry to successive pubertal stages as well as centiles were calculated by logistic regression. Girls were somewhat earlier in their breast and pubic hair development than Stockholm girls investigated in earlier studies; however, somewhat later in their development of axillary hair. The boys entered G2 earlier than boys studied in 1970 but entered G5 at exactly the same age, 15.1 years. Boys entered PH2 somewhat later than 1970 boys, but again reached PH5 at exactly the same age, 15.5 years. The present study is based on a more recent and somewhat larger sample of children drawn from a wider area of Stockholm than the earlier studies. It is further suggested that these values be used in the proposed new height and weight reference values for youth in Sweden.

  16. 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.

  17. 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

  18. Two-stage production of olefins utilizing a faujasite structure zeolite in hydrogenation stage

    SciTech Connect

    Kreuter, W.; Mansmann, M.; Watson, A.; Weber, H.; Wernicke, H.J.

    1980-02-12

    A process is disclosed for the production of olefins in two stages. In the first stage, heavy petroleum fractions are hydrogenated in the presence of hydrogen and a hydrogenation catalyst and, in the second stage, the thus-hydrogenated fractions are subjected to thermal cracking the presence of steam. The improvement comprises employing as the hydrogenation catalyst a zeolite of the faujasite structure combined with elements from groups VIB, VIIB and VIII of the periodic table of the elements, wherein the alkali component of the zeolite is exchanged at least partially for ammonium, hydronium, alkaline earth and/or rare earth ions, and the elements are present in a metallic, ionic, oxidic and/or sulfidic form.

  19. 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).

  20. A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma

    PubMed Central

    Li, Jian-Pei; Chen, Shu-Lin; Liu, Xiao-Min; He, Xia; Xing, Shan; Liu, Yi-Jun; Lin, Yue-Hao; Liu, Wan-Li

    2016-01-01

    Recent studies have indicated that inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), modified GPS (mGPS) and C-reactive protein/Albumin (CRP/Alb) ratio, platelet–lymphocyte ratio (PLR), and neutrophil–lymphocyte ratio (NLR), have been reported to have prognostic value in patients with many types of cancer, including nasopharyngeal carcinoma (NPC). In this study, we proposed a novel inflammation-based stage, named I stage, for patients with NPC. A retrospective study of 409 newly-diagnosed cases of NPC was conducted. The prognostic factors (GPS, mGPS, CRP/Alb ratios, PLR, and NLR) were evaluated using univariate and multivariate analyses. Then, according to the results of the multivariate analyses, we proposed a I stage combination of independent risk factors (CRP/Alb ratio and PLR). The I stage was calculated as follows: patients with high levels of CRP/Alb ratio (>0.03) and PLR (>146.2) were defined as I2; patients with one or no abnormal values were defined as I1 or I0, respectively. The relationships between the I stage and clinicopathological variables and overall survival (OS) were evaluated. In addition, the discriminatory ability of the I stage with other inflammation-based prognostic scores was assessed using the AUCs (areas under the curves) analyzed by receiver operating characteristics (ROC) curves. The p value of <0.05 was considered to be significant. A total of 409 patients with NPC were enrolled in this study. Multivariate analyses revealed that only the CRP/Alb ratio (Hazard ratio (HR) = 2.093; 95% Confidence interval (CI): 1.222–3.587; p = 0.007) and PLR (HR: 2.003; 95% CI: 1.177–3.410; p = 0.010) were independent prognostic factors in patients with NPC. The five-year overall survival rates for patients with I0, I1, and I2 were 92.1% ± 2.9%, 83.3% ± 2.6%, and 63.1% ± 4.6%, respectively (p < 0.001). The I stage had a higher area under the curve value (0.670) compared with other systemic inflammation

  1. [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.

  2. 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.

  3. 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.

  4. 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

  5. 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).

  6. Resource competition in stage-structured populations.

    PubMed

    Revilla, T A

    2000-05-21

    Two models are made to account for the dynamics of a consumer-resource system in which the consumers are divided into juveniles and adults. The resource grows logistically and a type II functional response is assumed for consumers. Resource levels determine fecundity and maturation rates in one model, and mortality rates in the other. The analysis of the models shows that the condition for establishment of consumers is that the product of per capita fecundity rate and maturation rates is higher than the product of juvenile and adult per capita decay rates at a resource level equal to its carrying capacity. This result imposes a minimal abundance of resource able to maintain the consumers. A second result shows an equilibrium stage structure, with a small instability when juveniles and adults mean saturation constants are different. The implications of these results for community dynamics are discussed.

  7. 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.

  8. 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.

  9. "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.

  10. Adiponectin and end-stage renal disease.

    PubMed

    Markaki, Anastasia; Psylinakis, Emmanuel; Spyridaki, Aspasia

    2016-07-01

    Adiponectin (ADPN) is an adipokine with significant anti-inflammatory, insulin-sensitizing and anti-atherogenic properties, which is generally associated with a beneficial cardiometabolic profile. Paradoxically, end-stage renal disease (ESRD) is characterized by markedly increased plasma ADPN levels and increased cardiovascular risk. In spite of the cardioprotective properties attributed to adiponectin, cardiovascular complications remain the main cause of mortality in the ESRD population. Furthermore, these patients have enhanced chronic inflammation, increased insulin resistance and persistent protein-energy wasting. Studies of the impact of ADPN on clinical outcomes among ESRD patients have so far yielded contradictory results. This review article summarizes the current knowledge on ADPN functions and explores the role of ADPN in ESRD patients, with specific focus on inflammation, insulin resistance, cardiovascular disease and wasting.

  11. Two-stage eutectic metal brushes

    DOEpatents

    Hsu, John S [Oak Ridge, TN

    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.

  12. Deformation stages of technical aluminum at reverse

    NASA Astrophysics Data System (ADS)

    Vaulina, O. Yu; Durnovtseva, A. N.; Shvagrukova, E. V.

    2016-02-01

    Durability and reliability of machines and mechanisms are determined, mainly, by their fatigue resistance as far as, in the most cases, variable load impacts on machine components. Accordingly, the problem of fatigue failure is extremely topical, still. Its complexity is connected with a wide range of factors. First of all, at cyclic load the compatibility relations of a material surface layer, which is loaded over the yield point and the elastic-loaded substrate layer, play a very important role. This fact determines involvement into plastic flow and failure of all the scale hierarchy of deformation structural levels. Reverse loading under the condition of the elastic-loaded substrate layer causes strong localization of plastic deformation in the surface layers. In the deformation localization areas the material reaches its limit state, when fatigue cracks arise and expand. The paper presents the mechanisms of fatigue deformation for technical aluminum at various fatigue stages.

  13. 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

  14. Beginning stages of local magnetic field formation

    NASA Astrophysics Data System (ADS)

    Bumba, V.

    Based on a study of the initial stages of local magnetic field formation, the appearance of a new magnetic flux in the photosphere is studied. This magnetic flux is found to occur both under the influence of different modes of convective motion as well as under the action of Paleomagnetic fields. Waldmeier's Heliographic Maps of the Photosphere and Mt. Wilson Observatory daily magnetic maps were used in the analysis. Observed regularities could not be explained by a model of magnetic flux tubes emerging on the photospheric surface. This model can not account for the practically simultaneous development of separate active regions, belonging to different solar hemispheres and different cycles of solar activity in one, relatively narrow, 'unipolar' sector of the background field. It is also difficult to explain the different roles and velocities of negative and positive polarities during the formation of new magnetic fields. The importance of velocity measurements and maps for solving the observed phenomenon is stressed.

  15. 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.

  16. 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.

  17. 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.

  18. Integrated Solar Upper Stage Technical Support

    NASA Technical Reports Server (NTRS)

    Jaworske, Donald A.

    1998-01-01

    NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test

  19. Docetaxel, cisplatin and 5-fluorouracil adjuvant chemotherapy following three-field lymph node dissection for stage II/III N1, 2 esophageal cancer.

    PubMed

    Hashiguchi, Tadasuke; Nasu, Motomi; Hashimoto, Takashi; Kuniyasu, Tetsuji; Inoue, Hirohumi; Sakai, Noritaka; Ouchi, Kazutomo; Amano, Takayuki; Isayama, Fuyumi; Tomita, Natsumi; Iwanuma, Yoshimi; Tsurumaru, Masahiko; Kajiyama, Yoshiaki

    2014-09-01

    To determine the efficacy of postoperative adjuvant chemotherapy with docetaxel + cisplatin + 5-fluorouracil (DCF) in lymph node metastasis-positive esophageal cancer, we retrospectively analyzed 139 patients with stage II/III (non-T4) esophageal cancer with lymph node metastasis (1-6 nodes), who did not receive preoperative treatment and underwent three-field lymph node dissection in the Juntendo University Hospital between December, 2004 and December, 2009. The tumors were histologically diagnossed as squamous cell carcinoma. The patients were divided into two groups, a surgery alone group (S group, 88 patients) and a group that received postoperative DCF therapy (DCF group, 51 patients). The disease-free and overall survival were compared between the groups and a multivariate analysis of prognostic factors was performed. The same analysis was performed for cases classified as N1 and N2, according to the TNM classification. There were no significant differences between the S and DCF groups regarding clinicopathological factors other than intramural metastasis and main tumor location. The presence of intramural metastasis, blood vessel invasion and the number of lymph nodes were identified as prognostic factors. The 5-year disease-free and overall survival were 55.8 and 57.3%, respectively, in the S group and 52.8 and 63.0%, respectively, in the DCF group. These differences were not considered to be statistically significant (P=0.789 and 0.479 for disease-free and overall survival, respectively). Although there were no significant differences in disease-free and overall survival between the S and DCF groups in N1 cases, both disease-free and overall survival were found to be better in the DCF group (54.2 and 61.4%, respectively) compared to the S group (29.6 and 28.8%, respectively) in N2 cases (P=0.029 and 0.020 for disease-free and overall survival, respectively). Therefore, postoperative adjuvant chemotherapy with DCF was shown to improve disease-free and

  20. 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