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Sample records for die who-klassifikation maligner

  1. Die histologischen Typen der lymphomatoiden Papulose - Ein Vorschlag für die Vereinfachung des Buchstabenchaos.

    PubMed

    Kempf, Werner; Mitteldorf, Christina; Karai, Laszlo J; Robson, Alistair

    2017-04-01

    Die lymphomatoide Papulose (LYP) ist klinisch durch rezidivierende papulonoduläre Läsionen charakterisiert. Im Gegensatz zu dieser stereotypen klinischen Präsentation zeigt die Erkrankung ein breites histologisches Spektrum mit verschiedenen Infiltratmustern, unterschiedlichen Tumorzellgrößen und variablen Phänotypen. Die revidierte WHO-Klassifikation 2016 umfasst die histologischen LYP-Typen A bis E und einen sechsten Typ, dem eine spezielle Mutation zugrunde liegt. Darüber hinaus werden jedoch immer wieder neue Typen vorgeschlagen, wobei sich die Ausweitung nicht ausschließlich auf histologische Muster bezieht, sondern sich auch auf klinische und genetische Aspekte ausdehnt. Dies führt zu einer Ausweitung der alphabetischen Liste mit zunehmender Komplexität der Terminologie und kann anstelle eines vereinfachten diagnostischen Zugangs zur Verwirrung führen. Zudem kann es zu Überschneidungen unterschiedlicher Typen kommen. Diese Entwicklung wirft die Frage auf, wie die Terminologie der lymphomatoiden Papulose vereinfacht werden kann, ohne dabei auf die histologischen Besonderheiten zu verzichten. Wir schlagen daher einen praktischen Zugang zur Terminologie der lymphomatoide Papulosen vor, welcher sich ausschließlich auf deskriptive Begriffe beschränkt und nicht auf einer alphabetischen Bezeichnung der LYP-Typen beruht. Unser Vorschlag soll einen praktikablen und benutzerfreundlichen Zugang zur Terminologie der lymphomatoiden Papulose ermöglichen und damit den diagnostischen Prozess sowie die Kommunikation zwischen Klinikern und Pathologen vereinfachen. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  2. "I'm just waiting…": an exploration of the experience of living and dying with primary malignant glioma.

    PubMed

    Philip, Jennifer; Collins, Anna; Brand, Caroline A; Moore, Gaye; Lethborg, Carrie; Sundararajan, Vijaya; Murphy, Michael A; Gold, Michelle

    2014-02-01

    Referral to supportive and palliative care services for people with high-grade primary malignant glioma (PMG) often occurs late in the illness course, despite significant care needs and overall poor prognosis. This study aimed to understand patient experience at the end of life and document supportive and palliative care needs. A qualitative study was conducted involving ten PMG patients who were at different stages in the illness course including the end of life and had varying levels of physical and cognitive function. Consecutive, eligible patients attending neurosurgery, oncology, and palliative care services of two metropolitan hospitals were recruited. In-depth interviews explored supportive and palliative care needs across the disease trajectory. Interviews were analysed independently by three investigators consistent with a grounded theory approach, and emerging ideas were compared and refined to define key patient experiences. Despite the medical treatment and supportive care available, there remains a gap in services addressing complex existential and psychosocial needs that were markedly valued by patients. Patient experience was characterised by a pervasive loss of all that encompassed their former sense of self and a focus on immediate needs. Patients in this study had substantial needs, which were often not shared and not addressed by the current medical system of care. An improved multidisciplinary care model is indicated, which proactively (1) engages care coordination and advocacy; (2) minimises patients' sense of waiting and uncertainty through mapping out a plan, including involvement of palliative care in a timely fashion; and (3) actively invites discussion around goals and preferences for care to promote patients' sense of self.

  3. Dying for love: Perimenopausal degeneration of vaginal microbiome drives the chronic inflammation-malignant transformation of benign prostatic hyperplasia to prostatic adenocarcinoma.

    PubMed

    Reece, Albert Stuart

    2017-04-01

    Prostatic carcinoma is the second commonest cancer in males and is so common as to become almost holoendemic with advancing age. The recent demonstration that far from being benign, "benign" prostatic hypertrophy is a likely a reaction of the prostate to chronic untreated lower genital tract infection, and that this chronic inflammation is likely the usual precursor to the frequent occurrence of prostatic carcinoma has far reaching implications. The obvious source for the chronic inflammatory stimulus in the prostate is the documented dramatically altered lower female genital microbiota associated with the menopause. Hence the major hypothesis is that prostatic cancer may arise due to chronic infection and inflammation in the prostate gland consequent upon the altered microbiome of the menopausal female genital tract. This has implications for testing and diagnosis, treatment, population health and personal hygiene practices. It suggests that male dyspareunia, although almost never encountered in clinical practice may in fact be relatively common in older males, and in particular if diagnosed, represents a critical opportunity for therapeutic intervention to interrupt the chronic inflammation - cancer transformation and progression which has been well documented in other tissues. It implies that the coordinated application of next generation sequencing to the microbiome of the lower genital tracts of male and female couples, including seminal fluid, will have both research applications to further explore this sequence, as well as finding application as a potential population level screening procedure as is presently done for the "Thin Prep" cervical screening for human papillomavirus in females. Moreover this insight opens up new opportunities for chemointervention and chemoprevention for this important clinicopathological progression. These considerations give rise to the exciting possibility that prostatic malignancy may be preventable by various methods of local

  4. SPHERICAL DIE

    DOEpatents

    Livingston, J.P.

    1959-01-27

    A die is presented for pressing powdered materials into a hemispherical shape of uniforin density and wall thickness comprising a fcmale and male die element held in a stationary spaced relation with the space being equivalent to the wall thickness and defining the hemispherical shape, a pressing ring linearly moveable along the male die element, an inlet to fill the space with powdered materials, a guiding system for moving the pressing ring along the male die element so as to press the powdered material and a heating system for heating the male element so that the powdered material is heated while being pressed.

  5. Malignant peritoneal mesothelioma

    PubMed Central

    Munkholm-Larsen, Stine; Cao, Christopher Q; Yan, Tristan D

    2009-01-01

    Malignant mesothelioma is a highly aggressive neoplasm. The incidence of malignant mesothelioma is increasing worldwide. Diffuse malignant peritoneal mesothelioma (DMPM) represents one-fourth of all mesotheliomas. Association of asbestos exposure with DMPM has been observed, especially in males. The great majority of patients present with abdominal pain and distension, caused by accumulation of tumors and ascitic fluid. In the past, DMPM was considered a pre-terminal condition; therefore attracted little attention. Patients invariably died from their disease within a year. Recently, several prospective trials have demonstrated a median survival of 40 to 90 mo and 5-year survival of 30% to 60% after combined treatment using cytoreductive surgery and perioperative intraperitoneal chemotherapy. This remarkable improvement in survival has prompted new search into the medical science related to DMPM, a disease previously ignored as uninteresting. This review article focuses on the key advances in the epidemiology, diagnosis, staging, treatments and prognosis of DMPM that have occurred in the past decade. PMID:21160794

  6. Sputtered protective coatings for die casting dies

    NASA Technical Reports Server (NTRS)

    Mirtich, M. J.; Nieh, C. Y.; Wallace, J. F.

    1981-01-01

    This investigation determined whether selected ion beam sputtered coatings on H-13 die steel would have the potential of improving the thermal fatigue behavior of the steel used as a die in aluminum die casting. The coatings were selected to test candidate insulators and metals capable of providing protection of the die surface. The studies indicate that 1 micrometer thick W and Pt coatings reduced the thermal fatigue more than any other coating tested and are candidates to be used on a die surface to increase die life.

  7. Mesothelioma - malignant

    MedlinePlus

    ... Names Mesothelioma - malignant; Malignant pleura mesothelioma (MPM) Images Respiratory system References Broaddus VC, Robinson BWS. Pleural tumors. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

  8. Pleural malignancies.

    PubMed

    Friedberg, Joseph S; Cengel, Keith A

    2010-07-01

    Pleural malignancies, primary or metastatic, portend a grim prognosis. In addition to the serious oncologic implications of a pleural malignancy, these tumors can be highly symptomatic. A malignant pleural effusion can cause dyspnea, secondary to lung compression, or even tension physiology from a hydrothorax under pressure. The need to palliate these effusions is a seemingly straightforward clinical scenario, but with nuances that can result in disastrous complications for the patient if not attended to appropriately. Solid pleural malignancies can cause great pain from chest wall invasion or can cause a myriad of morbid symptoms because of the invasion of thoracic structures, such as the heart, lungs, or esophagus. This article reviews pleural malignancies, the purely palliative treatments, and the treatments that are performed with definitive (curative) intent. Copyright 2010 Elsevier Inc. All rights reserved.

  9. Wege in die Zukunft

    NASA Astrophysics Data System (ADS)

    Kauermann, Göran; Mosler, Karl

    Die Zukunft stellt große Herausforderungen an die Arbeit der Deutschen Statistischen Gesellschaft. Sie betreffen die gestiegenen Anforderungen der Nutzer von Statistik, die Kommunikationsmöglichkeiten des Internets sowie die Dynamik der statistischen Wissenschaften und ihrer Anwendungsgebiete. Das Kapitel 5 beschreibt, wie sich die Gesellschaft diesen Herausforderungen stellt und welche Ziele sie sich in der wissenschaftlichen Zusammenarbeit und im Kampf gegen das Innumeratentum gesetzt hat.

  10. Malignant hyperthermia

    MedlinePlus

    ... counseling is recommended for anyone with a family history of myopathy, muscular dystrophy, or malignant ... et al, eds. Harrison's Principles of Internal Medicine . 17th ed. [online version]. New York, NY: McGraw ...

  11. Malignant mesothelioma

    PubMed Central

    Moore, Alastair J; Parker, Robert J; Wiggins, John

    2008-01-01

    Malignant mesothelioma is a fatal asbestos-associated malignancy originating from the lining cells (mesothelium) of the pleural and peritoneal cavities, as well as the pericardium and the tunica vaginalis. The exact prevalence is unknown but it is estimated that mesotheliomas represent less than 1% of all cancers. Its incidence is increasing, with an expected peak in the next 10–20 years. Pleural malignant mesothelioma is the most common form of mesothelioma. Typical presenting features are those of chest pain and dyspnoea. Breathlessness due to a pleural effusion without chest pain is reported in about 30% of patients. A chest wall mass, weight loss, sweating, abdominal pain and ascites (due to peritoneal involvement) are less common presentations. Mesothelioma is directly attributable to occupational asbestos exposure with a history of exposure in over 90% of cases. There is also evidence that mesothelioma may result from both para-occupational exposure and non-occupational "environmental" exposure. Idiopathic or spontaneous mesothelioma can also occur in the absence of any exposure to asbestos, with a spontaneous rate in humans of around one per million. A combination of accurate exposure history, along with examination radiology and pathology are essential to make the diagnosis. Distinguishing malignant from benign pleural disease can be challenging. The most helpful CT findings suggesting malignant pleural disease are 1) a circumferential pleural rind, 2) nodular pleural thickening, 3) pleural thickening of > 1 cm and 4) mediastinal pleural involvement. Involvement of a multidisciplinary team is recommended to ensure prompt and appropriate management, using a framework of radiotherapy, chemotherapy, surgery and symptom palliation with end of life care. Compensation issues must also be considered. Life expectancy in malignant mesothelioma is poor, with a median survival of about one year following diagnosis. PMID:19099560

  12. Hematologic malignancies

    SciTech Connect

    Hoogstraten, B.

    1986-01-01

    The principle aim of this book is to give practical guidelines to the modern treatment of the six important hematologic malignancies. Topics considered include the treatment of the chronic leukemias; acute leukemia in adults; the myeloproliferative disorders: polycythemia vera, essential thrombocythemia, and idiopathic myelofibrosis/agnogenic myeloid metaplasia; Hodgkin's Disease; non-Hodgkin's lymphoma; and Multiple Myeloma.

  13. Displaced capillary dies

    DOEpatents

    Kalejs, Juris P.; Chalmers, Bruce; Surek, Thomas

    1982-01-01

    An asymmetrical shaped capillary die made exclusively of graphite is used to grow silicon ribbon which is capable of being made into solar cells that are more efficient than cells produced from ribbon made using a symmetrically shaped die.

  14. Displaced capillary dies

    DOEpatents

    Kalejs, Juris P.; Chalmers, Bruce; Surek, Thomas

    1984-01-01

    An asymmetrical shaped capillary die made exclusively of graphite is used to grow silicon ribbon which is capable of being made into solar cells that are more efficient than cells produced from ribbon made using a symmetrically shaped die.

  15. Packaged die heater

    DOEpatents

    Spielberger, Richard; Ohme, Bruce Walker; Jensen, Ronald J.

    2011-06-21

    A heater for heating packaged die for burn-in and heat testing is described. The heater may be a ceramic-type heater with a metal filament. The heater may be incorporated into the integrated circuit package as an additional ceramic layer of the package, or may be an external heater placed in contact with the package to heat the die. Many different types of integrated circuit packages may be accommodated. The method provides increased energy efficiency for heating the die while reducing temperature stresses on testing equipment. The method allows the use of multiple heaters to heat die to different temperatures. Faulty die may be heated to weaken die attach material to facilitate removal of the die. The heater filament or a separate temperature thermistor located in the package may be used to accurately measure die temperature.

  16. The Ambiguous Dying Syndrome

    ERIC Educational Resources Information Center

    Bern-Klug, Mercedes

    2004-01-01

    More than one-half of the 2.4 million deaths that will occur in the United States in 2004 will be immediately preceded by a time in which the likelihood of dying can best be described as "ambiguous." Many people die without ever being considered "dying" or "at the end of life." These people may miss out on the…

  17. The Ambiguous Dying Syndrome

    ERIC Educational Resources Information Center

    Bern-Klug, Mercedes

    2004-01-01

    More than one-half of the 2.4 million deaths that will occur in the United States in 2004 will be immediately preceded by a time in which the likelihood of dying can best be described as "ambiguous." Many people die without ever being considered "dying" or "at the end of life." These people may miss out on the…

  18. Primary pineal malignant melanoma

    PubMed Central

    Cedeño Diaz, Oderay Mabel; Leal, Roberto García; La Cruz Pelea, Cesar

    2011-01-01

    Primary pineal malignant melanoma is a rare entity, with only thirteen cases reported in the world literature to date. We report a case of a 70-year-old man, who consulted with gait disturbance of six months duration, associated in the last month with dizziness, visual abnormalities and diplopia. No other additional melanocytic lesions were found elsewhere. The magnetic resonance showed a 25 mm expansive mass in the pineal gland that was associated with hydrocephaly, ventricular and transependimary oedema. The lesion was partially excised by a supracerebellar infratentorial approach. The histological examination revealed a melanoma. The patient received radiation therapy, but died of disease 16 weeks later. We herein review the literature on this rare tumour and comment on its clinical, radiological and histopathological features and differential diagnosis. PMID:24765293

  19. HIGH PRESSURE DIES

    DOEpatents

    Wilson, W.B.

    1960-05-31

    A press was invented for subjecting specimens of bismuth, urania, yttria, or thoria to high pressures and temperatures. The press comprises die parts enclosing a space in which is placed an electric heater thermally insulated from the die parts so as not to damage them by heat. The die parts comprise two opposed inner frustoconical parts and an outer part having a double frustoconical recess receiving the inner parts. The die space decreases in size as the inner die parts move toward one another against the outer part and the inner parts, though very hard, do not fracture because of the mode of support provided by the outer part.

  20. Malignant hyperthermia.

    PubMed

    Cantin, R Y; Poole, A; Ryan, J F

    1986-10-01

    The increasing use of intravenous and inhalation sedation in the dental office has the potential of increasing the incidence of malignant hyperthermia (MH) in susceptible subjects. The object of this article is to present two cases of MH and to discuss its pathophysiology, its clinical picture, and its management in the light of the current literature. Stringent screening procedures should be adopted and maintained in order to channel suspected cases to appropriate centers for expert consultation and management. It is further advocated that a program of education for patients and their families be instituted, as it is an essential prerequisite of effective prophylaxis.

  1. Malignant hyperthermia

    PubMed Central

    2012-01-01

    Malignant hyperthermia (MH) is an uncommon, life-threatening pharmacogenetic disorder of the skeletal muscle. It presents as a hypermetabolic response in susceptible individuals to potent volatile anesthetics with/without depolarizing muscle relaxants; in rare cases, to stress from exertion or heat stress. Susceptibility to malignant hyperthermia (MHS) is inherited as an autosomally dominant trait with variable expression and incomplete penetrance. It is known that the pathophysiology of MH is related to an uncontrolled rise of myoplasmic calcium, which activates biochemical processes resulting in hypermetabolism of the skeletal muscle. In most cases, defects in the ryanodine receptor are responsible for the functional changes of calcium regulation in MH, and more than 300 mutations have been identified in the RYR1 gene, located on chromosome 19q13.1. The classic signs of MH include increase of end-tidal carbon dioxide, tachycardia, skeletal muscle rigidity, tachycardia, hyperthermia and acidosis. Up to now, muscle contracture test is regarded as the gold standard for the diagnosis of MHS though molecular genetic test is used, on a limited basis so far to diagnose MHS. The mortality of MH is dramatically decreased from 70-80% to less than 5%, due to an introduction of dantrolene sodium for treatment of MH, early detection of MH episode using capnography, and the introduction of diagnostic testing for MHS. This review summarizes the clinically essential and important knowledge of MH, and presents new developments in the field. PMID:23198031

  2. Sputtered protective coatings for die casting dies

    NASA Technical Reports Server (NTRS)

    Mirtich, M. J.; Nieh, C.-Y.; Wallace, J. F.

    1981-01-01

    Three experimental research designs investigating candidate materials and processes involved in protective die surface coating procedures by sputter deposition, using ion beam technologies, are discussed. Various pre-test results show that none of the coatings remained completely intact for 15,000 test cycles. The longest lifetime was observed for coatings such as tungsten, platinum, and molybdenum which reduced thermal fatigue, but exhibited oxidation and suppressed crack initiation only as long as the coating did not fracture. Final test results confirmed earlier findings and coatings with Pt and W proved to be the candidate materials to be used on a die surface to increase die life. In the W-coated specimens, which remained intact on the surface after thermal fatigue testing, no oxidation was found under the coating, although a few cracks formed on the surface where the coating broke down. Further research is planned.

  3. Sputtered protective coatings for die casting dies

    NASA Technical Reports Server (NTRS)

    Mirtich, M. J.; Nieh, C.-Y.; Wallace, J. F.

    1981-01-01

    Three experimental research designs investigating candidate materials and processes involved in protective die surface coating procedures by sputter deposition, using ion beam technologies, are discussed. Various pre-test results show that none of the coatings remained completely intact for 15,000 test cycles. The longest lifetime was observed for coatings such as tungsten, platinum, and molybdenum which reduced thermal fatigue, but exhibited oxidation and suppressed crack initiation only as long as the coating did not fracture. Final test results confirmed earlier findings and coatings with Pt and W proved to be the candidate materials to be used on a die surface to increase die life. In the W-coated specimens, which remained intact on the surface after thermal fatigue testing, no oxidation was found under the coating, although a few cracks formed on the surface where the coating broke down. Further research is planned.

  4. Die singulation method

    DOEpatents

    Swiler, Thomas P [Albuquerque, NM; Garcia, Ernest J [Albuquerque, NM; Francis, Kathryn M [Rio Rancho, NM

    2014-01-07

    A method is disclosed for singulating die from a semiconductor substrate (e.g. a semiconductor-on-insulator substrate or a bulk silicon substrate) containing an oxide layer (e.g. silicon dioxide or a silicate glass) and one or more semiconductor layers (e.g. monocrystalline or polycrystalline silicon) located above the oxide layer. The method etches trenches through the substrate and through each semiconductor layer about the die being singulated, with the trenches being offset from each other around at least a part of the die so that the oxide layer between the trenches holds the substrate and die together. The trenches can be anisotropically etched using a Deep Reactive Ion Etching (DRIE) process. After the trenches are etched, the oxide layer between the trenches can be etched away with a HF etchant to singulate the die. A release fixture can be located near one side of the substrate to receive the singulated die.

  5. Die singulation method

    DOEpatents

    Swiler, Thomas P.; Garcia, Ernest J.; Francis, Kathryn M.

    2013-06-11

    A method is disclosed for singulating die from a semiconductor substrate (e.g. a semiconductor-on-insulator substrate or a bulk silicon substrate) containing an oxide layer (e.g. silicon dioxide or a silicate glass) and one or more semiconductor layers (e.g. monocrystalline or polycrystalline silicon) located above the oxide layer. The method etches trenches through the substrate and through each semiconductor layer about the die being singulated, with the trenches being offset from each other around at least a part of the die so that the oxide layer between the trenches holds the substrate and die together. The trenches can be anisotropically etched using a Deep Reactive Ion Etching (DRIE) process. After the trenches are etched, the oxide layer between the trenches can be etched away with an HF etchant to singulate the die. A release fixture can be located near one side of the substrate to receive the singulated die.

  6. Extrusion die and method

    DOEpatents

    Lipp, G. Daniel

    1994-04-26

    A method and die apparatus for manufacturing a honeycomb body of rhombic cell cross-section by extrusion through an extrusion die of triangular cell discharge slot configuration, the die incorporating feedholes at selected slot intersections only, such that slot segments communicating directly with the feedholes discharge web material and slot segments not so connected do not discharge web material, whereby a rhombic cell cross-section in the extruded body is provided.

  7. The Angry Dying Patient.

    PubMed

    Houston, Robert E.

    1999-02-01

    Over 25 years ago, Kubler-Ross identified anger as a predictable part of the dying process. When the dying patient becomes angry in the clinical setting, all types of communication become strained. Physicians can help the angry dying patient through this difficult time by using 10 rules of engagement. When physicians engage and empathize with these patients, they improve the patient's response to pain and they reduce patient suffering. When physicians educate patients on their normal responses to dying and enlist them in the process of family reconciliation, they can impact the end-of-life experience in a positive way.

  8. Malignant hyperthermia.

    PubMed

    Bandschapp, Oliver; Girard, Thierry

    2012-07-31

    Malignant hyperthermia (MH) is a subclinical myopathy, usually triggered by volatile anaesthetics and depolarising muscle relaxants. Clinical symptoms are variable, and the condition is sometimes difficult to identify. Nevertheless, rapid recognition and specific as well as symptomatic treatment are crucial to avoid a lethal outcome. Molecular genetic investigations have confirmed the skeletal muscle type ryanodine receptor to be the major MH locus with more than 70% of MH families carrying a mutation in this gene. There is no screening method to test for MH, as current tests are invasive (open muscle biopsy) or restricted to MH families with known MH-associated mutations (molecular genetic testing). The prevalence of the MH trait is unknown, because the clinical penetrance after contact with triggering agents is very variable. More recently, MH mutations have been associated with rhabdomyolysis following statin therapy or with non-pharmacological triggering, such as exertional heat stroke.

  9. Die Soldering in Aluminium Die Casting

    SciTech Connect

    Han, Q.; Kenik, E.A.; Viswanathan, S.

    2000-03-15

    Two types of tests, dipping tests and dip-coating tests were carried out on small steel cylinders using pure aluminum and 380 alloy to investigate the mechanism of die soldering during aluminum die casting. Optical and scanning electron microscopy were used to study the morphology and composition of the phases formed during soldering. A soldering mechanism is postulated based on experimental observations. A soldering critical temperature is postulated at which iron begins to react with aluminum to form an aluminum-rich liquid phase and solid intermetallic compounds. When the temperature at the die surface is higher than this critical temperature, the aluminum-rich phase is liquid and joins the die with the casting during the subsequent solidification. The paper discusses the mechanism of soldering for the case of pure aluminum and 380 alloy casting in a steel mold, the factors that promote soldering, and the strength of the bond formed when soldering occurs. conditions, an aluminum-rich soldering layer may also form over the intermetallic layer. Although a significant amount of research has been conducted on the nature of these intermetallics, little is known about the conditions under which soldering occurs.

  10. Is Dying Young Worse than Dying Old?

    ERIC Educational Resources Information Center

    Jecker, Nancy S.; Schneiderman, Lawrence J.

    1994-01-01

    Notes that, in contemporary Western society, people feel death of small child is greater injustice than death of older adult and experience correspondingly greater sorrow, anger, regret, or bitterness when very young person dies. Contrasts these attitudes with those of ancient Greece and shows relevance that different attitudes toward death have…

  11. Is Dying Young Worse than Dying Old?

    ERIC Educational Resources Information Center

    Jecker, Nancy S.; Schneiderman, Lawrence J.

    1994-01-01

    Notes that, in contemporary Western society, people feel death of small child is greater injustice than death of older adult and experience correspondingly greater sorrow, anger, regret, or bitterness when very young person dies. Contrasts these attitudes with those of ancient Greece and shows relevance that different attitudes toward death have…

  12. Pultrusion Die Assembly

    NASA Technical Reports Server (NTRS)

    Wilson, Maywood L. (Inventor); Johnson, Gary S. (Inventor); Frye, Mark W. (Inventor); Stanfield, Clarence E. (Inventor)

    1988-01-01

    This invention relates generally to pultrusion die assemblies, and more particularly, to a pultrusion die assembly which incorporates a plurality of functions in order to produce a continuous, thin composite fiber reinforced thermoplastic material. The invention is useful for making high performance thermoplastic composite materials in sheets which can be coiled on a spool and stored for further processing.

  13. Extrusion die and method

    DOEpatents

    Lipp, G. Daniel

    1994-05-03

    A method and die apparatus for manufacturing a honeycomb body of triangular cell cross-section and high cell density, the die having a combination of (i) feedholes feeding slot intersections and (ii) feedholes feeding slot segments not supplied from slot intersections, whereby a reduction in feedhole count is achieved while still retaining good extrusion efficiency and extrudate uniformity.

  14. Micromechanical die attachment surcharge

    DOEpatents

    Filter, William F.; Hohimer, John P.

    2002-01-01

    An attachment structure is disclosed for attaching a die to a supporting substrate without the use of adhesives or solder. The attachment structure, which can be formed by micromachining, functions purely mechanically in utilizing a plurality of shaped pillars (e.g. round, square or polygonal and solid, hollow or slotted) that are formed on one of the die or supporting substrate and which can be urged into contact with various types of mating structures including other pillars, a deformable layer or a plurality of receptacles that are formed on the other of the die or supporting substrate, thereby forming a friction bond that holds the die to the supporting substrate. The attachment structure can further include an alignment structure for precise positioning of the die and supporting substrate to facilitate mounting the die to the supporting substrate. The attachment structure has applications for mounting semiconductor die containing a microelectromechanical (MEM) device, a microsensor or an integrated circuit (IC), and can be used to form a multichip module. The attachment structure is particularly useful for mounting die containing released MEM devices since these devices are fragile and can otherwise be damaged or degraded by adhesive or solder mounting.

  15. Extrusion die and method

    SciTech Connect

    Lipp, G.D.

    1994-05-03

    A method and die apparatus for manufacturing a honeycomb body of triangular cell cross-section and high cell density, the die having a combination of (i) feedholes feeding slot intersections and (ii) feedholes feeding slot segments not supplied from slot intersections, whereby a reduction in feedhole count is achieved while still retaining good extrusion efficiency and extrudate uniformity. 4 figures.

  16. Malignant change in dermatitis artefacta.

    PubMed Central

    Alcolado, J. C.; Ray, K.; Baxter, M.; Edwards, C. W.; Dodson, P. M.

    1993-01-01

    Dermatitis artefacta is a chronic skin lesion produced by self-trauma. Avoidance of further trauma, topical steroids and psychological therapy all play a part in the treatment of such lesions. Unresolved lesions may become large and disfiguring and subject to infection. We report a case of one such lesion in an elderly woman who persistently excoriated a cholecystectomy scar over 40 years. Malignant transformation occurred in a manner analogous to the neoplastic change observed in other types of chronic ulcer (Marjolin's ulcer). The squamous cell carcinoma presented with widespread metastases from which the patient eventually died. Recent literature concerning Marjolin's ulcers is reviewed and it is noted that this is the first reported case of death caused by malignant change in dermatitis artefacta. Images Figure 1 PMID:8234114

  17. [Malignant hyperthermia].

    PubMed

    Metterlein, T; Schuster, F; Graf, B M; Anetseder, M

    2014-12-01

    Malignant hyperthermia (MH) is a rare hereditary, mostly subclinical myopathy. Trigger substances, such as volatile anesthetic agents and the depolarizing muscle relaxant succinylcholine can induce a potentially fatal metabolic increase in predisposed patients caused by a dysregulation of the myoplasmic calcium (Ca) concentration. Mutations in the dihydropyridine ryanodine receptor complex in combination with the trigger substances are responsible for an uncontrolled release of Ca from the sarcoplasmic reticulum. This leads to activation of the contractile apparatus and a massive increase in cellular energy production. Exhaustion of the cellular energy reserves ultimately results in local muscle cell destruction and subsequent cardiovascular failure. The clinical picture of MH episodes is very variable. Early symptoms are hypoxia, hypercapnia and cardiac arrhythmia whereas the body temperature rise, after which MH is named, often occurs later. Decisive for the course of MH episodes is a timely targeted therapy. Following introduction of the hydantoin derivative dantrolene, the previously high mortality of fulminant MH episodes could be reduced to well under 10 %. An MH predisposition can be detected using the invasive in vitro contracture test (IVCT) or mutation analysis. Few elaborate diagnostic procedures are in the developmental stage.

  18. Die Kometenmission Rosetta

    NASA Astrophysics Data System (ADS)

    Krüger, Harald

    2016-11-01

    Die Rosetta-Mission ist ein Meilenstein in der Erforschung der Kometen und ihrer Entstehung. Eine der größten üerraschungen war die unregelmäßge hantelförmige Gestalt des Zielkometen 67P/Tschurjumow-Gerassimenko. Er besteht wahrscheinlich aus zwei Einzelkörpern, die durch ihre Schwerkraft aneinander gehalten werden. Seine Oberfläche ist sehr rau und zeigt eine sehr vielf ältige Morphologie, die auf eine Vielzahl von ablaufenden Prozessen hindeutet. Der Kometenkern ist vermutlich auf Gr ößnskalen von mehr als etwa 10 bis 100 Metern homogen, Inhomogenitäten auf kleineren Skalen k nnten f r seine Aktivä t verantwortlich sein. Diese ist auf kleine Gebiete konzentriert, und auch Oberflächenveränderungen, die sich innerhalb von einigen Tagen bis wenigen Wochen abspielen, sind lokal. Im Kometenmaterial wurde eine Vielzahl an organischen Substanzen gemessen, die zum Teil als Schlüsselmoleküle für die Synthese der Grundbausteine des Lebens gelten, wie wir es kennen.

  19. Death, dying, and domination.

    PubMed

    Spindelman, Marc

    2008-06-01

    This Article critiques conventional liberal arguments for the right to die on liberal grounds. It contends that these arguments do not go far enough to recognize and address private, and in particular structural, forms of domination. It presents an alternative that does, which is thus more respectful of true freedom in the context of death and dying, and also more consistent with liberalism. After discussing obstacles to the achievement of a right to die that encompasses freedom from both public and private domination, the Article closes with a significant reform project within bioethics that might help bring it about.

  20. Die Zeitung der Zukunft

    NASA Astrophysics Data System (ADS)

    Wieser, Christoph; Schaffert, Sebastian

    Schon lange wird spekuliert, wie wir in Zukunft Zeitung lesen werden. Werden wir am Frühstückstisch wie gewohnt in einer Zeitung aus Papier schmökern oder werden wir die Zeitung als biegsame Folie beschrieben mit elektronischer Tinte in Händen halten? Wird die Zeitung mit anderen Medien wie Radio und Fernsehen verschmelzen? Viele Varianten sind denkbar. Heute lässt sich schon ein Trend ablesen: Immer mehr Leser entdecken die Online-Zeitung als Informationsmedium, eine Voraussetzung für die Nutzung neuer Technologien in der Zeitung der Zukunft. In diesem Kapitel stellen wir Entwicklungsmöglichkeiten der Online-Zeitung dar, wie sie im Social Semantic Web möglich werden.

  1. Assisted Dying & Disability.

    PubMed

    Riddle, Christopher A

    2017-07-01

    This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal. I suggest that these changes are likely to only strengthen opposition to assisted dying from disability rights activists and people with disabilities. Second, I focus on respect for people with disabilities and in particular, respect for their autonomy and decision-making abilities. Third, I explore the opposition to assisted dying that focuses on risk and the vulnerability of people with disabilities. Here I suggest that this risk ought not to be of special concern. Ultimately, I conclude that upholding respect for the disabled requires the legalization of assisted dying, rather than the denial of access in a misguided effort to protect people with disabilities. © 2017 John Wiley & Sons Ltd.

  2. Malignant hyperthermia

    PubMed Central

    Rosenberg, Henry; Davis, Mark; James, Danielle; Pollock, Neil; Stowell, Kathryn

    2007-01-01

    Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stresses such as vigorous exercise and heat. The incidence of MH reactions ranges from 1:5,000 to 1:50,000–100,000 anesthesias. However, the prevalence of the genetic abnormalities may be as great as one in 3,000 individuals. MH affects humans, certain pig breeds, dogs, horses, and probably other animals. The classic signs of MH include hyperthermia to marked degree, tachycardia, tachypnea, increased carbon dioxide production, increased oxygen consumption, acidosis, muscle rigidity, and rhabdomyolysis, all related to a hypermetabolic response. The syndrome is likely to be fatal if untreated. Early recognition of the signs of MH, specifically elevation of end-expired carbon dioxide, provides the clinical diagnostic clues. In humans the syndrome is inherited in autosomal dominant pattern, while in pigs in autosomal recessive. The pathophysiologic changes of MH are due to uncontrolled rise of myoplasmic calcium, which activates biochemical processes related to muscle activation. Due to ATP depletion, the muscle membrane integrity is compromised leading to hyperkalemia and rhabdomyolysis. In most cases, the syndrome is caused by a defect in the ryanodine receptor. Over 90 mutations have been identified in the RYR-1 gene located on chromosome 19q13.1, and at least 25 are causal for MH. Diagnostic testing relies on assessing the in vitro contracture response of biopsied muscle to halothane, caffeine, and other drugs. Elucidation of the genetic changes has led to the introduction, on a limited basis so far, of genetic testing for susceptibility to MH. As the sensitivity of genetic testing increases, molecular genetics will be used for identifying those at risk with greater frequency. Dantrolene

  3. Case Report: Pulmonary metastases of malignant meningioma

    PubMed Central

    Basunaid, Suhail; Franssen, Frits M.E.; Accord, Ryan; Hamid, Myrurgia Abdul; Mahesh, Shekar; Baumert, Brigitta G.; Schijns, Olaf E.M.G.

    2014-01-01

    Meningioma accounts for approximately one-third of primary central nervous system tumors. Most meningiomas are benign, although up to one third are classified as atypical or malignant. We describe a 63-year Caucasian male presenting with pleural metastases from an intracranial meningioma. Distant metastases from meningiomas are infrequently found in clinical practice and mostly are associated with atypical or malignant meningiomas. There is no standard treatment; however surgical resection of both the primary and metastatic lesions is the safest therapy. The overall prognosis of atypical meningiomas is poor. Our patient died one week after discharge from our hospital. PMID:25254095

  4. Die einzelnen Beanspruchungsarten

    NASA Astrophysics Data System (ADS)

    Böge, Gert; Böge, Wolfgang

    Wird ein Stab mit beliebigem, gleichbleibendem Querschnitt durch die äußere Kraft F in der Schwerachse auf Zug oder Druck beansprucht, so wird bei gleichmäßiger Spannungsverteilung, also in genügender Entfernung vom Angriffspunkt der Kraft, die Zug- oder Druckspannung σ_{z,d}= Zug- oder Druckkraft F/Querschnittsfläche A {Zug- und Druck-Hauptgleichung} σ_{z,d}=F/A\\qquad σ&F&A N/mm2 & N&mm2 Je nach vorliegender Aufgabe kann die Hauptgleichung umgestellt werden zur Berechnung des erforderlichen Querschnitts (Querschnittsnachweis): A_{erf}=F/σ_{zul} Berechnung der vorhandenen Spannung (Spannungsnachweis): σ_{vorh}=F/A Berechnung der maximal zulässigen Belastung (Belastungsnachweis): F_{max}=σ_{zul}A Treten Zug- und Druckspannungen in einer Rechnung gleichzeitig auf, werden sie durch den Index z und d oder durch das Vorzeichen + und - unterschieden.

  5. Assisted Dying in Canada.

    PubMed

    Schuklenk, Udo

    2014-01-01

    This paper makes an affirmative ethical case in favour of the decriminalization of assisted dying in Canada. It then proceeds to defending the affirmative case against various slippery-slope arguments that are typically deployed by opponents of assisted dying. Finally, a recent case of questionable professional conduct by anti-euthanasia campaigners cum academics is flagged as a warning to all of us not to permit the quality of the professional debate to deteriorate unacceptably, despite the personal emotional investments involved on all sides of the debate.

  6. Multiple primary malignancies in patients with prostate cancer: increased risk of secondary malignancies after radiotherapy.

    PubMed

    Okajima, Kaoru; Ishikawa, Kazuki; Matsuura, Tomohiro; Tatebe, Hitoshi; Fujiwara, Kazuhisa; Hiroi, Keiji; Hasegawa, Hirokazu; Nishimura, Yasumasa

    2013-12-01

    New treatment strategies for prostate cancer have recently been developed, but multiple malignancies remain a major concern. The aim of this study was to evaluate the characteristics of multiple malignancies and to analyze the risk of secondary malignancies after radiotherapy for prostate cancer. From 2000 to 2011, 150 patients with prostate cancer were treated with curative radiotherapy in our department. Patient age range was 54-92 years (median, 70 years), and the follow-up period was 4-142 months (median, 48 months). The incidence of multiple primary cancers was compared with the estimated incidence. A total of 147 patients (98 %) survived more than 12 months (12-142 months; median, 48 months); 20/150 patients (13 %) died within 10 years. Cause of death was recurrent prostate cancer in 11 patients, other primary malignancies in 7 patients, and cardiovascular disease in 2 patients. Multiple primary cancers were present in 26 of 150 patients (17 %), including 16 subsequent malignancies (11 %) with latent periods of 13-83 months (median, 43 months). The subsequent non-prostate malignancies were lung cancer in 4 patients, urinary bladder or ureter cancer in 4, stomach cancer in 3, malignant lymphoma in 2, and other in 3. Analysis of the observed incidence of secondary malignancies compared with the estimated incidence in the general population revealed a higher incidence of ureter cancer and malignant lymphoma. Close attention should be paid to secondary malignancies after radiotherapy for prostate cancer, including malignancies occurring within 5 years, which could be attributable to radiotherapy.

  7. When Somebody Dies

    MedlinePlus

    ... to have fun with. That absence leaves a big hole in our lives. Maybe you had a pet that died . Remember the first few times you walked into the house after your dog or cat was gone? It was strange not to have ...

  8. When a Baby Dies.

    ERIC Educational Resources Information Center

    Church, Martha Jo; And Others

    Written especially for grieving mothers whose babies have died, this booklet offers an overview of stages and experiences through which bereaved parents commonly pass. Specifically, the text is intended to give comfort to bereaved parents, offer insight into the grieving process, and provide thoughts on leave-taking ceremonies. The first section…

  9. Die Kosmologie der Griechen.

    NASA Astrophysics Data System (ADS)

    Mittelstraß, J.

    Contents: 1. Mythische Eier. 2. Thales-Welten. 3. "Alles ist voller Götter". 4. Griechische Astronomie. 5. "Rettung der Phänomene". 6. Aristotelische Kosmololgie. 7. Aristoteles-Welt und Platon-Welt. 8. Noch einmal: die Göttlichkeit der Welt. 9. Griechischer Idealismus.

  10. Poetry and the Dying.

    ERIC Educational Resources Information Center

    Kramer, Aaron

    1992-01-01

    Demonstrates roles poetry can play as people confront the death of loved ones and their own dying. Gives examples of Heinrich Heine transforming his agony into art and, from the poetry of two college students, both in advanced stages of neurological disease, which was read aloud in class, teaching all present something about how to approach their…

  11. When a Student Dies.

    ERIC Educational Resources Information Center

    Dowling-Sendor, Benjamin

    1998-01-01

    A student athlete died after the first day of football practice in Texas. His parents brought suit (Roventini v. Pasadena Independent School District) for monetary damages in federal district court contending that the defendants violated the student's rights. Presents the judge's analysis of the legal issues. Advises board members and…

  12. Dying to Play.

    ERIC Educational Resources Information Center

    Miller, John K.

    1998-01-01

    In August 1995, a young football player died as a result of heat exhaustion suffered on the first day of football practice in Arkansas. Spurred by this tragedy, the district made some changes that every school district with an athletic program should consider. These include using a heat-stress monitor; abandoning the practice of group physical…

  13. Dying in hospital.

    PubMed

    Pearce, Lynne

    2016-06-22

    While surveys consistently show that about two thirds of people want to die at home, more than half of all deaths happen in hospitals. And in their last days, many people are cared for by generalist nursing staff who may be reticent, or even afraid, to talk about what is happening.

  14. When Somebody Dies

    MedlinePlus

    ... container is gone, but what's inside — the water — remains. The part of a person that's left after the body dies is often called the "soul" or "spirit." Some people believe the soul is the part of a human that loves, feels, and creates; it's the part ...

  15. [Malignant soft tissue tumors].

    PubMed

    Schauer, A; Altmannsberger, M

    1984-01-01

    This article is a survey of actual aspects. With regard to frequency, the malignant fibrous histocytoma comes first, followed by lipo- and fibrosarcoma, synovial sarcoma, malignant schwannoma, malignant tumours proceeding from arteries and veins and the unstriated musculature. Staging and grading of these tumours are difficult. Until now their overall TNM-classification was not possible due to insufficient hard criteria.

  16. Herausforderungen durch die deutsche Wiedervereinigung

    NASA Astrophysics Data System (ADS)

    Stäglin, Reiner

    Die Wiedervereinigung stellte auch die Statistik vor große Aufgaben. Die als Organ der staatlichen Planung staatsnah orientierte Statistik der DDR musste auf das zur Neutralität und wissenschaftlichen Unabhängigkeit verpflichtete System der Bundesrepublik umgestellt werden. Ebenso verlangten die Universitäten eine Neuorientierung. Die Deutsche Statistische Gesellschaft hat sich vor allem dreier Aufgaben mit großem Engagement, aber auch mit Bedachtsamkeit angenommen: Aufnahme und Integration der Statistiker aus den neuen Bundesländern in die Gesellschaft, Begleitung der Neuausrichtung des Faches Statistik an deren Hochschulen und Sicherung sowie Nutzung von Datenbeständen der ehemaligen DDR.

  17. Modeling the Mechanical Performance of Die Casting Dies

    SciTech Connect

    R. Allen Miller

    2004-02-27

    The following report covers work performed at Ohio State on modeling the mechanical performance of dies. The focus of the project was development and particularly verification of finite element techniques used to model and predict displacements and stresses in die casting dies. The work entails a major case study performed with and industrial partner on a production die and laboratory experiments performed at Ohio State.

  18. Synchronous double malignancy: adenocarcinoma of lung and malignant astrocytoma induced by asbestos exposure.

    PubMed

    Kishimoto, T; Hashimoto, H; Ono, T; Okada, K

    1992-01-01

    A 54-year-old male died of cerebellar herniation induced by brain tumor. Radiological examination of this case showed two separate tumorous lesions in the brain and lung. Autopsy proved malignant astrocytoma in the brain and coincidental alveolar cell carcinoma in the lung. He had a history of asbestos exposure for 8 years doing piping work in a shipyard. Furthermore, we detected a large number of asbestos bodies in the lung and one asbestos body in the brain. Therefore, this rare case of double cancer (malignant astrocytoma and lung cancer) might have been induced by asbestos exposure.

  19. Precursors to Lymphoproliferative Malignancies

    PubMed Central

    Goldin, Lynn R.; McMaster, Mary L.; Caporaso, Neil E.

    2013-01-01

    We review monoclonal B-cell lymphocytosis (MBL) as a precursor to chronic lymphocytic leukemia and monoclonal gammopathy of undetermined significance (MGUS) as a precursor to plasma cell disorders. These conditions are present in the general population and increase with age. These precursors aggregate with lymphoproliferative malignancies in families suggesting shared inheritance. MBL and MGUS may share some of the same risk factors as their related malignancies but data are limited. While these conditions are characterized by enhanced risk for the associated malignancy, the majority of individuals with these conditions do not progress to malignancy. A key focus for current work is to identify markers that predict progression to malignancy. PMID:23549397

  20. Die kalte Zunge

    NASA Astrophysics Data System (ADS)

    Bartels, Sören; Müller, Rüdiger

    Gefühlte Temperaturen. Ist ein Null Grad Celsius kalter Metallstab eigentlich kälter als ein Holzstab mit der selben Temperatur? Rein physikalisch gesehen natürlich nicht, aber wenn wir beide Stäbe anfassen, kommt uns der Metallstab deutlich kälter vor. Und wer kennt nicht die Szene aus dem Film Dumm und Dümmer in der Harry mit seiner Zunge am Metallrahmen des Skilifts hängen bleibt.Würde das auch passieren, wenn man an einem eiskalten Stück Holz lecken würde? Wohl kaum, doch woran liegt das eigentlich? Unterschiedliche Materialien haben verschiedene Fähigkeiten, Wärme zu übertragen und zu leiten. So transportiert Metall die von der Zunge ausgehende Wärme sehr schnell weiter und verändert seine Temperatur kaum, während die Zunge abkühlt. Holz hingegen leitet Wärme fast gar nicht und daher wird der Teil, der von der Zunge berührt wird, aufgewärmt.

  1. Heated die facilitates tungsten forming

    NASA Technical Reports Server (NTRS)

    Chattin, J. H.; Haystrick, J. E.; Laughlin, J. C.; Leidy, R. A.

    1966-01-01

    Tungsten forming in a press brake employs a bottom die assembly with a heating manifold between two water-cooled die sections. The manifold has hydrogen-oxygen burners spaced along its length for even heat during forming.

  2. 'We Have No Dying Patients'

    ERIC Educational Resources Information Center

    Robinson, Lisa

    1974-01-01

    A course on death and dying offered by the University of Maryland School of Nursing focuses on developing relationships between health care workers and dying people, using actual clients as the vehicle for learning. (Author/EA)

  3. Designing a Die for Hydroforming

    NASA Astrophysics Data System (ADS)

    Vasile, Radu

    2016-12-01

    Designing a die is in every application field an intensive process of bringing together know how from design, testing and every-day use from previous dies with the new application requirements. Contribution deals with a knowledge oriented, modular and feature integrated computer aided design system for die development. This paper describes the concepts behind designing a hydroforming die for sheet metal forming, with easy application-use in small workshops for testing hydroforming capabilities of different materials.

  4. Psychotherapy with Older Dying Persons.

    ERIC Educational Resources Information Center

    Dye, Carol J.

    Psychotherapy with older dying patients can lead to problems of countertransference for the clinician. Working with dying patients requires flexibility to adapt basic therapeutics to the institutional setting. Goals of psychotherapy must be reconceptualized for dying clients. The problems of countertransference arise because clinicians themselves…

  5. Dying with dignity.

    PubMed

    Madan, T N

    1992-08-01

    Death is a theme of central importance in all cultures, but the manner in which it is interpreted varies from society to society. Even so, traditional cultures, including Christian, Hindu and Jain religious traditions, exhibited a positive attitude to death and did not look upon it in a dualistic framework of good vs bad, or desirable vs undesirable. Nor was pessimism the dominant mood in their thinking about death itself. A fundamental paradigm shift occurred in the West in the eighteenth century when death was desacralized and transformed into a secular event amenable to human manipulation. From those early beginnings, dying and death have been thoroughly medicalized and brought under the purview of high technology in the twentieth century. Once death is seen as a problem for professional management, the hospital displaces the home, and specialists with different kinds and degrees of expertise take over from the family. Everyday speech and the religious idiom yield place to medical jargon. The subject (an ageing, sick or dying person) becomes the object of this make-believe yet real world. As the object of others' professional control, he or she loses the freedom of self-assessment, expression and choice. Or, he or she may be expected to choose when no longer able to do so. Thus, not only freedom but dignity also is lost, and lawyers join doctors in crisis manipulation and perpetuation. Although the modern medical culture has originated in the West, it has gradually spread to all parts of the world, subjugating other kinds of medical knowledge and other attitudes to dying and death.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Undiagnosed Pheochromocytoma Simulating Malignant Hyperthermia.

    PubMed

    Ramani, Nisha S; Stoppacher, Robert; Morani, Ajaykumar C; Catanese, Charles

    2017-09-01

    Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure. Postoperatively, his blood pressures dropped from 220/100 to 80/30 mm Hg. He later developed high fever with core temperature reaching a peak of 42.2°C, rapid breathing, and died after unsuccessful attempts to stabilize him. Autopsy revealed a tumor in his right adrenal gland, measuring 10 cm in greatest dimension and weighing 530 g. It was red brown with a hemorrhagic and cystic cut surface. A thin rim of yellow-orange adrenal cortex was visible at the margin of the tumor, indicating that it originated from the underlying adrenal medulla. The left adrenal gland was unremarkable.Sections showed hypercellular tumor with zellballen architecture. The tumor cells were round to oval with finely granular basophilic cytoplasm and mild pleomorphism. A 24-hour urine sample collected before his death showed greater than 22727 μg/g Ratio to Creatinine metanephrines and normetanephrine, indicating that the tumor was active and secreted high levels of catecholamine. The cause of death was established as the complications of pheochromocytoma in the settings of general anesthesia for shoulder arthroscopy. The manner of death was natural. Pheochromocytoma can mimic malignant hyperthermia, and it should always be considered and managed appropriately in such scenarios to avoid untoward consequences. Pathologists must also be aware of this when conducting an autopsy in cases with a previous clinical diagnosis of malignant hyperthermia.

  7. Rep. George Brown dies

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    George E. Brown, ranking Democratic member of the U.S. House of Representatives Science Committee, died on July 15 at the age of 79 due to complications following a heart valve replacement last May. He was a strong advocate for science and environmental protection measures, and an independent thinker who sometimes found himself alone or far ahead of other people on issues. A congressman for 34 years who represented first the 29th Congressional District and then the 42nd District in California, Brown served on the science committee since 1965 and was chair from 1991 through 1994.

  8. Malignant tumor formation at the site of previously irradiated acanthomatous epulides in four dogs

    SciTech Connect

    Thrall, D.E.; Goldschmidt, M.H.; Biery, D.N.

    1981-01-15

    The radiation response of acanthomatous epulis in 32 dogs was good, with an estimated median survival time of 21 months. Of the 32 patients, 14 have died. In 4 of those 14, malignant tumors developed at the site of the acanthomatous epulis. The tumors were of epithelial origin in 3 patients and of mesenchymal origin in 1 patient. Possibilities explaining the appearance of the malignancies included spontaneous malignant transformation, radiation induction of neoplasms, and radiation induction of malignant transformation. This uncommon complication was not considered contradictory to radiotherapy of acanthomatous epulides, because of their excellent response to irradiation and the long latent period between irradiation and appearance of the malignant tumor.

  9. Vasculitis associated with malignancy.

    PubMed

    Mertz, L E; Conn, D L

    1992-02-01

    A large variety of vasculopathic syndromes are uncommonly associated with malignancies. Vasculitis is usually manifested by skin lesions and is generally associated with hematologic malignancies rather than solid tumors. Evidence of autoantibodies, immune complexes, and complement consumption is typically absent. Myelodysplastic syndromes can be confidently linked to vasculitis on the basis of recent literature. The temporal relationship of malignancy to vasculitis development is variable except that vasculitis generally follows the discovery of hairy cell leukemia and splenectomy. Vasculitis may occasionally be a complication of chemotherapy, radiation therapy, and bone marrow transplantation. Occasionally, malignant disorders may mimic vasculitic syndromes. The etiopathogenesis of vasculitis in patients with malignant disorders is unknown. The recent literature on vasculitis and malignancy addresses predominantly case reports and small patient cohorts and identifies clinical characteristics rather than pathogenic mechanisms.

  10. [Contribution on the familial occurrence of malignant testicular tumors].

    PubMed

    Kleinteich, B; Marx, G

    1983-01-01

    Eight cases of testis tumors in monozygote twin brothers are described in the bibliography. One case is added here. Nearly at the same age, two twin brothers got a right side embryonal teratocarcinoma. The histories of diseases were approximately identical. The brothers died two years later. The possibility of genetic factors causing or influencing the development of malignant testicular tumors are briefly discussed.

  11. Pediatric Salivary Gland Malignancies.

    PubMed

    Ord, Robert A; Carlson, Eric R

    2016-02-01

    Pediatric malignant salivary gland tumors are extremely rare. The percentage of malignant tumors is higher than that seen in adults, although the outcomes in terms of survival are better in pediatric patients. The mainstay of treatment is surgical excision with negative margins. This article reviews current concepts in demographics, etiology, management, and outcomes of malignant salivary tumors in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Rheumatic Diseases and Malignancies

    PubMed Central

    BOJINCA, Violeta; JANTA, Iustina

    2012-01-01

    ABSTRACT There are many studies which demonstrate a higher risk for malignancy in patients with rheumatic diseases. There have been a number of possible explanations for the differences in the risk of certain malignancies in patients with rheumatic disease, compared with general population, but a clear mechanism is difficult to identify. Rheumatoid syndromes may be associated with malignancy as paraneoplastic conditions, which can antedate the neoplasm diagnosis. On the other hand, autoimmune rheumatic diseases have a higher risk of malignancy by themselves or because of the immunosuppressant treatments. PMID:23482881

  13. Malignant Vagal Paraganglioma.

    PubMed

    Hamersley, Erin R S; Barrows, Amy; Perez, Angel; Schroeder, Ashley; Castle, James T

    2016-06-01

    Paragangliomas are rare, typically benign neuroendocrine tumors that represent a small portion of head and neck tumors. A small percentage of these are known to have malignant potential. They arise from the carotid body, jugular bulb or vagus nerves. There is limited literature discussing the management of malignant vagal paragangliomas. We present a case of a 25 year old female with a left malignant vagal paraganglioma. The following case presentation will describe the presentation, classic radiologic findings, and management of a malignant vagal paraganglioma along with a review of the literature.

  14. Die großen Zeppeline: Die Geschichte des Luftschiffbaus

    NASA Astrophysics Data System (ADS)

    Kleinheins, Peter; Meighörner, Wolfgang

    Über die glanzvolle Zeit der Zeppeline sind viele Bücher erschienen, die vorwiegend den Einsatz der Luftschiffe in Frieden und Krieg schildern. Nur wenige wissen, dass die Baugeschichte der Zeppeline eine der faszinierendsten Phasen der modernen Technik ist. Peter Kleinheins hat dieses Geschehen sachkundig aufgearbeitet und zusammengestellt. Entstanden ist eine reich illustrierte Dokumentation in einer interessanten Mischform aus zeitgenössischen Berichten und hochwertigen Originalquellen.

  15. Accurate defect die placement and nuisance defect reduction for reticle die-to-die inspections

    NASA Astrophysics Data System (ADS)

    Wen, Vincent; Huang, L. R.; Lin, C. J.; Tseng, Y. N.; Huang, W. H.; Tuo, Laurent C.; Wylie, Mark; Chen, Ellison; Wang, Elvik; Glasser, Joshua; Kelkar, Amrish; Wu, David

    2015-10-01

    Die-to-die reticle inspections are among the simplest and most sensitive reticle inspections because of the use of an identical-design neighboring-die for the reference image. However, this inspection mode can have two key disadvantages: (1) The location of the defect is indeterminate because it is unclear to the inspector whether the test or reference image is defective; and (2) nuisance and false defects from mask manufacturing noise and tool optical variation can limit the usable sensitivity. The use of a new sequencing approach for a die-to-die inspection can resolve these issues without any additional scan time, without sacrifice in sensitivity requirement, and with a manageable increase in computation load. In this paper we explore another approach for die-to-die inspections using a new method of defect processing and sequencing. Utilizing die-to-die double arbitration during defect detection has been proven through extensive testing to generate accurate placement of the defect in the correct die to ensure efficient defect disposition at the AIMS step. The use of this method maintained the required inspection sensitivity for mask quality as verified with programmed-defectmask qualification and then further validated with production masks comparing the current inspection approach to the new method. Furthermore, this approach can significantly reduce the total number of defects that need to be reviewed by essentially eliminating the nuisance and false defects that can result from a die-to-die inspection. This "double-win" will significantly reduce the effort in classifying a die-to-die inspection result and will lead to improved cycle times.

  16. Where people die.

    PubMed Central

    Katz, B P; Zdeb, M S; Therriault, G D

    1979-01-01

    Death certificates for 1977 filed with the New York State Department of Health were studied to determine where people died. Data were examined by the location and cause of death and by the age, sex, race, and marital status of the decedent. Comparisons were made with a similar study in which U.S. data were used for 1958 events. Approximately 60 percent of all the 1977 deaths in upstate New York occurred in hospitals; only 27 percent occurred outside an institution. The location of death varied by all the factors studied. Within all age categories, males had a higher percentage of hospital deaths. In those age categories in which nursing home deaths comprised a significant proportion of total deaths, females had a higher percentage of such deaths than males. Differences in the location of death according to its cause reflect the nature of the cause of death, for example, whether it was of sudden onset or the result of chronic disease. Most people do not consider in advance where they might die. The idea that age, sex, and marital status, as well as the more obvious cause, all play a part in the location may seem surprising. Yet all these factors were found to be associated withe location of deaths in upstate New York, and there is no reason to believe that this association does not hold true for the entire nation. More research, however, needs to be done based on more years and other geographic artal stutus may be instructive as to the present state of health resources. PMID:515338

  17. Bronchial malignant melanoma.

    PubMed

    Weshler, Z; Sulkes, A; Kopolovitch, J; Leviatan, A; Shifrin, E

    1980-01-01

    We describe a case of malignant melanoma presenting initially as an endobronchial lesion located in the left main bronchus causing total atelectasis. This resolved with radiation therapy. Widespread metastases developed shortly thereafter. The differential diagnosis of primary and metastatic bronchial malignant melanoma is discussed. Other isolated case reports are reviewed.

  18. Malignant tumors —

    Cancer.gov

    Main criteria for malignancy include size over 5 mm in diameter, invasion of airways, blood or lymphatic vessels, regional and distant metastasis, and ability to grow upon transplantation. Nuclear and cellular atypia, and loss of architecture should be considered as ancillary criteria for defining malignancy.

  19. Graphite/Thermoplastic-Pultrusion Die

    NASA Technical Reports Server (NTRS)

    Wilson, Maywood L.; Frye, Mark W.; Johnson, Gary S.; Stanfield, Clarence E.

    1990-01-01

    Attachment to extruder produces thermoplastic-impregnated graphite tape. Consists of profile die, fiber/resin collimator, and crosshead die body. Die designed to be attached to commercially available extrusion machine capable of extruding high-performance thermoplastics. Simple attachment to commercial extruder enables developers of composites to begin experimenting with large numbers of proprietary resins, fibers, and hybrid composite structures. With device, almost any possible fiber/resin combination fabricated.

  20. Die Milchstraße.

    NASA Astrophysics Data System (ADS)

    Henbest, N.; Couper, H.

    This book is a German translation, by M. Röser, from the English original "The guide to the Galaxy", published in 1994 (see Abstr. 61.003.065). Contents: 1. Die Entdeckung unserer Galaxis. 2. Die Lokale Gruppe. 3. Die Geographie der Galaxis. 4. Der Perseus-Arm. 5. Der Orion-Arm. 6. Unsere lokale Nachbarschaft: ein typischer Winkel der Galaxis. 7. Der Sagittarius-Arm: innerhalb der Sonnenumlaufbahn. 8. Das Zentrum der Galaxis.

  1. Graphite/Thermoplastic-Pultrusion Die

    NASA Technical Reports Server (NTRS)

    Wilson, Maywood L.; Frye, Mark W.; Johnson, Gary S.; Stanfield, Clarence E.

    1990-01-01

    Attachment to extruder produces thermoplastic-impregnated graphite tape. Consists of profile die, fiber/resin collimator, and crosshead die body. Die designed to be attached to commercially available extrusion machine capable of extruding high-performance thermoplastics. Simple attachment to commercial extruder enables developers of composites to begin experimenting with large numbers of proprietary resins, fibers, and hybrid composite structures. With device, almost any possible fiber/resin combination fabricated.

  2. Maintaining Low Voiding Solder Die Attach for Power Die While Minimizing Die Tilt

    SciTech Connect

    Hamm, Randy; Peterson, Kenneth A.

    2015-10-01

    This paper addresses work to minimize voiding and die tilt in solder attachment of a large power die, measuring 9.0 mm X 6.5 mm X 0.1 mm (0.354” x 0.256” x 0.004”), to a heat spreader. As demands for larger high power die continue, minimizing voiding and die tilt is of interest for improved die functionality, yield, manufacturability, and reliability. High-power die generate considerable heat, which is important to dissipate effectively through control of voiding under high thermal load areas of the die while maintaining a consistent bondline (minimizing die tilt). Voiding was measured using acoustic imaging and die tilt was measured using two different optical measurement systems. 80Au-20Sn solder reflow was achieved using a batch vacuum solder system with optimized fixturing. Minimizing die tilt proved to be the more difficult of the two product requirements to meet. Process development variables included tooling, weight and solder preform thickness.

  3. Malignancies after mitoxantrone for multiple sclerosis

    PubMed Central

    Seuffert, Linda; Mäder, Uwe; Toyka, Klaus V.

    2016-01-01

    Objective: To assess the therapy-related risk of malignancies in mitoxantrone-treated patients with multiple sclerosis. Methods: This retrospective observational cohort study included all mitoxantrone-treated patients with multiple sclerosis seen at our department between 1994 and 2007. We collected follow-up information on medically confirmed malignancies, life status, and cause of death, as of 2010. Malignancy rates were compared to the German national cancer registry matched for sex, age, and year of occurrence. Results: Follow-up was completed in 676 of 677 identified patients. Median follow-up time was 8.7 years (interquartile range 6.8–11.2), corresponding to 6,220 person-years. Median cumulative mitoxantrone dose was 79.0 mg/m2 (interquartile range 50.8–102.4). Thirty-seven patients (5.5%) were diagnosed with a malignancy after mitoxantrone initiation, revealing a standardized incidence ratio of 1.50 (95% confidence interval [CI] 1.05–2.08). Entities included breast cancer (n = 9), colorectal cancer (n = 7), acute myeloid leukemia (n = 4, 0.6%), and others (each entity n = 1 or 2). The standardized incidence ratio of colorectal cancer was 2.98 (95% CI 1.20–6.14) and of acute myeloid leukemia 10.44 (95% CI 3.39–24.36). It was not increased for other entities including breast cancer. Multivariate Cox regression identified higher age at treatment initiation but neither cumulative mitoxantrone dose (>75 vs ≤75 mg/m2) nor treatment with other immunosuppressive drugs or sex as a risk factor. Fifty-five patients had died, among them 12 of a malignancy and 43 reportedly of other causes. Conclusions: While the overall incidence of malignancies was only mildly increased, the risk of leukemia and colorectal cancer was heightened. If confirmed, posttherapy colonoscopy could become advisable. PMID:27170571

  4. General Information about Malignant Mesothelioma

    MedlinePlus

    ... form in the lining of the chest or abdomen. Malignant mesothelioma is a disease in which malignant ( ... that examine the inside of the chest and abdomen are used to detect (find) and diagnose malignant ...

  5. Adapt or die?

    PubMed

    Visser, S S; Nel, A H

    1996-12-01

    The worldwide economic recession and the concomitant limited stock of finances have had an influence on the available money of every household and have also inhibited the improvement of socio-economic conditions and medicine. The Reconstruction and Development Programme (RDP) has the objective of improving the living conditions of the people with regard to housing, education, training and health care. The latter seems to be a major problem which has to be addressed with the emphasis on the preventive and promotional aspects of health care. A comprehensive health care system did not come into being property in the past because of the maldistribution of health care services, personnel and differences in culture and health care beliefs and values. The question that now arises, is how to render a quality health care service within the constraints of inadequate financing and resources. A comprehensive literature study has been done with reference to quality health care and financing followed by a survey of existing health services and finances. Recommendations are made about minimum requirements to be accepted if one were to adapt rather than die in terms of the provision of healthcare: the decentralization and rationalization of the administration of health care, the stress on and realization of effective and efficient primary health care, the acceptance of participative management in health providing organizations, the provision of financial management training for health care managers and the application of management accounting principles for the improvement of the efficiency and effectiveness of management.

  6. Dying and 'euthanasia'.

    PubMed

    Benatar, S R

    1992-07-01

    Medical progress, secularisation of life, growing acceptance of individual human rights (including the right to refuse medical treatment) and of shared decision-making in medicine have focused public attention on the ways in which life may, and perhaps even ought to, be allowed to end in our complex modern era. Intense and thoughtful bio-ethical debate over many years has 'unpacked' the many different understandings and interpretations of the word euthanasia. The consequent conceptual clarification together with recognition and acknowledgement of psychological implications has facilitated a growing rational consensus on openly accepting the withholding and withdrawing of treatment (under defined conditions) within the realm of sound medical practice. This is clearly distinct from assisted suicide and active euthanasia which are generally considered unacceptable perversions of medical practice. Given the ability to sustain life for prolonged periods, often in a permanent state of unconsciousness, the unrealistic expectations of some medical personnel and the lay public, the severe constraints on health care facilities in South Africa and the totally inadequate allocation of resources for highly effective medical treatments, it is appropriate to re-open public debate on the limits of 'striving officiously to keep alive' and on the distinction between 'allowing to die' and 'killing'. Concern that 'rational' arguments reflect moral decay rather than moral progress keeps the debate open and focuses attention on some 'slippery slope' consequences.

  7. Procaine in Malignant Hyperpyrexia

    PubMed Central

    Moulds, R. F. W.; Denborough, M. A.

    1972-01-01

    The caffeine contracture of normal human muscle, which has been used as a model for malignant hyperpyrexia, is greatly potentiated by halothane. Prior administration of procaine markedly reduces the halothane-potentiated caffeine contracture, and procaine given at the height of the contracture induces relaxation. Lignocaine, on the other hand, produces a variable response and sometimes increases the contracture. The muscle from a patient with an inherited susceptibility to malignant hyperpyrexia contracted spontaneously with halothane alone, and this contracture was reversed by procaine. These experiments support the therapeutic use of procaine in malignant hyperpyrexia. PMID:4642792

  8. I Could Have Died Laughing.

    ERIC Educational Resources Information Center

    Maher, Michael Forrest; Smith, Douglas

    1993-01-01

    Notes that caregivers of the dying would do well to consider the prescriptive power of humor when confronting the challenges of healthy care for the terminally ill. Addresses laughter as the best medicine not only for the dying person but also for family and principal caregivers. Includes examples of therapeutic use of humor with the terminally…

  9. Two Piece Compaction Die Design

    SciTech Connect

    Coffey, Ethan N

    2010-03-01

    Compaction dies used to create europium oxide and tantalum control plates were modeled using ANSYS 11.0. Two-piece designs were considered in order to make the dies easier to assemble than the five-piece dies that were previously used. The two areas of concern were the stresses at the interior corner of the die cavity and the distortion of the cavity wall due to the interference fit between the two pieces and the pressure exerted on the die during the compaction process. A successful die design would have stresses less than the yield stress of the material and a maximum wall distortion on the order of 0.0001 in. Design factors that were investigated include the inner corner radius, the value of the interference fit, the compaction force, the size of the cavity, and the outer radius and geometry of the outer ring. The results show that for the europium oxide die, a 0.01 in. diameter wire can be used to create the cavity, leading to a 0.0055 in. radius corner, if the radial interference fit is 0.003 in. For the tantalum die, the same wire can be used with a radial interference fit of 0.001 in. Also, for the europium oxide die with a 0.003 in. interference fit, it is possible to use a wire with a diameter of 0.006 in. for the wire burning process. Adding a 10% safety factor to the compaction force tends to lead to conservative estimates of the stresses but not for the wall distortion. However, when the 10% safety factor is removed, the wall distortion is not affected enough to discard the design. Finally, regarding the europium oxide die, when the cavity walls are increased by 0.002 in. per side or the outer ring is made to the same geometry as the tantalum die, all the stresses and wall distortions are within the desired range. Thus, the recommendation is to use a 0.006 in. diameter wire and a 0.003 in. interference fit for the europium oxide die and a 0.01 in. diameter wire and a 0.001 in. interference fit for the tantalum die. The dies can also be made to have the

  10. Asbestos-related malignancy

    SciTech Connect

    Antmann, K.; Aisner, J.

    1986-01-01

    This book contains 20 chapters. Some of the chapter titles are: The Radiology of Asbestosis and Related Neoplasms; Computed Tomography and Malignant Mesothelioma; Radiation Therapy for Pleural Mesothelioma; and Radiation Therapy of Peritoneal Mesothelioma.

  11. Gynecologic malignancy in pregnancy

    PubMed Central

    Ji, Yong Il

    2013-01-01

    Gynecologic malignancy during pregnancy is a stressful problem. For the diagnosis and treatment of malignancy during pregnancy, a multidisciplinary approach is needed. Patients should be advised about the benefits and risk of treatment. When selecting a treatment for malignancy during pregnancy, the physiologic changes that occur with the pregnancy should be considered. Various diagnostic procedures that do not harm the fetus can be used. Laparoscopic surgery or laparotomy may be safely performed. The staging approach and treatment should be standard. Systemic chemotherapy during the first trimester should be delayed if possible. Radiation therapy should preferably start postpartum. Although delivery should be delayed preferably until after 35 weeks of gestation, termination of pregnancy may be considered when immediate treatment is required. Subsequent pregnancies do not increase the risk of malignancy recurrence. PMID:24328018

  12. What Is Malignant Mesothelioma?

    MedlinePlus

    ... you learn about the treatment options and possible side effects, and point you to information and services to help you in your cancer journey. ... free PDFs of our malignant mesothelioma information ...

  13. Dying: A universal human experience?

    PubMed

    Bregman, L

    1989-03-01

    This paper explores the question, "Is there a universal psychological experience suffered by all dying persons?" a question to which the popular theory of Kübler-Ross presupposes an affirmative answer. Our answer takes three steps: first, a comparison between the Kübler-Ross model of dying and that of the late medievalBook of the Craft of Dying centered upon the five Kübler-Ross "stages"; second, a philosophical critique of the terms of this comparison; and third, a revised look at the alleged similarities between the two models, providing a deeper look at the moral and spiritual assumptions behind each.

  14. Effective treatment for malignant mediastinal teratoma.

    PubMed Central

    Parker, D; Holford, C P; Begent, R H; Newlands, E S; Rustin, G J; Makey, A R; Bagshawe, K D

    1983-01-01

    Primary malignant mediastinal teratoma is a rare tumour previously regarded as inevitably fatal. In a series of eight male patients with a mean age of 24 years five remain alive and well. All patients showed raised serum concentrations of human chorionic gonadotrophin or alpha fetoprotein. The patients were treated with intermittent combination chemotherapy that included cisplatin. Six patients responded to chemotherapy with a fall in human chorionic gonadotrophin or alpha fetoprotein to near normal levels and they then had radical excision of the remaining tumour. Living malignant tumour was found in four of the specimens and these patients received postoperative chemotherapy. One patient died after eight months and the remaining five patients are alive and well 13-136 months after the start of treatment. The two patients who did not undergo surgery died at one month and 15 months. Intermittent combination chemotherapy and carefully timed radical excision of these tumours would appear to have produced better results than have been reported in other series. Images PMID:6198739

  15. De Novo Malignant Neoplasms in Renal Transplant Patients.

    PubMed

    Yılmaz Akçay, Eda; Tepeoğlu, Merih; Özdemir, Binnaz Handan; Deniz, Ebru; Börcek, Pelin; Haberal, Mehmet

    2016-11-01

    The aim of this study was to evaluate the incidence of posttransplant malignancy in kidney transplant patients and investigate the clinical and histopathologic features of these patients. We retrospectively reviewed information on donor and recipient characteristics, patient and graft survival, and cancer incidence after transplant for 867 kidney transplant patients. Patients with neoplasms prior to transplant were excluded. A follow-up study estimated cancer incidence after transplant. Neoplasms were diagnosed in 59 patients (6.8%), 41 men and 18 women; 22 (37.3%) had skin tumors, 19 (32.2%) had solid tumors, 10 (16.9%) had posttransplant lymphoproliferative disorders, and 8 (13.6%) had Kaposi sarcoma. The mean age at the time of malignant tumor diagnosis was 42.7 ± 13.6 years, and statistically significant differences were found between tumor groups (P < .01). The average latency period between transplant and diagnosis of malignant tumors was 99.8 ± 56.9 months for solid tumors, 78.4 ± 52 months for skin tumors, 64.5 ± 48.8 months for posttransplant lymphoproliferative disorders, and 13.5 ± 8.8 months for Kaposi sarcoma, with significant difference found between tumor groups (P < .01). Ten patients (16.9%) had more than 1 malignant tumor. Eighteen patients died, with a mean time to death of 31.5 ± 22.8 months after tumor diagnosis. A significant positive association was found between survival and the number of tumors (P = .001); 5-year survival after tumor diagnosis was 81% and 40% for patients with 1 malignant tumor and patients with more than 1 malignant tumor, respectively. Malignancy is a common cause of death after renal transplant. Early detection and treatment of posttransplant malignancies is an important challenge. Screening these patients for malignancies posttransplant is crucial, and efforts should be directed to define effective immunosuppressive protocols that are associated with a lower incidence of malignancy.

  16. Die Sonne, Stern unserer Erde

    NASA Astrophysics Data System (ADS)

    Lang, Kenneth R.; Ehlers, A.

    Dieses reich bebilderte Buch gibt eine Einführung in die Physik der Sonne und ihre Bedeutung für die Erde. Gestützt auf neueste Forschungsergebnisse aus Radioteleskop- und Satellitenbeobachtungen beschreibt der Autor die gewaltigen atomenergetischen Prozesse der Sonne, ihren geheimnisvollen Neutrinofluß, ihre seismischen Aktivitäten, Magnetfelder und Sonnenflecke, Korona, Sonnenausbrüche und Protuberanzen, den Sonnenwind, und die außerordentlich wichtige und vielfältige Bedeutung des Sonnenlichts, das Leben auf der Erde entstehen läßt und es auch gefährdet. Gut verständlich und in ansprechender Sprache geschrieben ist es ein wunderbares Buch für den Leser populärwissenschaftlicher Literatur, ein wertvolles Geschenk für Studenten der Astronomie und verwandter Disziplinen sowie Amateurastronomen.

  17. REFRACTORY DIE FOR EXTRUDING URANIUM

    DOEpatents

    Creutz, E.C.

    1959-08-11

    A die is presented for the extrusion of metals, said die being formed of a refractory complex oxide having the composition M/sub n/O/sub m/R/sub x/O/sub y/ where M is magnesium, zinc, manganese, or iron, R is aluminum, chromic chromium, ferric iron, or manganic manganese, and m, n, x, and y are whole numbers. Specific examples are spinel, magnesium aluminate, magnetite, magnesioferrite, chromite, and franklinite.

  18. Heat treatment of forging dies

    NASA Astrophysics Data System (ADS)

    Dovnar, S. A.; Kadnikov, S. A.

    1987-08-01

    In forging-die production there is a considerable range of forging dies which are promising for a changeover into advanced heat treatment involving bulk temper hardening and surface hardening using induction heating. The heat treatment suggested provides a saving of material resources as a result of improving the life of forging dies by a factor of 1.5-3 depending on the grade of die steel. As a result of induction hardening of forging dies, after temper hardening close to the boundary of the hardened layer a zone of reduced hardness forms whose unfavorable effect may be reduced by using before induction surface hardening bulk warming in a furnace or deep induction heating with a reduced energy concentration in the heating zone to the tempering temperature in the temper hardening cycle. In order to improve the uniformity of induction surface hardening for dies with a complex working shape it is desirable to use heating at reduced power with an increase in heating time.

  19. Hemostasis and malignancy.

    PubMed

    Francis, J L; Biggerstaff, J; Amirkhosravi, A

    1998-01-01

    There is considerable evidence that the hemostatic system is involved in the growth and spread of malignant disease. There is an increased incidence of thromboembolic disease in patients with cancers and hemostatic abnormalities are extremely common in such patients. Antihemostatic agents have been successfully used to treat a variety of experimental tumors, and several clinical trials in humans have been initiated. Although metastasis is undoubtedly multifactorial, intravascular coagulation activation and peritumor fibrin deposition seem to be important. The mechanisms by which hemostatic activation facilitates the malignant process remain to be completely elucidated. Of central importance may be the presence on malignant cells of tissue factor and urokinase receptor. Recent studies have suggested that these proteins, and others, may be involved at several stages of metastasis, including the key event of neovascularization. Tissue factor, the principal initiator of coagulation, may have additional roles, outside of fibrin formation, that are central to the biology of some solid tumors.

  20. Malignant Vestibular Schwannoma

    PubMed Central

    Gruber, B.; Petchenik, L.; Williams, M.; Thomas, C.; Luken, M.G.

    1994-01-01

    A 61-year-old woman underwent a translabyrinthine resection of a right intracanulicular acoustic neuroma, which had been detected in the work-up of sudden hearing loss. At the time of surgery, the tumor was roughly twice as large as indicated by the magnetic resonance scan taken only 2 months previously. The tumor eroded the vertical and transverse crests and extended well into the cerebellopontine angle. It was impossible to distinguish the facial nerve proximal to the geniculate ganglion. All visible tumor was resected, along with the facial nerve. Histological evaluation showed a highly cellular tumor, with many mitoses and areas of necrosis, meeting the criteria for malignant schwannoma. The patient has no stigmata of neurofibromatosis, and has no known relatives with that condition. This case is only the fourth reported of a malignant vestibular schwannoma. The relationships between vestibular schwannoma, neurofibromatosis, and malignancy are discussed. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6 PMID:17171176

  1. Giant malignant insulinoma

    PubMed Central

    Karavias, Dimitrios; Habeos, Ioannis; Maroulis, Ioannis; Kalogeropoulou, Christina; Tsamandas, Athanasios; Chaveles, Ioannis

    2015-01-01

    Insulinomas are the most common pancreatic neuroendocrine tumors. Most insulinomas are benign, small, intrapancreatic solid tumors and only large tumors have a tendency for malignancy. Most patients present with symptoms of hypoglycemia that are relieved with the administration of glucose. We herein present the case of a 75-year-old woman who presented with an acute hypoglycemic episode. Subsequent laboratory and radiological studies established the diagnosis of a 17-cm malignant insulinoma, with local invasion to the left kidney, lymph node metastasis, and hepatic metastases. Patient symptoms, diagnostic and imaging work-up and surgical management of both the primary and the metastatic disease are reviewed. PMID:25960993

  2. Envy and malignant envy.

    PubMed

    Shengold, L

    1994-10-01

    Envy begins early in psychic development and is initially characterized by destructive primal hatred. With maturation, envy becomes modified in intensity. Its primal murderous quality is attenuated, and, as object relationships develop, it becomes partly transformed into jealousy. Malignant envy is a retention of, or regression to, the original primal murderous affective mix. Clinically, one sees in malignant envy the phenomenon of the subject feeling with delusional intensity that what the envied one has is not only urgently wanted but has been stolen from the self--an intensity that is reacted to defensively by projection and delusion formation. This operates as a formidable resistance in analytic work.

  3. Use of RSP Tooling to Manufacture Die Casting Dies

    SciTech Connect

    Kevin McHugh

    2004-07-01

    The technology and art used to construct die casting dies has seen many improvements over the years. However, the time lag from when a design is finalized to the time a tool is in production has remained essentially the same. The two main causes for the bottleneck are the need to qualify a part design by making prototypes (usually from an alternative process), and the production tooling lead time after the prototypes are approved. Production tooling costs are high due to the labor and equipment costs associated with transforming a forged block of tool steel into a finished tool. CNC machining, sink EDM, benching, engraving and heat treatment unit operations are typically involved. As a result, there is increasing interest in rapid tooling (RT) technologies that shorten the design-to-part cycle and reduce the cost of dies. There are currently more than 20 RT methods being developed and refined around the world (1). The "rapid" in rapid tooling suggests time compression for tool delivery, but does not address robustness as nearly all RT approaches are intended for low-volume prototype work, primarily for molding plastics. Few options exist for die casting. An RT technology suitable for production-quality tooling in the time it normally takes for prototype tooling is highly desirable. In fact, there would be no need for a distinction between prototype and production tooling. True prototype parts could be made using the same processing conditions and materials intended for production. Qualification of the prototype part would allow the manufacturer to go directly into production with the same tool. A relatively new RT technology, Rapid Solidification Process (RSP) Tooling, is capable of making production-quality tooling in an RT timeframe for die casting applications. RSP Tooling, was developed at the Idaho National Engineering and Environmental Laboratory (INEEL), and commercialized with the formation of RSP Tooling, LLC (2). This paper describes the process, and

  4. Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: case report and review of the literature.

    PubMed

    Kobayashi, Kazuo; Murakami, Ryuichi; Fujii, Tohru; Hirano, Akiyoshi

    2005-10-01

    Ameloblastic fibrosarcoma is a rare malignant odontogenic tumour and is regarded as the malignant counterpart of the ameloblastic fibroma. The epithelial component remains benign, but the mesenchymal component becomes malignant. The diagnosis is made by histopathology. The case of a 26-year-old man who underwent curettage of an ameloblastic fibroma and died of an ameloblastic fibrosarcoma is presented, and the course of malignant transformation is analysed retrospectively. One-third of ameloblastic fibrosarcoma cases seem to have developed from recurrent ameloblastic fibromas. Knowledge of the malignant potential in the mesenchymal spindle cells of ameloblastic fibroma will assist in determining the management of these benign tumours, and may prevent malignant transformation to ameloblastic fibrosarcoma.

  5. Early malignant syphilis*

    PubMed Central

    Ortigosa, Yara Martins; Bendazzoli, Paulo Salomão; Barbosa, Angela Marques; Ortigosa, Luciena Cegatto Martins

    2016-01-01

    Early malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by lesions, which can suppurate and be accompanied by systemic symptoms such as high fever, asthenia, myalgia, and torpor state. We report a diabetic patient with characteristic features of the disease showing favorable evolution of the lesions after appropriate treatment. PMID:28300925

  6. Malignant tumors of childhood

    SciTech Connect

    Brooks, B.J.

    1986-01-01

    This book contains 34 papers about malignant tumors. some of the titles are: Invasive Cogenital Mesoblastic Nephroma, Leukemia Update, Unusual Perinatal Neoplasms, Lymphoma Update, Gonadal Germ Cell Tumors in Children, Nutritional Status and Cancer of Childhood, and Chemotherapy of Brain tumors in Children.

  7. Acting to let someone die.

    PubMed

    McGee, Andrew

    2015-02-01

    This paper examines the recent prominent view in medical ethics that withdrawing life-sustaining treatment (LST) is an act of killing. I trace this view to the rejection of the traditional claim that withdrawing LST is an omission rather than an act. Although that traditional claim is not as problematic as this recent prominent view suggests, my main claim is that even if we accepted that withdrawing LST should be classified as an act rather than as an omission, it could still be classified as letting die rather than killing. Even though omissions are contrasted with acts, letting die need not be, for one can let die by means of acts. The remainder of the paper is devoted to establishing this claim and addresses certain objections to it. © 2013 John Wiley & Sons Ltd.

  8. Clinical management of dying patients.

    PubMed Central

    Gavrin, J; Chapman, C R

    1995-01-01

    Dying is universal, and death should be a peaceful time. Myriad comfort measures are available in the last weeks before life ends. Discussions about end-of-life issues often suffer from lack of informed opinion. Palliative care experts have identified specific somatic and psychological sources of distress for dying patients and their loved ones. Pain, shortness of breath, nausea and vomiting, and fear of abandonment contribute substantially to both physical and psychological discomfort toward the end of life. Simple, effective methods exist for relieving those symptoms. Knowledge about the natural events associated with dying and an informed approach to medical and psychological interventions contribute to systematic and successful comfort care. We describe the origin of physical and psychological distress at the end of life and provide strategies for alleviating many of the discomforts. PMID:7571591

  9. Portable punch and die jig

    DOEpatents

    Lewandowski, Edward F.; Anderson, Petrus A.

    1978-01-01

    A portable punch and die jig includes a U-shaped jig of predetermined width having a slot of predetermined width in the base thereof extending completely across the width of the jig adapted to fit over the walls of rectangular tubes and a punch and die assembly disposed in a hole extending through the base of the jig communicating with the slot in the base of the jig for punching a hole in the walls of the rectangular tubes at precisely determined locations.

  10. [Dying with cancer: Hollywood lessons].

    PubMed

    Niemeyer, Fernanda; Kruse, Maria Henriqueta Luce

    2013-12-01

    The study attempts to understand how dying from cancer is portrayed by five movies produced in Hollywood between 1993 and 2006. Based on the cultural studies and their post-structuralism version and supported by the notions of discourse and subjectivity, as proposed by philosopher Michel Foucault, we suggest one of the possible readings of the movie picture corpus. We assess how the movie picture discourse acts as a cultural pedagogy that produces ways of seeing dying with cancer: immortalizing the healthy body image, silencing death, taking care of the dead body and, finally, accepting death. Our proposal is intended to stimulate reflections that may contribute to care and education in nursing.

  11. Die Herz-Lungen-Maschine

    NASA Astrophysics Data System (ADS)

    Krane, Markus; Bauernschmitt, Robert; Lange, Rüdiger

    Das Kapitel der modernen Herzchirurgie mit Einsatz der Herz-Lungen-Maschine am Menschen beginnt am 6. Mai 1953, als J. Gibbon bei einer 18-jährigen Patientin einen angeborenen Defekt in der Vorhofscheidewand verschließt [1]. Mit ersten experimentellen Versuchen zur extrakorporalen Zirkulation begann Gibbon bereits in den 30er Jahren des 20. Jahrhunderts. Die Grundlage für die heute gebräuchliche Rollerpumpe schufen Porter und Bradley mit ihrer "rotary pump“, welche sie 1855 zum Patent anmeldeten. Diese Pumpe wurde von DeBakey und Schmidt modifiziert und entspricht im Wesentlichen noch der heute sich im Routinebetrieb befindlichen Rollerpumpe [2].

  12. [Malignant peritoneal mesothelioma. Case report and review of the literature].

    PubMed

    Ruiz-Tirado, María Luisa; Olvera-Rodríguez, Arturo; Díaz-Barranco, Irma; Ruiz-Romano, Agueda; Castillo-Ruiz, Natalia; Olvera-Quiroz, Silvia Eurydice

    2011-01-01

    A woman 88 years old with a clinical picture initiated eight days before characterized by asthenia, adynamia, hyporexia, increase of the abdominal perimeter, pain and constipation. Her husband worked at the automotive industry for more than 30 years (brakes specialist). She had a history of hypertension; abdominal ultrasound showed a metastatic liver of unknown origin and ascites. An ascites sample was gotten. Malignant cells matching with malignant peritoneal mesothelioma were observed. The patient died 30 days after the diagnosis. The peritoneal mesothelioma is a rare form of cancer that can be benign or malignant. Incidence rate increases with age. It is more frequent in men and over 60 years with a survival from five to twelve months after diagnosis. The most important risk factor is the chronic labor exposition to asbestos that includes the family. The diagnosis is difficult even for experts. Additionally, we present a brief review of the literature.

  13. The Weight of the Pineal Gland in Malignancy

    PubMed Central

    Tapp, E.; Blumfield, Marianne

    1970-01-01

    A series of 150 pineal glands removed at routine postmortems in a general hospital have been examined. Statistical analysis of the weights of 147 of these glands from patients aged between 45 and 90 years, shows that the glands from patients dying of malignant disease are significantly lighter than those where the cause of death was non-malignant. These results are almost the exact reverse of those described recently in a similar series in America. After decalcification very little difference in the weight of the gland can be detected between the two groups and it would appear that the higher weight of the glands from non-malignant patients is due, at least in part, to the presence of a greater amount of mineral in these glands. PMID:4913769

  14. Cerebral malignant nerve sheath tumor, triton tumor variant: case report.

    PubMed

    Bornstein-Quevedo, Leticia; Peralta-Olvera, Fabiola; Marhx-Bracho, Alfonso; Rodríguez-Jurado, Rodolfo; De Leon-Bojorge, Beatriz

    2003-01-01

    A case of a cerebral malignant triton tumor in a 3-year-old boy with a 2-month history of frontal headache and no clinical evidence of neurofibromatosis is reported. The computed tomography (CT) scan showed a large, irregular tumor in the right parietooccipital lobe. A partial surgical resection was performed. Histologically, the tumor was highly cellular and consisted of spindle cells with hyperchromatic and pleomorphic nuclei. Focally, neoplastic cells with rhabdomyoblastic features were found. The immunohistochemical study showed that tumor cells were positive for S-100 protein and CD57, and the rhabdomyoblasts expressed desmin, Myo-D1, and myoglobin. During the postoperative period, a massive intraparenchymal hemorrhage was identified and surgical drainage was performed. The patient worsened and died 10 days after the first surgery. Postmortem study was not authorized. Six cases of cerebral malignant nerve sheath tumor have been described; however, primary intraparenchymal malignant triton tumor has not been previously described.

  15. Malignant otitis externa.

    PubMed

    Karaman, Emin; Yilmaz, Mehmet; Ibrahimov, Metin; Haciyev, Yusuf; Enver, Ozgün

    2012-11-01

    Malignant external otitis is a severe infection of the external auditory canal and skull base, which most often affects elderly patients with diabetes mellitus. This disease is still a serious disease associated with cranial nerve complications and high morbidity-mortality rate. Malignant otitis externa requires urgent diagnosis and treatment. The most effective treatment is to control the diabetes and to fight infection with the proper antibiotic and debridement necrotic tissue; sometimes, aggressive surgical management is done. We present our 5-year institutional experience in the management of this disease. The aim of this study was to present our experience with the management of malignant otitis externa. All patients' records with malignant otitis externa during the last 5 years (2007-2012) were retrieved and reviewed. Diabetes mellitus profile, erythrocyte sedimentation rate, ear swab for culture and sensitivity, computed tomography, and scintigraphy using technetium 99 and gallium 67 were investigated for all patients. During the last 5 years (2007-2012), 10 patients with the diagnosis of malignant otitis externa were admitted to our clinic for investigation and treatment. There were 7 men and 3 women, all between 64 and 83 years of age, with severe persistent otalgia, purulent otorrhea, granulation tissue in the external auditory canal, and diffuse external otitis, and there were 4 patients with facial nerve palsy. Nine patients were confirmed to have a diabetes, and 4 of these 9 cases just had chronic renal failure and underwent dialysis; the remainder 1 case had no diabetes mellitus, but with chronic renal failure on dialysis. Ear swabs for culture and sensitivity usually revealed Pseudomonas aeruginosa. Local debridement and local and systemic antibiotic treatment were sufficient to control the disease. Facial nerve decompression was done in facial paralysis. Hyperbaric oxygen therapy was performed in facial nervy palsy cases. Malignant otitis externa is

  16. Pediatric malignant salivary gland tumors: 60 year follow up.

    PubMed

    Cockerill, Cara C; Gross, Brian C; Contag, Stephanie; Rein, Sarah; Moore, Eric J; Olsen, Kerry D; Orvidas, Laura J

    2016-09-01

    To evaluate the presentation, treatments and outcomes in pediatric patients with salivary gland malignancies. Retrospective chart review (1950-2012), Prospective phone interview. Patients ≤18 years old with a salivary gland malignancy treated at our institution were identified. Patients were also contacted by phone for a follow up survey. Fifty-six patients were identified. Tumor origin was 88% parotid (n = 49), 5% (n = 3) submandibular and 7% (n = 4) minor salivary glands. Time from onset of symptoms to diagnosis was over one year (mean = 14.4 years). Fifteen out of 52 patients with major gland malignancy had a locoregional recurrence and local recurrences were almost all after initial enucleation. Two of these patients died of disease (overall disease specific survival = 96%). Three out of 4 patients with minor gland malignancy had a local recurrence and two patients with high grade pathology developed metastases and died of their disease (overall survival = 50%). On long term follow up survey in 13 patients (25%), 100% reported normal facial movement and 54% described symptoms of Frey's syndrome, which is higher than other reported series in children. Recurrence was noted up to 45 years after initial treatment. The majority of malignant pediatric salivary gland tumors are low grade and have excellent survival, especially if found at an early stage. Minor salivary gland malignancies, particularly high grade, have a worse prognosis. Long term mild Frey's syndrome can be expected in approximately half of patients. We advocate a need for long term follow up and increased awareness among providers to diagnose these patients earlier. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Head and neck malignancies in Croatian renal transplant recipients.

    PubMed

    Basić-Jukić, Nikolina; Bubić-Filipi, Ljubica; Prgomet, Drago; Djanić Hadzibegović, Ana; Bilić, Mario; Kovac, Lana; Kastelan, Zeljko; Pasini, Josip; Mokos, Ivica; Basić-Koretić, Martina; Kes, Petar

    2010-04-01

    Renal transplantation is associated with increased incidence of cancer. We reviewed a large series of renal transplant recipients to determine the incidence and outcome of patients with malignant changes located at the head and neck. A total of 1232 renal transplant recipients have been followed at Department of Dialysis University Hospital Centre Zagreb from 1972 to 2009. Demographic data, localization and disease outcome were evaluated in patients who developed cancer. Twenty one patients (1.7%) developed 27 head and neck malignancies. The average time from transplantation to development of cancer was 56.8 months. The mean length of follow-up was 9.4+/-4.8 years. Eighteen malignancies were cutaneous in origin and 9 were noncutaneous. Of cutaneous malignancies, 88.9% were basal cell carcinoma; one patient had Merkell-cell carcinoma and one patient developed squamous cell carcinoma. Six cases of basocellular skin cancer were recorded in one fair-skin patient. Noncutaneous malignancies involved the oral cavity (2 cases of Kaposi's sarcoma and one pharyngeal cancer) and the thyroid gland in 3 patients each. Two patients had post-transplant lymphoproliferative disorder occurring at the head and neck. One patient had brain tumor. Radical surgery, radiation, and/or chemotherapy were necessary in 33.3% of patients. Immunosuppression was reduced in all patients, and 12 patients were switched from the calcineurin-based immunosuppression to sirolimus. They all have stable graft function. None of the patients died from cancer. Immunosuppression was ceased in one patient with Kaposi's sarcoma who returned to dialysis and died 10 years later from heart failure. An increased incidence of cancer occurring in the head and neck was recorded. Careful skin examination and oral examination is mandatory for discovering cancer before dissemination. Sirolimus is safe alternative to calcineurin-based immunosuppression in patients who developed head and neck malignancies.

  18. Lymphoscintigraphy in malignant melanoma

    SciTech Connect

    Berman, C.G.; Norman, J.; Cruse, C.W.; Reintgen, D.S.; Clark, R.A. )

    1992-01-01

    The development and rationale for the use of lymphoscintigraphy in the preoperative evaluation of patients with malignant melanoma being considered for elective lymph node dissection is reviewed. This overview is updated by an analysis of 135 patients with early stage malignant melanoma involving the head, neck, shoulders, and trunk at Moffitt Cancer Center and Research Institute at the University of South Florida (Tampa, FL). High discordancy rates (overall, 41%) were seen between drainage patterns predicted from historical anatomical guidelines and those revealed by the lymphoscintigraphic examination. The high discordancy rate was most pronounced in the head (64%) and the neck (73%). Surgical management was changed in 33% of the patients, overall. A preoperative lymphoscintigram is recommended for all patients with melanoma with head, neck, and truncal lesions evaluated for elective lymph node dissection as the lymphatic drainage patterns are often unpredictable and variable.

  19. Malignancy from Radium

    PubMed Central

    Loutit, J. F.

    1970-01-01

    Human experience of the toxicity of radium acts as a guide for the setting of occupationally permissible levels for radioactive nucleides, especially bone-seekers. Reviewing the published statements and photomicrographs in early reports especially those of Martland (1931) one can make a case that malignancy was induced in bone-marrow (leukaemia, malignant myelosclerosis) as well as in bone (osteosarcoma) by radium, especially with large doses. Three case reports of radium intoxication in Britons are noted as compatible with this suggestion, after revised interpretation in two of them. ImagesFigs. 9-10Fig. 4Fig. 5Figs. 11-12Figs. 6-7Fig. 8Figs. 13-14 PMID:5271269

  20. Hyaluronan in human malignancies

    SciTech Connect

    Sironen, R.K.; Tammi, M.; Tammi, R.; Auvinen, P.K.; Anttila, M.; Kosma, V-M.

    2011-02-15

    Hyaluronan, a major macropolysaccharide in the extracellular matrix of connective tissues, is intimately involved in the biology of cancer. Hyaluronan accumulates into the stroma of various human tumors and modulates intracellular signaling pathways, cell proliferation, motility and invasive properties of malignant cells. Experimental and clinicopathological evidence highlights the importance of hyaluronan in tumor growth and metastasis. A high stromal hyaluronan content is associated with poorly differentiated tumors and aggressive clinical behavior in human adenocarcinomas. Instead, the squamous cell carcinomas and malignant melanomas tend to have a reduced hyaluronan content. In addition to the stroma-cancer cell interaction, hyaluronan can influence stromal cell recruitment, tumor angiogenesis and epithelial-mesenchymal transition. Hyaluronan receptors, hyaluronan synthases and hyaluronan degrading enzymes, hyaluronidases, are involved in the modulation of cancer progression, depending on the tumor type. Furthermore, intracellular signaling and angiogenesis are affected by the degradation products of hyaluronan. Hyaluronan has also therapeutic implications since it is involved in multidrug resistance.

  1. Managing Malignant Cerebral Infarction

    PubMed Central

    Sahuquillo, Juan; Sheth, Kevin N.; Kahle, Kristopher T.; Walcott, Brian P.

    2011-01-01

    Opinion statement Managing patients with malignant cerebral infarction remains one of the foremost challenges in medicine. These patients are at high risk for progressive neurologic deterioration and death due to malignant cerebral edema, and they are best cared for in the intensive care unit of a comprehensive stroke center. Careful initial assessment of neurologic function and of findings on MRI, coupled with frequent reassessment of clinical and radiologic findings using CT or MRI are mandatory to promote the prompt initiation of treatments that will ensure the best outcome in these patients. Significant deterioration in either neurologic function or radiologic findings or both demand timely treatment using the best medical management, which may include osmotherapy (mannitol or hypertonic saline), endotracheal intubation, and mechanical ventilation. Under appropriate circumstances, decompressive craniectomy may be warranted to improve outcome or to prevent death. PMID:21190097

  2. Managing malignant pericardial effusion.

    PubMed Central

    Buzaid, A C; Garewal, H S; Greenberg, B R

    1989-01-01

    The involvement of the pericardium by metastatic tumors is not uncommon, particularly in patients with lung cancer, breast cancer, lymphomas, leukemias, and melanomas. There are five therapeutic modalities for the treatment of malignant pericardial effusion, including pericardiocentesis, pericardial sclerosis, systemic chemotherapy, radiotherapy, and surgical treatment. The optimal treatment selection is dependent principally on a patient's life expectancy; responsiveness of the tumor to chemotherapy, irradiation, or both; and whether or not cardiac tamponade is present at diagnosis. The overall prognosis of patients with malignant pericardial effusion is primarily influenced by the extent and histologic features of the underlying cancer. Although this condition is usually incurable, a reasonable period of useful palliation can be obtained in most patients. Images PMID:2471362

  3. Robert Merton Dies at 92

    ERIC Educational Resources Information Center

    Snell, Joel C.

    2006-01-01

    This article features Robert Merton, who died recently at age 92. Merton came into this world as a Jewish baby named Meyer Schkolnick. He lived in South Philly where his parents wrenched a living as blue-collar workers. Merton chose an Anglicized name to move into the Yankee dominated America of the 20's and 30's. At Harvard, he studied under…

  4. Robert Merton Dies at 92

    ERIC Educational Resources Information Center

    Snell, Joel C.

    2006-01-01

    This article features Robert Merton, who died recently at age 92. Merton came into this world as a Jewish baby named Meyer Schkolnick. He lived in South Philly where his parents wrenched a living as blue-collar workers. Merton chose an Anglicized name to move into the Yankee dominated America of the 20's and 30's. At Harvard, he studied under…

  5. Attitudes on Death and Dying.

    ERIC Educational Resources Information Center

    Andrus, Charles E.

    This paper explored attitudes toward death and dying revealed through interviews with members of the clergy, the medical profession, funeral directors, nursing home residents, and selected others. The sampling was small and results are not intended to be representative of the groups to which these people belong. Rather, the study may be used as a…

  6. Attitudes on Death and Dying.

    ERIC Educational Resources Information Center

    Andrus, Charles E.

    This paper explored attitudes toward death and dying revealed through interviews with members of the clergy, the medical profession, funeral directors, nursing home residents, and selected others. The sampling was small and results are not intended to be representative of the groups to which these people belong. Rather, the study may be used as a…

  7. Palliation of malignant ascites.

    PubMed

    Rosenberg, Stefanie M

    2006-03-01

    The management of recurrent, symptomatic malignant ascites can be problematic for physicians and patients. The most common, low-risk method is large-volume paracentesis. Patient disease progression often leads to rapid reaccumulation of ascites, which requires frequent return visits to the hospital for symptom management. Other techniques have been developed to achieve palliation of symptoms, including tunneled external drainage catheters, peritoneal ports, and peritoneovenous

  8. Lymphoscintigraphy in gynecologic malignancies

    SciTech Connect

    Bloomer, W.D.

    1983-01-01

    Lymphoscintigraphy is an easily performed noninvasive procedure that offers the potential to detect small numbers of ascitic tumor cells and early diaphragmatic tumor involvement. Moreover, it can be used to delineate and define abnormalities in lymph nodes that are not routinely visualized by bipedal contrast lymphangiography, ultrasound or computed tomography. Lymphoscintigraphy is recommended as an important investigative and adjunctive procedure in diagnosing gynecologic malignancies; there does not appear to be sufficient sensitivity and specificity to justify its routine clinical use.

  9. Malignant Catatonia Mimicking Pheochromocytoma

    PubMed Central

    Li, Dailin

    2013-01-01

    Malignant catatonia is an unusual and highly fatal neuropsychiatric condition which can present with clinical and biochemical manifestations similar to those of pheochromocytoma. Differentiating between the two diseases is essential as management options greatly diverge. We describe a case of malignant catatonia in a 20-year-old male who presented with concurrent psychotic symptoms and autonomic instability, with markedly increased 24-hour urinary levels of norepinephrine at 1752 nmol/day (normal, 89–470 nmol/day), epinephrine at 1045 nmol/day (normal, <160 nmol/day), and dopamine at 7.9 μmol/day (normal, 0.4–3.3 μmol/day). The patient was treated with multiple sessions of electroconvulsive therapy, which led to complete clinical resolution. Repeat urine collections within weeks of this presenting event revealed normalization or near normalization of his catecholamine and metanephrine levels. Malignant catatonia should be considered in the differential diagnosis of the hypercatecholamine state, particularly in a patient who also exhibits concurrent catatonic features. PMID:24251048

  10. Treatment of Malignant Pheochromocytoma

    PubMed Central

    Ajallé, R.; Plouin, P. F.; Pacak, K.; Lehnert, H.

    2013-01-01

    Pheochromocytoma (PCC) is a rare disease, mainly sporadic, but also associated with some familial disorders, with a malignancy frequency of approximately 10%. Only the presence of distant metastases, derived from large pleomorphic chromaffin cells, is widely accepted as a criterion of malignancy. Variable symptoms may be caused by production and release of catecholamines. Since there is no curative treatment for malignant PCC and due to its unfavorable prognosis, assuring quality of life is one of the main therapeutic objectives. Besides a long-term medical treatment of symptoms using selective α-1 blockers and nonselective, noncompetitive α- and / or β-blockers, debulking surgery is the first treatment step. In case of a sufficient uptake of 123I-MIBG treatment with targeted radiation therapy, use of 131I-MIBG is an option as an adjuvant therapy, following debulking surgery. Chemotherapy should be applied to patients without positive MIBG-scan, with no response to 131I-MIBG or progression after radionuclide treatment, and especially in cases with high proliferation index. The most effective chemotherapy regimen appears to be the CVD-scheme, including cyclophosphamide, vincristine, and dacarbazine. The so-called targeted molecular therapies with treatment combinations of temozolomide and thalidomide, or sunitinib monotherapy, and novel therapeutic somatostatin analogues have shown promising results and should thus encourage clinical trials to improve the prognosis of metastatic PCC. Within this review the current treatment modalities and novel molecular strategies in the management of this disease are discussed and a treatment algorithm is suggested. PMID:19672813

  11. Treatment of malignant pheochromocytoma.

    PubMed

    Adjallé, R; Plouin, P F; Pacak, K; Lehnert, H

    2009-09-01

    Pheochromocytoma (PCC) is a rare disease, mainly sporadic, but also associated with some familial disorders, with a malignancy frequency of approximately 10%. Only the presence of distant metastases, derived from large pleomorphic chromaffin cells, is widely accepted as a criterion of malignancy. Variable symptoms may be caused by production and release of catecholamines. Since there is no curative treatment for malignant PCC and due to its unfavorable prognosis, assuring quality of life is one of the main therapeutic objectives. Besides a long-term medical treatment of symptoms using selective alpha-1 blockers and nonselective, noncompetitive alpha- and/or beta-blockers, debulking surgery is the first treatment step. In case of a sufficient uptake of (123)I-MIBG treatment with targeted radiation therapy, use of (131)I-MIBG is an option as an adjuvant therapy, following debulking surgery. Chemotherapy should be applied to patients without positive MIBG-scan, with no response to (131)I-MIBG or progression after radionuclide treatment, and especially in cases with high proliferation index. The most effective chemotherapy regimen appears to be the CVD-scheme, including cyclophosphamide, vincristine, and dacarbazine. The so-called targeted molecular therapies with treatment combinations of temozolomide and thalidomide, or sunitinib monotherapy, and novel therapeutic somatostatin analogues have shown promising results and should thus encourage clinical trials to improve the prognosis of metastatic PCC. Within this review the current treatment modalities and novel molecular strategies in the management of this disease are discussed and a treatment algorithm is suggested.

  12. Asbestos-related malignancy

    SciTech Connect

    Talcott, J.A.; Antman, K.H.

    1988-05-01

    Asbestos-associated malignancies have received significant attention in the lay and medical literature because of the increasing frequency of two asbestos-associated tumors, lung carcinoma and mesothelioma; the wide distribution of asbestos; its status as a prototype environmental carcinogen; and the many recent legal compensation proceedings, for which medical testimony has been required. The understanding of asbestos-associated carcinogenesis has increased through study of animal models, human epidemiology, and, recently, the application of modern molecular biological techniques. However, the detailed mechanisms of carcinogenesis remain unknown. A wide variety of malignancies have been associated with asbestos, although the strongest evidence for a causal association is confined to lung cancer and mesothelioma. Epidemiological studies have provided evidence that both the type of asbestos fiber and the industry in which the exposure occurs may affect the rates of asbestos-associated cancers. It has been shown that asbestos exerts a carcinogenic effect independent of exposure to cigarette smoking that, for lung cancers, is synergistically enhanced by smoking. Other questions remain controversial, such as whether pulmonary fibrosis necessarily precedes asbestos-associated lung cancer and whether some threshold level of exposure to asbestos (including low-dose exposures that may occur in asbestos-associated public buildings) may be safe. Mesothelioma, the most closely asbestos-associated malignancy, has a dismal natural history and has been highly resistant to therapy. However, investigational multi-modality therapy may offer benefit to some patients. 179 references.

  13. Pembrolizumab in Treating Patients With Malignant Mesothelioma

    ClinicalTrials.gov

    2016-11-14

    Biphasic Mesothelioma; Epithelioid Mesothelioma; Peritoneal Malignant Mesothelioma; Pleural Biphasic Mesothelioma; Pleural Epithelioid Mesothelioma; Pleural Malignant Mesothelioma; Pleural Sarcomatoid Mesothelioma; Recurrent Peritoneal Malignant Mesothelioma; Recurrent Pleural Malignant Mesothelioma; Sarcomatoid Mesothelioma

  14. Primary Intracranial Malignant Melanoma with Extracranial Metastasis

    PubMed Central

    Hirota, Kengo; Yoshimura, Chika; Kubo, Osami; Kasuya, Hidetoshi

    2017-01-01

    We report a case of primary intracranial malignant melanoma (PIMM) with extracranial metastases. The patient was an 82-year-old woman diagnosed with PIMM under the left cerebellar tentorium. We performed a tumor resection followed by gamma knife surgery. An magnetic resonance imaging at 11 months after surgery showed a local intracranial recurrence. At 12 months, vertebral metastasis was suspected, and 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) showed multiple extracranial metastases. She died at 13 months after surgery. Although extracranial metastases of PIMM are extremely rare, we should carefully follow up extracranial metastases together with intracranial ones, especially by FDG-PET/CT, even at an early asymptomatic stage. PMID:28061499

  15. The thermal fatigue resistance of H-13 Die Steel for aluminum die casting dies

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The effects of welding, five selected surface coatings, and stress relieving on the thermal fatigue resistance of H-13 Die Steel for aluminum die casting dies were studied using eleven thermal fatigue specimens. Stress relieving was conducted after each 5,000 cycle interval at 1050 F for three hours. Four thermal fatigue specimens were welded with H-13 or maraging steel welding rods at ambient and elevated temperatures and subsequently, subjected to different post-weld heat treatments. Crack patterns were examined at 5,000, 10,000, and 15,000 cycles. The thermal fatigue resistance is expressed by two crack parameters which are the average maximum crack and the average cracked area. The results indicate that a significant improvement in thermal fatigue resistance over the control was obtained from the stress-relieving treatment. Small improvements were obtained from the H-13 welded specimens and from a salt bath nitrogen and carbon-surface treatment. The other surface treatments and welded specimens either did not affect or had a detrimental influence on the thermal fatigue properties of the H-13 die steel.

  16. A micro-mechanical evaluation of the effects of die hardener on die stone.

    PubMed

    He, Li-Hong; van Vuuren, Ludwig Jansen; Planitz, Nina; Swain, Michael V

    2010-08-01

    The purpose of this study was to investigate the properties of a die hardener penetrated layer and evaluate its protective effects on the surface of die stone. A commercial die hardener (PDQ die hardener, Whipmix corp., USA) was tested on a die stone (GC Fujirock EP die stone, GC Europe, Belgium) and a dental plaster (Dental Stone, United States Gypsum Company, USA). Nanoindentation and micro-scratch tests were performed on both coated and uncoated specimens. The scratch damage was observed by SEM and the penetration depth of die hardener was detected by the affiliated EDX. Upon drying, the die hardener penetrated into the die stone to a depth of 3-5 microm, and deposited a thin film on the surface of die stone. Although the die hardener penetrated layer did not show improved mechanical properties, the die hardener film on the surface did protect the specimens from abrasion damage.

  17. Malignant melanoma in a seagull (Larus fuscus): morphological and immunohistochemical approach.

    PubMed

    Costagliola, Alessandro; Britti, Domenico; Russo, Valeria; Meomartino, Leonardo; Castagna, Fabio; Giordano, Debora; Insabato, Luigi; Paciello, Orlando

    2011-03-01

    A common seagull (Larus fuscus) was found near the southern coast of Italy by the veterinarians of the local wild animal rescue center. Physical examination of the bird revealed an ulcerated mass involving a majority of the oral cavity; the mass did not allow for normal feeding. After the bird died necropsy was performed and the mass was histologically and immunohistochemically examined. The morphology and the immunoreactivity for Melan-A and S-100 antigens led to a diagnosis of malignant melanoma. This is the first case of malignant melanoma described in a seagull, and herein we compare the characteristics of the present case with malignant melanoma already described in domestic animals.

  18. Exploratory study on H13 steel dies

    SciTech Connect

    Sunwoo, A.J.

    1994-04-01

    Ultrahigh-strength H13 steel is a recommended die material for aluminum die casting; dies made from H13 steel can be safely water- cooled during hot working operations without cracking. However, after time the dies exhibited surface cracking and excessive wear. Erosive wear also occurs owing to high pressure injection of molten Al. An exploratory study was made of the causes for surface cracking of H13 dies. Results suggest that surface cracking is caused by interrelated factors, internal to the die material as well as externally induced conditions.

  19. Integrated Forming Simulations and Die Structural Analysis for Optimal Die Designs

    NASA Astrophysics Data System (ADS)

    Aitharaju, Venkat; Liu, Malcolm; Dong, Jennifer; Zhang, Jimmy; Wang, Chuan-tao

    2005-08-01

    After gaining a huge success in applying stamping simulations and formability analysis to validate die face developments, GM moves forward to winning total manufacturability in stamping process. Of which, ensuring die structure integrity and minimizing weight is one of the important initiatives. Stamping die design (or solid modeling of stamping dies) was traditionally conducted by following the die design manuals and standards. For any design changes beyond the standards, however, there are no math-based tools available to die designers to verify the outcome of the changes. Die structural analysis (DSA) provides a math-tool to validate the design changes and quantify the safety factors. Several years ago, GM Manufacturing Engineering — Die Center started die structural analysis to meet the increasing demands of customer needs in various areas: (1) to validate design changes; (2) to identify root cause of die breakage during the tryout and stamping operations and propose repair schemes; (3) to optimize the die design for weight reduction; (4) to improve press throughput via optimizing the scrap chute openings, and (5) to provide a math-based tool to validate revisions to the current die design standards. In the integrated forming and die structural analysis, after successful line die surface developments, the forming loads (binder force, pad force, and forming tonnages) are extracted from forming simulations and applied to solid die members for structural analyses of stress, strains, and deflections. In the past few years, Die Center conducted static, dynamic and fatigue analysis for many dies that covers the die design changes requested by die design, die construction and stamping plants. This paper presents some fundamentals and issues of integrated forming and die structural analysis and illustrates the significant impact of die structural analysis on die design, die construction and production stamping.

  20. Should assisted dying be legalised?

    PubMed

    Frost, Thomas D G; Sinha, Devan; Gilbert, Barnabas J

    2014-01-15

    When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion "This House Would Legalise Assisted Dying". This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework.

  1. [Hyperthermia of malignant tumors].

    PubMed

    Terashima, Hiromi

    2004-04-01

    The results of hyperthermia in the malignant tumors were reviewed. It is well known that hyperthermia enhances the effects of radiotherapy and chemotherapy for cancer patients. The clinical study on hyperthermia has been performed in the world since 1975. Several randomized clinical study revealed the benefits of hyperthermia in the head and neck cancers, recurrent breast cancers, and uterine cervical cancers. However, there are many difficulties to perform the hyperthermia in Japan because of lack of man-power and financial aid. Further clinical trials were recommended to obtain the evidences of hyperthermia.

  2. Disseminated Blastomycosis Mimicking Malignancy.

    PubMed

    Hsu, Jennifer L; Tjarks, B Joel; Berg, Aaron; Oliver, Tony

    2017-04-01

    Blastomycosis is an endemic fungal infection commonly found within the Mississippi and Ohio River basins and Great Lakes region. While patients typically present with acute pneumonia, Blastomyces dermatitidis has the potential to spread hematogenously, resulting in disseminated infection of multiple organs. In this report, we describe a 57-year-old male with disseminated blastomycosis acquired in South Dakota. The diagnostic evaluation was confounded by concern for malignancy given the involvement of multiple locations, including brain, lungs, adrenal glands, and testes. Despite aggressive therapy with amphotericin B, the patient succumbed to this infection. Copyright© South Dakota State Medical Association.

  3. Killing, letting die and euthanasia.

    PubMed Central

    Husak, D N

    1979-01-01

    Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible. PMID:541821

  4. Adolescents’ Perceived Risk of Dying

    PubMed Central

    Fischhoff, Baruch; de Bruin, Wändi Bruine; Parker, Andrew M.; Millstein, Susan G.; Halpern-Felsher, Bonnie L.

    2009-01-01

    Purpose Although adolescents’ expectations are accurate or moderately optimistic for many significant life events, they greatly overestimate their chances of dying soon. We examine here whether adolescents’ mortality judgments are correlated with their perceptions of direct threats to their survival. Such sensitivity would indicate the importance of ensuring that adolescents have accurate information about those threats, as well as the psychological support needed to deal with them. Methods Data from two separate studies were used: a national study of 3,436 14–18 year old adolescents and a regional sample of 124 7th graders and 132 9th graders, 12–16 years old. Participants were asked about their chance of dying in the next year and before age 20, and about the extent of various threats to their physical well being. Results Adolescents in both samples greatly overestimated their chance of dying. Those mortality estimates were higher for adolescents who reported direct threats (e.g., an unsafe neighborhood). Thus, adolescents were sensitive to the relative size of threats to their survival, but not to the implications for absolute risk levels. Conclusions Contrary to the folk wisdom that adolescents have a unique sense of invulnerability, those studied here reported an exaggerated sense of mortality, which was highest among those reporting greater threats in their lives. Such fears could affect adolescents’ short-term well being and future planning. PMID:20159504

  5. Killing, letting die and euthanasia.

    PubMed

    Husak, D N

    1979-12-01

    Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible.

  6. Letting die and mercy killing.

    PubMed

    Narbekovas, Andrius; Meilius, Kazimieras

    2003-01-01

    We are all called to make moral decisions, not only about preserving life and health, but also about accepting our death and dying. There are situations, when it is morally right, and indeed obligatory, to allow a dying person to die in peace and dignity. But there is a world of difference between allowing a peaceful death, and deliberately setting out to bring death of the person either by acts of commission (s.c. 'active euthanasia'), or by acts of omission (s.c. 'passive euthanasia'). The word "killing" seems proper for euthanasia, because "to kill" does mean " to intentionally cause the death of someone." It can be morally acceptable to withhold or withdraw a treatment precisely because it is reasonably judged as inefficacious (futile), or excessively burdensome for the patient. One's reason for withholding such treatment must not be a judgement about the desirability of putting an end to the patient's life, but a judgement about the desirability of putting an end to the treatment, which is futile or burdensome.

  7. Surgery in (pre)malignant celiac disease

    PubMed Central

    van de Water, Jolanda MW; Nijeboer, Petula; de Baaij, Laura R; Zegers, Jessy; Bouma, Gerd; Visser, Otto J; van der Peet, Donald L; Mulder, Chris JJ; Meijerink, Wilhelmus JHJ

    2015-01-01

    AIM: To report the outcome of surgery in patients with (pre)malignant conditions of celiac disease (CD) and the impact on survival. METHODS: A total of 40 patients with (pre)malignant conditions of CD, ulcerative jejunitis (n = 5) and enteropathy associated T-cell lymphoma (EATL) (n = 35), who underwent surgery between 2002 and 2013 were retrospectively evaluated. Data on indications, operative procedure, post-operative morbidity and mortality, adjuvant therapy and overall survival (OS) were collected. Eleven patients with EATL who underwent chemotherapy without resection were included as a control group for survival analysis. Patients were followed-up every three months during the first year and at 6-mo intervals thereafter. RESULTS: Mean age at resection was 62 years. The majority of patients (63%) underwent elective laparotomy. Functional stenosis (n = 13) and perforation (n = 12) were the major indications for surgery. In 70% of patients radical resection was performed. Early postoperative complications, mainly due to leakage or sepsis, occurred in 14/40 (35%) of patients. Eight patients required reoperation. More patients who underwent resection in the acute setting (n = 3, 20%) died compared to patients treated in the elective setting. With a median follow-up of 20 mo, seven patients (18%) required reoperation due to long-term complications. Significantly more patients who underwent acute surgery could not be treated with adjuvant chemotherapy. Patients who first underwent surgical resection showed significantly better OS than patients who received chemotherapy without resection. CONCLUSION: Although the complication rate is high, the preferred first step of treatment in (pre)malignant CD consists of local resection as early as possible to improve survival. PMID:26604647

  8. [Primary Malignant Cardiac Tumors: Surgical results].

    PubMed

    Saraiva, Joana; Antunes, Pedro Engrácia; Carvalho, Lina; Antunes, Manuel Jesus

    2016-04-01

    To characterize primary malignant cardiac tumors operated on in our center and to analyze patient survival. Between January 1994 and August 2014, 123 patients with cardiac tumors underwent surgery, of which 12 (9.8%) were primary malignant tumors - eight sarcomas (67%), three B-cell lymphomas (25%) and one epithelioid hemangioendothelioma (8.3%). The tumor affected the left atrium in five cases (42%), the right atrium in four (33%), the right ventricle in two (17%) and the pulmonary valve in one (8%). Patients' mean age was 55.4 ± 16.9 years, 67% were female and 75% presented in New York Heart Association class III-IV. Resection was complete (negative margins) in five cases and partial in seven (five sarcomas and two lymphomas), and 11 patients needed adjuvant therapy, surgery alone being curative in only one (epithelioid hemangioendothelioma). Mean follow-up was 41.7 ± 61.3 months: 24.8 ± 30.0 months (3.8-95.7) for sarcomas, 70.1 ± 118.0 months (1-206.3) for lymphomas and 91.9 months for the epithelioid hemangioendothelioma. During follow-up, 10 patients died (83%) and two were alive (17%). Overall survival at 30 days, six months, one year and two years was 91.7%, 66.7%, 58.3% and 41.7%, respectively. In the sarcoma group, 1-year and 2-year survival were 62.5% and 37.5%, respectively. Resection of primary malignant cardiac tumors, even partial, is safe, provides relief of obstructive symptoms and improves quality of life, but is rarely curative and has a low survival rate. Due to the rarity of such tumors, a multicenter database could improve knowledge and help clarify the indications for cardiac surgery as a treatment option. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  9. Guide for extrusion dies eliminates straightening operation

    NASA Technical Reports Server (NTRS)

    Gyorgak, C. A.; Hoover, R. J.

    1964-01-01

    To prevent distortion of extruded metal, a guidance assembly is aligned with the die. As the metal emerges from the extrusion dies, it passes directly into the receiver and straightening tube system, and the completed extrusion is withdrawn.

  10. On the Child's Own Initiative: Parents Communicate with Their Dying Child About Death.

    PubMed

    Jalmsell, Li; Kontio, Taru; Stein, Maria; Henter, Jan-Inge; Kreicbergs, Ulrika

    2015-01-01

    Open and honest communication has been identified as an important factor in providing good palliative care. However, there is no easy solution to if, when, and how parents and a dying child should communicate about death. This article reports how bereaved parents communicated about death with their child, dying from a malignancy. Communication was often initiated by the child and included communication through narratives such as fairy tales and movies and talking more directly about death itself. Parents also reported that their child prepared for death by giving instructions about his or her grave or funeral and giving away toys.

  11. Radioimmunotherapy of malignancies

    SciTech Connect

    Reilly, R.M. )

    1991-05-01

    The critical issues in radioimmunotherapy are highlighted, and novel ways of improving the therapeutic indexes of radioimmunotherapeutic agents are outlined. The use of radioactively labeled monoclonal antibodies to treat malignant tumors has been investigated in animals and humans. Radionuclides suitable for labeling antibodies for such use include iodine 125, iodine 131, yttrium 90, rhenium 188, and copper 67. Radiobiological factors to be considered in radioimmunotherapy include the size and density of the tumor and the ability of a radiolabeled antibody to penetrate the tumor nodule. The dose of radiation required to destroy a tumor varies; however, the whole-body dose must not exceed 200 rads to avoid irreversible toxicity to the bone marrow. Despite the theoretical inadequacy of radiation doses to tumors indicated by conventional dosimetry, responses have been observed in animals and humans. More reliable and accurate dosimetric methods are under development. The induction of human antimouse antibodies can alter the pharmacokinetics of radiolabeled antibodies. Improving the therapeutic index of radioimmunotherapeutic agents may be achieved through regional therapy, administering a secondary antibody to improve clearance, combining radioimmunotherapy with external-beam irradiation, using an avidin-biotin conjugate system to deliver the radiolabeled antibodies, and addressing the problem of tumor antigen heterogeneity. Researchers are working to reduce or eliminate the clinical problems associated with radioimmunotherapy. Hematologic malignancies, such as lymphomas, are more likely than solid tumors to respond satisfactorily. 110 refs.

  12. Prevention of malignant melanoma

    PubMed Central

    Chaidemenos, G; Stratigos, A; Papakonstantinou, M; Tsatsou, F

    2008-01-01

    The results of Primary Prevention programs, aiming at the decrease of melanoma incidence, were less encouraging than those of Secondary prevention which aims at an early diagnosis of malignant melanoma. Australia was the country with the best results obtained in both Prevention strategies, especially in avoiding intense, though intermittent, UV exposure. The success of these programs encouraged health authorities to initiate their application to other disorders. New sunscreens containing substances correcting the UV-damaged DNA may offer a promising result in the decades to come. However, so far no one epidemiological study has proved the prevention of malignant melanoma with the use of sun protecting agents. A meta-analysis verified the connection between melanoma and solarium use. The protective role of vitamin D in the development of prostate, breast and colon cancer was shown in a meta-analysis. The authors, however, suggest that fair-skinned persons should take oral supplementation of vitamin D, instead of exposing themselves to the sun. The Hellenic Society of Dermatology and Venereology published the results of 5-year-prevention programs in Greece. Their favorable results in the early diagnosis of melanoma justify an intense continuation of these efforts. PMID:18923759

  13. Contoured Orifice for Silicon-Ribbon Die

    NASA Technical Reports Server (NTRS)

    Mackintosh, B. H.

    1985-01-01

    Die configuration encourages purity and stable growth. Contour of die orifice changes near ribbon edges. As result, silicon ribbon has nearly constant width and little carbon contamination. Die part of furnace being developed to produce high-quality, low-cost material for solar cells.

  14. Contoured Orifice for Silicon-Ribbon Die

    NASA Technical Reports Server (NTRS)

    Mackintosh, B. H.

    1985-01-01

    Die configuration encourages purity and stable growth. Contour of die orifice changes near ribbon edges. As result, silicon ribbon has nearly constant width and little carbon contamination. Die part of furnace being developed to produce high-quality, low-cost material for solar cells.

  15. Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008.

    PubMed

    Donin, Nicholas; Filson, Christopher; Drakaki, Alexandra; Tan, Hung-Jui; Castillo, Alex; Kwan, Lorna; Litwin, Mark; Chamie, Karim

    2016-10-01

    In the current study, the authors attempted to describe the incidence, most common sites, and mortality of second primary malignancies among survivors of common cancers. The authors identified patients aged ≥18 years who were diagnosed with a primary malignancy from the 10 most common cancer sites (prostate, breast, lung, colon, rectum, bladder, uterus, kidney, melanoma, and non-Hodgkin lymphoma) between 1992 and 2008 from Surveillance, Epidemiology, and End Results data. Factors associated with the incidence of second primary malignancies were explored using bivariable and multivariable models, and mortality attributable to first and second primary malignancies was examined. A cohort of 2,116,163 patients was identified, 170,865 of whom (8.1%) developed a second primary malignancy. Survivors of bladder cancer had the highest risk of developing a second cancer. In a multivariable model controlling for age, race, tumor grade, stage of disease, marital status, educational level, and income, a history of non-Hodgkin lymphoma (hazard ratios of 2.70 and 2.88, respectively, for men and women) and bladder cancer (hazard ratios of 1.88 and 1.66, respectively, for men and women) predicted the highest risk of developing a second cancer. For patients with 2 incident cancers, 13% died of their initial cancer, but greater than one-half (55%) died of their second primary malignancy. Lung cancer was the cause of death in 12% of patients with 2 incident cancers. Nearly 1 in 12 patients diagnosed with a common cancer developed a second malignancy, the most common of which was lung cancer. Greater than one-half of patients with 2 incident cancers died of their secondary malignancy. The findings from the current study may inform care strategies among cancer survivors. Cancer 2016;122:3075-3086. © 2016 American Cancer Society. © 2016 American Cancer Society.

  16. Translational advances in pleural malignancies.

    PubMed

    Stathopoulos, Georgios T

    2011-01-01

    Pleural malignancies, including primary malignant pleural mesothelioma and secondary pleural metastasis of various tumours resulting in malignant pleural effusion, are frequent and lethal diseases that deserve devoted translational research efforts for improvements to be introduced to the clinic. This paper highlights select clinical advances that have been accomplished recently and that are based on preclinical research on pleural malignancies. Examples are the establishment of folate antimetabolites in mesothelioma treatment, the use of PET in mesothelioma management and the discovery of mesothelin as a marker of mesothelioma. In addition to established translational advances, this text focuses on recent research findings that are anticipated to impact clinical pleural oncology in the near future. Such progress has been substantial, including the development of a genetic mouse model of mesothelioma and of transplantable models of pleural malignancies in immunocompetent hosts, the deployment of stereological and imaging methods for integral assessment of pleural tumour burden, as well as the discovery of the therapeutic potential of aminobiphosphonates, histone deacetylase inhibitors and ribonucleases against malignant pleural disease. Finally, key obstacles to overcome towards a more rapid advancement of translational research in pleural malignancies are outlined. These include the dissection of cell-autonomous and paracrine pathways of pleural tumour progression, the study of mesothelioma and malignant pleural effusion separately from other tumours at both the clinical and preclinical levels, and the expansion of tissue banks and consortia of clinical research of pleural malignancies. © 2010 The Author. Respirology © 2010 Asian Pacific Society of Respirology.

  17. Malignant lymphoma of bone.

    PubMed

    Dürr, Hans Roland; Müller, Peter Ernst; Hiller, Erhard; Maier, Markus; Baur, Andrea; Jansson, Volkmar; Refior, Hans Jürgen

    2002-02-01

    Malignant lymphoma of bone is rare. In many cases, its diagnosis is delayed because of unspecific clinical signs and equivocal radiographs. Therapy in general is multimodal, including surgery and radio- and chemotherapy. Our objective was to demonstrate the clinical and radiological aspects of the lesion to optimize diagnostic approaches and to evaluate treatment and prognostic factors. Thirty-six patients with malignant lymphoma of bone who were surgically treated over a 15-year-period were retrospectively reviewed. Seventeen of them showed a singular bone non-Hodgkin's lymphoma (NHL) which was classified as primary lymphoma of the bone (PLB). In 13 cases, dissemination of the disease with multiple bone or visceral involvement was apparent (dNHL). Six patients suffered from bone involvement due to Hodgkin's disease (HD). Surgical treatment was indicated for diagnostic reasons or complications due to the disease. Radiation and chemotherapy were part of the oncological treatment. The patients' mean age was 57 years. The main symptom in malignant bone lymphoma in 33 patients was pain, with an average duration of 8 months. In the secondary cases, bone involvement appeared on average 57 months after the initial diagnosis. An osteolytic pattern was seen in 58% of the lesions. Soft-tissue involvement was seen in 71% of cases (PLB 80%, dNHL 73%, HD 40%) and was the primary diagnostic sign associated with this disease. The 5-year survival rate was 61% (PLB 88%, dNHL 38%, HD 50%). Multiple vs solitary bone involvement was the most significant factor in the prognosis. Extraskeletal involvement significantly decreased survival. No correlation was found between gender, age, location, or histological subtypes and survival. Bone involvement in NHL appears late in the extraskeletal disease. The clinical appearance is nonspecific, and the delay between the onset of symptoms and diagnosis is often long. One of the major radiologic signs is the existence of a soft-tissue tumor

  18. Oral potentially malignant disorders: Is malignant transformation predictable and preventable?

    PubMed Central

    van der Waal, Isaäc

    2014-01-01

    Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in regression or even disappearance of the leukoplakia and will diminish the risk of cancer development either at the site of the leukoplakia or elsewhere in the mouth or the upper aerodigestive tract. The debate on the allegedly potentially malignant character of oral lichen planus is going on already for several decades. At present, there is a tendency to accept its potentially malignant behaviour, the annual malignant transformation rate amounting less than 0.5%. As in leukoplakia, there are no reliable predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented either. Follow-up visits, e.g twice a year, may be of some value. It is probably beyond the scope of most dentists to manage patients with these lesions in their own office. Timely referral to a specialist seems most appropriate, indeed. Key words:Oral potentially malignant disorders, oral leukoplakia, oral lichen planus. PMID:24905952

  19. Die Welt des Herrn Kuhn

    NASA Astrophysics Data System (ADS)

    Kern, Daniela

    Eines Morgens erwachte Herr Kuhn fröstelnd und staunte darüber, dass es in seinerWohnung eiskalt war. Dennoch quälte er sich aus seiner kuscheligen Bettdecke heraus und schlurfte ins Bad. "Hoffentlich wird wenigstens das Wasser warm", dachte er sich, als er den Wasserhahn betätigte - aber es kam nicht nur kein warmesWasser, außer einem unheilvollen Gluckser kam gar nichts aus der Leitung. "Dann werde ich wohl mal den Klempner anrufen", sprach er sich leise in den Bart und griff zu seinem Handy - doch das Netz war tot! Herr Kuhn begann nun, sich ernsthaft Sorgen zu machen, "Oje, was ist denn heute nur los? Ist irgendetwas Schlimmes passiert?" Um einen besseren Überblick über die Lage zu bekommen und sich austauschen zu können, brannte er nun förmlich darauf, rauszugehen und zur Arbeit zu fahren. An anderen Tagen, die er frisch geduscht und mit Kaffee und Marmeladen-Brot begann, war er selten so motiviert. So ging er also nun mit leerem Magen aus dem Haus. Hätte er den Versuch unternommen, sein tägliches Marmeladenbrot zuzubereiten, und dafür den Kühlschrank geöffnet, um das Marmeladenglas herauszunehmen, wäre ihm aufgefallen, dass auch die Stromversorgung Störungen unterworfen war, unschön zu erkennen an den ersten grünen, felligen Inseln auf seinem Lieblingskäse.

  20. Malignant Pleural Mesothelioma

    PubMed Central

    Tsao, Anne S.; Wistuba, Ignacio; Roth, Jack A.; Kindler, Hedy Lee

    2009-01-01

    Malignant pleural mesothelioma (MPM) is a deadly disease that occurs in 2,000 to 3,000 people each year in the United States. Although MPM is an extremely difficult disease to treat, with the median overall survival ranging between 9 and 17 months regardless of stage, there has been significant progress over the last few years that has reshaped the clinical landscape. This article will provide a comprehensive discussion of the latest developments in the treatment of MPM. We will provide an update of the major clinical trials that impact mesothelioma treatment in the resectable and unresectable settings, discuss the impact of novel therapeutics, and provide perspective on where the clinical research in mesothelioma is moving. In addition, there are controversial issues, such as the role of extrapleural pneumonectomy, adjuvant radiotherapy, and use of intensity-modulated radiotherapy versus hemithoracic therapy that will also be addressed in this manuscript. PMID:19255316

  1. End-of-life care for hematological malignancies: the 'technological imperative' and palliative care.

    PubMed

    McGrath, Pam

    2002-01-01

    Recent research indicates that hospice/palliative care practices have not yet been integrated into the care of patients with hematological malignancies. As research in relation to palliative care and hematological malignancies is in its infancy, many of the end-of-life care practices with these diagnostic groups are based on unexamined ideas. The findings presented in this article, which are taken from recent post-doctoral research on hematological malignancies and palliative care, make a contribution to documenting information on what is happening to patients and their families in this area. In particular, the findings provide insights on issues associated with the patient and carer awareness that the patient is dying, understanding of prognosis, and the desire to die at home. Such insights are placed in the context of descriptions of the patients' experience with treatment during the terminal stage.

  2. Treatment of Malignant Pheochromocytoma

    PubMed Central

    Drasin, Harry

    1978-01-01

    Pheochromocytoma is a tumor derived from chromaffin tissue, which secretes catecholamines. Today, about 90 percent of patients with this tumor are cured by surgical procedures. In 8 to 15 percent of patients with this tumor there is unresectable, recurrent or metastatic disease, which causes significant morbidity and mortality. The natural history of metastatic disease includes long-term survivors; many, however, die early of disseminated disease. The most common site of metastatic lesions is the skeleton. Palliation for these lesions can often be achieved with the use of radiation therapy. Other sites are, in general, less responsive to radiation therapy. Chemotherapy has been used in combination with radiation therapy, but the results generally have been disappointing. Chemotherapy with doxorubicin hydrochloride and cyclophosphamide in combination with radiation therapy has provided good palliation for skeletal disease for about five months, when disease progression was again noted. Further information is needed concerning the optimal chemotherapeutic treatment of this unusual tumor. PMID:629048

  3. The malignant primate?

    PubMed

    de Grouchy, J

    1991-01-01

    Speciation and carcinogenesis result from genomic instability at the gametic or at the somatic levels. After an infinity of trials they occur, by chromosome rearrangements, in single individuals or in single cells and evolve by similar chromosomal or clonal evolutions. Loss of heterozygosity for the first event is essential in both processes: in evolution, a chromosomal rearrangement, a pericentric inversion or a Robertsonian fusion, must become homozygous to ensure a reproductive barrier for a new species; Knudson's two-event sequence is a similar situation in cancer. Position effect is equally important: we have shown overexpression of the SOD1 gene in the orangutan phylum probably by an intrachromosomal rearrangement; the t(9;22) in CML acts by typical position effect. Parental imprinting underlies the evolution of genome function and the unset of certain cancers. Evolution and malignancy are interweaved by viruses and oncogenes since the dawn of life. Cancer uses its intelligence to expand and to destroy the other tissues, using subtle metabolic pathways and a variety of tricks to metastasize other cells. It always wins but saws the branch on which it sits. Mankind also grows exponentially, killing thousands of other species, poisoning the oceans and soft waters, polluting the atmosphere, all for his egoistic needs. Man also travels and metastasizes other Earths. He modifies his genome or that of other species, and develops new technologies for his reproduction. He can destroy the planet in an eyeblink. To be or not to be the malignant primate, that will be the dilemma for the 21st Century.

  4. Primary malignant melanoma of prostate.

    PubMed

    Doublali, M; Chouaib, A; Khallouk, A; Tazi, M F; El Fassi, M J; Farih, My H; Elfatmi, H; Bendahou, M; Benlemlih, A; Lamarti, O

    2010-05-01

    Primary genitourinary melanoma accounts for less than one per cent of all cases of melanoma. Most cases attributed to the prostate actually originate from the prostatic urethra. Due to its infrequency, primary malignant melanoma of the genitourinary tract presents a difficult diagnostic and management challenge. We report a case of primary malignant melanoma of the prostate found during transurethral resection of the prostate.

  5. Oral potentially malignant disorders: is malignant transformation predictable and preventable?

    PubMed

    van der Waal, Isaäc

    2014-07-01

    Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in regression or even disappearance of the leukoplakia and will diminish the risk of cancer development either at the site of the leukoplakia or elsewhere in the mouth or the upper aerodigestive tract. The debate on the allegedly potentially malignant character of oral lichen planus is going on already for several decades. At present, there is a tendency to accept its potentially malignant behaviour, the annual malignant transformation rate amounting less than 0.5%. As in leukoplakia, there are no reliable predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented either. Follow-up visits, e.g twice a year, may be of some value. It is probably beyond the scope of most dentists to manage patients with these lesions in their own office. Timely referral to a specialist seems most appropriate, indeed.

  6. Malignant phyllodes tumor in an 11-year-old girl with fatal clinical outcome. A case report.

    PubMed

    Hassan, Sidra; Ud Din, Nasir; Kayani, Naila

    2016-01-27

    Phyllodes tumors are rare biphasic tumors occur predominantly in middle aged women. Malignant phyllodes tumor in children is very rare. To report a case of malignant phyllodes tumor in a pre-menarchal girl. H&E slides of the case were reviewed and follow up was obtained. The patient was 11-year-old girl who noticed a lump in her right breast 1 year back which grew rapidly in size. Wide local excision of the mass was done and histopathology revealed a malignant phyllodes tumor. Patient underwent mastectomy one month later due to recurrence. Two years later, she presented with dyspnea and chest pain. CT showed lung metastasis. The patient died of disease 1 year later due to widespread metastasis in liver and bone. We report a case of malignant phyllodes tumor in an 11-year-old girl, which behaved aggressively and patient died of disease due to widespread metastases 3 years after diagnosis.

  7. Malignant eroticized countertransference.

    PubMed

    Chessick, R D

    1997-01-01

    Gabbard (1994) divided the pathology of therapists, both male and female, who commit sexual boundary violations into those who are psychotic, those who are predatory psychopaths, those engaging in masochistic surrender, and those called "the lovesick therapist." Lovesick therapists are the most common type and manifest crucial narcissistic themes of "a desperate need for validation by their patients, a hunger to be loved and idealized, and a tendency to use patients to regulate their own self-esteem" (p. 127). Among the psychodynamic aspects of this curiously circumscribed area of loss of reality testing that makes it difficult for the therapist to see how self-destructive and harmful such enactment is, are an unconscious reenactment of incestuous longings, a misperception of the patient's wish for maternal nurturance as a sexual overture, enactments of rescue fantasies, a projected idealization of the self of the therapist, a confusion of the therapist's needs with the patient's needs, a fantasy that love is curative, acting out disavowed rage at the patient, or rage at an organization, an institute, or one's training analyst, a manic defense against mourning, a narcissistic fantasy that their sexual affair is an exception, insecurity regarding masculine identity, and assorted primitive preoedipal themes. Gabbard's (1991) erotized countertransference is one variety of what I have termed malignant eroticized countertransference. His variety is a development that occurs under the pressure of the patient's preemptive and compelling expressions of lust and love, the patient's erotic transference. But malignant eroticized countertransference can also occur without the patient having offered any such expressions; it can even occur on first meeting the patient when he or she walks into the office! This is akin to the romantic "love-at-first-sight" theme so favored in the movies and by novelists, but it is always pathological when it occurs in the therapeutic situation

  8. Malignant cause of ventriculoperitoneal shunt 'pseudocyst': a case report.

    PubMed

    Awori, Jonathan; Wu, Chris Y; Maher, Cormac O

    2015-01-01

    Abdominal pseudocysts are an uncommon complication of ventriculoperitoneal (VP) shunts. We present the case of a 4-year-old boy with a history of complicated hydrocephalus managed with a VP shunt due to sequelae of prematurity. The patient presented with abdominal distention, and a pseudocyst was diagnosed. Despite shunt externalization and aspiration, the pseudocyst continued to produce up to 1 liter of serosanguineous fluid per day. After MRI revealed malignant features within the pseudocyst, laparotomy was performed and the pseudocyst was partially excised. Pathology reports suggested sarcoma. The cystic mass grew back aggressively, accompanied by distant metastasis. The patient's condition deteriorated and he died from his disease. To our knowledge, this represents the first report of an abdominal malignancy mimicking a pseudocyst and causing VP shunt failure.

  9. Malignant intraventricular meningioma with craniospinal dissemination and concurrent pulmonary metastasis

    PubMed Central

    2014-01-01

    Background Malignant intraventricular meningiomas are quite rare and may spread along the craniospinal axis or extraneurally. However, simultaneous cerebrospinal dissemination and distal extraneural metastasis has seldom been reported. Case presentation A 51-year-old woman presented with recurrent anaplastic meningioma in the trigone of right lateral ventricle over a 1.5-year period. Suggested radiotherapy was refused after each operation. The patient showed a local relapse and dissemination around the previous tumoral cavity and along the spinal canal during the last recurrence. Left pulmonary metastasis was also found. She died despite multiple lesion resections. Conclusions Malignant intraventricular meningiomas are an uncommon subset of intracranial meningiomas, and have a great potential for intraneural and extraneural metastasis. Systemic investigation for metastasis is required after surgery, especially for those without adjuvant therapies. PMID:25073808

  10. Synchronous primary oesophageal malignant melanoma and sigmoid adenocarcinoma

    PubMed Central

    Malik, Ahsan; Bansil, Sandeep; Junglee, Naushad; Sutton, Jonathon; Gasem, Jaber; Ahmed, Waqar

    2011-01-01

    The authors present a case of a gentleman in his 70s who was referred to the gastroenterology outpatient clinic with dysphagia. An oesophagogastroduodenoscopy was performed which showed a polypoidal black coloured mass in the oesophagus. Endoscopic biopsies confirmed malignant melanoma. Further staging investigations were organised to assess suitability for surgery which revealed a mass in the sigmoid colon. Subsequent colonoscopy and biopsy confirmed adenocarcinoma. As this was an unusual case to associate these two malignancies at the same time, there was no ideal or recognised management plan available. Different treatment options were considered and a consensus was developed regarding best surgical approach but due to the lapse in time a repeat staging CT scan was organised which unfortunately now demonstrated lymph node metastasis. Patient was managed conservatively from this point onwards and he died 12 months later. PMID:22689833

  11. Rotary press utilizing a flexible die wall.

    PubMed

    Amidon, G E; Smith, D P; Hiestand, E N

    1981-06-01

    A die with a flexible wall was constructed and evaluated on a specially modified instrumented rotary tablet press. The design permits an inward deflection of the die wall by a side punch, which rolls past a side compression roll during compression-decompression. The side compression roll is instrumented to monitor the applied side compression roll forces. On decompression, return of the die wall to its original position permits release of residual die wall pressure. The decreased residual die wall pressure can decrease fracture and capping of tablets for problem formulations. The performance was tested on three experimental formulations. For these formulations, tablets made in a conventional die exhibited severe capping problems. However, most tablets compressed in the special die were superior. With proper adjustment of punch and die wall compression forces, excellent tablets could be manufactured. The merits of the special die and modified tablet machine are substantiated, although this initial design did not provide adequate die wall pressure for all formulations. Further engineering efforts could result in practical production equipment.

  12. Malignant schwannoma of the infratemporal fossa: a case report.

    PubMed

    Touati, Mohamed Mliha; Darouassi, Youssef; Chihani, Mehdi; Al Jalil, Abdelfettah; Tourabi, Khalid; Lakouichmi, Mohamed; Essadi, Ismail; Bouaity, Brahim; Ammar, Haddou

    2015-07-04

    Malignant schwannomas or neurofibrosarcomas are rare nerve tumors of unknown etiology. These neoplasms are highly aggressive with a marked propensity for local recurrence and metastatic spread. Their management continues to be a challenge for pathologists and surgeons. Maxillofacial locations are very exceptional. We report the case of a patient with unusual malignant schwannoma of the infratemporal fossa discovered at a late evolving stage. A 56-year-old woman, of Moroccan nationality, presented to our hospital in 2013 with a large right-sided hemifacial swelling that had evolved over the previous 4 months, with a limitation of mouth opening, nasal obstruction and episodes of epistaxis. A CT scan and MRI showed a large and invasive tumor occupying her right infratemporal fossa and maxillary sinus, with sphenoidal, ethmoidonasal, nasopharyngeal and intraorbital extension. A nasal endoscopic biopsy was performed. Immunohistochemical examination concluded a diagnosis of malignant schwannoma, and a palliative radiotherapy was decided; however, our patient died 10 days later. Malignant schwannoma of paranasal sinuses and the anterior skull base is a rare tumor that involves a high rate of local invasion. The prognosis is poorer compared to that occurring in the trunk and extremities.

  13. Leukemia cutis in association with cutaneous epidermal malignancies.

    PubMed

    Ra, Seong; Su, Albert; Ellison, Doug; Koperski, Judith; Bonilla, Maria; Robbins, Bruce

    2012-10-01

    Epidermal malignancies developing in association with hematolymphoid malignancies are exceptional. Only one prior case of myeloid leukemia cutis with a cutaneous epidermal malignancy has been reported. We report two cases; one occurred in association with squamous cell carcinoma (SCC) and another with basal cell carcinoma (BCC). Both patients were 83-year-old males without established histories of systemic hematopoietic disorders; one presented with an erythematous papule on the right upper back and the other with a nodule on the left wrist. One biopsy revealed nodular BCC with an associated perivascular myeloid leukemic infiltrate showing immunohistochemical positivity for CD43 and CD45. The other biopsy showed SCC associated with a leukemic infiltrate in sheets with myeloid blasts, eosinophilic myelocytes and maturing myeloid precursors. The myeloid cells showed immunohistochemical expression of CD43, CD68, CD33, CD117 and myeloperoxidase. Both patients had myeloblasts on peripheral blood smear. One patient declined further treatment and died of disease 5 weeks after the initial biopsy. The other patient underwent chemotherapy and is alive after 6 months. Although most inflammatory infiltrates associated with cutaneous epidermal malignancies are reactive, careful examination is necessary to exclude systemic hematopoietic disease, especially in elderly patients. Copyright © 2012 John Wiley & Sons A/S.

  14. Fulminant course in a case of malignant phyllodes tumor

    PubMed Central

    Chang, Young Woo; Kim, Hwan Soo; Kim, Deok Woo

    2017-01-01

    We present the case of a 31-year-old woman with an inflammatory and ulcerative malignant phyllodes tumor in her right breast. A right modified radical mastectomy and transverse rectus abdominis myocutaneous (TRAM) flap were performed. A month after the initial operation, several masses recurred at the superior margin and deep margin of the TRAM flap. Wide excision was performed, but masses recurred at the inferior margin and in both lung fields 2 weeks after the second operation. Six weeks after the second operation, the patient died due to progression of dyspnea and respiratory failure. PMID:28203559

  15. Malignant fibrous histiocytoma developing in irradiated sacral chordoma

    SciTech Connect

    Halpern, J.; Kopolovic, J.; Catane, R.

    1984-06-15

    Malignant fibrous histiocytoma (MFH), arising at the site of a sacral chordoma 8 years after massive radiotherapy, is described. Initially, the patient received 7000 rad to the sacral area and, on recurrence, 5 years later, an additional 4000 rad. Two years later, a sacral mass was noted again. Biopsy then revealed MFH; chest x-ray showed multiple lung metastases. A combination chemotherapy, consisting of cyclophosphamide, vincristine, adriamycin (doxorubicin), and DTIC, resulted in a 6 month partial response. Subsequently, the patient died because of progressive metastatic disease. At autopsy, 8 years after diagnosis, both the sacral lesion and the lung metastases proved to be MFH, and no residual chordoma was found.

  16. Psychiatry and the dying prisoner.

    PubMed

    Hanson, Annette

    2017-02-01

    Due to the growing number of ageing prisoners in the American correctional system, penal institutions are increasingly caring for patients with chronic and potentially terminal medical conditions. To address this problem states have attempted sentencing reform initiatives and adopted compassionate release programmes; however, these efforts have failed to significantly reduce the number of elderly or seriously ill inmates. Correctional mental health services are now called upon to aid in the care of prisoners at the end of life. This article presents the common elements of prison hospice programmes and the role psychiatry plays in this multidisciplinary effort. The right-to-die movement holds future implications for correctional mental health professionals. The historical and legal background of this international movement is presented with particular attention given to landmark cases and statutes protecting institutionalized patients.

  17. Should assisted dying be legalised?

    PubMed Central

    2014-01-01

    When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework. PMID:24423249

  18. Bacteria Interactions with Dying Diatoms

    NASA Astrophysics Data System (ADS)

    Smriga, S.; Juarez, G.; Fernandez, V.; Stocker, R.

    2016-02-01

    Dying phytoplankton are surrounded by microscale gradients of dissolved organic matter (DOM) that can attract bacteria. These 'phycospheres' may impact the trophic transfer of DOM in the marine microbial food web and enable the growth of bacterial populations, yet these effects remain poorly quantified particularly in relation to the physiological state of the phytoplankton. We dissected phycosphere interactions at unprecedented spatial and temporal resolution using the model diatom Thalassiosira weissflogii and the bacterium Marinobacter adhaerans. Diatom stress was stimulated by addition of polyunsaturated aldehyde (PUA) and both diatom and bacterial responses were captured via time-lapse fluorescence microscopy. We found that stressed diatoms underwent lysis 10-15 h after PUA treatment. Coordinated with the timing of this transition into phytodetritus, wild-type Marinobacter accumulated via chemotaxis near the diatoms immediately following lysis. In contrast, at lysis there was no accumulation of either a non-chemotactic or a non-motile mutant of Marinobacter, pointing to behavioral rather than demographic responses as drivers for the accumulation. Despite the lack of response, non-chemotactic as well as non-swimming bacterial cells that by chance attached to or were located near (<30 µm) stressed diatoms experienced more growth than cells further afield. Growth within the phycosphere was even greater after diatom lysis. Through quantification at the microscale, these results reveal that chemotaxis may precede rapid bacterial attachment to stressed and dying diatoms and may be integral to the microbial colonization of new phytodetritus during phytoplankton blooms and bloom collapses in coastal ecosystems. Even while chemotactic cells retain a growth advantage given their ability to sense and respond to lysis events, phycosphere DOM provides growth benefits to both motile and non-motile taxa that become attached to or happen to be co-located with new

  19. Primary cerebral malignant melanoma

    PubMed Central

    Tang, Kai; Kong, Xiangyi; Mao, Gengsheng; Qiu, Ming; Zhu, Haibo; Zhou, Lei; Nie, Qingbin; Xu, Yi; Du, Shiwei

    2017-01-01

    Abstract Primary intracranial melanomas are uncommon and constitute approximately 1% of all melanoma cases and 0.07% of all brain tumors. In nature, these primary melanomas are very aggressive and can spread to other organs. We report an uncommon case of primary cerebral malignant melanoma—a challenging diagnosis guided by clinical presentations, radiological features, and surgical biopsy results, aiming to emphasize the importance of considering primary melanoma when making differential diagnoses of intracranial lesions. We present a rare case of a primary cerebral melanoma in the left temporal lobe. The mass appeared iso-hypodense on brain computed tomography (CT), short signal on T1-weighted magnetic resonance images (T1WI) and long signal on T2WI. It was not easy to make an accurate diagnosis before surgery. We showed the patient's disease course and reviewed related literatures, for readers’ reference. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Because of this, there is no need to conduct special ethic review and the ethical approval is not necessary. After surgery, the pathological examination confirmed the diagnosis of melanoma. The patient was discharged without any complications and went on to receive adjuvant radiochemotherapy. It is difficult to diagnose primary cerebral melanoma in the absence of any cutaneous melanosis. A high index of clinical suspicion along with good pathology reporting is the key in diagnosing these extremely rare tumors. PMID:28121927

  20. Galectins in hematological malignancies.

    PubMed

    Giordano, Mirta; Croci, Diego O; Rabinovich, Gabriel A

    2013-07-01

    Galectins are a family of lectin molecules that have emerged as key players in inflammation and tumor progresssion by displaying intracellular and extracellular activities. This review describes the recent advances on the role of galectins in hematological neoplasms. Galectin-1 and galectin-3 are the best studied galectins in oncohematology. Increased expression of galectin-1 has been associated with tumor progression in Hodgkin's lymphoma and chronic lymphocytic leukemia, whereas galectin-3 plays a supporting role in chronic myelogenous leukemia and multiple myeloma. Functional studies have assigned a key role for galectin-1 as a negative regulator of T-cell immunity in Hodgkin's lymphoma and cutaneous T-cell lymphoma. Of therapeutic interest is the development of agents with the capacity to interfere with galectin functions. Current knowledge indicates a key role for galectins in hematological neoplasms by favoring the growth and survival of tumor cells and facilitating tumor immune escape. Intervention using specific galectin inhibitors is emerging as an attractive therapeutic option to alter the course of these malignancies.

  1. Malignancy and chronic renal failure.

    PubMed

    Peces, Ramon

    2003-01-01

    Increased incidence of cancer at various sites is observed in patients with end-stage renal disease (ESRD). Certain malignant diseases, such as lymphomas and carcinomas of the kidney, prostate, liver and uterus, show an enhanced prevalence compared with the general population. In particular, renal cell carcinoma (RCC) shows an excess incidence in ESRD patients. A multitude of factors, directly or indirectly associated with the renal disease and the treatment regimens, may contribute to the increased tumor formation in these patients. Patients undergoing renal replacement therapy (RRT) are prone to develop acquired cystic kidney disease (ACKD), which may subsequently lead to the development of RCC. In pre-dialysis patients with coexistent renal disease, as in dialysis and transplant patients, the presence of ACKD may predispose to RCC. Previous use of cytotoxic drugs (eg, cyclophosphamide) or a history of analgesic abuse, are additional risk factors for malignancy. Malignancy following renal transplantation is an important medical problem during the follow-up. The most common malignancies are lymphoproliferative disorders (early after transplantation) and skin carcinomas (late after transplantation). Another important confounder for risk of malignancy after renal transplantation is the type of immunosuppression. The type of malignancy is different in various countries and dependent on genetic and environmental factors. Finally, previous cancer treatment in a uremic patient on the transplant waiting list is of great importance in relation to waiting time and post-malignancy screening.

  2. Evaluation of permanent die coatings to improve the wear resistance of die casting dies. Final project report, January 1, 1995--April 30, 1997

    SciTech Connect

    Shivpuri, R.

    1997-09-18

    Die Casting dies are subject to severe service conditions during the die casting operation. While these severe conditions are necessary to achieve high production rates, they cause the dies which are commonly made of H13 die steel, to suffer frequent failures. The major die failure mechanisms are erosion or washout, Heat checking, soldering and corrosion. Due to their geometrical complexity, die casting dies are very expensive (some dies cost over a million dollars), and thus a large number of parts have to be produced by a die, to justify this cost and leverage the advantages of the die casting process (high production rates, low manpower costs). A potential increase in the die service life, thus has a significant impact on the economics of the die; casting operation. There are many ways to extend die life: developing new wear resistant die materials, developing new surface treatments including coatings, improving heat treatment of existing H13 dies, using better lubricants that can protect the die material, or modifying the die geometry and process parameters to reduce the intensity of wear. Of these the use of coatings to improve the wear resistance of the die surface has shown a lot of promise. Consequently, use of coatings in the die casting industry and their wide use to decrease die wear can improve significantly the productivity of shop operations resulting in large savings in material and energy usage.

  3. Vacuum die attach for integrated circuits

    DOEpatents

    Schmitt, E.H.; Tuckerman, D.B.

    1991-09-10

    A thin film eutectic bond for attaching an integrated circuit die to a circuit substrate is formed by coating at least one bonding surface on the die and substrate with an alloying metal, assembling the die and substrate under compression loading, and heating the assembly to an alloying temperature in a vacuum. A very thin bond, 10 microns or less, which is substantially void free, is produced. These bonds have high reliability, good heat and electrical conduction, and high temperature tolerance. The bonds are formed in a vacuum chamber, using a positioning and loading fixture to compression load the die, and an IR lamp or other heat source. For bonding a silicon die to a silicon substrate, a gold silicon alloy bond is used. Multiple dies can be bonded simultaneously. No scrubbing is required. 1 figure.

  4. Die singulation method and package formed thereby

    DOEpatents

    Anderson, Robert C [Tucson, AZ; Shul, Randy J [Albuquerque, NM; Clews, Peggy J [Tijeras, NM; Baker, Michael S [Albuquerque, NM; De Boer, Maarten P [Albuquerque, NM

    2012-08-07

    A method is disclosed for singulating die from a substrate having a sacrificial layer and one or more device layers, with a retainer being formed in the device layer(s) and anchored to the substrate. Deep Reactive Ion Etching (DRIE) etching of a trench through the substrate from the bottom side defines a shape for each die. A handle wafer is then attached to the bottom side of the substrate, and the sacrificial layer is etched to singulate the die and to form a frame from the retainer and the substrate. The frame and handle wafer, which retain the singulated die in place, can be attached together with a clamp or a clip and to form a package for the singulated die. One or more stops can be formed from the device layer(s) to limit a sliding motion of the singulated die.

  5. Reinraumtechnik für die Medizintechnik

    NASA Astrophysics Data System (ADS)

    Petek, Max; Jungbluth, Martin; Krampe, Erhard

    Die Reinraumtechnik ist heute ein unverzichtbarer Bestandteil bei der Fertigung von Produkten der Life Sciences, den Bereichen Pharma, Lebensmittel, Kosmetik und Medizintechnik. In Anbetracht der langen Historie der Medizintechnik ist sie jedoch eine sehr junge Disziplin. Die Bedeutung von Keimen und die richtige Einschätzung ihrer Größe wurden zwar sehr früh bereits durch Paracelsus erkannt, jedoch wurden daraus noch keine speziellen oder kontinuierlich umgesetzten Hygienevorschriften abgeleitet. Die erste bekannte technische Umsetzung von Hygieneempfehlungen geht auf den Franzosen François Nicolas Appert zurück, der eine aseptische Abfüllmethode für Lebensmittel entwickelte und diese 1810 veröffentlichte [1]. Die erste dokumentierte medizinische Umsetzung stellten Hygienevorschriften für Ärzte dar, die Ignaz Philipp Semmelweis nach 1847 in der Wiener Klinik für Geburtshilfe einführte [2].

  6. Vacuum die attach for integrated circuits

    DOEpatents

    Schmitt, Edward H.; Tuckerman, David B.

    1991-01-01

    A thin film eutectic bond for attaching an integrated circuit die to a circuit substrate is formed by coating at least one bonding surface on the die and substrate with an alloying metal, assembling the die and substrate under compression loading, and heating the assembly to an alloying temperature in a vacuum. A very thin bond, 10 microns or less, which is substantially void free, is produced. These bonds have high reliability, good heat and electrical conduction, and high temperature tolerance. The bonds are formed in a vacuum chamber, using a positioning and loading fixture to compression load the die, and an IR lamp or other heat source. For bonding a silicon die to a silicon substrate, a gold silicon alloy bond is used. Multiple dies can be bonded simultaneously. No scrubbing is required.

  7. Malignant renal tumors in children

    PubMed Central

    Sanchez, Thomas Ray; Wootton-Gorges, Sandra

    2015-01-01

    Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. PMID:28326263

  8. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    SciTech Connect

    Michaelson, Evan M.; Chen, Yu-Hui; Silver, Barbara; Tishler, Roy B.; Marcus, Karen J.; Stevenson, Mary Ann; Ng, Andrea K.

    2014-03-01

    Purpose: To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes. Methods and Materials: Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model. Results: With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively. Conclusions: Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time.

  9. Malignant mesothelioma: attributable risk of asbestos exposure.

    PubMed Central

    Spirtas, R; Heineman, E F; Bernstein, L; Beebe, G W; Keehn, R J; Stark, A; Harlow, B L; Benichou, J

    1994-01-01

    OBJECTIVES--To evaluate a case-control study of malignant mesothelioma through patterns of exposure to asbestos based upon information from telephone interviews with next of kin. METHODS--Potential cases, identified from medical files and death certificates, included all people diagnosed with malignant mesothelioma and registered during 1975-1980 by the Los Angeles County Cancer Surveillance Program, the New York State Cancer Registry (excluding New York City), and 39 large Veterans Administration hospitals. Cases whose diagnosis was confirmed in a special pathology review as definite or probable mesothelioma (n = 208) were included in the analysis. Controls (n = 533) had died of other causes, excluding cancer, respiratory disease, suicide, or violence. Direct exposure to asbestos was determined from responses to three types of questions: specific queries as to any exposure to asbestos; occupational or non-vocational participation in any of nine specific activities thought to entail exposure to asbestos; and analysis of life-time work histories. Indirect exposures were assessed through residential histories and reported contact with family members exposed to asbestos. RESULTS--Among men with pleural mesothelioma the attributable risk (AR) for exposure to asbestos was 88% (95% confidence interval (95% CI) 76-95%). For men, the AR of peritoneal cancer was 58% (95% CI 20-89%). For women (both sites combined), the AR was 23% (95% CI 3-72%). The large differences in AR by sex are compatible with the explanations: a lower background incidence rate in women, lower exposure to asbestos, and greater misclassification among women. CONCLUSIONS--Most of the pleural and peritoneal mesotheliomas in the men studied were attributable to exposure to asbestos. The situation in women was less definitive. PMID:7849863

  10. Malignant hyperthermia: a review.

    PubMed

    Rosenberg, Henry; Pollock, Neil; Schiemann, Anja; Bulger, Terasa; Stowell, Kathryn

    2015-08-04

    Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane, isoflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stressors such as vigorous exercise and heat. The incidence of MH reactions ranges from 1:10,000 to 1: 250,000 anesthetics. However, the prevalence of the genetic abnormalities may be as great as one in 400 individuals. MH affects humans, certain pig breeds, dogs and horses. The classic signs of MH include hyperthermia, tachycardia, tachypnea, increased carbon dioxide production, increased oxygen consumption, acidosis, hyperkalaemia, muscle rigidity, and rhabdomyolysis, all related to a hypermetabolic response. The syndrome is likely to be fatal if untreated. An increase in end-tidal carbon dioxide despite increased minute ventilation provides an early diagnostic clue. In humans the syndrome is inherited in an autosomal dominant pattern, while in pigs it is autosomal recessive. Uncontrolled rise of myoplasmic calcium, which activates biochemical processes related to muscle activation leads to the pathophysiologic changes. In most cases, the syndrome is caused by a defect in the ryanodine receptor. Over 400 variants have been identified in the RYR1 gene located on chromosome 19q13.1, and at least 34 are causal for MH. Less than 1 % of variants have been found in CACNA1S but not all of these are causal. Diagnostic testing involves the in vitro contracture response of biopsied muscle to halothane, caffeine, and in some centres ryanodine and 4-chloro-m-cresol. Elucidation of the genetic changes has led to the introduction of DNA testing for susceptibility to MH. Dantrolene sodium is a specific antagonist and should be available wherever general anesthesia is administered. Increased understanding of the clinical manifestation and pathophysiology of the syndrome, has lead to the

  11. Drugs Approved for Malignant Mesothelioma

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for malignant mesothelioma. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  12. Genetics Home Reference: malignant hyperthermia

    MedlinePlus

    ... Genetic and Rare Diseases Information Center (2 links) King Denborough syndrome Malignant hyperthermia Educational Resources (5 links) ... Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews® [Internet]. Seattle (WA): University of ...

  13. Orbital exenteration in periorbital malignancies.

    PubMed

    Roche, Phoebe; Timon, Conrad

    2012-08-01

    Orbital exenteration is a disfiguring procedure most commonly performed for locally advanced or recurrent periorbital malignancies. We performed a retrospective review of 22 patients who underwent orbital exenteration for advanced periorbital malignancy at our institution, by the senior author over a seventeen-year period. Specifically, we have reviewed the tumour histology along with stage at presentation, patient age, history of previous surgical intervention and surgical outcomes. The review highlighted two main groups who required orbital exenteration - patients with recurrent or locally advanced periorbital skin cancers, and patients with malignancy of the sinus. We discuss the presentation and management of the two pathological processes and highlight the importance of aggressive early management of periorbital malignancy with a view to prevention of exenteration and improving survival. Copyright © 2011 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Malignant external otitis: CT evaluation

    SciTech Connect

    Curtin, H.D.; Wolfe, P.; May, M.

    1982-11-01

    Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull.

  15. Microwave Ablation of Hepatic Malignancy

    PubMed Central

    Lubner, Meghan G.; Brace, Christopher L.; Ziemlewicz, Tim J.; Hinshaw, J. Louis; Lee, Fred T.

    2013-01-01

    Microwave ablation is an extremely promising heat-based thermal ablation modality that has particular applicability in treating hepatic malignancies. Microwaves can generate very high temperatures in very short time periods, potentially leading to improved treatment efficiency and larger ablation zones. As the available technology continues to improve, microwave ablation is emerging as a valuable alternative to radiofrequency ablation in the treatment of hepatic malignancies. This article reviews the current state of microwave ablation including technical and clinical considerations. PMID:24436518

  16. [Current concepts in malignant glaucoma].

    PubMed

    Călugăru, M; Marin, C

    1990-01-01

    The paper reports on the main pathogenic types of anatomical blocking of the aqueous humor circulation in malignant glaucoma: pupillary, secondary iridolenticular, ciliovitreolenticular, iridociliovitreous blocks and in suprachoroidal effusion. The paper also presents some of the entities correlated with malignant glaucoma: glaucoma with blocked angle following the administration of miotics, traumatisms, the operations of scleral obstruction for retina detachment, panretinal photocoagulation and thrombosis of the retina central vein.

  17. Malignant tumours after renal transplantation.

    PubMed

    Fahlenkamp, D; Reinke, P; Kirchner, S; Schnorr, D; Lindeke, A; Loening, S A

    1996-10-01

    In 1243 patients after renal transplantation, 39 malignant tumours were detected in 37 patients. The average latency period between transplantation and tumour disease was 72 months. Tumours included 8 malignant lymphomas, 7 dermatomas and 24 visceral tumours. The patients who developed a tumour had received fewer blood transfusions before transplantation than a tumour-free control group of 60 patients with renal transplants. Rejection crises occurred in a significantly smaller number of tumour patients compared with the control group.

  18. Molecular Diagnosis for Breast Malignancy

    DTIC Science & Technology

    1997-07-01

    AD GRANT NUMBER DAMD17-94-J-4033 TITLE: Molecular Diagnosis for Breast Malignancy PRINCIPAL INVESTIGATOR: Wen-Tien Chen, Ph.D. CONTRACTING...Biomedical Laboratories. - Signature -^yjgf Wen-Tien Chen, Ph.D. Page 4 Molecular diagnosis for breast malignancy (1) FRONT COVER: (2) SF 298...June 8-9, 1995 (abstract). Chen, W.-T, Goldstein LA, Pineiro-Sänchez M, Howard L, Ghersi G, Salamone M, Flessate D, Yeh Y. 1977. " Molecular Diagnosis for

  19. Telomerase Activation in Hematological Malignancies

    PubMed Central

    Ropio, Joana; Merlio, Jean-Philippe; Soares, Paula; Chevret, Edith

    2016-01-01

    Telomerase expression and telomere maintenance are critical for cell proliferation and survival, and they play important roles in development and cancer, including hematological malignancies. Transcriptional regulation of the rate-limiting subunit of human telomerase reverse transcriptase gen (hTERT) is a complex process, and unveiling the mechanisms behind its reactivation is an important step for the development of diagnostic and therapeutic applications. Here, we review the main mechanisms of telomerase activation and the associated hematologic malignancies. PMID:27618103

  20. Primary malignant melanoma of prostate

    PubMed Central

    Doublali, M.; Chouaib, A.; Khallouk, A.; Tazi, M. F.; El Fassi, M. J.; Farih, My. H.; Elfatmi, H.; Bendahou, M.; Benlemlih, A.; Lamarti, O.

    2010-01-01

    Primary genitourinary melanoma accounts for less than one per cent of all cases of melanoma. Most cases attributed to the prostate actually originate from the prostatic urethra. Due to its infrequency, primary malignant melanoma of the genitourinary tract presents a difficult diagnostic and management challenge. We report a case of primary malignant melanoma of the prostate found during transurethral resection of the prostate. PMID:20882159

  1. Immune Modulation in Hematologic Malignancies

    PubMed Central

    Dhodapkar, Madhav V.; Dhodapkar, Kavita M.

    2015-01-01

    The therapeutic potential of the immune system in the context of hematologic malignancies has long been appreciated particularly due to the curative impact of allogeneic hematopoietic stem cell transplantation. The role of immune system in shaping the biology and evolution of these tumors is now well recognized. While the contribution of the immune system in anti-tumor effects of certain therapies such as immune-modulatory drugs and monoclonal antibodies active in hematologic malignancies is quite evident, the immune system has also been implicated in anti-tumor effects of other targeted therapies. The horizon of immune-based therapies in hematologic malignancies is rapidly expanding with promising results from immune-modulatory drugs, immune-checkpoint blockade and adoptive cellular therapies, including genetically-modified T cells. Hematologic malignancies present distinct issues (relative to solid tumors) for the application of immune therapies due to differences in cell of origin/developmental niche of tumor cells, and patterns of involvement such as common systemic involvement of secondary lymphoid tissues. This article discusses the rapidly changing landscape of immune modulation in hematologic malignancies and emphasizes areas wherein hematologic malignancies present distinct opportunities for immunologic approaches to prevent or treat cancer. PMID:26320065

  2. Goethe almost died of urosepsis.

    PubMed

    Gross, A J; Hummel, G

    1999-12-01

    In the year of 1805, Goethe almost died of urosepsis. His urological problems were not diseases arising from full health but a new variation in a life accompanied by illnesses. Some sources date the first colics he experienced to the year 1795 and others say 1805. The most dramatic period in the course of his illness was in February, when he suffered from fever of such an extent that one could speak of urosepsis. Recovery took place slowly and was accompanied by minor relapses. Nothing about this is written down in his work. On the advice of his doctors, Goethe undertook a cure in Lauchstädt in July and August. The report of his consultant, Professor Johann Christian Reil, on his problems in the field of urology remained undiscovered until 1937. Professor Reil recommended treatment with thermae carolinae, aqua calcis, soap soda crystallisata, herbae subastringentes, and uva ursi, among other measures. With increasing age, Goethe's colics disappeared. The passing of a stone has never been described. Whereas Goethe hinted about medical problem other than those reported herein, the urological problems discussed in this article were left unmentioned. Nonetheless, literature that deals with Goethe's diseases is interesting from the aspect of both the history of medicine and the history of culture.

  3. Die Evolution der Religiosität

    NASA Astrophysics Data System (ADS)

    Voland, Eckart

    Ein konsequent darwinischer Blick auf den Menschen bedeutet, auch im Denken, Fühlen und Handeln biologische Anpassungsgeschichte zu suchen, denn auch die psychischen und mentalen Eigenheiten des Homo sapiens unterliegen der natürlichen Selektion. Lässt sich die religiöse Lebenspraxis von Menschen daher auch aus einer Fitnessperspektive betrachten?

  4. The Right To Die. Public Talk Series.

    ERIC Educational Resources Information Center

    Pasquerella, Lynn

    This program guide on the right to die provides policy issue information where ethical concerns have a prominent place. Three positions about the right to die are presented: (1) mercy killing and assisted suicide should be legally permitted in certain cases; (2) legal status should be given to living wills and other advance directives that would…

  5. Apparatus for restraining and transporting dies

    DOEpatents

    Allison, James W.; LaBarre, Timothy L.

    1994-01-01

    Apparatus for restraining and transporting dies in punch press operations is provided. A floatation platen for supporting a die on the platen's upper surface has a plurality of recessed gas exhaust ports on the platen's lower surface. A source of pressurized gas delivers gas to a platen manifold, for delivery to orifices located in the gas exhaust ports. The flow of gas is controlled by a first valve adjacent the gas source and a second valve adjacent the manifold, with the second valve being used to control the gas flow during movement of the die. In this fashion, a die may be moved on a cushion of air from one workstation to a selected second workstation. A moveable hydraulically operated restraining fixture is also provided, for clamping the die in position during the compacting phase, and for releasing the die after completion of the compacting phase by releasing the hydraulic pressure on the restraining fixture. When pressure in the hydraulic cylinders on the restraining fixture is reversed, the restraining fixture will retract so that there is no contact between the die and the restraining fixture, thereby allowing the die to be removed from a first workstation and moved to a second selected workstation.

  6. Death and Dying: Issues for Educational Gerontologists.

    ERIC Educational Resources Information Center

    Wass, Hannelore, Myers, Jane E.

    1984-01-01

    Reviews research on death orientations, the dying process, and bereavement, with a major focus on the elderly. Suggests that relevant knowledge about death and dying are important for gerontological practitioners and proposes that death-related content be systematically integrated into academic curricula at the preservice and inservice levels.…

  7. Energy Consumption of Die Casting Operations

    SciTech Connect

    Jerald Brevick; clark Mount-Campbell; Carroll Mobley

    2004-03-15

    Molten metal processing is inherently energy intensive and roughly 25% of the cost of die-cast products can be traced to some form of energy consumption [1]. The obvious major energy requirements are for melting and holding molten alloy in preparation for casting. The proper selection and maintenance of melting and holding equipment are clearly important factors in minimizing energy consumption in die-casting operations [2]. In addition to energy consumption, furnace selection also influences metal loss due to oxidation, metal quality, and maintenance requirements. Other important factors influencing energy consumption in a die-casting facility include geographic location, alloy(s) cast, starting form of alloy (solid or liquid), overall process flow, casting yield, scrap rate, cycle times, number of shifts per day, days of operation per month, type and size of die-casting form of alloy (solid or liquid), overall process flow, casting yield, scrap rate, cycle times, number of shifts per day, days of operation per month, type and size of die-casting machine, related equipment (robots, trim presses), and downstream processing (machining, plating, assembly, etc.). Each of these factors also may influence the casting quality and productivity of a die-casting enterprise. In a die-casting enterprise, decisions regarding these issues are made frequently and are based on a large number of factors. Therefore, it is not surprising that energy consumption can vary significantly from one die-casting enterprise to the next, and within a single enterprise as function of time.

  8. Student Nurses' Perception of Death and Dying

    ERIC Educational Resources Information Center

    Niederriter, Joan E.

    2009-01-01

    Student nurses are involved in caring for patients who are actively dying or who have been told they have a terminal illness and are faced with the process of dying. Students encounter these patients in hospitals, nursing homes, at home or in hospice care settings. According to Robinson (2004), "nurses are the healthcare providers that are most…

  9. Puzzling cases about killing and letting die.

    PubMed

    Favor, C D

    1996-01-01

    Discussions of euthanasia often appeal to the distinction between killing people and letting them die. Favor asks whether this distinction is morally important--in particular, whether killing is worse than merely letting someone die, even when the motivations and consequences are the same. She explores our moral intuitions via a discussion of various subtly different hypothetical examples.

  10. Killing and letting die: a defensible distinction.

    PubMed

    Cartwright, W

    1996-04-01

    The distinction between killing and letting die is investigated and clarified. It is then argued that in most cases, though not in all, it is worse to kill than to let die. In euthanasia the significance of the distinction is diminished, but still important.

  11. Prediction of Part Distortion in Die Casting

    SciTech Connect

    R. Allen Miller

    2005-03-30

    The die casting process is one of the net shape manufacturing techniques and is widely used to produce high production castings with tight tolerances for many industries. An understanding of the stress distribution and the deformation pattern of parts produced by die casting will result in less deviation from the part design specification, a better die design and eventually more productivity and cost savings. This report presents methods that can be used to simulate the die casting process in order to predict the deformation and stresses in the produced part and assesses the degree to which distortion modeling is practical for die casting at the current time. A coupled thermal-mechanical finite elements model was used to simulate the die casting process. The simulation models the effect of thermal and mechanical interaction between the casting and the die. It also includes the temperature dependant material properties of the casting. Based on a designed experiment, a sensitivity analysis was conducted on the model to investigate the effect of key factors. These factors include the casting material model, material properties and thermal interaction between casting and dies. To verify the casting distortion predictions, it was compared against the measured dimensions of produced parts. The comparison included dimensions along and across the parting plane and the flatness of one surface.

  12. Student Nurses' Perception of Death and Dying

    ERIC Educational Resources Information Center

    Niederriter, Joan E.

    2009-01-01

    Student nurses are involved in caring for patients who are actively dying or who have been told they have a terminal illness and are faced with the process of dying. Students encounter these patients in hospitals, nursing homes, at home or in hospice care settings. According to Robinson (2004), "nurses are the healthcare providers that are most…

  13. Killing, letting die, and simple conflicts.

    PubMed

    Malm, H M

    1989-01-01

    Proponents of the moral equivalence of killing and letting die argue that in cases of simple conflict, where one agent must either perform a positive act and kill one person, or not perform that act and allow another person to die, the agent's alternatives are clearly morally equivalent. Malm rejects this view in a three part essay. He argues that in cases of simple conflict, the acts of killing and letting die are morally different, and that killing is not in itself worse than letting die. Malm considers and rejects the suggestion that the agent should decide randomly between the two alternatives. He concludes that while simple conflict cases require us to recognize a morally significant difference between killing and letting die, they do not require us to recognize a morally significant difference between acting and refraining.

  14. [Dying and death in societal transformation].

    PubMed

    Heller, Andreas; Wegleitner, Klaus

    2017-01-01

    Dying and death in modern societies are subject to profound social, professional and cultural-religious changes. Secularization and a stronger differentiation of societies have led to a change in the way humans handle the dying process. Normatively ritualized collective behaviour has been replaced by an individual, subjectivized approach. In late modern societies there are many different views of what "successful" or "good" dying means.In the article this change is described by the following seven theses: 1. We live longer and we die longer. 2. We no longer die suddenly and unexpectedly but slowly and foreseeably. 3. Even though our biological life on earth has become longer, our life has been shortened by the loss of eternity. 4. We no longer die on the stage of ritualized relationships with our family and neighbours but behind the curtains of organizations. 5. We live and die in a society of organizations and have to get organized for the final phase of our life. 6. Living and dying are no large, state-owned enterprises but small, private enterprises. 7. The hospice movement as well as palliative medicine have created public awareness, made dying a matter of discussion and offered a new set of options.In late modernism end-of-life care requires new approaches based on individual and shared responsibility as well as cooperation between professional institutions and community-based voluntary care.A change towards community care is visible. Thus "dying" is a topic in the discussion about the future of public health and societal solidarity.

  15. Awareness of dying: it needs words.

    PubMed

    Lokker, Martine E; van Zuylen, Lia; Veerbeek, Laetitia; van der Rijt, Carin C D; van der Heide, Agnes

    2012-06-01

    The purpose of this research is to study to what extent dying patients are aware of the imminence of death, whether such awareness is associated with patient characteristics, symptoms and acceptance of dying, and whether medical records and nurses' and family caregivers' views on patients' awareness of dying agree. Nurses and family caregivers of 475 deceased patients from three different care settings in the southwest Netherlands were requested to fill out questionnaires. The two groups were asked whether a patient had been aware of the imminence of death. Also, medical records were screened for statements indicating that the patient had been informed of the imminence of death. Nurses completed questionnaires about 472 patients, family caregivers about 280 patients (response 59%). According to the medical records, 51% of patients had been aware of the imminence of death; according to nurses, 58%; according to family caregivers, 62%. Patients who, according to their family caregiver, had been aware of the imminence of death were significantly more often in peace with dying and felt more often that life had been worth living. Inter-rater agreement on patients' awareness of dying was fair (Cohen's kappa = 0.23-0.31). Being aware of dying is associated with acceptance of dying, which supports the idea that open communication in the dying phase can contribute to the quality of the dying process. However, views on whether or not patients are aware of the imminence of death diverge between different caregivers. This suggests that communication in the dying phase of patients is open for improvement.

  16. Influence of die geometry and material selection on the behavior of protective die covers in closed-die forging

    NASA Astrophysics Data System (ADS)

    Yu, Yingyan; Rosenstock, Dirk; Wolfgarten, Martin; Hirt, Gerhard

    2016-10-01

    Due to the fact that tooling costs make up to 30% of total costs of the final forged part, the tool life is always one main research topic in closed-die forging [1]. To improve the wear resistance of forging dies, many methods like nitriding and deposition of ceramic layers have been used. However, all these methods will lose its effect after a certain time, then tool repair or exchange is needed, which requires additional time and costs. A new method, which applies an inexpensive and changeable sheet metal on the forging die to protect it from abrasive wear, was firstly proposed in [2]. According to the first investigation, the die cover is effective for decreasing thermal and mechanical loads, but there are still several challenges to overcome in this concept, like wrinkling and thinning of the die cover. Therefore, an experimental study using different geometries and die cover materials is presented within this work. The results indicate the existence of feasible application cases of this concept, since conditions are found under which a die cover made of 22MnB5 still keeps its original shape even after 7 forging cycles.

  17. Basic and clinical aspects of malignant melanoma

    SciTech Connect

    Nathanson, L. )

    1987-01-01

    This book contains the following 10 chapters: The role of oncogenes in the pathogenesis of malignant melanoma; Laminin and fibronectin modulate the metastatic activity of melanoma cells; Structure, function and biosynthesis of ganglioside antigens associated with human tumors derived from the neuroectoderm; Epidemiology of ocular melanoma; Malignant melanoma: Prognostic factors; Endocrine influences on the natural history of human malignant melanoma; Psychosocial factors associated with prognostic indicators, progression, psychophysiology, and tumor-host response in cutaneous malignant melanoma; Central nervous system metastases in malignant melanoma; Interferon trials in the management of malignant melanoma and other neoplasms: an overview; and The treatment of malignant melanoma by fast neutrons.

  18. A short-term follow-up study of photodynamic therapy on 23 cases of malignant tumors

    NASA Astrophysics Data System (ADS)

    Huang, Zhuo-Zheng; Chen, Chuang; Yang, Rongning; Zhao, Ying

    2005-07-01

    Objective: To summarize the PDT short-term effect on malignant tumors. Method: Made follow-up observation and analysis of 23 cases of various kinds and different stages malignant tumors received photodynamic therapy. Results: Within the 23 cases, through 1-6 months follow-up, the results of tumor lesions treated by PDT are as follows: 15 cases revealed CR, 8 cases had PR and 5 patients died of other causes, nothing involving PDT. Of the 23 cases, 6 early stage tumor patients showed complete remission and no relapse occurred in the follow-up period; 17 cases of advanced stage patients revealed CR or PR effective results. Conclusion: The confined lesion of early stage malignant tumors can be cured by PDT, the advanced stage malignant tumor cases can also present good short-term effect or palliative results. So, PDT is one of the effective therapies for malignant tumors.

  19. Small Cell Carcinoma of the Ovary (Hypercalcemic Type): Malignant Rhabdoid Tumor

    PubMed Central

    Kascak, Peter; Zamecnik, Michal; Bystricky, Branislav

    2016-01-01

    We present a rare case of malignant rhabdoid tumor (ovarian small cell carcinoma of hypercalcemic type) in a 24-year-old female with fulminant course. Clinically, hypercalcemia was not found at the time of primary diagnosis. However, it appeared later during the course of tumor progression. Histologically, the tumor showed classical features of small cell carcinoma of hypercalcemic type. Therapy included radical surgery with adjuvant chemotherapy. Despite this intensive therapy, the disease recurred and the patient died 10 months after the diagnosis. We discuss the diagnosis and therapy of this tumor, as well as its recent classification as malignant rhabdoid tumor. PMID:27462229

  20. [The specific features of the prevalence of thyroid malignancies in an iodine-deficiency area].

    PubMed

    Vereshchagin, N N; Nasteka, N L; Koniukhov, V A

    2009-01-01

    The trends in iodine-deficiency morbidity and thyroid malignancy morbidity and mortality in the Orenburg Region have been analyzed over many years. The analysis revealed a significant rise in the incidence of thyroid malignancies with high death rates among the subjects, first registered and died within a year after their diagnosis, in the central geographical zone as compared with the western and eastern ones. There was evidence for rather high morbidity rates among the region's women, with their tendency being noted for an increase.

  1. The cytologic criteria of malignancy.

    PubMed

    Fischer, Andrew H; Zhao, Chengquan; Li, Qing Kay; Gustafson, Karen S; Eltoum, Isam-Eldin; Tambouret, Rosemary; Benstein, Barbara; Savaloja, Lynnette C; Kulesza, Peter

    2010-07-01

    Cytology and cell biology are two separate fields that share a focus on cancer. Cancer is still diagnosed based on morphology, and surprisingly little is known about the molecular basis of the defining structural features. Cytology uses the smallest possible biopsy for diagnosis by reducing morphologic "criteria of malignancy" to the smallest scale. To begin to develop common ground, members of the American Society of Cytopathology Cell Biology Liaison Working Group classify some of the "criteria of malignancy" and review their relation to current cell biology concepts. The criteria of malignancy are extremely varied, apparently reflecting many different pathophysiologies in specific microenvironments. Criteria in Group 1 comprise tissue-level alterations that appear to relate to resistance to anoikis, alterations in cell adhesion molecules, and loss of apical-basal polarity. Criteria in Group 2 reflect genetic instability, including chromosomal and possibly epigenetic instability. Criteria in Groups 3 are subcellular structural changes involving cytoplasmic components, nuclear lamina, chromatin and nucleoli that cannot be accounted for by genetic instability. Some distinct criteria in Group 3 are known to be induced by cancer genes, but their precise structural basis remains obscure. The criteria of malignancy are not closely related to the histogenetic classification of cancers, and they appear to provide an alternative, biologically relevant framework for establishing common ground between cytologists and cell biologists. To understand the criteria of malignancy at a molecular level would improve diagnosis, and likely point to novel cell physiologies that are not encompassed by current cell biology concepts.

  2. Epidemiologic overview of malignant lymphoma.

    PubMed

    Huh, Jooryung

    2012-06-01

    Malignant lymphoma encompasses a wide variety of distinct disease entities. It is generally more common in developed countries and less common in developing countries. The East Asia region has one of the lowest incidence rates of malignant lymphoma. The incidence of malignant lymphoma around the world has been increasing at a rate of 3-4% over the last 4 decades, while some stabilization has been observed in developed countries in recent years. The reasons behind this lymphoma epidemic are poorly understood, although improving diagnostic accuracy, the recent AIDS epidemic, an aging world population and the increasing adoption of cancer-causing behaviors are suggested as contributing factors. Etiologies of malignant lymphoma include infectious agents, immunodeficiency, autoimmune disease, exposure to certain organic chemicals, and pharmaceuticals. The distribution of many subtypes exhibit marked geographic variations. Compared to the West, T/natural killer (NK) cell lymphomas (T/NK-cell lymphoma) and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) are relatively more common, whereas other B-cell lymphomas, particularly follicular lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma, are less common in Asia. Some subtypes of T/NK-cell lymphomas defined by Epstein-Barr virus association are predominantly Asian diseases, if not exclusively so. Both ethnic and environmental factors play roles in such diversity. In this review, we discuss the geographic distribution and etiology of malignant lymphoma, as well as the trend.

  3. Are UK primary care teams formally identifying patients for palliative care before they die?

    PubMed

    Harrison, Nadine; Cavers, Debbie; Campbell, Christine; Murray, Scott A

    2012-05-01

    The palliative care approach has the potential to improve care for patients with progressive life-threatening illnesses from the time of diagnosis. Policy and clinical directives in the UK advocate early identification. To determine the extent to which practices identify patients for palliative care, including factors influencing early identification and possible effects on place of death. Qualitative and quantitative data were collected from six general practices from three Scottish NHS boards and analysed. Records of patients who had died in the previous 6 months were analysed and interviews with practice staff (n = 21) and with patients currently on the practice palliative care register and bereaved relatives (n = 14) were conducted. In addition, a practice meeting was observed. In total, 29% of patients who died were recorded as being on the practice palliative care register before death. Two-thirds of patients with cancer were recorded on the register, but for those with non-malignant conditions only around 20% had any palliative care documented. This was a result of GPs not finding the current guidelines useful and being reluctant to discuss palliative care overtly with patients early in their illness. Palliative care services and documentation were geared towards patients with cancer. More district nurses than GPs saw the benefits of inclusion on the palliative care register. Only 25% of patients on the register died in hospital. Most patients with advanced progressive illnesses, especially those with non-malignant disease, are not being formally identified for a palliative care approach before they die. Those identified are more likely to benefit from coordinated care and may be more likely to die at home.

  4. [Where do people die?: On the question of dying in institutions].

    PubMed

    Thönnes, M; Jakoby, N R

    2011-10-01

    There is a great discrepancy in society between the number of people that prefer to die within their home and the number of cases where this wish actually becomes reality. The most frequent place of dying in Western societies is not the home but an institution, such as a hospital or nursing home. But what is the actual distribution of places of dying? Can we identify social patterns of dying related to the various places of dying? The article provides a theoretical and empirical overview of place of dying as a social phenomenon. Contemporary discourse on the institutionalization of dying is subjected to critical scrutiny in light of the state of the art of research.

  5. An acute multispecies episode of sheep-associated malignant catarrhal fever in captive wild animals in an Italian zoo

    USDA-ARS?s Scientific Manuscript database

    In July 2011, in a zoological garden in Rome, Italy, malignant catarrhal fever (MCF), a fatal, systemic disease of Artiodactyls, was suspected on the basis of neurological signs and gross lesions observed in a banteng, the first animal to die of this infection. An MCF type-specific, one-step PCR wit...

  6. Canine Malignant Hyperthermia: Diagnosis of Susceptibility in a Breeding Colony

    PubMed Central

    O'Brien, P. J.; Cribb, P. H.; White, R. J.; Olfert, E. D.; Steiss, J. E.

    1983-01-01

    Fifteen related dogs were studied for susceptibility to malignant hyperthermia using halothane challenge and caffeine contracture tests. These dogs had hypertrophied muscles, were of a nervous temperament and had rectal temperatures at the upper limit of the normal range. Clinical pathology findings were mild elevations of serum aspartate transaminase and mean corpuscular hemoglobin. In vitro caffeine contracture tests were performed on muscle biopsies from five of these dogs. The concentration of caffeine required to increase resting tension by 1 g in biopsy specimens of these dogs was significantly lower than that required for control dogs: 7.6 ± 1.38 (x̄ ± SEM) versus 15.5 ± 2.52 mM (P < 0.025), and in the presence of 1% halothane, 3.6 ± 1.44 versus 10.6 ± 2.19 mM (P < 0.05). Internal nuclei, fiber caliber variation and fiber hypertrophy were found in histological studies of muscle biopsies. Two other dogs possibly died of a canine stress syndrome analagous to the porcine stress syndrome which occurs in malignant hyperthermia susceptible swine. Eight others of this family were anesthetized with halothane or methoxyflurane. Methoxyflurane did not trigger the syndrome. The first exposure to halothane caused death from malignant hyperthermia in two dogs and a third died on the second exposure to halothane. Postmortem findings were nonspecific. The other three dogs exposed to halothane recovered uneventfully. Inheritance of the defect conforms to a multifactorial pattern, with gradations of susceptibility. PMID:17422267

  7. Cyclosporin-A associated malignancy

    PubMed Central

    Durnian, Jonathan M; Stewart, Rosalind MK; Tatham, Richard; Batterbury, Mark; Kaye, Stephen B

    2007-01-01

    The use of cyclosporin is well established within the ophthalmology community, especially against sight threatening intraocular inflammation. It is well known however, that immunosuppression in general is a risk factor for the development of malignancy and numerous studies point to the risk imposed by cyclosporin. This article analyses and reviews all relevant studies with regard to the development of malignancy associated with the use of cyclosporin and extrapolates this into the ophthalmic setting. This is to enable clinicians to assess the risks in individual patients and to present a monitoring regime which can be used in patients undergoing cyclosporin treatment. The review is solely concerned with the risk of the development of malignancy following cyclosporin immunosuppression and not with any other adverse effect. PMID:19668519

  8. XYY male and hematologic malignancy.

    PubMed

    Oguma, N; Shigeta, C; Kamada, N

    1996-09-01

    Two cases of XYY male with refractory anemia with excess of blasts are reported, and previous reported XYY males with hematologic malignancy are reviewed. Altogether 26 cases were collected for analysis: acute myeloid leukemia (10), acute lymphocytic leukemia (seven), acute leukemia (two), chronic myelocytic leukemia (three), myelodysplastic syndrome (three), and essential thrombocythemia (one). The age at the time of diagnosis ranged in age from 7.5 to 81 years. In three of six XYY/XY mosaicism cases, XYY clone was associated with malignancy. However, in two cases XYY clone was not involved. The evidence presented here suggests that the event of an XYY male with hematologic malignancy is incidental rather than a genetic etiology.

  9. Eosinophilic Dermatosis of Hematologic Malignancy.

    PubMed

    Lucas-Truyols, S; Rodrigo-Nicolás, B; Lloret-Ruiz, C; Quecedo-Estébanez, E

    Dermatosis characterized by tissue eosinophilia arising in the context of hematologic disease is known as eosinophilic dermatosis of hematologic malignancy. The most commonly associated malignancy is chronic lymphocytic leukemia. Eosinophilic dermatosis of hematologic malignancy is a rare condition with a wide variety of clinical presentations, ranging from papules, erythematous nodules, or blisters that simulate arthropod bites, to the formation of true plaques of differing sizes. Histology reveals the presence of abundant eosinophils. We present 4 new cases seen in Hospital Arnau de Vilanova, Valencia, during the past 7 years. Three of these cases were associated with chronic lymphocytic leukemia and 1 with mycosis fungoides. It is important to recognize this dermatosis as it can indicate progression of the underlying disease, as was the case in 3 of our patients. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Caring for dying people in hospital.

    PubMed

    Hopkinson, Jane B; Hallett, Christine E; Luker, Karen A

    2003-12-01

    Fifty-four per cent of people who die in England and Wales do so in hospital. Evidence suggests that care delivered to dying people in hospital does not match up to the ideal of a good death. These studies have provided organizational and structural explanations of nurses' behaviour that support argument for change at the macro level, in order to improve the quality of care delivered to dying people. There has been little study of the perceptions of nurses working in acute medical settings in relation to their experience of caring for dying people. Therefore, there is little evidence on which to base supportive strategies at the level of individual nurses. In this study we set out to develop an understanding of care for dying people in hospital, from the perspective of newly qualified staff nurses in the UK. The purpose was to build a theory of how nurses might be helped to deliver quality care to dying people in hospital. This paper is based on an exploratory study underpinned by phenomenological philosophy. In-depth interviews were conducted with 28 newly qualified nurses, focusing on their experiences of caring for dying people on medical wards in two acute hospitals in England in 1999. The interview transcripts were interpreted using a phenomenological approach. The findings presented in this paper relate to commonalities found to underlie study participants' perceptions of their experiences. All the nurses' stories were found to be built around six essences - the personal ideal, the actual, the unknown, the alone, tension and anti-tension. These essences, and the relationships between them, were used to build a model of the experience of caring for dying people in hospital. This descriptive study of the experience of individual nurses does not examine the wider social context. It attempts to complement existing sociological theory of death and dying. The study revealed how a group of newly qualified nurses experienced caring for dying people. We theorize that

  11. Imaging enhancement of malignancy by cyclophosphamide: surprising chemotherapy opposite effects

    NASA Astrophysics Data System (ADS)

    Yamauchi, Kensuke; Yang, Meng; Hayashi, Katsuhiro; Jiang, Ping; Xu, Mingxu; Yamamoto, Norio; Tsuchiya, Hiroyuki; Tomita, Katsuro; Moossa, A. R.; Bouvet, Michael; Hoffman, Robert M.

    2008-02-01

    Although side effects of cancer chemotherapy are well known, "opposite effects" of chemotherapy which enhance the malignancy of the treated cancer are not well understood. We have observed a number of steps of malignancy that are enhanced by chemotherapy pre-treatment of mice before transplantation of human tumor cells. The induction of intravascular proliferation, extravasation, and colony formation by cancer cells, critical steps of metastasis was enhanced by pretreatment of host mice with the commonly-used chemotherapy drug cyclophosphamide. Cyclophosphamide appears to interfere with a host process that inhibits intravascular proliferation, extravasation, and extravascular colony formation by at least some tumor cells. Cyclophosphamide does not directly affect the cancer cells since cyclophosphamide has been cleared by the time the cancer cells were injected. Without cyclophosphamide pretreatment, human colon cancer cells died quickly after injection in the portal vein of nude mice. Extensive clasmocytosis (destruction of the cytoplasm) of the cancer cells occurred within 6 hours. The number of apoptotic cells rapidly increased within the portal vein within 12 hours of injection. However, when the host mice were pretreated with cyclophosphamide, the cancer cells survived and formed colonies in the liver after portal vein injection. These results suggest that a cyclophosphamide-sensitive host cellular system attacked the cancer cells. This review describes an important unexpected "opposite effects" of chemotherapy that enhances critical steps in malignancy rather than inhibiting them, suggesting that certain current approaches to cancer chemotherapy should be modified.

  12. Years of life lost due to malignant neoplasms characterized by the highest mortality rate

    PubMed Central

    Pikala, Malgorzata

    2014-01-01

    Introduction The analysis of premature deaths measured with years of life lost between the studied and referential populations helps to emphasize the social and economic aspect of a loss caused by deaths due to malignant neoplasms. The aim of the study was to analyze years of life lost by inhabitants of the Lodz province due to malignant neoplasms. Material and methods The study material included a database which contained information gathered from 313,144 death certificates (including 66,899 people who died of malignant neoplasms) of inhabitants of the Lodz province who died between 1999 and 2008. The SEYLLp (Standard Expected Years of Life Lost per living person) method was used to determine years of life lost. Jointpoint models were used to analyze time trends. Results In males the diseases which mostly contributed to death were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 170.7) and cancer of the large intestine, rectum and anus (SEYLLp = 47.5). In females the principal diseases were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 61.6), breast cancer (SEYLLp = 60.4) and cancer of the large intestine, rectum and anus (SEYLLp = 42.3). The years of life lost were growing in the period under study. Conclusions The number of years lost due to malignant neoplasms in the Lodz province between 1999 and 2008 was growing. The main reasons for deaths in females were tracheal, bronchial and lung malignant neoplasms as well as breast cancer and in males – cancer of the large intestine, rectum and anus as well as prostate cancer. PMID:25395953

  13. Second Malignant Neoplasms Following Radiotherapy

    PubMed Central

    Kumar, Sanath

    2012-01-01

    More than half of all cancer patients receive radiotherapy as a part of their treatment. With the increasing number of long-term cancer survivors, there is a growing concern about the risk of radiation induced second malignant neoplasm [SMN]. This risk appears to be highest for survivors of childhood cancers. The exact mechanism and dose-response relationship for radiation induced malignancy is not well understood, however, there have been growing efforts to develop strategies for the prevention and mitigation of radiation induced cancers. This review article focuses on the incidence, etiology, and risk factors for SMN in various organs after radiotherapy. PMID:23249860

  14. [Kinase inhibitors against hematological malignancies].

    PubMed

    Tojo, Arinobu

    2014-06-01

    Dysregulation of protein phosphorylation, especially on tyrosine residues, plays a crucial role in development and progression of hematological malignancies. Since remarkable success in imatinib therapy of CML and Ph+ALL, extensive efforts have made to explore candidate molecular targets and next breakthrough drugs. Now that next generation ABL kinase inhibitors are available for CML, the therapeutic algorithm has been revolutionized. As for AML and lymphoid malignancies, many kinase inhibitors targeting FLT3, BTK and aurora-A are on early and late clinical trials, and a number of promising drugs including ibrutinib are picked up for further evaluation.

  15. Lenvatinib and Capecitabine in Patients With Advanced Malignancies

    ClinicalTrials.gov

    2016-09-23

    Advanced Cancer; Malignant Neoplasm of Breast; Malignant Neoplasms of Bone and Articular Cartilage; Malignant Neoplasms of Digestive Organs; Malignant Neoplasms of Eye Brain and Other Parts of Central Nervous System; Malignant Neoplasms of Female Genital Organs; Malignant Neoplasms of Ill-defined Secondary and Unspecified Sites; Malignant Neoplasms of Independent (Primary) Multiple Sites; Malignant Neoplasms of Lip Oral Cavity and Pharynx; Malignant Neoplasms of Male Genital Organs; Malignant Neoplasms of Mesothelial and Soft Tissue; Malignant Neoplasms of Respiratory and Intrathoracic Organs; Malignant Neoplasms of Thyroid and Other Endocrine Glands; Malignant Neoplasms of Urinary Tract

  16. Malignant triton tumor: Grand Round presentation of a rare aggressive case thoracolumbar spine tumor.

    PubMed

    Ghailane, Soufiane; Fauquier, Sandra; Lepreux, Sébastien; Le Huec, Jean-Charles

    2017-09-18

    We report a rare and aggressive case of malignant triton tumor (MTT) at the thoracolumbar junction with foraminal extension mistreated as schwannoma. A 70-year-old man with a 2-year history of lower back pain and left L4 radiculopathy with no history of neurofibromatosis. Pre-operative MRI suggested a typical schwannoma. Upon complete marginal resection, histological findings revealed a MTT. The patient presented with a local and regional recurrence and died 10 months after surgery. MTTs are a subgroup of malignant peripheral nerve sheath tumors, which develop from Schwann cells of peripheral nerves or within existing neurofibromas, and display rhabdomyoblastic differentiation. Based on the Grand Round case and relevant literature, we present a case of a highly aggressive and fast-growing tumor with a very high local and distant recurrence. There is no consensus treatment plan available and patients usually die shortly after diagnosis.

  17. Casting Characteristics of Aluminum Die Casting Alloys

    SciTech Connect

    Makhlouf M. Makhlouf; Diran Apelian

    2002-02-05

    The research program investigates the casting characteristics of selected aluminum die casting alloys. Specifically, the alloys' tendencies towards die soldering and sludge formation, and the alloys' fluidity and machinability are evaluated. It was found that: When the Fe and Mn contents of the alloy are low; caution has to be taken against possible die soldering. When the alloy has a high sludge factor, particularly a high level of Fe, measures must be taken to prevent the formation of large hardspots. For this kind of alloy, the Fe content should be kept at its lowest allowable level and the Mn content should be at its highest possible level. If there are problems in die filling, measures other than changing the alloy chemistry need to be considered first. In terms of alloy chemistry, the elements that form high temperature compounds must be kept at their lowest allowable levels. The alloys should not have machining problems when appropriate machining techniques and machining parameters are used.

  18. House of Lords debates assisted dying (again).

    PubMed

    2003-07-01

    Lord Joffe's Patient (Assisted Dying) Bill (see Bulletin 187) had its Second Reading on 6 June. The debate was lively, informed and inevitably somewhat polarised. However, some common themes emerged and are outlined below.

  19. Is there a moral duty to die?

    PubMed

    Corlett, J A

    2001-01-01

    In recent years, there has been a great deal of philosophical discussion about the alleged moral right to die. If there is such a moral right, then it would seem to imply a moral duty of others to not interfere with the exercise of the right. And this might have important implications for public policy insofar as public policy ought to track what is morally right. But is there a moral duty to die? If so, under what conditions, if any, ought one to have such a duty, and why? In this paper, I distinguish between different moral grounds for the putative moral duty to die: deontological, intuitionist, and contractarian. Subsequently, I argue in support of Paul Menzel's theory of health care distribution. More precisely, I concur with his claim that there is a moral duty to die inexpensively in health care contexts. Then I provide and defend a philosophical analysis of the conditions in which such a duty could exist.

  20. Hubble View of a Dying Star

    NASA Image and Video Library

    2003-05-21

    This image of a dying star, protoplanetary nebula IRAS22036+5306, containing strange, complex structures may help explain the death throes of stars and defy our current understanding of physics. Taken by NASA Wide Field and Planetary Camera 2.

  1. Supporting dignified dying in the Philippines

    PubMed Central

    Doorenbos, Ardith Z; Abaquin, Carmencita; Perrin, Margot E; Eaton, Linda; Balabagno, Araceli O; Rue, Tessa; Ramos, Rita

    2011-01-01

    Purpose This study aimed to assess the appropriateness of the International Classification for Nursing Practice (ICNP) Palliative Care for Dignified Dying catalogue for palliative nursing in the Philippines. Methods The study recruited 230 nurses to complete the ICNP Dignified Dying survey. Participants rated ICNP nursing intervention items and identified additional interventions for promoting dignified dying. Results All of the intervention items were scored on average as being at least ‘slightly important’. The three top-ranked nursing intervention categories were providing social support, maintaining privacy boundaries, and relieving psychological distress. Conclusions The ICNP Palliative Care for Dignified Dying catalogue lists nursing interventions that are appropriate to promoting dignity at the end of life in the Philippines. PMID:21471908

  2. Celestial Fireworks from Dying Stars

    NASA Astrophysics Data System (ADS)

    2011-04-01

    This image of the nebula NGC 3582, which was captured by the Wide Field Imager on the MPG/ESO 2.2-metre telescope at ESO's La Silla Observatory in Chile, shows giant loops of gas bearing a striking resemblance to solar prominences. These loops are thought to have been ejected by dying stars, but new stars are also being born within this stellar nursery. These energetic youngsters emit intense ultraviolet radiation that makes the gas in the nebula glow, producing the fiery display shown here. NGC 3582 is part of a large star-forming region in the Milky Way, called RCW 57. It lies close to the central plane of the Milky Way in the southern constellation of Carina (The Keel of Jason's ship, the Argo). John Herschel first saw this complex region of glowing gas and dark dust clouds in 1834, during his stay in South Africa. Some of the stars forming in regions like NGC 3582 are much heavier than the Sun. These monster stars emit energy at prodigious rates and have very short lives that end in explosions as supernovae. The material ejected from these dramatic events creates bubbles in the surrounding gas and dust. This is the probable cause of the loops visible in this picture. This image was taken through multiple filters. From the Wide Field Imager, data taken through a red filter are shown in green and red, and data taken through a filter that isolates the red glow characteristic of hydrogen are also shown in red. Additional infrared data from the Digitized Sky Survey are shown in blue. The image was processed by ESO using the observational data identified by Joe DePasquale, from the United States [1], who participated in ESO's Hidden Treasures 2010 astrophotography competition [2]. The competition was organised by ESO in October-November 2010, for everyone who enjoys making beautiful images of the night sky using astronomical data obtained using professional telescopes. Notes [1] Joe searched through ESO's archive and identified datasets that he used to compose his

  3. Malignancies in a renal transplant population: The St. Michael's Hospital experience

    PubMed Central

    Saleeb, R.; Faragalla, H.; Yousef, G. M.; Stewart, R.; Streutker, C. J.

    2016-01-01

    Introduction: Previous publications have shown an increased incidence of various malignancies amongst renal transplant populations. The objective of this study was to analyze the rate and types of malignancies occurring in the St. Michael's Hospital renal transplant population and to determine whether our results were comparable to those previously published. Methods: After approval by the hospital's research ethic board, review of the records and pathology of the 1584 patients in the renal transplant clinic database patients was performed. The reports dated back to the year 1970. Results: Amongst the 1584 renal transplant patients, 106 patients with 132 dysplastic and malignant posttransplant lesions were identified. The highest incidence amid the malignancies was in nonmelanoma skin malignancies squamous cell carcinoma (SCC), basal cell carcinoma, and Kaposi sarcoma, with a total of 32 patients having 54 separate tumors (2.02% of all patients, 43.2% of tumors). Following skin tumors in incidence were genitourinary (28 tumors), gastrointestinal tract (GIT) lesions (8 adenocarcinomas, 14 dysplastic lesions, 1 low grade neuroendocrine tumor/carcinoid), posttransplant lymphoproliferative disorders (PTLDs) (10 cases), gynecologic (6 carcinomas), cervical/anal/vulvar dysplasia and invasive (SCCs) (4), and thyroid (3 papillary tumors). Nine patients had tumors of multiple sites/types. With respect to outcome, 14 patients died of malignancy, with the highest mortality being in the GIT malignancies (six patients). Second in mortality were the PTLD and skin tumor groups. Discussion: Information on the incidence and outcome of various malignancies in renal transplant patients is important in designing guidelines for the follow-up of these patients regarding tumor screening and prevention. The rate of malignancies in our group is comparable to that reported in other centers. PMID:27141185

  4. Machining of Silicon-Ribbon-Forming Dies

    NASA Technical Reports Server (NTRS)

    Menna, A. A.

    1985-01-01

    Carbon extension for dies used in forming silicon ribbon crystals machined precisely with help of special tool. Die extension has edges beveled toward narrow flats at top, with slot precisely oriented and centered between flats and bevels. Cutting tool assembled from standard angle cutter and circular saw or saws. Angle cutters cuts bevels while slot saw cuts slot between them. In alternative version, custom-ground edges or additional circular saws also cut flats simultaneously.

  5. Thick film silicon growth techniques. [die materials

    NASA Technical Reports Server (NTRS)

    Bates, H. E.; Mlavsky, A. I.; Jewett, D. N.; White, V. E.

    1973-01-01

    The research which was directed toward finding an improved die material is reported. Wetting experiments were conducted with various materials to determine their compatibility with silicon. Work has also continued toward the development of quartz as a die material as new techniques have provided more optimistic results than observed in the past. As a result of the thermal modification previously described, improvements in growth stability have contributed to an increase in ribbon quality.

  6. Machining of Silicon-Ribbon-Forming Dies

    NASA Technical Reports Server (NTRS)

    Menna, A. A.

    1985-01-01

    Carbon extension for dies used in forming silicon ribbon crystals machined precisely with help of special tool. Die extension has edges beveled toward narrow flats at top, with slot precisely oriented and centered between flats and bevels. Cutting tool assembled from standard angle cutter and circular saw or saws. Angle cutters cuts bevels while slot saw cuts slot between them. In alternative version, custom-ground edges or additional circular saws also cut flats simultaneously.

  7. Is killing no worse than letting die?

    PubMed

    Nesbitt, W

    1995-01-01

    Those who wish to refute the view that it is worse to kill than to let die sometimes produce examples of cases in which an agent lets someone die but would be generally agreed to be no less reprehensible than if he had killed. It is argued that the examples produced typically possess a feature which makes their use in this context illegitimate, and that when modified to remove this feature, they provide support for the view which they were designed to undermine.

  8. Killing and letting die: hidden value assumptions.

    PubMed

    Atkinson, G

    1983-01-01

    In this paper I argue for several related theses: first, that the distinction between killing and letting die, as it is drawn by ordinary persons in ordinary contexts, is more complex than is generally understood; second, that the key feature of this complexity lies in the presence of a hidden normative component in what appears to be a straightforwardly descriptive distinction; and, third, that this complexity renders the killing/letting die distinction an inadequate and hazardous guide for moral reasoning.

  9. Malignant hyperthermia deaths related to inadequate temperature monitoring, 2007-2012: a report from the North American malignant hyperthermia registry of the malignant hyperthermia association of the United States.

    PubMed

    Larach, Marilyn Green; Brandom, Barbara W; Allen, Gregory C; Gronert, Gerald A; Lehman, Erik B

    2014-12-01

    AMRA (adverse metabolic or muscular reaction to anesthesia) reports submitted to The North American Malignant Hyperthermia Registry of the Malignant Hyperthermia Association of the United States from 1987 to 2006 revealed a 2.7% cardiac arrest and a 1.4% death rate for 291 malignant hyperthermia (MH) events. We analyzed 6 years of recent data to update MH cardiac arrest and death rates, summarized characteristics associated with cardiac arrest and death, and documented differences between early and recent cohorts of patients in the MH Registry. We also tested whether the available data supported the hypothesis that risk of dying from an episode of MH is increased in patients with inadequate temperature monitoring. We included U.S. or Canadian reports of adverse events after administration of at least 1 anesthetic drug, received between January 1, 2007, and December 31, 2012, with an MH clinical grading scale rank of "very likely MH" or "almost certain MH." We excluded reports that, after review, were judged to be due to pathologic conditions other than MH. We analyzed patient demographics, family and patient anesthetic history, anesthetic management including temperature monitoring, initial dantrolene dose, use of cardiopulmonary resuscitation, MH complications, survival, and reported molecular genetic DNA analysis of RYR1 and CACNA1S. A one-sided Cochran-Armitage test for proportions evaluated associations between mode of monitoring and mortality. We used Miettinen and Nurminen's method for assessing the relative risk of dying according to monitoring method. We used the P value of the slope to evaluate the relationship between duration of anesthetic exposure before dantrolene administration and peak temperature. We calculated the relative risk of death in this cohort compared with our previous cohort by using the Miettinen and Nurminen method adjusted for 4 comparisons. Of 189 AMRA reports, 84 met our inclusion criteria. These included 7 (8.3%) cardiac arrests, no

  10. Cutavirus in Cutaneous Malignant Melanoma

    PubMed Central

    Fridholm, Helena; Vinner, Lasse; Kjartansdóttir, Kristín Rós; Friis-Nielsen, Jens; Asplund, Maria; Herrera, Jose A.R.; Steiniche, Torben; Mourier, Tobias; Brunak, Søren; Willerslev, Eske; Izarzugaza, Jose M.G.; Hansen, Anders J.; Nielsen, Lars P.

    2017-01-01

    A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains to be investigated. PMID:28098541

  11. Nematode infection mimicking paratesticular malignancy.

    PubMed

    Kallampallil, Jins; Wood, Sarah J; O'Dempsey, Timothy; Craigie, Ross J

    2013-12-10

    Paratesticular swellings pose a diagnostic dilemma due to concerns over malignancy. We present a case of paratesticular swelling in a 13-year-old boy as a result of Dirofilaria immitis infection. The boy presented with a 2-month history of right testicular discomfort associated with an irregular mass within the scrotum.

  12. Malignant tumors of Stensen's duct.

    PubMed

    Steiner, M; Gould, A R; Miller, R L; Johnson, J A

    1999-01-01

    A rare case of squamous cell carcinoma arising in Stensen's duct is reported. The literature concerning malignant neoplasia originating in this site is reviewed, with attention given to the histopathologic diversity of neoplasms occurring in the duct, criteria for determination of origin in the duct, and outcomes of therapy.

  13. Malignant transformation of uterine leiomyoma.

    PubMed

    Al Ansari, Afaf A; Al Hail, Fatima A; Abboud, Emad

    2012-01-01

    A rare case of malignant transformation of uterine leiomyoma is reported. A 54 year old lady, nulliparous and 2 years postmenopausal presented to gynecology clinic with a pelvi - abdominal mass and ultrasound scan suggestive of multiple uterine fibroid. Total abdominal hysterectomy performed. Histopathology report showed leiomyosarcomative changes from benign leiomyoma within the huge mass.

  14. Malignant transformation of uterine leiomyoma

    PubMed Central

    Al Ansari, Afaf A.; Al Hail, Fatima A.; Abboud, Emad

    2012-01-01

    A rare case of malignant transformation of uterine leiomyoma is reported. A 54 year old lady, nulliparous and 2 years postmenopausal presented to gynecology clinic with a pelvi – abdominal mass and ultrasound scan suggestive of multiple uterine fibroid. Total abdominal hysterectomy performed. Histopathology report showed leiomyosarcomative changes from benign leiomyoma within the huge mass. PMID:25003044

  15. The Origin of Malignant Malaria

    USDA-ARS?s Scientific Manuscript database

    Plasmodium falciparum is the causative agent of malignant malaria, which is among the most severe human infectious diseases. Despite its overwhelming significance to human health, the parasite’s origins remain unclear. The favored origin hypothesis holds that P. falciparum and its closest known rel...

  16. Malignant haemangioendothelioma involving the liver

    PubMed Central

    Pollard, Stella M.; Millward-Sadler, G. H.

    1974-01-01

    The features of four cases of malignant haemangioendothelioma involving the liver and other organs are described. Two cases were associated with a microangiopathic haemolytic anaemia. The nature of the tumours and possible pathogenesis for the anaemias are discussed. Images PMID:4832301

  17. Manufacture of die casting dies by hot isostatic pressing. CRADA final report

    SciTech Connect

    Viswanathan, S.; Ren, W.; Luk, K.; Brucher, H.G.

    1998-09-01

    The reason for this Cooperative Research and Development Agreement (CRADA) between the Oak Ridge National Laboratory (ORNL) and Doehler-Jarvis was to investigate the manufacture die-casting dies with internal water-cooling lines by hot-isostatic pressing (HIPing) of H13 tool steel powder. The use of HIPing will allow the near-net-shape manufacture of dies and the strategic placement of water-cooling lines during manufacture. The production of near-net-shape dies by HIPing involves the generation of HIPing diagrams, the design of the can that can be used for HIPing a die with complex details, strategic placement of water-cooling lines in the die, computer modeling to predict movement of the water lines during HIPing, and the development of strategies for placing water lines in the appropriate locations. The results presented include a literature review, particle analysis and characterization of H13 tool steel powder, and modeling of the HIPing process.

  18. Cardiac surgery with extracorporeal circulation and concomitant malignancy: early and long-term results.

    PubMed

    Nardi, Paolo; Pellegrino, Antonio; Pugliese, Marta; Bovio, Emanuele; Chiariello, Luigi; Ruvolo, Giovanni

    2016-02-01

    We retrospectively evaluated early and long-term results of cardiac surgery using extracorporeal circulation (ECC) in patients affected by malignancies and the potential influence of ECC on malignancy progression during follow-up. Out of 7078 patients referred for cardiac surgery from January 2001 to December 2012, 241 consecutive patients (3.4%) (mean age 72 ± 8 years; men 170) had malignancy either known before or detected during hospital stay. Organ malignancies were present in 201 patients (83%) and hematological malignancies in 40 (17%). Early stages of cancer (I-II, in remission) were present in 180 (75%) patients, and advanced stages (III-IV for organ malignancies , multiple organ involvement for hematological malignancies) in 61 (25%). EuroSCORE I and II were 8.6 ± 5.4 and 3.8 ± 2.1%, respectively. Cardiac surgery with ECC consisted in isolated (n = 176) or multiple procedures (n = 65). Follow-up (mean 57 ± 40 months) was 99% complete. In-hospital mortality was 5.8% (n = 14); 1.67% (n = 4) died from cancer-related causes. Ten-year survival was 65 ± 5%, and freedom from cardiac death was 92 ± 3.5%. Freedom from cancer-related death was 90 ± 3% for patients operated on in early stages of cancer compared with 60 ± 8.4% for those who operated on in advanced stages (P < 0.0001), and 89 ± 2.6% for organ malignancies compared with 48 ± 13% for hematological malignancies (P = 0.0002); hematological malignancies different from Hodgkin/non-Hodgkin lymphoma affected long-term survival (P < 0.05). Progression of malignancy was observed in 29 patients (12.8%) at 18 ± 10 months. Cardiac surgery in cancer patients is not associated with increased in-hospital mortality and provides satisfactory freedom from cardiac death. Long-term survival in early stages of cancer appears satisfactory. Time interval between ECC and progression of malignancy during follow-up should apparently exclude

  19. Conversion to rapamycin immunosuppression for malignancy after kidney transplantation.

    PubMed

    Manuelli, M; De Luca, L; Iaria, G; Tatangelo, P; Sforza, D; Perrone, L; Bellini, M I; Angelico, R; Anselmo, A; Tisone, G

    2010-05-01

    Malignancies are a well-known complication of immunosuppressive therapy among renal transplant recipients, representing an important cause of long-term morbidity and mortality. Rapamycin has been shown to limit the proliferation of a number of malignant cell lines in vivo and in vitro. Fifteen patients developed the following malignancies at a mean of 90.3 months (range = 10-252) after kidney transplantation: metastatic gastric cancer (n = 1), metastatic colon cancer (n = 1), bilateral nephrourothelioma (n = 1), skin cancer (n = 2), Kaposi's sarcoma (n = 2), posttransplant lymphoproliferative disorder (PTLD; n = 4), renal cell carcinoma T1 (n = 1), MALT lymphoma (n = 1), intramucous colon carcinoma (n = 1), liposarcoma of the spermatic cord (n = 1). After the diagnosis of malignancy, the patients were switched from calcineurin inhibitor-based immunosuppression to rapamycin (monotherapy, n = 3), or associated with steroids (n = 6) or with mycophenolate mofetil (n = 6). Both patients with metastatic cancer underwent chemotherapy but succumbed after 6 and 13 months. Two patients with PTLD who underwent chemotherapy died after 12 and 36 months. At a mean follow-up of 32.7 months (range = 7-56), the remaining 11 patients are cancer-free. Two patients lost their grafts after 24 and 36 months after the switch due to chronic rejection. Renal graft function remained stable in all other patients from diagnosis throughout follow-up. Our observations suggested that rapamycin-based immunosuppression offers the possibility for regression of nonmetastatic tumors. Nevertheless, it is difficult to assess whether tumor regression was due to rapamycin treatment or to the reduced immunosuppression. Copyright (c) 2010. Published by Elsevier Inc.

  20. Tetracycline sclerosis in the management of malignant pericardial effusion.

    PubMed

    Shepherd, F A; Ginsberg, J S; Evans, W K; Scott, J G; Oleksiuk, F

    1985-12-01

    Twenty-two patients with malignant pericardial effusion were seen at the Toronto General Hospital between 1979 and 1984. Under ECG monitoring, an indwelling Kifa catheter was inserted into the pericardial sac and then connected to a Hemovac system and allowed to drain for 12 to 24 hours. Xylocaine hydrochloride, 100 mg, was first instilled intrapericardially, followed by tetracycline hydrochloride, 500 to 1,000 mg, dissolved in 20 mL normal saline. The catheter was clamped for one to two hours and then allowed to drain into the Hemovac. This procedure was repeated every 24 to 48 hours until the net drainage was less than 25 mL/24 hours. Nine men and 13 women were treated (median age, 55 years). The primary malignancy included lung in 15 patients, breast in two patients, and carcinoma of the stomach, ovary, pleural mesothelioma, chronic granulocytic leukemia, and adenocarcinoma of unknown primary in one patient each. Twenty patients received one to five instillations of tetracycline. In one patient the catheter could not be inserted into the pericardial sac, and in one patient the catheter clotted before tetracycline instillation. Minor complications included transient arrhythmia in two patients, postinjection pain in four patients, and self-limited temperature elevation greater than 38.5 degrees C in two patients. fifteen patients had good control of their malignant pericardial effusion for more than 30 days (median survival, 160 days; range, 38 to 275 days). Three patients died before 30 days without evidence of effusion, and no patient surviving longer than 30 days developed recurrent effusion or pericardial constriction. Intrapericardial tetracycline instillation is a safe and efficacious treatment for malignant pericardial effusion and should be considered the first treatment modality in this situation.

  1. Malignant hypertension in antiphospholipid syndrome without overt lupus nephritis.

    PubMed

    Cacoub, P; Wechsler, B; Piette, J C; Beaufils, H; Herreman, G; Bletry, O; Godeau, P

    1993-01-01

    The antiphospholipid syndrome is usually defined by the association of a clinical manifestation (recurrent venous and/or arterial thrombosis, recurrent spontaneous miscarriages) and a biological abnormality (anticardiolipin antibody, lupus anticoagulant). We retrospectively analyzed the records of 5 patients (4 females, 1 male, aged 30 +/- 12 years) with antiphospholipid syndrome, primary (n = 1) or secondary to systemic lupus erythematosus (n = 4), who developed malignant systemic hypertension with renal insufficiency, in the absence of lupus nephritis. Before the episode of malignant hypertension, all patients had normal systemic blood pressure and renal function. During malignant hypertension the systolic pressure was 206 +/- 39 mmHg and the diastolic pressure 130 +/- 25 mmHg, peak serum creatinine was 204 +/- 95 mumol/l, daily proteinuria was 1.1 +/- 0.8 gr, and complement serum levels were normal in all patients. Renal angiography found normal proximal renal arteries. Renal biopsy showed ischaemic glomeruli without proliferative lesions (n = 5), focal intimal fibrosis either isolated (n = 3) or associated with thrombosis (n = 2) of the intrarenal vessels, and the absence of vasculitis. Immunofluorescence study did not reveal typical lupus deposits. Patients were treated with antihypertensive agents, increasing doses of prednisone (n = 3), and anticoagulant (n = 2) or anti-aggregant therapy (n = 1). After a mean follow-up of 6.8 +/- 5.2 years, 4 patients were still alive with normal blood pressure and renal function, whereas 1 patient died of a probable catastrophic antiphospholipid syndrome. Patients with antiphospholipid syndrome, primary or secondary to systemic lupus erythematosus, may develop malignant hypertension with renal insufficiency and intrarenal vascular lesions, in the absence of lupus nephritis.

  2. Thermal Modelling In Pressure Die Casting

    NASA Astrophysics Data System (ADS)

    Rasgado, M. T. Alonso; Davey, K.; Watari, H.

    2004-06-01

    The pressure die casting process is cyclic and the temperature levels in the die are principally dictated by the total energy received from the casting. It is thus extremely important that any solidification model for the casting is able to predict energy extraction rates to a high degree of accuracy. In this paper an efficient three dimensional hybrid thermal model for the pressure die casting process is described. The finite element method (FEM) is used for modelling heat transfer in the casting, coupled to a boundary element (BE) model for the die. The FEM can efficiently account for the non-linearity introduced by the release of latent heat on solidification, whereas the BEM is ideally suited for modelling linear heat conduction in the die, as surface temperatures are of principal importance. The FE formulation for the casting is based on a control volume capacitance method, which is shown to provide high accuracy and stability. This method is similar to the apparent and effective heat capacitance methods, which are popular approaches used where conduction predominates over other heat transfer mechanisms. These methods involve the specification of element or nodal capacitances to accommodate for the release of latent heat. Unfortunately they suffer from a major drawback in that energy is not correctly transported through elements and so providing a source of inaccuracy. The control volume capacitance method allows for the transport of mass arising from volumetric shrinkage and ensures that energy is correctly transported. The BE model caters for surface phenomena such as boiling in the cooling channels, which is important, as this effectively controls the manner in which energy is extracted. The die temperature is decomposed into two components, one a steady-state part and the other a time-dependent perturbation. This approach enables the transient die temperatures to be calculated in an efficient way, since only die surfaces close to the die cavity are

  3. A comparison of the accuracy of three removable die systems and two die materials.

    PubMed

    Sivakumar, I; Mohan, J; Arunachalam, K S; Zankari, V

    2013-09-01

    The purpose of this study was to evaluate the dimensional shift of three commonly used die systems (Conventional system, Pindex system, Di-Lok tray system) with two commercially available type IV die stones (Ultra rock and Pearl stone). Under controlled conditions, ten casts, each with two removable dies, were constructed for each system for a total of 30 casts and 60 removable dies. Before and after sectioning measurements to within 0.01 mm in horizontal and vertical planes were recorded and differences calculated. Data were analyzed with 't' tests, one way analysis of variance and post hoc Tukey test. The results demonstrated that among the die systems compared, no single system was superior to the others in all respects. But among the die materials, dies poured in Pearl stone exhibited more dimensional changes than Ultra rock (p<0.05). Selection of die material is as critical as selection of any particular die system for successful fabrication of fixed partial denture and implant prosthesis.

  4. Identifying Regulators of the Immune Response to Dying Cells | Center for Cancer Research

    Cancer.gov

    Cytotoxic T cells are responsible for carrying out antigen-mediated immune responses against virally-infected and malignant cells. In both cases, cytotoxic T cells are stimulated by interacting with antigen presenting cells, such as dendritic cells (DCs). Infected cells produce virus-specific antigens and pathogen associated molecular patterns, which are recognized by DCs and lead to robust T cell activation. Dead or dying uninfected cells, on the other hand, release damage associated molecular patterns, but their release does not always appear to be sufficient to induce cytotoxic T cell activity. Tim Greten, M.D., of CCR’s Medical Oncology Branch, and a group of international collaborators set out to understand how immune responses against dying cancer cells are regulated. These processes are likely to be important for improving the efficacy of cancer treatment vaccines, which induce an immune reaction against a patient’s cancer cells.

  5. Malignant hyperthermia in children: an analysis of the North American malignant hyperthermia registry.

    PubMed

    Nelson, Priscilla; Litman, Ronald S

    2014-02-01

    Clinical characteristics of malignant hyperthermia (MH) in pediatric patients have not been elucidated. In this study, we used the North American Malignant Hyperthermia Registry to determine differences in clinical characteristics of acute MH across pediatric age groups. We hypothesized that there are differences in clinical presentation, clinical course, and outcomes, which correlate with age. A secondary aim was to determine the types of preexisting medical conditions associated with pediatric MH. We performed a retrospective review of the North American Malignant Hyperthermia Registry to identify pediatric subjects (up to and including 18 years) with an MH clinical grading score at or above 35 indicating "very likely" or "almost certain" MH. Preoperative patient characteristics, perianesthetic factors, and outcome data were compared for 3 cohorts based on age: 0 to 24 months, 25 months to 12 years, and 13 to 18 years. We used statistical analysis to determine differences among the groups. We analyzed 264 records: 35 in the youngest age group, 163 in the middle age group, and 66 in the oldest group. There was no indication of any predisposing risk factors for MH based on family history or physical examination. Sinus tachycardia, hypercarbia, and rapid temperature increase were the most common signs of acute MH (observed in 73.1%, 68.6%, and 48.5%, respectively) and were more common in the oldest age cohort. Higher maximum temperatures and higher peak potassium values were seen in the oldest age cohort. Masseter spasm was more common in the middle age cohort. The youngest age cohort was more likely to develop skin mottling and was approximately half as likely to develop muscle rigidity. The youngest age group also demonstrated significantly higher peak lactic acid levels and lower peak creatine kinase values. Treatments were similar across age cohorts. There were 10 MH-associated deaths, 6 in the middle age group and 4 in the oldest age group. Recrudescence of

  6. Ethical challenges when caring for dying children.

    PubMed

    Furingsten, Lovisa; Sjögren, Reet; Forsner, Maria

    2015-03-01

    Caring for dying children presents special challenges, according to the children themselves, their relatives and healthcare professionals. The aim of this study was to describe caring as represented in healthcare workers' experiences of caring for dying children. A phenomenological approach was chosen, in-depth interviews were carried out and data were analysed in four steps focusing on (a) open reading, (b) meaning units, (c) constituents and (d) essence. Four nurses in a general acute paediatric care setting in Sweden participated after providing written informed consent. Voluntary participation and confidentiality were ensured, and the study was ethically approved. The essence of caring for dying children was likened to a musically attuned composition, comprising five constituents: presence, self-knowledge, injustice in dying, own suffering and in need of others. Presence was found to be a prerequisite for caring when a child is dying. Self-knowledge and support from others can be of help when struggling with emotional pain and injustice. Caring for dying children has been found to be a delicate task for healthcare workers all over the world, and the ethical dimension is emphasized in international research. In this study, emotional pain and suffering accompanied caring, but an atmosphere in which it is possible to give and get support from colleagues and to have time to grieve and time to focus on the patient's needs may ease the burden, as can having time to process thoughts about life and death, and a possibility to grow in self-knowledge. Caring in ethically demanding situations may be facilitated through presence, atmosphere, self-knowledge and time. The challenge does not demand highly technological solutions; these assets are readily available, no matter where on earth. However, there is a need to further investigate these prerequisites for caring, particularly when a child is dying. © The Author(s) 2014.

  7. Primary malignant melanoma of uterine cervix with probable origin from benign cervical melanosis

    PubMed Central

    Singh, Nilanchali; Tripathi, Reva; Mala, Yedla Manikya

    2013-01-01

    We report a case of primary malignant melanoma of cervix which is a rare malignancy with only around 60 cases being reported. This patient presented with bleeding per vaginum. A large exophytic growth from cervix with black discolouration was seen. International Federation of Gynaecology and Obsterics (FIGO) staging was stage IIa. Histoimmunocytology confirmed the diagnosis of malignant melanoma of cervix. S-100 and HMB-45 are reliable markers for cervical melanomas. We attempted Wertheim's hysterectomy; but, due to extensive disease, paravescical and pararectal fossae could not be dissected and we had to perform type I hysterectomy. The patient was started on adjuvant chemotherapy with dacarbazine. Despite counselling, she refused a complete course of chemotherapy and died after 6 months. Radical surgery, chemotherapy and immunotherapy are the therapeutic modalities used. In bulky disease, neoadjuvant chemotherapy should be considered to reduce the tumour bulk and facilitate required surgery. Prognosis is poor and unpredictable. PMID:23737592

  8. Primary Pulmonary Malignant Melanoma: Report of an Important Entity and Literature Review

    PubMed Central

    Kyriakopoulos, Christos; Zarkavelis, George; Andrianopoulou, Artemis; Papoudou-Bai, Alexandra; Stefanou, Dimitrios

    2017-01-01

    Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are extremely rare. Published data on primary pulmonary malignant melanomas are limited. Up to now 40 relevant cases have been reported in the English literature. Herein, we report a case of a 56-year-old female patient who presented with intracranial metastases due to primary pulmonary melanoma. She underwent bronchoscopy and died 5 months after the initial diagnosis despite the administered biochemotherapy and subsequent immunotherapy. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin was excluded by detailed examination and radiographic imaging. Moreover, an extensive review of the literature regarding this rare entity has been performed. PMID:28352484

  9. Management of sessile malignant polyps: is colonoscopic polypectomy enough?

    PubMed

    Wu, Xian-rui; Liang, Jennifer; Church, James M

    2015-10-01

    The role of endoscopy in the management of malignant-pedunculated polyps has been well studied, but endoscopic management of malignant sessile polyps has not. Sometimes patients with malignant sessile polyps have comorbidities that make surgery exceptionally risky, and endoscopy beckons as a definitive management option. The aim of this study is to evaluate the potential role of endoscopy in the management of malignant sessile polyps. Patients undergoing colonoscopic polypectomy for malignant sessile polyps by a single endoscopist from 1997 to 2010 were evaluated. Demographic data, clinicopathological variables as well as long-term outcomes were recorded. Sixteen patients had malignant sessile polyps. Six (37.5 %) were male and 10 (62.5 %) were female. Mean age at diagnosis was 72.9 ± 12.2 years. Six polyps were proximal to the splenic flexure (37.5 %) and 10 (62.5 %) were distal. The mean size of the polyps was 30.5 ± 15.9 mm. All polyps were removed endoscopically but 7 patients (43.8 %) had formal colectomy following colonoscopic resection. There were no demographic differences between patients with and without surgery. Piecemeal polypectomy was necessary in 8 patients, 4 from the surgery group, and 4 from the endoscopy group. More patients in the surgery group had poorly differentiated cancers (4/6 vs. 0/6) and incomplete margins (5/6 vs. 1/6) and more patients in the endoscopically treated group had serious comorbidity (5/9 vs. 3/7). There was no procedure-related morbidity or mortality. After a mean follow-up of 48.4 ± 27.2 months, one patient from the polypectomy group patient had a local recurrence and a liver metastasis, after originally declining surgery. In the surgery group, one patient had lung metastasis. The two patients who recurred with distant metastasis died. Endoscopic management of sessile colorectal polyps appears to be feasible and safe in patients with well/moderately differentiated cancer and negative margins. Larger studies are needed

  10. The attitudes of brain cancer patients and their caregivers towards death and dying: a qualitative study

    PubMed Central

    Lipsman, Nir; Skanda, Abby; Kimmelman, Jonathan; Bernstein, Mark

    2007-01-01

    Background Much money and energy has been spent on the study of the molecular biology of malignant brain tumours. However, little attention has been paid to the wishes of patients afflicted with these incurable tumours, and how this might influence treatment considerations. Methods We interviewed 29 individuals – 7 patients dying of a malignant brain tumor and 22 loved ones. One-on-one interviews were conducted according to a pre-designed interview guide. A combination of open-ended questions, as well as clinical scenarios was presented to participants in order to understand what is meaningful and valuable to them when determining treatment options and management approaches. The results were analyzed, coded, and interpreted using qualitative analytic techniques in order to arrive at several common overarching themes. Results Seven major themes were identified. In general, respondents were united in viewing brain cancer as unique amongst malignancies, due in large part to the premium placed on mental competence and cognitive functioning. Importantly, participants found their experiences, however difficult, led to the discovery of inner strength and resilience. Responses were usually framed within an interpersonal context, and participants were generally grateful for the opportunity to speak about their experiences. Attitudes towards religion, spirituality, and euthanasia were also probed. Conclusion Several important themes underlie the experiences of brain cancer patients and their caregivers. It is important to consider these when managing these patients and to respect not only their autonomy but also the complex interpersonal toll that a malignant diagnosis can have. PMID:17996072

  11. Skin: A mirror of internal malignancy

    PubMed Central

    Vora, Rita V.; Kota, RahulKrishna S.; Diwan, Nilofar G.; Jivani, Nidhi B.; Gandhi, Shailee S.

    2016-01-01

    Skin manifestations are a reflection of many of the internal diseases. Sometimes, skin disease may be the only manifestation of the internal disease. Internal malignancies may give rise to a number of cutaneous manifestations through their immunological, metabolic, and metastatic consequences. Curth proposed criteria to establish a causal relationship between a dermatosis and a malignant internal disease. Malignancy can present with a plethora of cutaneous manifestations. Here, we describe in brief about various skin manifestations of internal malignancies. PMID:28144085

  12. Characteristics of patients who die in hospital with no attempt at resuscitation.

    PubMed

    Aune, Solveig; Herlitz, Johan; Bång, Angela

    2005-06-01

    To describe the characteristics, cause of hospitalisation and symptoms prior to death in patients dying in hospital without resuscitation being started and the extent to which these decisions were documented. All patients who died at Sahlgrenska University Hospital in Goteborg, Sweden, in whom cardiopulmonary resuscitation (CPR) was not attempted during a period of one year. Among 674 patients, 71% suffered respiratory insufficiency, 43% were unconscious and 32% had congestive heart failure during the 24h before death. In the vast majority of patients, the diagnosis on admission to hospital was the same as the primary cause of death. The cause of death was life-threatening organ failure, including malignancy (44%), cerebral lesion (10%) and acute coronary syndrome (10%). The prior decision of 'do not attempt resuscitation' (DNAR) was documented in the medical notes in 82%. In the remaining 119 patients (18%), only 16 died unexpectedly. In all these 16 cases, it was regarded retrospectively as ethically justifiable not to start CPR. In patients who died at a Swedish University Hospital, we did not find a single case in which it was regarded as unethical not to start CPR. The patient group studied here had a poor prognosis due to a severe deterioration in their condition. To support this, we also found a high degree of documentation of DNAR. The low rate of CPR attempts after in-hospital cardiac arrest appears to be justified.

  13. [Neuroleptic malignant syndrome. A case report].

    PubMed

    Guadagnucci, A; Tornaboni, D; Vignali, G; Mariotti, M; Cincinelli, A; Vignale, L

    1995-01-01

    A lethal case of neuroleptic malignant syndrome in a 42-year-old woman with a history of bipolar psychiatric disorder under treatment with haloperidol is reported. The patient, hospitalized many times in the past for psychiatric treatment, was then admitted for treatment of a relapse of the disease during a exceedingly hot period. The patient complained of hallucinations and stomach ache. It was necessary to increase the dose of haloperidol to 2 mg, 3 times a day, and to give a single dose of perphenazine enanthate 100 mg. All tests proved normal except for CPK 274 U/l and urea 14 mg/dl. On hospital day 2, went into coma with high temperature, diaphoresis, polyuria, leucocytosis (WBC count 15,440 U/mm3), urea 7 mg/dl, LDH 425 U/l, Na 114 mEq/l, K 2.5 mEq/l. The rapid improvement following hypertonic saline treatment encouraged a diagnosis of water intoxication. On hospital day 7, continuing with the haloperidol treatment, the patient developed a high temperature and deterioration torpor. On hospital day 9, the patient went back into coma with temperature over 40 degrees C (104 degrees F), with fine myoclonia most visible on the face, and muscular rigidity. The CPK, rose from 5,169 to 28,060 U/l in less than 24 hours; the serum myoglobin rose to 41,000 ug/l. On day hospital 11 developed renal, cardiac and respiratory insufficiency. The picture deteriorated and dantrolene was no longer of use in controlling the fever. Then with a fever of over 42 degrees (108 degrees F) and the CPK at 50,000 the patient died. The autopsy demonstrated widespread rhabdomyolysis, a picture of widespread aspecific shock in all organs and picture of myoglobin-induced tabular necrosis of the kidney.

  14. Abnormal activated partial thromboplastin time and malignancy.

    PubMed

    Delicata, M; Hambley, H

    2011-08-01

    Malignancy often results in clotting abnormalities. The aetiology of haemostasis problems in cancer is complex, and is still not completely understood. We describe a case of a patient with malignant mesothelioma, who was found to have elevated activated partial thromboplastin time, due to lupus anticoagulant. We suggest that patients with malignancy should have their coagulation checked prior to any invasive procedures.

  15. Malignant melanoma of the foot and ankle.

    PubMed

    John, K J; Hayes, D W; Green, D R; Dickerson, J

    2000-04-01

    Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

  16. Malignant Transformation of Pulmonary Benign Metastasizing Leiomyoma

    PubMed Central

    Song, Kyung Sub; Keum, Dong Yoon; Hwang, Il Seon

    2017-01-01

    Pulmonary benign metastasizing leiomyoma (PBML) is defined as metastasis of a leiomyoma to lung tissue. It was first reported in 1937. P BML is known as a benign disease, but can undergo malignant transformation. Only 1 case of the malignant transformation of PBML to leiomyosarcoma has been reported previously. In this report, we present a case of malignant transformation of PBML. PMID:28180107

  17. En bloc spondylectomy in malignant tumors of the spine.

    PubMed

    Liljenqvist, Ulf; Lerner, Thomas; Halm, Henry; Buerger, Horst; Gosheger, Georg; Winkelmann, Winfried

    2008-04-01

    En bloc spondylectomy is a technique that enables wide or marginal resection of malignant lesions of the spine. Both all posterior techniques as well as combined approaches are reported. Aim of the present study was to analyse the results of 21 patients with malignant lesions of the spine, all treated with en bloc excision in a combined posteroanterior (n = 19) or all posterior approach (n = 2). Twenty-one consecutive patients, operated between 1997 and 2005, were included into this retrospective study. Thirteen patients had primary malignant lesions, eight patients had solitary metastases, all located in the thoracolumbar spine. There were 16 single level, three two-level, one three-level and one four-level spondylectomy. The patients were followed clinically and radiographically (including CT studies) with an average follow-up of 4 years. Out of 11 patients with primary Ewing or osteosarcoma seven patients are alive without any evidence of disease. One patient died after 5 years from other causes and three are alive with evidence of disease. Latter had either a poor histologic response to the preoperative chemotherapy (n = 2) or an intralesional resection (n = 1). All three patients with solitary spinal metastases of Ewing or osteosarcoma died of the disease. Five patients with solitary metastases of mainly hypernephroma are alive. In total, six resections were intralesional, mainly due to large intraspinal tumor masses, with two patients having had previous surgery. In the remaining cases, wide (n = 10) or marginal (n = 5) resection was accomplished. There were one pseudarthrosis requiring extension of the fusion and two cases with local recurrences and repeated excisional surgery. At follow-up CT studies, all cages were fused. Health related quality of life analysis (SF-36) revealed only slightly decreased physical component and normal mental component scores compared to normals in those patients with no evidence of disease. En bloc spondylectomy enables wide

  18. En bloc spondylectomy in malignant tumors of the spine

    PubMed Central

    Lerner, Thomas; Halm, Henry; Buerger, Horst; Gosheger, Georg; Winkelmann, Winfried

    2008-01-01

    En bloc spondylectomy is a technique that enables wide or marginal resection of malignant lesions of the spine. Both all posterior techniques as well as combined approaches are reported. Aim of the present study was to analyse the results of 21 patients with malignant lesions of the spine, all treated with en bloc excision in a combined posteroanterior (n = 19) or all posterior approach (n = 2). Twenty-one consecutive patients, operated between 1997 and 2005, were included into this retrospective study. Thirteen patients had primary malignant lesions, eight patients had solitary metastases, all located in the thoracolumbar spine. There were 16 single level, three two-level, one three-level and one four-level spondylectomy. The patients were followed clinically and radiographically (including CT studies) with an average follow-up of 4 years. Out of 11 patients with primary Ewing or osteosarcoma seven patients are alive without any evidence of disease. One patient died after 5 years from other causes and three are alive with evidence of disease. Latter had either a poor histologic response to the preoperative chemotherapy (n = 2) or an intralesional resection (n = 1). All three patients with solitary spinal metastases of Ewing or osteosarcoma died of the disease. Five patients with solitary metastases of mainly hypernephroma are alive. In total, six resections were intralesional, mainly due to large intraspinal tumor masses, with two patients having had previous surgery. In the remaining cases, wide (n = 10) or marginal (n = 5) resection was accomplished. There were one pseudarthrosis requiring extension of the fusion and two cases with local recurrences and repeated excisional surgery. At follow-up CT studies, all cages were fused. Health related quality of life analysis (SF-36) revealed only slightly decreased physical component and normal mental component scores compared to normals in those patients with no evidence of disease. En bloc spondylectomy

  19. Mesothelioma of the tunica vaginalis: a series of eight cases with uncertain malignant potential.

    PubMed

    Brimo, Fadi; Illei, Peter B; Epstein, Jonathan I

    2010-08-01

    Well-differentiated papillary mesotheliomas have rarely been reported to involve the testis tunica vaginalis. While the classic histology of the originally described well-differentiated papillary mesotheliomas consisted of papillae lined by a single layer of bland cuboidal cells, more complex architectural patterns have been described. This report details our experience with eight paratesticular mesotheliomas that span the histological spectrum from classic well-differentiated papillary mesotheliomas to those with more complex patterns. We attempt to determine whether there are prognostic or immunohistochemical differences between these lesions and 28 diffuse malignant mesotheliomas. All cases had papillary/tubulopapillary in addition to more complex architectures (cribriform, condensed) and none showed evidence of invasion. Mitotic figures were present in seven cases and averaged 2.1 mitosis per 50 h.p.f. All cases showed died of unknown causes at 5 and 47 years, suggesting that these lesions behave more indolently than typical malignant mesotheliomas of the tunica vaginalis. If these cases were diffuse malignant mesotheliomas, one would have expected at least some of the patients to have died of disease within a couple of years after diagnosis. However, detailed and long-term follow-up were not sufficiently available to reach definitive conclusions on the true biological behavior of these tumors. The morphological continuum noted between our cases and classic well-differentiated papillary mesotheliomas, combined with their immunohistochemical profile and indolent behavior, contrasts with that of diffuse malignant mesotheliomas. We propose that these tunica vaginalis

  20. Compassionate community networks: supporting home dying.

    PubMed

    Abel, Julian; Bowra, Jon; Walter, Tony; Howarth, Glennys

    2011-09-01

    How may communities be mobilised to help someone dying at home? This conceptual article outlines the thinking behind an innovative compassionate community project being developed at Weston-super-Mare, UK. In this project, a health professional mentors the dying person and their carer to identify and match: (a) the tasks that need to be done and (b) the members of their social network who might help with these tasks. Network members may subsequently join a local volunteer force to assist others who are network poor. Performing practical tasks may be more acceptable to some family, friends and neighbours than having to engage in a conversation about dying, and provides a familiarity with dying that is often lacking in modern societies, so in this model, behavioural change precedes attitudinal change. The scheme rejects a service delivery model of care in favour of a community development model, but differs from community development schemes in which the mentor is a volunteer rather than a health professional, and also from those approaches that strive to build community capacity before any one individual dying person is helped. The pros and cons of each approach are discussed. There is a need for evaluation of this and similar schemes, and for basic research into naturally occurring resource mobilisation at the end of life.

  1. Gastrointestinal Malignancy and the Microbiome

    PubMed Central

    Abreu, Maria T.; Peek, Richard M.

    2014-01-01

    Microbial species participate in the genesis of a substantial number of malignancies—in conservative estimates, at least 15% of all cancer cases are attributable to infectious agents. Little is known about the contribution of the gastrointestinal (GI) microbiome to the development of malignancies. Resident microbes can promote carcinogenesis by inducing inflammation, increasing cell proliferation, altering stem cell dynamics, and producing metabolites such as butyrate, which affect DNA integrity and immune regulation. Studies in humans and rodent models of cancer have identified effector species and relationships among members of the microbial community in the stomach and colon that increase the risk for malignancy. Strategies to manipulate the microbiome, or the immune response to such bacteria, could be developed to prevent or treat certain GI cancers. PMID:24406471

  2. Endobronchial metastases from extrathoracic malignancies.

    PubMed

    Akoglu, Sebahat; Uçan, Eyüp S; Celik, Gülperi; Sener, Gülper; Sevinç, Can; Kilinç, Oğuz; Itil, Oya

    2005-01-01

    Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients' clinical conditions, symptoms, radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found 15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin's Disease (1). The most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean interval from initial diagnosis to diagnosis of EBM was 32.8 months (range, 0-96 months) and median survival time was 18 months (range, 4-84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically. Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.

  3. [Malignant fibrous histiocytoma. Case report].

    PubMed

    Morlino, A; Rossi, M T; Fabrizio, T; Scutari, F

    2010-03-01

    Malignant fibroous histiocytoma (MFH) is an aggressive soft tissue sarcoma, that most frequently occurs in the muscles of the extremities and in abdominal or in retroperitoneal space of young adults. It is seldom confined to the skin and subcutaneous tissue. It is rarely diagnosed before excision and pathological exam, and has an unfavorable prognostic in some cases. This work reports the case of a 94 years old patient with originally cutaneous MFH stressing the importance of the early diagnosis.

  4. Morphogens, morphostats, microarchitecture and malignancy.

    PubMed

    Potter, John D

    2007-06-01

    Morphogenetic fields organize tissue morphology in the embryo. By analogy, morphostatic fields maintain normal cell behaviour and normal tissue microarchitecture in the adult. The most prominent feature of cancer is the disruption of tissue microarchitecture. Cancer occurs much more frequently when morphostatic influences fail (metaplasia) or at the junction of two different morphostatic fields. This Review will describe what we know about morphostats and morphostasis, discuss the evidence for the role of disruption of morphostasis in malignancy, and address some testable hypotheses.

  5. Quality of end-of-life care in patients with hematologic malignancies: a retrospective cohort study.

    PubMed

    Hui, David; Didwaniya, Neha; Vidal, Marieberta; Shin, Seong Hoon; Chisholm, Gary; Roquemore, Joyce; Bruera, Eduardo

    2014-05-15

    To the authors' knowledge, only limited data are available regarding the quality of end-of-life care for patients with hematologic malignancies. In this retrospective cohort study, the quality of end-of-life care was compared between patients with hematologic malignancies and those with solid tumors. All adult patients who died of advanced cancer between September 1, 2009 and February 28, 2010 while under the care of the study institution were included. The authors collected baseline demographics and end-of-life care indicators, including emergency room visits, hospitalization, intensive care unit admissions, and systemic cancer therapy use within the last 30 days of life. Of a total of 816 decedents, 113 (14%) had hematologic malignancies. In the last 30 days of life, patients with hematologic malignancies were more likely to have emergency room visits (54% vs 43%; P = .03), hospital admissions (81% vs 47%; P < .001), ≥ 2 hospital admissions (23% vs 10%; P < .001), > 14 days of hospitalization (38% vs 8%; P < .001), intensive care unit admissions (39% vs 8%; P < .001) and death (33% vs 4%; P < .001), chemotherapy use (43% vs 14%; P < .001), and targeted therapy use (34% vs 11%; P < .001) compared with patients with solid tumors. Patients with hematologic malignancies were also less likely to have palliative care unit admissions (8% vs 17%; P = .02). The composite score for aggressiveness of care (with 0 indicating the best and 6 indicating the worst) was significantly higher among patients with hematologic malignancies compared with those with solid tumors (median, 2 vs 0; P < .001). On multivariate analysis, hematologic malignancy was found to be a significant factor associated with aggressive end-of-life care (odds ratio, 6.6; 95% confidence interval, 4.1-10.7 [P < .001]). The results of the current study indicate that patients with hematologic malignancies received more aggressive care at the end of life. © 2014 American Cancer Society.

  6. Targeting hedgehog in hematologic malignancy.

    PubMed

    Irvine, David A; Copland, Mhairi

    2012-03-08

    The Hedgehog pathway is a critical mediator of embryonic patterning and organ development, including hematopoiesis. It influences stem cell fate, differentiation, proliferation, and apoptosis in responsive tissues. In adult organisms, hedgehog pathway activity is required for aspects of tissue maintenance and regeneration; however, there is increasing awareness that abnormal hedgehog signaling is associated with malignancy. Hedgehog signaling is critical for early hematopoietic development, but there is controversy over its role in normal hematopoiesis in adult organisms where it may be dispensable. Conversely, hedgehog signaling appears to be an important survival and proliferation signal for a spectrum of hematologic malignancies. Furthermore, hedgehog signaling may be critical for the maintenance and expansion of leukemic stem cells and therefore provides a possible mechanism to selectively target these primitive cell subpopulations, which are resistant to conventional chemotherapy. Indeed, phase 1 clinical trials of hedgehog pathway inhibitors are currently underway to test this hypothesis in myeloid leukemias. This review covers: (1) the hedgehog pathway and its role in normal and malignant hematopoiesis, (2) the recent development of clinical grade small molecule inhibitors of the pathway, and (3) the potential utility of hedgehog pathway inhibition as a therapeutic strategy in hemato-oncology.

  7. Malignant cancer and invasive placentation

    PubMed Central

    D'Souza, Alaric W.; Wagner, Günter P.

    2014-01-01

    Cancer metastasis is an invasive process that involves the transplantation of cells into new environments. Since human placentation is also invasive, hypotheses about a relationship between invasive placentation in eutherian mammals and metastasis have been proposed. The relationship between metastatic cancer and invasive placentation is usually presented in terms of antagonistic pleiotropy. According to this hypothesis, evolution of invasive placentation also established the mechanisms for cancer metastasis. Here, in contrast, we argue that the secondary evolution of less invasive placentation in some mammalian lineages may have resulted in positive pleiotropic effects on cancer survival by lowering malignancy rates. These positive pleiotropic effects would manifest themselves as resistance to cancer cell invasion. To provide a preliminary test of this proposal, we re-analyze data from Priester and Mantel (Occurrence of tumors in domestic animals. Data from 12 United States and Canadian colleges of veterinary medicine. J Natl Cancer Inst 1971;47:1333-44) about malignancy rates in cows, horses, cats and dogs. From our analysis we found that equines and bovines, animals with less invasive placentation, have lower rates of metastatic cancer than felines and canines in skin and glandular epithelial cancers as well as connective tissue sarcomas. We conclude that a link between type of placentation and species-specific malignancy rates is more likely related to derived mechanisms that suppress invasion rather than different degrees of fetal placental aggressiveness. PMID:25324490

  8. Temozolomide for Treating Malignant Melanoma.

    PubMed

    Li, Rong-Hua; Hou, Xiao-Yang; Yang, Chun-Sheng; Liu, Wen-Lou; Tang, Jian-Qin; Liu, Yan-Qun; Jiang, Guan

    2015-09-01

    Melanoma is one of the most malignant forms of skin cancer; with a rapidly increasing prevalence. Early-stage melanoma is curable, but advanced metastatic melanoma is almost always fatal, and patients with such advanced disease have short median survival. Surgery and radiotherapy play a limited role in the treatment of metastatic melanoma. Rather, chemotherapy remains the mainstay of treatment, although other approaches, including biotherapy and gene therapy, have been attempted. The authors hereby, evaluated the use of temozolomide (TMZ) for treating metastatic melanoma compared to dacarbazine (DTIC), the effectiveness of TMZ for treating brain metastases, as well as TMZ resistance and how the efficacy of TMZ in malignant melanoma can be increased. Two chemotherapeutic regimens are commonly used for palliative treatment of malignant melanoma: intravenous administration of DTIC and oral administration of the alkylating agent temozolomide (TMZ). Compared to DTIC, TMZ is very well tolerated and has an advantage in terms of improving the quality of life of patients with metastatic melanoma. While the prognosis is currently unpromising, chemotherapy plays a palliative role for patients with metastatic melanoma. The toxicity of treatment regimens based on DTIC and TMZ do not differ significantly, although TMZ is costlier. These findings provide a reference for future researchers via a comprehensive analysis of the relevant literature.

  9. Malignant otitis externa: case series.

    PubMed

    Ali, T; Meade, K; Anari, S; ElBadawey, M R; Zammit-Maempel, I

    2010-08-01

    In the light of current concerns regarding ciprofloxacin resistance and the changing face of malignant otitis externa, we reviewed cases of malignant otitis externa treated in our centre, in order both to evaluate the current epidemiology of the condition and to assess the status of drug resistance in our patient population. Retrospective case review of all malignant otitis externa cases managed in a tertiary referral centre in the north-east of England between 2000 and 2009. Forty-one patients were identified, but the required data were available for only 37 cases. Patients' ages ranged from 51 to 101 years (median, 81 years). Diabetes was present in 51 per cent of patients (19/37), facial nerve palsy in 40 per cent (15/37) and multiple cranial nerve palsy in 24 per cent (9/37). Pseudomonas aeruginosa was the most commonly isolated organism (54 per cent), sensitive to ciprofloxacin in all cases. The incidence of cranial nerve palsy in our study was higher than in previous reports. The incidence of diabetes and Pseudomonas aeruginosa in our cohort was much lower than previously reported. The Pseudomonas aeruginosa strains isolated were all sensitive to ciprofloxacin, despite recent reports on emerging resistance.

  10. Killing, letting die and moral perception.

    PubMed

    Gillett, Grant

    1994-10-01

    There are a number of arguments that purport to show, in general terms, that there is no difference between killing and letting die. These are used to justify active euthanasia on the basis of the reasons given for allowing patients to die. I argue that the general and abstract arguments fail to take account of the complex and particular situations which are found in the care of those with terminal illness. When in such situations, there are perceptions and intuitions available that do not easily find propositional form but lead most of those whose practice is in the care of the dying to resist active euthanasia. I make a plea for their intuitions to be heeded above the sterile voice of abstract premises and arguments by examining the completeness of the outline form of the pro-euthanasia argument. In doing so, I make use of Nussbaum's discussion of moral perception and general claims to be found in the literature of moral particularism.

  11. Acts and omissions, killing and letting die.

    PubMed

    Gillon, R

    1986-01-11

    Gillon asks what, if any, moral importance resides in the distinction between killing and letting die in the context of medical care. He considers and rejects the acts and omissions doctrine, which claims that actions (killing) resulting in some undesirable end are in general morally worse than failures to act (allowing to die) that have the same result. He also refutes the argument that the moral distinction between killing and letting die is one of harming versus benefitting, and that a physician has a responsibility not to harm (kill) a patient but no duty to help (keep alive). Gillon concludes by discussing the moral claims upon which the Roman Catholic rejection of the acts and omissions doctrine is based, which are the subjects of his next British Medical Journal article on medical ethics.

  12. The right to be allowed to die.

    PubMed

    Campbell, A G

    1983-09-01

    The unbridled use of modern medical skills and technology in preserving life at all costs has stimulated interest in expressing a 'right to die' by the legally competent patient who is anxious to protect his autonomy. Some recent decisions by American courts are seen to threaten this 'right to die' of competent patients and imply that legally incompetent patients including children should not have this right under any circumstances, even when expressed on their behalf by guardians, nearest relatives or parents. It is argued that this is contrary to 'natural justice' as viewed by most people. It should be possible to develop procedures which are protective of the basic 'right to life' of the incompetent yet will recognise circumstances where they could be allowed to die. This paper was presented at the 1983 annual conference of the London Medical Group, 'Human Rights in Medicine'.

  13. Is there a duty to die?

    PubMed

    Hardwig, J

    1997-01-01

    Many people were outraged when Richard Lamm claimed that old people had a duty to die. Modern medicine and an individualistic culture have seduced many to feel that they have a right to health care and a right to live, despite the burdens and costs to our families and society. But in fact there are circumstances when we have a duty to die. As modern medicine continues to save more of us from acute illness, it also delivers more of us over to chronic illnesses, allowing us to survive far longer than we can take care of ourselves. It may be that our technological sophistication coupled with a commitment to our loved ones generates a fairly widespread duty to die.

  14. Giant Malignant Pheochromocytoma with Palpable Rib Metastases

    PubMed Central

    Gokce, Gokhan; Kilicli, Fatih; Elagoz, Sahande; Ayan, Semih; Gultekin, Emin Yener

    2014-01-01

    Pheochromocytoma is a rare and usually benign neuroendocrine neoplasm. Only 10% of all these tumors are malignant and there are no definitive histological or cytological criteria of malignancy. Single malignancy criteria are the presence of advanced locoregional disease or metastases. We report a case, with a giant retroperitoneal tumor having multiple metastases including palpable rib metastases, who was diagnosed as a malignant pheochromocytoma. The patient was treated with surgery. The literature was reviewed to evaluate tumor features and current diagnostic and therapeutic approaches for patients with metastatic or potentially malignant pheochromocytoma. PMID:25152826

  15. Naked megakaryocyte nuclei: a clue to malignancy.

    PubMed

    Lefkowitz, M; Lefkowitz, E

    1977-10-01

    Bone marrow smears from 63 patients with various malignancies and a series of 51 controls were examined for the presence and percentage of naked megakaryocyte nuclei (NMN). Patients with malignancy had more than 15% NMN, which, when compared with the incidence in controls, was statistically significant. The etiology of this artifact is unknown. It is a clue to the presence of malignancy, and might be useful in following treated cases of malignancy for evidence of relapse. NMN should not be confused with metastatic malignant cells.

  16. Diagnosing dying: an integrative literature review.

    PubMed

    Kennedy, Catriona; Brooks-Young, Patricia; Brunton Gray, Carol; Larkin, Phil; Connolly, Michael; Wilde-Larsson, Bodil; Larsson, Maria; Smith, Tracy; Chater, Susie

    2014-09-01

    To ensure patients and families receive appropriate end-of-life care pathways and guidelines aim to inform clinical decision making. Ensuring appropriate outcomes through the use of these decision aids is dependent on timely use. Diagnosing dying is a complex clinical decision, and most of the available practice checklists relate to cancer. There is a need to review evidence to establish diagnostic indicators that death is imminent on the basis of need rather than a cancer diagnosis. To examine the evidence as to how patients are judged by clinicians as being in the final hours or days of life. Integrative literature review. Five electronic databases (2001-2011): Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL. The search yielded a total of 576 hits, 331 titles and abstracts were screened, 42 papers were retrieved and reviewed and 23 articles were included. Analysis reveals an overarching theme of uncertainty in diagnosing dying and two subthemes: (1) 'characteristics of dying' involve dying trajectories that incorporate physical, social, spiritual and psychological decline towards death; (2) 'treatment orientation' where decision making related to diagnosing dying may remain focused towards biomedical interventions rather than systematic planning for end-of-life care. The findings of this review support the explicit recognition of 'uncertainty in diagnosing dying' and the need to work with and within this concept. Clinical decision making needs to allow for recovery where that potential exists, but equally there is the need to avoid futile interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Treatment of upper abdominal malignancies with organ cluster procedures

    PubMed Central

    Mieles, Luis; Todo, Satoru; Tzakis, Andreas; Starzl, Thomas E.

    2010-01-01

    Upper abdominal exenteration for upper abdominal malignancies was carried out in 15 patients with removal of the liver, spleen, pancreas, duodenum, all or part of the stomach, proximal jejunum and ascending and transverse colon. Organ replacement was with the liver, pancreas and duodenum plus, in some cases, a short segment of jejunum. Eleven of the 15 patients survived for more than 4 months; 2 died, after 6½ and 10 months, of recurrent tumor. Of the 9 patients who are surviving after 6½ to 14 months, recurrent tumor is suspected in only 1 and proven in none. Four patients with sarcomas and carcinoid tumors (2 each) have had no recurrences. The other 5 survivors had duct cell cancers (3 examples), a cholangiocarcinoma (1 example), and a hepatoma (1 example). The experience so far supports further cautious trials with this drastic cancer operation. PMID:10147561

  18. Ambiguities in 'killing' and 'letting die'.

    PubMed

    Atkinson, G M

    1983-05-01

    In a recent article Carla Kary (1980) attempts to show that there can be a significant moral difference between instances of killing and letting die. I shall maintain in Section I that Kary's argument is somewhat weakened by her failure to note an important ambiguity in the notion of killing a person. I shall also argue in Section II that a similar ambiguity affects the notion of letting someone die, and that failure to note this latter ambiguity also weakens the position developed by Robert Coburn (1980) with regard to defective newborns.

  19. Chromosome 7 and Haematological Malignancies.

    PubMed

    Cotter, F E; Johnson, E

    1997-01-01

    Abnormalities of chromosome 7 are the most common clonal chromosomal changes observed in myelodysplasia (MDS) and the second most frequent in acute myeloid leukaemia (AML) [1-5]. These changes may consist of long arm deletion (7q-) or total loss of the whole chromosome (monosomy 7) from bone marrow cells [1, 4, 6-24] and was first reported in association with myeloid disease in 1964 with the report of 3 cases of refractory anaemia, granulocytic hyperplasia [25]. The association between chromosome 7 alterations, MDS and AML in children and adults is clear, however, a rare association with lymphoid malignancies has also been recently reported. The abnormalities may occur in de novo MDS/AML, secondary cases following exposure to drugs, radiotherapy and toxins and in addition in a range of constitutional disorders including Fanconi's anaemia, congenital neutropenia and neurofibromatosis type 1 (NF1). The broad spread of conditions in which this consistent genetic change can occur leads one to speculate that there is an underlying instability in chromosome 7 and that genes on this chromosome play a role in the development of malignancy. The loss of DNA associated with malignant progression suggests the presence of a tumour suppressor gene (or genes) [26, 27]. Patients with monosomy 7 usually present as classical MDS with abnormal erythroid, megakaryocyte and myeloid differentiation [7, 28]. From a mechanistic perspective, increased cell proliferation and apoptosis is a common feature possibly induced by the failure of normal haematopoietic maturation. In all groups the presence of chromosome 7 abnormalities defines a poor prognostic group [29]. The majority of patients with MDS transform to a form of acute leukaemia resistant to therapy, including bone marrow transplantation (BMT). Although fluorescence in situ hybridization (FISH) has accelerated the study of these disorders at the cytogenetic and molecular levels, [4, 30, 31, 32, 33] no gene has been clearly

  20. Der Einfluss der Digitalisierung auf die Organisation eines Unternehmens

    NASA Astrophysics Data System (ADS)

    Walter, Wolfram M.

    Die Digitalisierung schreitet mit großen Schritten voran. Dies wirkt sich nicht nur auf die Gesellschaft im Grundsatz, sondern auch auf das Verhalten der Kunden aus. Neue Kommunikationswege beschleunigen die Interaktion zwischen Unternehmen und Verbraucher. Im Vergleich mit großen Internetfirmen werden etablierte Dienstleistungsunternehmen - vom Energieversorger bis zu Versicherungen - stark unter Druck gesetzt, sich noch intensiver mit dem Kundenservice auseinanderzusetzen. Dies wird nur möglich sein, wenn sich die Organisationen entsprechend positionieren und sich frühzeitig auf die Veränderungen einstellen. Hieraus ergeben sich mehr Chancen als Risiken, zumal es nicht nur neue Prozesse, sondern auch neue Berufsbilder geben wird.

  1. Temozolomide and radiation for aggressive pediatric central nervous system malignancies.

    PubMed

    Loh, Kenneth C; Willert, Jennifer; Meltzer, Hal; Roberts, William; Kerlin, Bryce; Kadota, Richard; Levy, Michael; White, Greg; Geddis, Amy; Schiff, Deborah; Martin, Laura; Yu, Alice; Kung, Faith; Spear, Matthew A

    2005-05-01

    This study describes the outcomes of children treated with combinations of temozolomide and radiation therapy for various aggressive central nervous system malignancies. Their age at diagnosis ranged from 1 to 15 years. Patients with focal disease were treated with concomitant temozolomide (daily 75 mg/m) and three-dimensional conformal radiotherapy in a dose that ranged from 50 to 54 Gy, followed by temozolomide (200 mg/m/d x 5 days/month in three patients, 150 mg/m x 5 days/ month in one patient). Patients with disseminated disease were treated with craniospinal radiation (39.6 Gy) before conformal boost. One patient received temozolomide (200 mg/m x 5 days/month) before craniospinal radiation, and one patient received temozolomide (daily 95 mg/m) concomitant with craniospinal radiation and a radiosurgical boost, followed by temozolomide (200 mg/m x 5 days/month). Three patients achieved a partial response during treatment, with two of these patients dying of progressive disease after treatment. One patient has no evidence of disease. Three patients achieved stable disease, with one of these patients dying of progressive disease after treatment. Toxicities observed included low-grade neutropenia, thrombocytopenia, and lymphopenia. The combination of temozolomide and radiotherapy appears to be well tolerated in a variety of treatment schemas for aggressive pediatric central nervous system malignancies. This information is of particular use in designing future studies, given the recent positive results in a randomized study examining the use of temozolomide concomitant with radiation in the treatment of adult glioblastoma.

  2. Malignant Peripheral Nerve Sheath Tumor -A Rare Malignancy in Mandible

    PubMed Central

    Majumdar, Sumit; Kotina, Sreekanth; Uppala, Divya; Kumar, Singam Praveen

    2016-01-01

    Malignant Peripheral Nerve Sheath Tumor (MPNST) is biologically an aggressive tumor that is usually found in the extremities, trunk and infrequently found in the head and neck area particularly in the jaws, arising from the cells allied with nerve sheath. Mandibular MPNST may either arise from a preexisting neurofibroma or develop de novo. Because of the greater variability from case to case in overall appearance both clinically and histologically, a case of MPNST of the mandible in a 25-year-old female patient is reported. The lesion was excised and immunohistological studies (S-100 & Neuron specific enolase) were conducted to confirm the neural origin. PMID:27504425

  3. Die Arbeitsunfähigkeit in der Statistik der GKV

    NASA Astrophysics Data System (ADS)

    Busch, Klaus

    Der vorliegende Beitrag gibt anhand der Statistiken des Bundesministeriums für Gesundheit (BMG) einen Überblick über die Arbeitsunfähigkeitsdaten der Gesetzlichen Krankenkassen (GKV). Zunächst werden die Arbeitsunfähigkeitsstatistiken der Krankenkassen und die Erfassung der Arbeitsunfähigkeit erläutert. Hiernach wird auf die Entwicklung der Fehlzeiten auf GKV-Ebene eingegangen. Ebenfalls wird Bezug auf die Unterschiede der Fehlzeiten zwischen den verschiedenen Kassen genommen.

  4. Die Europäische Union, die Europäische Gemeinschaft und ihre Rechtsordnung, die Europäische Lebensmittelkontrolle

    NASA Astrophysics Data System (ADS)

    Gallhoff, Gudrun; Rimkus, Gerhard G.

    Die Europäische Union (EU) ist ein Zusammenschluss von siebenundzwanzig unabhängigen Staaten, um deren wirtschaftliche, politische und soziale Zusammenarbeit zu verstärken. Seit 1. Mai 2007 hat sie die folgenden Mitglieder: Österreich, Belgien, Bulgarien, Dänemark, Finnland, Frankreich, Deutschland, Griechenland, Irland, Italien, Luxemburg, die Niederlande, Portugal, Spanien, Schweden, das Vereinigte Königreich von Großbritannien und Nordirland, Zypern, die Tschechische Republik, Estland, Ungarn, Lettland, Litauen, Malta, Polen, Rumänien, die Slowakei und Slowenien [1]. (Hinweis: Die Republik Zypern hat juristisch Souveränität über die ganze Insel, da die Türkische Republik Nordzypern international nicht anerkannt wird.)

  5. Effect of Die Strength and Work Piece Strength on the Wear of Hot Forging Dies

    NASA Astrophysics Data System (ADS)

    Levy, B. S.; Van Tyne, C. J.

    2015-01-01

    The effect of the strength ratio extracted from an Archard model for wear is used to describe the wear rates expected in hot forging dies. In the current study, the strength ratio is the strength of the hot forging die to the strength of the work piece. Three hot forging die steels are evaluated. The three die steels are FX, 2714, and WF. To determine the strength of the forging die, a continuous function has been developed that describes the yield strength of three die steels for temperatures from 600 to 700 °C and for times up to 20 h (i.e., tempering times of up to 20 h). The work piece material is assumed to be AISI 1045. Based on the analysis, the wear resistance of WF should be superior and FX should be slightly better than 2714. Decreasing the forging temperature increases the strength ratio, because the strength of the die surface increases faster than the flow strength of AISI 1045. The increase in the strength ratio indicates a decrease in the expected wear rate.

  6. Deformation properties of pharmaceutical excipients determined using an in-die and out-die method.

    PubMed

    Ilić, Ilija; Govedarica, Biljana; Šibanc, Rok; Dreu, Rok; Srčič, Stane

    2013-03-25

    This study investigated deformation mechanisms of some commonly used pharmaceutical fillers, such as microcrystalline cellulose, lactose, dicalcium phosphate, isomalt and cornstarch, using a combination of the in-die and out-die method with the Heckel and Walker models. The tableting mixtures contained of 98.5% (w/w) filler, the rest consisted of dry binder and an antiadhesive agent. Our results showed that plasticity and elasticity may be considered independent deformation properties as highly plastic materials (microcrystalline cellulose, cornstarch) also exhibited high elasticity. Particular emphasis was placed on explaining the differences observed between the in-die and out-die method-comparison revealed that the differences are a consequence of the material's elastic properties. Larger error of in-die results can be expected for more elastic materials, and thus in-die Heckel should be used with some considerations. In contrast, the Walker model was found to be more robust and smaller differences were observed between the two methods. We consider the most correct results to have been obtained by the out-die approach, which excludes the elastic properties of the material evaluated. An excellent correlation between elastic determination at the single-particle level and multiple-particle scale was demonstrated, suggesting a great potential of nanoscale determination of a material's mechanical properties for better elucidation of deformation mechanisms. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Investigation of Die Stress Profiles during Powder Compaction using Instrumented Die

    SciTech Connect

    Hong, Sung-tae; Hovanski, Yuri; Lavender, Curt A.; Weil, K. Scott

    2008-06-01

    The radial stress profile in a cylindrical die during compaction of titanium (Ti) powder was investigated by experiments. The concept of an instrumented die was extended to design an enhanced instrumented die. Custom-made strain gage pins were used to measure the radial stress during powder compaction. The test fixture was designed to simulate double-action pressing. The measured die stress profile for Ti powder was compared with that for a commercially available iron (Fe) powder. The stress history shows that an appreciable residual stress remains in the die in the radial direction after the axial compaction stress is removed from the powder. Furthermore, the radial stress profile in the die, while under maximum axial compaction stress, is more uniform across the height of the Fe compact than that of the Ti compact. In addition, the residual stress profile in the die in the radial direction reduces symmetrically in both directions beyond the height of the compact for both powders. Finally, the Ti powder shows a significantly higher frictional coefficient at the maximum axial compaction stress, and consequently a higher maximum axial ejection stress than the Fe powder.

  8. Wissenschaft, die unsere Kultur verändert. Tiefenschichten des Streits um die Evolutionstheorie

    NASA Astrophysics Data System (ADS)

    Patzelt, Werner J.

    Die Evolutionstheorie ist eine der erfolgreichsten wissenschaftlichen Theorien. Sie erlaubt es, unsere Herkunft zu verstehen und riskante Merkmale gerade der menschlichen Spezies zu begreifen. Zugleich ist die Evolutionstheorie eine der umstrittensten Theorien. Das liegt nicht an ihrer empirischen Tragfähigkeit, sondern an ihrem Gegenstand. Sie handelt nämlich nicht nur - wie Hunderte andere wissenschaftliche Theorien - von der "Welt da draußen“, sondern vor allem auch von uns selbst und von unserem Platz in dieser Welt. Den einen gilt sie obendrein als Überwinderin religiösen Aberglaubens, den anderen als neuer Zugang zu Gott und seinem Wirken in der Welt. Ferner sehen die einen in der Evolution eine unbezweifelbare Tatsache gleich der Schwerkraft oder dem Holocaust, die anderen aber eine - noch oder dauerhaft - unbewiesene Hypothese oder gar eine falsche Schöpfungslehre. Und während die meisten Streitfragen solcher Art nach wechselseitig akzeptierten Regeln ‚normaler Wissenschaft‘ geklärt werden, wird bei der Frage nach dem Woher unserer Spezies und Kultur die intellektuelle Zuständigkeit von Wissenschaft mitunter überhaupt bezweifelt. Anscheinend geht es schon um recht tiefe Schichten unserer Kultur und nicht nur der wissenschaftlichen, wenn - wie seit 150 Jahren - um die Evolutionstheorie gestritten wird. Wie sehen diese Schichten aus?

  9. Malignant mesothelioma in a cohort of asbestos insulation workers: clinical presentation, diagnosis, and causes of death.

    PubMed Central

    Ribak, J; Lilis, R; Suzuki, Y; Penner, L; Selikoff, I J

    1988-01-01

    Malignant mesothelioma has been rare in the general population. In recent decades its incidence has risen dramatically, parallel to the increasing use of asbestos in industry since 1930. Altogether 17,800 asbestos insulation workers, members of the International Association of Heat and Frost Insulators and Asbestos Workers (AFL-CIO-CLC) in the United States and Canada, were enrolled for prospective study on 1 January 1967 and followed up to the present. Every death that occurs is investigated by our laboratory. One hundred and seventy five deaths from mesothelioma occurred among the 2221 men who died in 1967-76 and 181 more such deaths in the next eight years. Altogether, 356 workers had died of malignant mesothelioma (pleural or peritoneal) by 1984. Diagnosis of mesothelioma was accepted only after all available clinical, radiological, and pathological material was reviewed by our laboratory and histopathological confirmation by the pathology unit made in each case. One hundred and thirty four workers died of pleural and 222 of peritoneal mesothelioma. Age at onset of exposure, age at onset of the disease, and age at death were similar in both groups of patients. Significant difference was noted only in the time elapsed from onset of exposure to the development of first symptoms, which was longer in the group with peritoneal mesothelioma. Shortness of breath, either new or recently increased, and chest pain were the most frequent presenting symptoms in the group with pleural mesothelioma; abdominal pain and distension were frequent in the patients with peritoneal mesothelioma. Pleural effusion or ascites were found in most patients. The most effective approach to the diagnosis of malignant pleural mesothelioma in these cases was by open lung biopsy; exploratory laparotomy was best for diagnosing peritoneal mesothelioma. Patients with pleural mesothelioma died principally from pulmonary insufficiency whereas those with peritoneal mesothelioma succumbed after a

  10. A Dying Star in a Different Light

    NASA Image and Video Library

    2010-11-17

    This image composite shows two views of a puffy, dying star, or planetary nebula, known as NGC 1514. At left is a view from a ground-based, visible-light telescope; the view on the right shows the object in infrared light from NASA WISE telescope.

  11. Mold Die Making. 439-322/324.

    ERIC Educational Resources Information Center

    Yunke, P.; And Others

    Each unit in this curriculum guide on mold die making contains an introduction, objectives, materials required, lessons, space for notes, figures, and diagrams. There are 10 units in this guide: (1) introduction to Electrical Discharge Machining (EDM); (2) EDM principles; (3) the single pulse; (4) EDM safety; (5) electrode material; (6) electrode…

  12. Expectation and Variation with a Virtual Die

    ERIC Educational Resources Information Center

    Watson, Jane; English, Lyn

    2015-01-01

    By the time students reach the middle years they have experienced many chance activities based on dice. Common among these are rolling one die to explore the relationship of frequency and theoretical probability, and rolling two dice and summing the outcomes to consider their probabilities. Although dice may be considered overused by some, the…

  13. The Hospice: Advocate for the Dying.

    ERIC Educational Resources Information Center

    Anspaugh, David J.

    1978-01-01

    The hospice philosophy seeks to meet the needs of dying patients and their families. These needs include: effective control of pain; to be loved and to alleviate loneliness; to retain dignity and maintain control of as many aspects of life as possible; and to help the family be supportive and adapt to their inevitable loss. (JMF)

  14. The Onion and "When Legends Die."

    ERIC Educational Resources Information Center

    Bell, Loren C.

    1984-01-01

    Describes the eight layers in Thomas Black Bull's ("When the Legends Die") journey to spiritual rebirth and stresses that students can easily identify these layers and can thereby achieve a clearer understanding of the relationship between structure and meaning in fiction. (CRH)

  15. Counseling Older Persons: Careers, Retirement, Dying.

    ERIC Educational Resources Information Center

    Sinick, Daniel

    The focus of this monograph is on three areas of counseling with older clients: career counseling, retirement counseling, and counseling regarding death and dying. The portion on career counseling includes reasons older persons change careers, obstacles they are likely to face when seeking employment, myths surrounding the employability of older…

  16. Ceramic for Silicon-Shaping Dies

    NASA Technical Reports Server (NTRS)

    Sekercioglu, I.; Wills, R. R.

    1982-01-01

    Silicon beryllium oxynitride (SiBON) is a promising candidate material for manufacture of shaping dies used in fabricating ribbons or sheets of silicon. It is extremely stable, resists thermal shock, and has excellent resistance to molten silicon. SiBON is a solid solution of beryllium silicate in beta-silicon nitride.

  17. Asymmetric Die Grows Purer Silicon Ribbon

    NASA Technical Reports Server (NTRS)

    Kalejs, J. P.; Chalmers, B.; Surek, T.

    1983-01-01

    Concentration of carbide impurities in silicon ribbon is reduced by growing crystalline ribbon with die one wall higher than other. Height difference controls shape of meniscus at liquid/crystal interface and concentrates silicon carbide impurity near one of broad faces. Opposite face is left with above-average purity. Significantly improves efficiency of solar cells made from ribbon.

  18. Care of the Dying: A Swedish Perspective

    ERIC Educational Resources Information Center

    Feigenberg, Loma; Fulton, Robert

    1977-01-01

    This article illustrates various aspects of terminal care, and shows that rules and norms for such care do not exist today. The authors advocate the formulation of an aim for humane treatment of dying patients, and its application in a manner appropriate to Swedish medical concepts and Swedish conditions. (Author)

  19. Continuing Education on Dying and Death.

    ERIC Educational Resources Information Center

    Chodil, Judith J.; Dulaney, Peggy E.

    1984-01-01

    "Dying and Death in Critical Care Practice" was a one-day continuing education offering designed for registered nurses who practiced in settings such as emergency rooms, intensive care units, coronary care units, and operating rooms. The workshop was part of a continuing education curriculum in critical care nursing. (SSH)

  20. Care of the Dying: A Swedish Perspective

    ERIC Educational Resources Information Center

    Feigenberg, Loma; Fulton, Robert

    1977-01-01

    This article illustrates various aspects of terminal care, and shows that rules and norms for such care do not exist today. The authors advocate the formulation of an aim for humane treatment of dying patients, and its application in a manner appropriate to Swedish medical concepts and Swedish conditions. (Author)

  1. Stamping Die Making. 439-318/320.

    ERIC Educational Resources Information Center

    Yunke, P.; And Others

    Each unit in this curriculum guide on stamping die making contains an introduction, objectives, materials required, lessons, space for notes, figures, and diagrams. There are 29 units in this guide, dealing with the following topics: EZ-MILL programming; EZ-MILL BATT; print of punch and EZ-MILL part programming; download to Computer Numerical…

  2. The Onion and "When Legends Die."

    ERIC Educational Resources Information Center

    Bell, Loren C.

    1984-01-01

    Describes the eight layers in Thomas Black Bull's ("When the Legends Die") journey to spiritual rebirth and stresses that students can easily identify these layers and can thereby achieve a clearer understanding of the relationship between structure and meaning in fiction. (CRH)

  3. Expectation and Variation with a Virtual Die

    ERIC Educational Resources Information Center

    Watson, Jane; English, Lyn

    2015-01-01

    By the time students reach the middle years they have experienced many chance activities based on dice. Common among these are rolling one die to explore the relationship of frequency and theoretical probability, and rolling two dice and summing the outcomes to consider their probabilities. Although dice may be considered overused by some, the…

  4. The Academic Study of Death and Dying.

    ERIC Educational Resources Information Center

    Amend, Edward W.

    The current study of death and dying is an example of constant change and development in academic disciplines. While the discussion of death in time of crisis is hard, if not impossible, youthful undergraduates find this topic to be of considerable interest. For them, a course can be organized effectively as a small and intimate seminar, which…

  5. Death and Dying in Young Adult Fiction.

    ERIC Educational Resources Information Center

    Harvey, Carolyn; Dowd, Frances S.

    1993-01-01

    Reports on a content analysis study of 25 novels about youth facing death and dying to determine whether death and grieving are realistically portrayed in young adult literature. Describes the evaluative instruments developed and discusses findings, concluding that young people can be informed and comforted by these realistic novels. (38…

  6. Teaching Humane Care for Dying Patients.

    ERIC Educational Resources Information Center

    Lev, Elise L.

    1986-01-01

    Describes an elective, upper-level course on caring for terminally ill patients, designed for baccalaureate nursing students. Discusses the hospice concept and its background, course design, communication with dying patients and their families, and outcomes of the course as measured by a pretest and two posttests. (CH)

  7. A profile of silicosis cases who died.

    PubMed

    Phoon, W H

    1982-01-01

    Silicosis cases which had been notified by doctors and confirmed after investigations were followed up by the Industrial Health Division. Up to August 1981, a total of 313 persons were confirmed as having the disease. Of these, 59 had died. The majority of these 59 persons had had their silica exposure in the granite quarries. 13 had been exposed to "rubber powder" which contained a high percentage of free silica. 52 of those who died were male, and their average age at death was 60.87 years. This did not appear to be significantly shorter than their life expectancy of 65.1 years. But the average age of death for the 7 women was 58.86 years, which was much shorter than their life expectancy of 70 years. Many of the men died from causes unrelated to silicosis. But 6 of the 7 women had progressive massive fibrosis (PMF) and they apparently died of the disease or complications arising from it.

  8. Constructing Death: Three Pathographies about Dying.

    ERIC Educational Resources Information Center

    Hawkins, Anne Hunsaker

    1991-01-01

    Discusses three pathographies as models for the "good death." In each, the author organizes the phenomena associated with the illness and death of a spouse from cancer into a coherent pattern. The result is three different paradigms of the experience of dying: "ritual death,""victorious death," and "one's own death." (Author/LLL)

  9. Die Baukastensystematik in der Fördertechnik

    NASA Astrophysics Data System (ADS)

    Sebulke, Johannes

    In der Fördertechnik wird kaum ein größerer Einsatzfall so dem anderen gleichen, dass man zwei Anlagen nach denselben Zeichnungen fertigen kann. Konstruktionszeiten, Rüst- und Umstellungszeiten der Fertigung sind hoch; der Kunde muss bei Einzelanfertigung lange Lieferzeiten in Kauf nehmen. In der Fördertechnik haben sich daher Baukastenprinzip, Standardisierung und die Konstruktion von Erzeugnisreihen weitgehend durchgesetzt.

  10. March of Asteroids Across Dying Star

    NASA Image and Video Library

    2013-12-12

    A dying star, called the Helix nebula, is shown surrounded by the tracks of asteroids in an image captured by NASA WISE. Skirting around the edges of the Helix nebula are the footprints of asteroids marching across the field of view.

  11. Stamping Die Making. 439-318/320.

    ERIC Educational Resources Information Center

    Yunke, P.; And Others

    Each unit in this curriculum guide on stamping die making contains an introduction, objectives, materials required, lessons, space for notes, figures, and diagrams. There are 29 units in this guide, dealing with the following topics: EZ-MILL programming; EZ-MILL BATT; print of punch and EZ-MILL part programming; download to Computer Numerical…

  12. The Academic Study of Death and Dying.

    ERIC Educational Resources Information Center

    Amend, Edward W.

    The current study of death and dying is an example of constant change and development in academic disciplines. While the discussion of death in time of crisis is hard, if not impossible, youthful undergraduates find this topic to be of considerable interest. For them, a course can be organized effectively as a small and intimate seminar, which…

  13. Asymmetric Die Grows Purer Silicon Ribbon

    NASA Technical Reports Server (NTRS)

    Kalejs, J. P.; Chalmers, B.; Surek, T.

    1983-01-01

    Concentration of carbide impurities in silicon ribbon is reduced by growing crystalline ribbon with die one wall higher than other. Height difference controls shape of meniscus at liquid/crystal interface and concentrates silicon carbide impurity near one of broad faces. Opposite face is left with above-average purity. Significantly improves efficiency of solar cells made from ribbon.

  14. Ceramic for Silicon-Shaping Dies

    NASA Technical Reports Server (NTRS)

    Sekercioglu, I.; Wills, R. R.

    1982-01-01

    Silicon beryllium oxynitride (SiBON) is a promising candidate material for manufacture of shaping dies used in fabricating ribbons or sheets of silicon. It is extremely stable, resists thermal shock, and has excellent resistance to molten silicon. SiBON is a solid solution of beryllium silicate in beta-silicon nitride.

  15. A moral dilemma: killing and letting die.

    PubMed

    Johnson, K

    Most health care professionals believe that there is a clear difference between killing and letting die, i.e. between active and passive euthanasia. Philosophers, however, have repeatedly attacked the moral validity of their argument. This article explores various related issues and theoretical approaches to the distinction between acts and omissions.

  16. A moral dilemma: killing and letting die.

    PubMed

    Johnson, Kath

    1993-06-24

    Most health care professionals believe that there is a clear difference between killing and letting die, i.e. between active and passive euthanasia. Philosophers, however, have repeatedly attacked the moral validity of their argument. This article explores various related issues and theoretical approaches to the distinction between acts and omissions.

  17. Mold Die Making. 439-322/324.

    ERIC Educational Resources Information Center

    Yunke, P.; And Others

    Each unit in this curriculum guide on mold die making contains an introduction, objectives, materials required, lessons, space for notes, figures, and diagrams. There are 10 units in this guide: (1) introduction to Electrical Discharge Machining (EDM); (2) EDM principles; (3) the single pulse; (4) EDM safety; (5) electrode material; (6) electrode…

  18. Porcelain shoulder adaptation using direct refractory dies.

    PubMed

    Schneider, D M; Levi, M S; Mori, D F

    1976-11-01

    Eleven direct refractory dies were made from separate polysulfide rubber impressions of two Dentoform teeth which had been prepared for porcelain-fused-to-gold veneer crowns with labial porcelain shoulders. Porcelain veneer crowns were built and fired directly on the dies, following the manufacturer's instructions and using a common laboratory technique. The finished crowns were seated on the Dentoform teeth, and the porcelain-tooth adaptation was measured with a micrometer eyepiece in a dissecting microscope. In general, the study indicated that by use of a direct refractory die, the porcelain adaptation of an average porcelain shoulder veneer crown could be made to fall within the tolerances of a clinically acceptable gold margin (39 mu).21 The crown could likewise be made to adapt closer than the normal thickness of cement film may allow (20 to 40 mu).22 However the adaptation of many crowns was more uneven than the above statements would tend to indicate. The study also showed that with great care and a limited number of firings, margins of a lesser thickness than a piece of 0.001 inch (25.4 mu) platinum foil could be attained. There appears to be promise in the use of a direct refractory die material. However, more studies are needed to overcome some of the problems in the technique described.

  19. Wie LCC-Management die Produktionstechnik und die Instandhaltung verändert

    NASA Astrophysics Data System (ADS)

    Zick, Manfred

    Die zunehmende Komplexität von Produktionsanlagen und deren steigende Investitionssummen erfordern eine intensive Nutzung und überschaubare Folgekosten, zum Beispiel in der Instandhaltung. Um diese Ziele beim Investitionsvorgang von Anlagen effizienter als in der Vergangenheit zu gestalten sind Organisationsverfahren wie Life Cycle Cost Management (LCC-Management) bzw. Total Cost of Ownership (TCO) sinnvoll. Dieser Beitrag zeigt, wie Hersteller und Betreiber bis heute mit diesen Verfahren die Auslegung und das Betriebsverhalten von Anlagen entwickeln, deren reduzierten Instandhaltungsaufwand prognostizieren und die Leistungen zum Vorteil beider Vertragspartner steigern.

  20. Dying other, dying self: creating culture and meaning in palliative healthcare.

    PubMed

    McCann, Christopher J; Adames, Hector Y

    2013-08-01

    Dying is an act of creativity, and we each die as cultural beings. Culture helps us create the meaning death requests of us. However, the dominant culture of the healthcare system views death as a failure of modern medicine, an event of unspeakable terror and taboo. Palliative clinicians must honor each dying person's cultural identity (as well as the person's family), not subject it to the dominant discourse of Western medicine. This article offers practical guidelines for palliative clinicians to do so, as well as a case vignette.

  1. [Malignant infantile osteopetrosis revealed by choanal atresia: A case report].

    PubMed

    Ba, I D; Ba, A; Thiongane, A; Ly/Ba, A; Ba, M; Fattah, M; Faye, P M; Cissé, D F; Diouf, F N

    2016-05-01

    Malignant infantile osteopetrosis is a rare genetic disease characterized by increased bone density due to osteoclastic dysfunction. We report on the case of a 3-month-old girl who was referred to our hospital by the ENT department for severe anemia in the context of bilateral choanal atresia. Clinical examination showed failure to thrive, anemia, respiratory distress, bilateral choanal atresia, and chest deformation. The abdomen was soft with large hepatosplenomegaly. We noted a lack of eye tracking, no optical-visual reflexes, and left nerve facial paralysis. The blood count showed normocytic normochromic anemia with severe thrombocytopenia. The infectious work-up and blood smears were negative. The skeleton X-ray showed diffuse bone densification of the skull, long bones, pelvis, vertebrae, and ribs. The facial bone CT confirmed membranous choanal atresia. The molecular biology search for the TCIRG1 gene mutation was not available. The patient had supportive treatment (transfusion, oral steroid, vitamin D, oxygen, nutrition). Bone marrow transplantation was indicated but not available. She died at 6 months in a context of severe anemia and bleeding. Malignant infantile osteopetrosis is rare and symptoms are nonspecific. Diagnosis should be considered in young infants presenting refractory anemia, particularly in the context of choanal atresia. Bone marrow transplantation remains the only curative treatment.

  2. [Malignant fibrous histiocytoma of the chest wall in a nonagenarian].

    PubMed

    Kodama, K; Igase, M; Kazatani, Y; Matsuzaki, K; Murakami, E; Kokubu, T

    1995-01-01

    We report a case of malignant fibrous histiocytoma of the chest wall observed in a 94-year-old woman. She noticed appetite loss and general edema a week before admission. The patient was diagnosed as having congestive heart failure due to valvular heart disease on the basis of echocardiographic findings and became symptom-free by treatment with vasodilators and diuretics. However, chest roentgenogram disclosed a extrapleural mass in the left mid-lateral chest. About 2 months after admission, she experienced left lateral chest pain for the first time. The chest CT scan revealed a 5 x 5 x 2 cm mass, adjacent to the lateral-posterior chest wall and projecting into the thoracic cavity and rib osteolysis. Gallium-67 citrate scintigram showed abnormal isotope accumulation in the left middle chest. Biopsy was not done. The therapeutic approach was mainly pain relief, and no tumor resection, chemotherapy, or radiotherapy was performed. The mass increased in size, and increasingly extended into the thoracic cavity on follow-up CT scans. Furthermore, marked invasion of the tumor to subcutis and subscapula was found. She died of cachexia and respiratory failure 34 weeks after admission. Histologic examination revealed malignant fibrous histiocytoma.

  3. MALIGNANT DEGENERATION IN BURN SCARS

    PubMed Central

    Castañares, Salvador

    1961-01-01

    The malignant potential of burn scars has been recognized since Marjolin's classical description of cancer arising in several types of post-traumatic scars. With improved burn therapy since the last war, there has been a higher survival rate of severe burns with proportionate increase in cancer associated with burn scars. This will create increasing problems of permanent disability and compensation. The younger the patient at the time of the burn, the longer the time required for the cancer to develop. Acute cancer development in burn scars has been reported after a four-week interval. Cancer may develop from six weeks to fifty years or more. The etiology of cancer in burn scars is not known. The most important clinical finding is the fact that most of the burn cancers occur in areas which were not grafted. The most common type of cancer encountered in burn scars is squamous cell carcinoma, which forms in Marjolin ulcers. Basal cell carcinoma may develop in the most superficial of burn scars. Treatment should be directed primarily to prompt and adequate skin grafting in all deep burns in order to prevent malignant degeneration of the burn scars. Once it has developed the treatment is the same as for other malignancies which are not associated with burns. Wide surgical excision with block dissection of the regional lymph nodes when they are involved is the treatment of choice. The prognosis of burn scar cancer is poor, once the process has extended because of early and distant metastasis. ImagesFigure 1.Figure 2.Figure 2.Figure 3.Figure 3.Figure 4. PMID:13691372

  4. Meningioma after radiotherapy for malignancy.

    PubMed

    Morgenstern, Peter F; Shah, Kalee; Dunkel, Ira J; Reiner, Anne S; Khakoo, Yasmin; Rosenblum, Marc K; Gutin, Philip

    2016-08-01

    Complications of radiation exposure have gained importance with increasing cancer survivorship. Secondary malignancies have been associated with cranial radiation exposure. We present our experience with intracranial radiation-induced meningioma (RIM) and discuss the implications of its presentation and natural history for patient management. Patients diagnosed with meningioma who had received radiation therapy between 1960 and 2014 were identified. Records were retrospectively reviewed for details of radiation exposure, previous malignancies, meningioma subtypes, multiplicity and pathologic descriptions, treatment and follow-up. Thirty patients were diagnosed with RIM. Initial malignancies included acute lymphocytic leukemia (33.3%), medulloblastoma (26.7%) and glioma (16.7%) at a mean age of 8.1years (range 0.04-33years). The mean radiation dose was 34Gy (range 16-60Gy) and latency time to meningioma was 26years (range 8-51years). Twenty-one patients (70%) underwent surgery. Of these, 57.1% of tumors were World Health Organization (WHO) grade I while 42.9% were WHO II (atypical). The mean MIB-1 labeling index for patients with WHO I tumors was 5.44%, with 33.3% exhibiting at least 5% staining. Mean follow-up after meningioma diagnosis was 5.8years. Mortality was zero during the follow-up period. Meningioma is an important long-term complication of therapeutic radiation. While more aggressive pathology occurs more frequently in RIM than in sporadic meningioma, it remains unclear whether this translates into an effect on survival. Further study should be aimed at delineating the risks and benefits of routine surveillance for the development of secondary neoplasms after radiation therapy.

  5. Malignant external otitis in Spain.

    PubMed

    Guerrero-Espejo, Antonio; Valenciano-Moreno, Inmaculada; Ramírez-Llorens, Rafael; Pérez-Monteagudo, Palmira

    Malignant external otitis is a necrotizing infection, which extends from the squamous epithelium of the ear canal to the adjacent tissue. The objective of the study was to investigate its incidence and other epidemiological data in Spain, reporting the largest case series to date. A descriptive, retrospective study of the Spanish population was carried out using the minimum basic data set (MBDS) based on data of patients admitted to hospitals in the 2008-2013 period. Patients whose diagnosis (principal or secondary) at discharge was encoded as 380.14 (malignant external otitis), according to ICD-9-CM, were included as cases. The Spanish incidence rate was calculated for all its communities and provinces, as well as by season and mortality. A total of 355 patients (302 as principal diagnosis and 53 as secondary) were diagnosed. The incidence rate was 1.30 (95% CI, 1.17 to 1.44) per 106 inhabitants and year, although there were variations among geographical areas. The median age of cases with main diagnosis was 74 years (range 10-95 years). The predominant age group was in patients over 84 years old (19.3 cases per 10(6) inhabitants and year). The incidence was higher in men and the male-female relative risk was 2.4. Diabetes was present in 74.6% of patients. The diagnosis was predominant in the last quarter of the year. The gross in-hospital mortality rate was 3.7%. Malignant external otitis is seen mostly among male elderly and diabetic patients. The incidence and mortality rate are low in Spain. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  6. Meningioma after radiotherapy for malignancy

    PubMed Central

    Morgenstern, Peter F.; Shah, Kalee; Dunkel, Ira J.; Reiner, Anne S.; Khakoo, Yasmin; Rosenblum, Marc K.; Gutin, Philip

    2017-01-01

    Complications of radiation exposure have gained importance with increasing cancer survivorship. Secondary malignancies have been associated with cranial radiation exposure. We present our experience with intracranial radiation-induced meningioma (RIM) and discuss the implications of its presentation and natural history for patient management. Patients diagnosed with meningioma who had received radiation therapy between 1960 and 2014 were identified. Records were retrospectively reviewed for details of radiation exposure, previous malignancies, meningioma subtypes, multiplicity and pathologic descriptions, treatment and follow-up. Thirty patients were diagnosed with RIM. Initial malignancies included acute lymphocytic leukemia (33.3%), medulloblastoma (26.7%) and glioma (16.7%) at a mean age of 8.1 years (range 0.04–33 years). The mean radiation dose was 34 Gy (range 16–60 Gy) and latency time to meningioma was 26 years (range 8–51 years). Twenty-one patients (70%) underwent surgery. Of these, 57.1% of tumors were World Health Organization (WHO) grade I while 42.9% were WHO II (atypical). The mean MIB-1 labeling index for patients with WHO I tumors was 5.44%, with 33.3% exhibiting at least 5% staining. Mean follow-up after meningioma diagnosis was 5.8 years. Mortality was zero during the follow-up period. Meningioma is an important long-term complication of therapeutic radiation. While more aggressive pathology occurs more frequently in RIM than in sporadic meningioma, it remains unclear whether this translates into an effect on survival. Further study should be aimed at delineating the risks and benefits of routine surveillance for the development of secondary neoplasms after radiation therapy. PMID:27068012

  7. Analysis of treatment of large abdominal malignancies in children complicated with abdominal compartment syndrome

    PubMed Central

    Le-Xiang, Zeng; Yao-Hao, Wu; Na, Li; Rong-Lin, Qiu; Jia-Jia, Zhou; Wen-Li, Jiang; Jie, Zhang; Xiao-Geng, Deng

    2017-01-01

    Abstract To explore effective treatment of large abdominal malignancies in children complicated with abdominal compartment syndrome (ACS). Six children with large abdominal malignancies complicated with ACS were admitted to our department from January 2013 to January 2016, and the changes in their breathing, heart rate, oxygen saturation, abdominal circumference, bladder pressure, and urine output, as well as the treatment measures and outcomes, were retrospectively analyzed. The 6 children included 1 child with bilateral nephroblastoma, 1 child with abdominal alveolar rhabdomyosarcoma, 1 child with right ovarian malignant teratoma complicated with abdominal glioma, 1 child with abdominal malignant teratoma, 1 child with right nephroblastoma, and 1 child with left adrenal gland neuroblastoma. All patients were treated in a timely manner. The first 4 children underwent abdominal cavity decompression through surgical resection of the tumor, and the ACS was successfully cured allowing for follow-up care, whereas the last 2 patients failed to receive emergency surgery and eventually died due to the gradual aggravation of ACS. Decompression through surgical resection of the tumor is the only effective measure for treating large abdominal malignancies in children complicated with ACS. PMID:28445278

  8. High incidence of activating TERT promoter mutations in meningiomas undergoing malignant progression.

    PubMed

    Goutagny, Stéphane; Nault, Jean C; Mallet, Maxime; Henin, Dominique; Rossi, Jessica Z; Kalamarides, Michel

    2014-03-01

    Meningiomas are common central nervous system tumors. The World Health Organization (WHO) defines three grades, predictive of the risk of recurrence. These tumors can relapse frequently and sometimes undergo malignant transformation. Maintenance of telomere length is a key process in malignant progression, and mutations in TERT promoter have recently been identified in various types of cancer. We sequenced the TERT promoter in 85 meningiomas from 73 patients. We found a high incidence of TERT promoter mutations in patients with meningiomas undergoing malignant histological progression (28%, n = 5/18 patients). In this subset of patients with histological progression, TERT promoter mutations were found in both the lowest and the highest grade tumors, and in both NF2-mutated and nonmutated samples. In contrast, one mutation was identified in 35 meningiomas without recurrence or progression, belonging to various histological grades. This sample was an aggressive meningioma in a patient who died shortly after surgery. Interestingly, tumors showing relapse without histological progression were not mutated for TERT promoter (n = 20). Finally, TERT promoter mutations were associated with a marked increase in TERT expression. Thus, TERT promoter mutations are pivotal genetic alterations involved in malignant progression of meningiomas and could be used as a biomarker to identify meningiomas at risk of malignant transformation. © 2013 International Society of Neuropathology.

  9. Surgical management of bone metastases from urological malignancies: an analysis of 70 cases.

    PubMed

    Toğral, Güray; Arıkan, Murat; Aktaş, Erdem; Öztürk, Recep; Güven, Oğuz; Eksioğlu, Fatih

    2015-01-01

    The purpose of this study was to evaluate symptomatic bone metastases from urological malignancies and the efficacy of surgical treatment of bone metastases in achieving local tumor control. This was a retrospective observational study of patients diagnosed with bone metastases from urological malignancies who died from their diseases between 2002 and 2013. Data on clinicopathology, number and sites of bone metastasis, time to first and subsequent metastasis, survival after metastasis, nature of metastasis (blastic, mixed, lytic), type of surgical reconstruction, systemic affections, and visceral organ metastasis for 70 bone metastases from deceased urological malignancies patients (55 male, 15 female) with evidence of bone metastasis were statistically analyzed. Forty-three patients (61.42%) had renal cell carcinoma (RCC), 15 patients (21.43%) had prostate cancer, and 12 patients (17.15%) had bladder carcinoma as primary diagnosis. Osteolytic lesions were most prevalent (n=61; 87%). The most common surgical modality for extremities was wide resection with prosthetic replacement (42 patients), followed by wide resection or wide resection with bone cement application with internal fixation (21 patients); 65 patients were treated with limb salvage procedures, and 2 patients were treated with amputation. Overall median survival was 13 months for RCC, 16 months for prostate carcinoma, and 11 months for bladder carcinoma patients. Detection of bone metastases in patients with urological malignancies influences the treatment strategy. Diagnosis of bone metastases may be delayed in urologic malignities; thus, these patients receive long-term clinical follow-up.

  10. Malignant tumors associated with ovarian mature teratoma: A single institution experience.

    PubMed

    Trabzonlu, Levent; Durmaz, Guray; Vural, Cigdem; Muezzinoglu, Bahar; Corakci, Aydin

    2017-05-01

    The aims of this study are to present demographical features of cases diagnosed with malignant tumor associated with ovarian mature teratoma and to analyze histopathological features and clinical follow up of these tumors. Single-institution retrospective charts were reviewed to identify all cases of ovarian mature teratoma diagnosed from 1998 to 2015. Clinicopathological parameters that were analyzed include age, tumor size, tumor stage, histological type, laterality, IOC diagnosis and whether or not patient has received adjuvant chemotherapy. A total of 218 ovarian mature teratoma cases were identified during the study period. Of the 218 ovarian mature teratoma specimens, eight (3.7%) exhibited malignant tumors. The average age for cases of malignancy associated with ovarian mature teratoma was 44.6 years. The average size of tumors was 10.36cm. On final pathology, histological types of tumors were as follows: two cases each of squamous cell carcinoma and papillary thyroid carcinoma; one case each of mucinous adenocarcinoma, metastatic adenocarcinoma, sebaceous carcinoma and oligodendroglioma. Only one patient with Stage IIB tumor died of disease. One patient was alive with metastatic disease two months after initial diagnosis. Mean and median follow-up times were 64.1 and 49 months, respectively. An ovarian mass that has characteristics of a teratoma in a postmenopausal patient should alert for malignancy -regardless of tumor size. IOC is a valuable tool for the detection of malignancy and should be requested to determine the modality of surgical approach. Copyright © 2017 Elsevier GmbH. All rights reserved.

  11. Second Malignancies Among Elderly Survivors of Cancer

    PubMed Central

    Hurria, Arti

    2011-01-01

    The U.S. population is aging, life expectancy is increasing, and cancer is a disease associated with aging. Advances in screening and therapeutics have led to a growing number of cancer survivors who are at risk for the development of secondary malignancies. Although the risks for the development of second malignancies following a first diagnosis of cancer are well described for survivors of childhood malignancies, there are fewer data for malignancies common in older adults. With the aging of the U.S. population, and with improving survival statistics in many adult malignancies, there is an increasing need to identify those second malignancies that might develop in the older adult survivor of cancer. In this paper, we describe the types and rates of second malignancies following cancers commonly seen in older adults and review the literature on these malignancies. Comparisons are made between older and younger adults with regard to the risks for developing treatment-related cancers with different modalities. Recommendations for early detection of second malignancies are summarized, though there remains an unmet need for evidence-based guidelines for screening for second malignancies in the older adult in particular. PMID:22042787

  12. Radiation therapy for intrahepatic malignancies.

    PubMed

    Quick, Allison M; Lo, Simon S; Mayr, Nina A; Kim, Edward Y

    2009-10-01

    Historically, radiation was not used in the management of hepatocellular carcinoma and liver metastasis because of the low tolerance of the liver to radiation. More recently, improvements in radiation delivery using advanced techniques, such as 3D conformal radiation therapy, intensity-modulated radiation therapy, image-guided radiation therapy, stereotactic body radiation therapy, proton-beam therapy and internal radiation therapy, have enabled partial and selective irradiation of the liver with promising response rates and toxicity profiles. This review will discuss the different techniques of radiation that can now be used to treat intrahepatic malignancies and the important clinical studies in the medical literature.

  13. TP53-Associated Pediatric Malignancies

    PubMed Central

    Pinto, Emilia M.; Ribeiro, Raul C.; Figueiredo, Bonald C.; Zambetti, Gerard P.

    2011-01-01

    Although the majority of pediatric malignancies express wild-type p53, it is well established that germline TP53 mutations or functional inactivation of this pathway by other means contribute to childhood cancer. Epidemiology studies have revealed the existence of diverse inherited mutant TP53 alleles that display different levels of tumor suppressor activity, which correlate with cancer risk in terms of penetrance, age of onset, and tumor types. In this monograph, the authors describe those childhood cancers associated with functional inactivation of TP53 focusing on adrenocortical carcinoma as a model for tissues that are highly sensitive to loss of p53 activity. PMID:21779516

  14. [Lymphadenopathy: demarcation to malignant lymphomas].

    PubMed

    Feller, A C

    2013-05-01

    Recognition of the differential diagnosis between lymphadenitis and malignant lymphoma requires good knowledge of the basic forms of the disease as well in depth knowledge of the structure of the individual compartments. There are defined forms of lymphadenitis where the differential diagnosis to certain lymphoma entities is known. Other reactive structural alterations show indistinct limits so that a decision is only possible after using additional techniques, such as immunohistochemistry and molecular analyses. Finally, there are marginal areas which can only be clarified by including clinical data.

  15. Second malignant neoplasms in childhood cancer survivors in a tertiary paediatric oncology centre in Hong Kong, China.

    PubMed

    Sun, Wai-Fun; Cheng, Frankie Wai-Tsoi; Lee, Vincent; Leung, Wing-Kwan; Shing, Ming-Kong; Yuen, Patrick Man-Pan; Li, Chi-Kong

    2011-11-01

    Childhood cancer survivors were at risk of development of second malignant neoplasms. The aim of this study is to evaluate the incidence, risk factors and outcome of second malignant neoplasms in childhood cancer survivors in a tertiary paediatric oncology centre in Hong Kong, China. We performed a retrospective review of patients with childhood cancer treated in Children's Cancer Centre in Prince of Wales Hospital, Hong Kong, China between May 1984 and June 2009. Case records of patients who developed second malignant neoplasms were reviewed. Totally 1374 new cases aged less than 21-year old were treated in our centre in this 25-year study period. Twelve cases developed second malignant neoplasms with 10-year and 20-year cumulative incidence of 1.3% (95% confidence interval 0.3% - 2.3%) and 2.9% (95% confidence interval 1.1% - 4.7%) respectively. Another 4 cases were referred to us from other centres for the management of second malignant neoplasms. In this cohort of 16 children with second malignant neoplasms, the most frequent second malignant neoplasms were acute leukemia or myelodysplastic syndrome (n = 6) and central nervous system tumor (n = 4). Median interval between diagnosis of primary and second malignant neoplasms was 7.4 years (range 2.1 - 13.3 years). Eight patients developed second solid tumor within the previous irradiated field. Radiotherapy significantly increased the risk of development of second solid tumor in patients with acute lymphoblastic leukemia (P = 0.027). Seven out of 16 patients who developed second malignant neoplasms had a family history of cancer among the first or second-degree relatives. Nine patients died of progression of second malignant neoplasms, mainly resulted from second central nervous system tumor and osteosarcoma. Cumulative incidence of second cancer in our centre was comparable to western countries. Radiotherapy was associated with second solid tumour among patients with acute lymphoblastic leukemia. Patients who

  16. Profiling cancer risk in oral potentially malignant disorders-A patient cohort study.

    PubMed

    Thomson, P J; Goodson, M L; Smith, D R

    2017-08-20

    Oral potentially malignant disorders harbour variable and unpredictable risk for squamous carcinoma development. Whilst current management strategies utilise histopathological diagnoses, dysplasia grading and targeted intervention for "high-risk" lesions, clinicians are unable to predict malignant potential. Detailed, retrospective clinico-pathological analysis of potentially malignant lesions undergoing malignant transformation, from a 590 patient cohort treated by interventional laser surgery and followed for a mean of 7.3 years, was undertaken. Clinical outcome was documented at study census date (31 December 2014). A total of 99 patients (16.8%) developed cancer: 71 (12%) seen "unexpectedly" upon excision and 28 (4.8%) progressing to malignancy at a median of 87.3 months post-surgery. Thirty "unexpected" excisions were micro-invasive (42.3%) arising primarily in severely dysplastic precursors (75%) at ventro-lateral tongue and floor of mouth sites (54.5%); 1 patient (1.4%) had a cancer-related death, whilst 58 (81.7%) were disease free. A total of 19 of 28 "progressive" cancers (67.9%) arose at new sites, with erythroleukoplakia a significant predictor of malignancy (P = .0019). Nine (32.1%) developed at the same precursor site, with 6 (77.7%) on the ventro-lateral tongue and floor of mouth. Three (10.7%) were micro-invasive, 9 patients (32.1%) died from metastatic disease and 12 (42.9%) were disease free (P < .001). Squamous carcinoma may arise at the site of a precursor lesion as transformation or new-site development via field cancerisation. Whilst interventional surgery facilitates early diagnosis and treatment of occult disease, thus reducing risk from same-site transformation, new-site cancer is a significant long-term risk for patients with potentially malignant disorder. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Malignant peritoneal mesothelioma: a review

    PubMed Central

    Bhagwandin, Shanel; Labow, Daniel M.

    2017-01-01

    Mesothelioma is a malignancy of serosal membranes. It is most commonly encountered in the visceral pleura with the second most common location in the peritoneum. The diagnosis is very rare and has been linked to toxic exposure to industrial pollutants, especially asbestos. Malignant peritoneal mesothelioma (MPM) commonly presents with diffuse, extensive spread throughout the abdomen with rare metastatic spread beyond the abdominal cavity. Due to its rarity and nonspecific symptoms, it is usually diagnosed late when the disease burden is extensive. Because pleural mesothelioma is more common than MPM, most research has been on the pleural variant and extrapolated for MPM. While treatment advances have been made for MPM, the disease is universally fatal from either abdominal complications secondary to the spread of disease or starvation. Untreated, the life expectancy is less than a year. Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) has become the mainstay of therapy with systemic therapies still being developed. We will review the epidemiology of MPM and discuss diagnostic and treatment strategies. PMID:28706904

  18. Nimotuzumab treatment of malignant gliomas.

    PubMed

    Bode, Udo; Massimino, Maura; Bach, Ferdinand; Zimmermann, Martina; Khuhlaeva, Elena; Westphal, Manfred; Fleischhack, Gudrun

    2012-12-01

    In spite of new alkylating medication and recently accumulated knowledge about genomics, the prognosis of malignant gliomas remains poor. The introduction of single substances interfering with tumour proliferation dynamics has been disappointing and the lessons learned indicate that a complicated network of proliferation needs time consuming, in-depth analysis in order to more specifically treat now distinguishable subgroups of a disease, which too long was thought of as a uniform entity. The clinical trials using the EGFR antibody nimotuzumab in the treatment of malignant gliomas are reviewed. Pending conformation in future studies the antibody might be part of the treatment of MGMT-negative, EGFR-amplified, not completely resected gliomas of adulthood and juvenile DIPG (pontine gliomas). Upcoming genomic results of the different tumour entities may suggest certain combination partners of the antibody. Recent studies of nimotuzumab indicate the reason for the lack of toxicity, which is the most attractive argument for its clinical use besides modest efficacy. We await the final results on the use of the antibody together with vinorelbine and radiation therapy for the therapy of DIPG. Adult patients with MGMT-negative, EGFR amplified, not totally resected GBM may also profit from this combination therapy. TK-inhibitors combined with the antibody and irradiation may be an option for a therapeutic trial in paediatric patients.

  19. Malignant hyperthermia, a Scandinavian update.

    PubMed

    Broman, M; Islander, G; Müller, C R

    2015-09-01

    Malignant Hyperthermia (MH) is a rare pharmacogenetic disorder, triggered by halogenated anesthetics and/or succinylcholine. In susceptible individuals, these drugs can activate an explosive life threatening clinical reaction. Leading symptoms are hypercarbia, muscle rigidity, and metabolic acidosis. MH is inherited in an autosomal-dominant manner and linked to mutations in the large ryanodine 1 gene (RYR1) gene in the majority of cases. Very few MH patients have been found to carry mutations in the CACNA1S gene. For this review a large litterature search was carried out and the Swedish MH database consisting of 436 probands who have undergone in vitro muscle contraction test (IVCT) during 1984-2014 was analyzed. Twelve different MH causative mutations have been found in Swedish patients so far. These mutations lead to a disturbed calcium balance in striated muscle tissue. A muscle biopsy for the IVCT or finding of an approved causative mutation are required for the diagnosis. A Malignant Hyperthermia susceptible (MHS) patient should be anesthetized with trigger-free anesthesia. There are a few reports of MH-like reactions in patients unrelated to anesthesia. The outcome is dependent on early recognizing of the reaction and fast disconnection of the trigger agents and administration of dantrolene. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Cytosine modifications in myeloid malignancies.

    PubMed

    Meldi, Kristen M; Figueroa, Maria E

    2015-08-01

    Aberrant DNA methylation is a hallmark of many cancers, including the myeloid malignancies acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). The discovery of TET-mediated demethylation of 5-methylcytosine (5mC) and technological advancements in next-generation sequencing have permitted the examination of other cytosine modifications, namely 5-hydroxymethylcytosine (5hmC), in these myeloid malignancies on a genome-wide scale. Due to the prominence of mutations in epigenetic modifiers that can influence cytosine modifications in these disorders, including IDH1/2, TET2, and DNMT3A, many recent studies have evaluated the relative levels, distribution, and functional consequences of cytosine modifications in leukemic cells. Furthermore, several therapies are being used to treat AML and MDS that target various proteins within the cytosine modification pathway in an effort to revert the abnormal epigenetic patterns that contribute to the diseases. In this review, we provide an overview of cytosine modifications and selected technologies currently used to distinguish and analyze these epigenetic marks in the genome. Then, we discuss the role of mutant enzymes, including DNMT3A, TET2, IDH1/2, and the transcription factor, WT1, in disrupting normal patterns of 5mC and 5hmC in AML and MDS. Finally, we describe several therapies, both standard, front-line treatments and new drugs in clinical trials, aimed at inhibiting the proteins that ultimately lead to aberrant cytosine modifications in these diseases. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Oncolytic Virotherapy for Hematological Malignancies

    PubMed Central

    Bais, Swarna; Bartee, Eric; Rahman, Masmudur M.; McFadden, Grant; Cogle, Christopher R.

    2012-01-01

    Hematological malignancies such as leukemias, lymphomas, multiple myeloma (MM), and the myelodysplastic syndromes (MDSs) primarily affect adults and are difficult to treat. For high-risk disease, hematopoietic stem cell transplant (HCT) can be used. However, in the setting of autologous HCT, relapse due to contamination of the autograft with cancer cells remains a major challenge. Ex vivo manipulations of the autograft to purge cancer cells using chemotherapies and toxins have been attempted. Because these past strategies lack specificity for malignant cells and often impair the normal hematopoietic stem and progenitor cells, prior efforts to ex vivo purge autografts have resulted in prolonged cytopenias and graft failure. The ideal ex vivo purging agent would selectively target the contaminating cancer cells while spare normal stem and progenitor cells and would be applied quickly without toxicities to the recipient. One agent which meets these criteria is oncolytic viruses. This paper details experimental progress with reovirus, myxoma virus, measles virus, vesicular stomatitis virus, coxsackievirus, and vaccinia virus as well as requirements for translation of these results to the clinic. PMID:22312362

  2. Malignant lymphoma with cardiac involvement.

    PubMed

    Terakura, Seitaro; Onji, Masaaki; Iriyama, Chisako; Goto, Tatsunori; Ushijima, Yoko; Shimada, Kazuyuki; Ishikawa, Yuichi; Nishida, Tetsuya; Hayakawa, Fumihiko; Murata, Makoto; Kiyoi, Hitoshi

    Malignant lymphoma with cardiac involvement is difficult to diagnose and treatment selection decisions can be challenging, because patients usually present with atypical disease involvement and the incidence is low. Herein, we describe the clinical characteristics and courses of three non-Hodgkin lymphoma patients showing cardiac involvement. All three patients were male, ages 32, 74 and 64 years. All three patients had presented with cardiac involvement mainly in the right heart system. We promptly performed needle biopsies for patients 1 and 3, and open-heart biopsy for patient 2, which showed PMBL for patient 1, DLBCL for patients 2 and 3. Since we were concerned regarding possible transient exacerbation of heart failure or the occurrence of fatal arrhythmia, we chose to start with relatively low dose chemotherapeutic interventions or pre-phase steroid therapy. After one course of chemotherapy or pre-phase steroid therapy, symptoms associated with heart failure almost completely subsided, and we further administered full-dose chemotherapy thereafter, resulting in complete responses in 2 cases. This case series demonstrates that malignant lymphoma with cardiac involvement is a treatable disease, despite widespread involvement. Furthermore, rapid and appropriate diagnostic imaging and biopsy are important when this disease is suspected.

  3. Serum cholesterol in cerebral malignancies.

    PubMed

    Grieb, P; Ryba, M S; Jagielski, J; Gackowski, W; Paczkowski, P; Chrapusta, S J

    1999-01-01

    Reduced blood cholesterol levels were reported in patients with a variety of malignant peripheral tumors. This fact is likely related to increased cholesterol demand by proliferating tumor cells. The question arises whether this 'tumor-associated hypocholesterolemia' occurs also in patients with brain tumors, and--if it does not--whether its absence can be related to the location of the tumors. We have compared fasting serum total cholesterol levels among three groups of patients: 52 patients with gliomas, 56 patients with symptomatic metastatic brain tumors, and 50 patients harboring malignant tumors of peripheral location but showing no clinical signs of brain metastases. Patients in the last group, despite being--on an average--more age-advanced, had lower total serum cholesterol levels than either the patients with gliomas, or the patients with brain metastases. No difference in the cholesterol levels was found between the two latter groups, and a majority of these patients had borderline or elevated cholesterol levels. This apparent absence of 'tumor-associated hypocholesterolemia' in brain tumor patients may be related to either brain tumors' ability to synthesize cholesterol de novo and their reduced dependence on peripheral cholesterol supply, the existence of brain tumor-blood barrier, effect of medications used to counteract brain edema and seizures, or a combination of these factors.

  4. Imaging probe for tumor malignancy

    NASA Astrophysics Data System (ADS)

    Tanaka, Shotaro; Kizaka-Kondoh, Shinae; Hiraoka, Hasahiro

    2009-02-01

    Solid tumors possess unique microenvironments that are exposed to chronic hypoxic conditions ("tumor hypoxia"). Although more than half a century has passed since it was suggested that tumor hypoxia correlated with poor treatment outcomes and contributed to cancer recurrence, a fundamental solution to this problem has yet to be found. Hypoxia-inducible factor (HIF-1) is the main transcription factor that regulates the cellular response to hypoxia. It induces various genes whose functions are strongly associated with malignant alteration of the entire tumor. The cellular changes induced by HIF-1 are extremely important targets of cancer therapy, particularly in therapy against refractory cancers. Imaging of the HIF-1-active microenvironment is therefore important for cancer therapy. To image HIF-1activity in vivo, we developed a PTD-ODD fusion protein, POHA, which was uniquely labeled with near-infrared fluorescent dye at the C-terminal. POHA has two functional domains: protein transduction domain (PTD) and VHL-mediated protein destruction motif in oxygen-dependent degradation (ODD) domain of the alpha subunit of HIF-1 (HIF-1α). It can therefore be delivered to the entire body and remain stabilized in the HIF-1-active cells. When it was intravenously injected into tumor-bearing mice, a tumor-specific fluorescence signal was detected in the tumor 6 h after the injection. These results suggest that POHA can be used an imaging probe for tumor malignancy.

  5. Malignant melanoma of the skin

    PubMed Central

    Armstrong, B. K.; Holman, C. D. J.

    1987-01-01

    Ultra-violet radiation (UVR) in sunlight is thought to be the main cause of malignant melanoma in lightly-pigmented populations. Individuals with fair skin, fair hair, blue eyes and/or a tendency to burn rather than tan when exposed to the sun are at particularly high risk of melanoma and should be given special attention in primary prevention programmes. Intermittent exposure to the sun, as in recreational exposure, may be a more potent cause of melanoma than more continuous exposure. Primary prevention offers the best prospects for a substantial reduction in mortality from malignant melanoma. However, there is little evidence available to judge the effectiveness of primary prevention of melanoma through reduction of exposure to the sun. Education for reducing exposure to the sun is common in high-risk populations but has never been evaluated adequately. Mortality from melanoma could also possibly be reduced by earlier diagnosis through education or screening of high-risk groups. Regular screening of patients with the familial dysplastic naevus syndrome should reduce their mortality from melanoma. PMID:3301043

  6. [Diabetes in patients with malignant tumors].

    PubMed

    Lengyel, Zoltán; Boér, Katalin; Halászlaki, Csaba; Németh, Zsuzsanna

    2013-09-01

    Disturbances of the carbohydrate metabolism are fairly common is patients with malignancy. On the other hand, diabetes appears to have an effect on the development and progression of various tumors. Malignant diseases and the therapies used in their treatment often have an impact on carbohydrate metabolism, while diabetes may hinder specific oncotherapy or influence oncological therapeutic decisions. Several complications of malignant diseases and some of the medications used in their treatment, such as steroids or parenteral nutrition, may raise blood glucose levels. The various obstacles of oral nutrition frequently seen in patients with malignancy can lead to hypoglycaemia in patients with diabetes. Our article endeavours to review the pathophysiological and clinical connection between diabetes and malignant diseases and the use of insulin, oral antidiabetic drugs and diet in patients with malignant disease.

  7. [Anguish about death and fear of dying, supportive care for the dying].

    PubMed

    Bouregba, A; Lebret, T

    2008-11-01

    During metastatic patient follow up, anguish about death is different from the fear of dying. In fact anguish is unconscious and associated with anxiety, on the other hand the fear of dying is a reaction to the threat of imminent death. Physical pain and isolation are factors that increase the pangs of death. The support of friends and family constitutes a real benefit for the treatment of patients during this period.

  8. Cerebellar degeneration following neuroleptic malignant syndrome.

    PubMed Central

    Lal, V.; Sardana, V.; Thussu, A.; Sawhney, I. M.; Prabhakar, S.

    1997-01-01

    A 55-year-old woman with a history of bipolar affective disorder developed hyperpyrexia, rigidity and depressed consciousness (neuroleptic malignant syndrome) after commencing neuroleptic therapy. On regaining consciousness, she was mute and had signs suggesting pancerebellar involvement. Hyperpyrexia, which is a cardinal feature of neuroleptic malignant syndrome, may have caused cerebellar damage. Neuroleptic malignant syndrome needs both early recognition and prompt treatment to obviate devastating complications. PMID:9519191

  9. Malignant causes of fever of unknown origin.

    PubMed

    Foggo, Vanessa; Cavenagh, Jamie

    2015-06-01

    The presence of fever in malignancy usually indicates infection, though transfusion, thrombosis and drugs are also culprits. However, particularly in some tumour types, fever can also be a paraneoplastic syndrome, caused by the malignancy itself. This can be a difficult diagnosis to establish and presents a therapeutic challenge to the physician when the underlying malignancy is not easily treated. © Royal College of Physicians 2015. All rights reserved.

  10. Atypical presentations of malignant otitis externa.

    PubMed

    Vourexakis, Z; Kos, M-I; Guyot, J-P

    2010-11-01

    Malignant otitis externa is a life-threatening infection of the skull base. Its presentation is not always typical. We report three cases of malignant otitis externa which illustrate the diversity of its clinical manifestations and the difficulties in its diagnosis. The perception of malignant otitis externa as an infection caused by Pseudomonas aeruginosa in diabetic patients is not always correct. The adoption of diagnostic criteria could be helpful in identifying atypical cases.

  11. Primary retroperitoneal malignant melanoma: A case report

    PubMed Central

    LIU, GUO-BING; WU, GUANG-YAO; GHIMIRE, PRASANNA; ZHANG, ZAI-PENG

    2011-01-01

    Primary malignant melanoma occurring at an extra cutaneous site is rare. A case of primary malignant melanoma located in the retroperitoneum of an 18-year-old female is presented in this study. Histopathological examination of the tissue biopsies at laparotomy with immunohistochemical stains confirmed a diagnosis of malignant melanoma. Further extensive clinical and radiological investigations proved the retroperitoneum to be the primary site. PMID:22848275

  12. B-Cell Hematologic Malignancy Vaccination Registry

    ClinicalTrials.gov

    2016-12-28

    Monoclonal Gammopathy of Undetermined Significance; Multiple Myeloma; Waldenstrom Macroglobulinemia; Lymphocytosis; Lymphoma, Non-Hodgkin; B-Cell Chronic Lymphocytic Leukemia; Hematological Malignancies

  13. Architecture for on-die interconnect

    SciTech Connect

    Khare, Surhud; More, Ankit; Somasekhar, Dinesh; Dunning, David S.

    2016-03-15

    In an embodiment, an apparatus includes: a plurality of islands configured on a semiconductor die, each of the plurality of islands having a plurality of cores; and a plurality of network switches configured on the semiconductor die and each associated with one of the plurality of islands, where each network switch includes a plurality of output ports, a first set of the output ports are each to couple to the associated network switch of an island via a point-to-point interconnect and a second set of the output ports are each to couple to the associated network switches of a plurality of islands via a point-to-multipoint interconnect. Other embodiments are described and claimed.

  14. Spiritual aspects of death and dying.

    PubMed Central

    Mermann, A. C.

    1992-01-01

    Dying is an event beyond our comprehension, an experience that can only be imagined. Patients with cancer have a gift denied many others: some time to prepare for the approaching end of life. This time can be used to bring old conflicts to a close, to say goodbye and seek forgiveness from others, to express love and gratitude for the gifts of a life. Physicians can help patients by being aware of the spiritual dimensions to life that many patients have. In major religious traditions, death is accepted as the natural end of the gift of life and as a point of transition to another, yet unknown, existence. For many patients, it is not death that is feared, but abandonment. The physician's awareness of the spiritual needs of patients can make care of the dying more rewarding and fulfilling for all concerned. PMID:1519377

  15. Clayton's compromises and the assisted dying debate.

    PubMed

    Parker, Malcolm

    2015-03-01

    Richard Huxtable has recently argued that while assisted dying has been both repeatedly condemned and commended, a compromise resolution is possible. Following critique of other purported solutions, he argues for a new legal offence of "compassionate killing" as a plausible compromise between supporters and opponents of legalised assisted dying, because it offers something of significance to both sides. However, it turns out that "compassionate killing" would leave both sides with insufficient net benefit for the proposal to qualify as a compromise between them. By analogy with another apparently intractable bioethical debate, concerning destructive embryo research, this column rejects Huxtable's solution as another "Clayton's compromise". True compromise is not possible in bioethical debates involving divisions over deeply held values and world views. Resolving such debates inevitably involves the substitution of one dominant world view with another.

  16. Natural law and the "right to die".

    PubMed

    Whiting, R A

    Over the last two decades social concerns with the "right to die" have grown beyond the ability of our governmental and judicial institutions to consistently deal with them. One reason for this difficulty has been the unavailability of any legal or judicial standard that is consistent with American conceptions of liberty, morality, and justice. This article attempts to examine the theory of natural law to determine whether it may provide a consistent standard for resolving these difficult questions. As natural law theories are traced through history, they lead directly to the United States where a uniquely American interpretation became one of the foundational principles for our constitution. By applying these theories to the contemporary question of the "right to die," natural law can again provide the foundational principles needed to develop standards for dealing with such questions that are consistent with our historical, philosophical, and political traditions.

  17. [Assisted dying and conflict of interest].

    PubMed

    Hug, G

    1997-01-18

    A Swiss physician obtained his elderly patient's house, valued at $2 million, as a gift. The patient retained the right to stay in the house until her death. The physician also knew that she had made him the beneficiary of her estate, valued at + 10 million. She then died of untreated pneumonia while in his care. He had not discussed withholding of antibiotics with her or her family. In countries with advanced life-sustaining technology, 35% of all deaths are thought to occur after withholding of treatment. Physicians and others making such "MDEL" (medical decisions concerning the end of life) have a conflict of interest, if they benefit from their patients' death. These conflicts are unethical. They are dangerous to patients, physicians, the medical profession, and the public. The Netherlands have laws and rules of professional conduct that prohibit MDEL-for-profit, i.e., a mode of assisted dying that benefits caregivers to the detriment of patients and their families.

  18. [Sudden die-off of honeybee colonies].

    PubMed

    Muz, Mustafa N

    2008-01-01

    Apis mellifera is used for honeybee keeping all over Turkey. Recently, honeybees have been suddenly disappearing for no apparent reason. It is presumed that some viral and parasitic honeybee pathogens are responsible for this. No medical research has been conducted to determine the pathologic causes of the sudden die-off of the honeybee colonies in Turkey as yet. This is of urgent importance for future of the honeybee industry.

  19. Died of wounds: a mortality review.

    PubMed

    Keene, Damian Douglas; Penn-Barwell, J G; Wood, P R; Hunt, N; Delaney, R; Clasper, J; Russell, R J; Mahoney, P F

    2016-10-01

    Combat casualty care is a complex system involving multiple clinicians, medical interventions and casualty transfers. Improving the performance of this system requires examination of potential weaknesses. This study reviewed the cause and timing of death of casualties deemed to have died from their injuries after arriving at a medical treatment facility during the recent conflicts in Iraq and Afghanistan, in order to identify potential areas for improving outcomes. This was a retrospective review of all casualties who reached medical treatment facilities alive, but subsequently died from injuries sustained during combat operations in Afghanistan and Iraq. It included all deaths from start to completion of combat operations. The UK military joint theatre trauma registry was used to identify cases, and further data were collected from clinical notes, postmortem records and coroner's reports. There were 71 combat-related fatalities who survived to a medical treatment facility; 17 (24%) in Iraq and 54 (76%) in Afghanistan. Thirty eight (54%) died within the first 24 h. Thirty-three (47%) casualties died from isolated head injuries, a further 13 (18%) had unsurvivable head injuries but not in isolation. Haemorrhage following severe lower limb trauma, often in conjunction with abdominal and pelvic injuries, was the cause of a further 15 (21%) deaths. Severe head injury was the most common cause of death. Irrespective of available medical treatment, none of this group had salvageable injuries. Future emphasis should be placed in preventative strategies to protect the head against battlefield trauma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Public attitudes toward the right to die.

    PubMed Central

    Genuis, S J; Genuis, S K; Chang, W C

    1994-01-01

    OBJECTIVE: To determine public attitudes toward the right to die, euthanasia and related end-of-life decisions. DESIGN: Mail survey based on telephone numbers randomly selected by computer. SETTING: Edmonton. PARTICIPANTS: Of 1347 computer-generated, randomly selected telephone numbers called between February and June 1992, 902 individuals were reached, and 500 eligible contacts (55%) agreed to fill out the mailed questionnaire based on 12 vignettes involving end-of-life decisions. A total of 356 usable questionnaires (71%) were subsequently returned. MAIN OUTCOME MEASURES: Attitudes toward end-of-life decisions including withdrawal of life support, euthanasia, chronic suffering and the right to die, living wills and family involvement in decision making for incompetent individuals. Comments and demographic data were also solicited. RESULTS: Of the respondents 84% supported a family's right to withdraw life support from a patient in a persistent coma, and 90% supported a mentally competent patient's right to request that life support be withdrawn. Active euthanasia was supported by 65% for only patients experiencing severe pain and terminal illness. There was marked opposition to euthanasia for patients in other circumstances, such as an elderly disabled person who feels he or she is a burden on relatives (opposed by 65%), a patient with chronic depression resistant to treatment (by 75%) or an elderly person no longer satisfied with life and who has various minor physical ailments (by 83%). In all, 63% of the respondents felt that legalization of euthanasia for terminal illnesses would lead to euthanasia for many other, unsupported reasons, and 34% supported legislation to prohibit euthanasia in all situations. CONCLUSIONS: Public support for the right to die varies depending on the circumstances of the patient. The single most significant factor determining attitudes was the level of religious activity. The family's wishes were an important factor in end

  1. Diagnosing dying: an integrative literature review

    PubMed Central

    Kennedy, Catriona; Brooks-Young, Patricia; Brunton Gray, Carol; Larkin, Phil; Connolly, Michael; Wilde-Larsson, Bodil; Larsson, Maria; Smith, Tracy; Chater, Susie

    2014-01-01

    Background To ensure patients and families receive appropriate end-of-life care pathways and guidelines aim to inform clinical decision making. Ensuring appropriate outcomes through the use of these decision aids is dependent on timely use. Diagnosing dying is a complex clinical decision, and most of the available practice checklists relate to cancer. There is a need to review evidence to establish diagnostic indicators that death is imminent on the basis of need rather than a cancer diagnosis. Aim To examine the evidence as to how patients are judged by clinicians as being in the final hours or days of life. Design Integrative literature review. Data sources Five electronic databases (2001–2011): Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL. The search yielded a total of 576 hits, 331 titles and abstracts were screened, 42 papers were retrieved and reviewed and 23 articles were included. Results Analysis reveals an overarching theme of uncertainty in diagnosing dying and two subthemes: (1) ‘characteristics of dying’ involve dying trajectories that incorporate physical, social, spiritual and psychological decline towards death; (2) ‘treatment orientation’ where decision making related to diagnosing dying may remain focused towards biomedical interventions rather than systematic planning for end-of-life care. Conclusions The findings of this review support the explicit recognition of ‘uncertainty in diagnosing dying’ and the need to work with and within this concept. Clinical decision making needs to allow for recovery where that potential exists, but equally there is the need to avoid futile interventions. PMID:24780536

  2. The hospice: Humane care for the dying.

    PubMed

    Franco, V W

    1983-09-01

    The hospice movement arose as a reaction to the dehumanizing atmosphere of acute-care hospitals, where excessive utilization of life support equipment deprived dying patients of a meaningful vision of their destiny. Respecting the spiritual quest of the terminally ill for wholeness and dignity, the hospice concept prescribes the rendering of compassionate and pastoral care by a benevolent community of family, health care staff, friends, and clergy. Approximately 800 hospice programs are currently evolving in the United States. St. Mary's (formerly "Hillhaven") Hospice in Tucson, Arizona, offers the most comprehensive program of services, including home care, inpatient care, and artistic media through which the dying express their creativity. Numerous demonstration projects funded by several government agencies, principally the Health Care Financing Administration (HCFA), are expected to result in the legislative actions eliminating barriers to reimbursement of the cost of hospice services by Medicare, Medicaid, and other third-party payers. Existential analysis reveals the value of religion and spiritual support in enabling the dying to banish anxiety and muster the hope requisite for fully appreciating the authentic meaning of their destiny.

  3. The hospice: Humane care for the dying.

    PubMed

    Franco, V W

    1985-03-01

    The hospice movement arose as a reaction to the dehumanizing atmosphere of acute-care hospitals, where excessive utilization of life support equipment deprived dying patients of a meaningful vision of their destiny. Respecting the spiritual quest of the terminally ill for wholeness and dignity, the hospice concept prescribes the rendering of compassionate and pastoral care by a benevolent community of family, health care staff, friends, and clergy. Approximately 800 hospice programs are currently evolving in the United States. St. Mary's (formerly "Hillhaven") Hospice in Tucson, Arizona, offers the most comprehensive program of services, including home care, inpatient care, and artistic media through which the dying express their creativity. Numerous demonstration projects funded by several government agencies, principally the Health Care Financing Administration (HCFA), are expected to result in legislative actions eliminating barriers to reimbursement of the cost of hospice services by Medicare, Medicaid, and other third-party payers. Existential analysis reveals the value of religion and spiritual support in enabling the dying to banish anxiety and muster the hope requisite for fully appreciating the authentic meaning of their destiny.

  4. Parents dying of cancer and their children.

    PubMed

    Beale, Estela A; Sivesind, Debra; Bruera, Eduardo

    2004-12-01

    We reviewed our experience with 28 consecutive children referred for assessment and intervention. These were the children of patients with terminal cancer referred to the Palliative Care and Symptom Control Service. In all cases the dying parent was a biological parent. Eleven parameters were assessed in each of 29 children and their incidence was calculated. The children and their parents were seen in a semistructured interview, together as well as separately. The parameters were: seeking reassurance (82), becoming a caretaker (79), inability to separate from parent (79), anger about feeling abandoned (68), despair (57), guilt (54), discipline problems, aggressive behavior (46), denial (39), blame of others (21), and fear for the child's own health (18). Our results suggest that children with dying parents manifest significant distress as well as a greater understanding of their parent's illness than is usually suspected. Timely intervention by a child psychiatrist or other mental health professional with proven competence in working with children can help children to better cope with the death and dying of their parent and ameliorate the process of bereavement following the parent's death. Because of our small sample, we cannot generalize about all of the findings. Further research is required to characterize the level of distress in the children and the long-term impact in their overall adjustment to life.

  5. Caring Science Conscious Dying: An Emerging Metaparadigm.

    PubMed

    Rosa, William; Estes, Tarron; Watson, Jean

    2017-01-01

    Caring science is an extant theory of human relationship, guiding the profession of nursing with the understanding and application of a moral-ethical praxis that promotes, protects, and provides human dignity throughout the life continuum. Over the past 30 or more years, caring science has transformed nursing by calling for a heightened ethical perspective of human dignity in how nurses practice, educate, research, and evolve the profession. Conscious dying is a framework rooted in a human caring ontology, which strives to deepen the nurse healer's awareness in tending to a patient's dying and death, returning death to its sacred place in the cycle of life. Reflective inventories are self-reflection tools that have been used to encourage nurses' personal growth and development and may be utilized in individual or group settings. The purpose herein is to introduce an emerging metaparadigm that links self to system, interweaving and integrating the teachings of caring science and conscious dying through the use of reflective inventories for both the individual nurse and collective of nursing.

  6. Killing, letting die, and withdrawing aid.

    PubMed

    McMahan, Jeff

    1993-01-01

    One of the aims of this article is to contribute to the identification of the empirical criteria governing the use of the concepts of killing and letting die. I will not attempt a comprehensive analysis of the concepts but will limit the inquiry to certain problematic cases -- namely, cases involving the removal or withdrawal of life-supporting aid or protection. The analysis of these cases will, however, shed light on the criteria for distinguishing killing and letting die in other cases as well. My overall aims in the article are partly constructive and partly skeptical. I hope to advance our understanding of the nature of the distinction between killing and letting die. This, I believe, will enable us to defend the moral relevance of the distinction against certain objections -- in particular, objections that claim that the distinction fails to coincide with commonsense moral intuitions. Yet I will suggest that, as we get clearer about the nature of the distinction and the sources of its intuitive appeal, it may seem that the intuitions it supports are not so well grounded as one could wish.

  7. Diffuse Malignant Mesothelioma: A Review

    PubMed Central

    Rom, William N.; Lockey, James E.

    1982-01-01

    Diffuse malignant mesothelioma is a signal tumor of asbestos exposure. Mesothelioma incidence has been steadily rising during the past two decades, reflecting the increases in asbestos use during and following World War II. The onset of the disease follows exposure by 25 to 40 years. The dose-response relationship appears to be much lower than that for asbestosis or lung cancer—it is not known whether current levels of exposure will entail a risk for disease 30 years hence. There is no synergistic or additive interaction with smoking for this tumor. Current knowledge indicates that pleural plaques, per se, do not increase the risk for this tumor beyond that of the previous asbestos exposure alone. Durable fibers with high aspect ratios, especially amphiboles, are associated with experimental tumor induction. Treatment modalities including surgical procedures and chemotherapy with doxorubicin and 5-azacytidine offer prospects for palliation. ImagesFigure 1.Figure 2. PMID:6761970

  8. Secondary malignancies following cancer chemotherapy.

    PubMed

    Boffetta, P; Kaldor, J M

    1994-01-01

    Many agents used in cancer chemotherapy are known carcinogens. However, few secondary malignancies have been definitely linked to chemotherapy, since studies on this problem are complicated by methodological problems. A causal relationship has been established between alkylating agents and leukaemia and between cyclophosphamide and bladder cancer. The risk of leukaemia peaks at 5-10 years after beginning of chemotherapy and declines steadily after its end. The interaction between chemotherapy and radiotherapy has not been fully clarified, nor has the leukaemogenic potency of individual drugs, although combinations without nitrogen mustard seem to entail a lower risk. Other tumours reported at increased incidence, in particular among Hodgkin's disease patients, for whom a carcinogenic effect of chemotherapy seems plausible, are non-Hodgkin's lymphoma and lung cancer. Other secondary solid tumors have also been reported, but for none of them an independent effect of chemotherapy has been demonstrated.

  9. Molecular Profiling of Endometrial Malignancies

    PubMed Central

    Samarnthai, Norasate; Hall, Kevin; Yeh, I-Tien

    2010-01-01

    Molecular profiling of endometrial neoplasms reveals genetic changes in endometrial carcinomas that support the dualistic model, in which type I carcinomas are estrogen-dependent, low grade lesions and type II carcinomas are nonestrogen dependent and high grade. The molecular changes in type I endometrial carcinomas include mutations in PTEN, PIK3CA, KRAS, and β-catenin, along with microsatellite instability, whereas type II endometrial carcinomas are characterized by genetic alterations in p53, HER2/neu, p16, and E-cadherin. For endometrial neoplasms with a malignant mesenchymal component, C-MYC mutations and loss of heterozygosity are frequently seen in carcinosarcomas, and a fusion gene, JAZF1/JJAZ1, is distinctive for endometrial stromal sarcoma. In addition, p53 mutations may play an important role in tumorigenesis of undifferentiated endometrial sarcoma. These molecular changes can help in the diagnosis of endometrial neoplasms, as well as form the basis of molecular targeted therapy. PMID:20368795

  10. Isolated urachal malakoplakia mimicking malignancy

    PubMed Central

    Pakalapati, Saisriharsha; Parachuri, Sanjay; Kakarla, Venkateshwara Rao; Byrappa, Mahesh Babu

    2017-01-01

    Malakoplakia is an unusual inflammatory disease with uncertain pathogenesis affecting any organ in the body, but predominantly genitourinary tract, with specific predilection to the bladder. We report a rare case of isolated malakoplakia of the urachus in a 29-year-old male patient who presented with lower urinary tract symptoms without any hematuria. Investigations revealed sterile pyuria with no bacterial growth in urine. Radiological investigations revealed a mass in the urachal region. The patient underwent cystoscopy with biopsy followed by pelvic lymph node dissection and partial cystectomy with excision of the urachal mass. Histopathological examination of the mass revealed malakoplakia. Postoperative course was uneventful. To the best of our knowledge, this is the first ever case report of isolated urachal malakoplakia without any concomitant malignancy or bladder involvement reported in our country and one of the very few reported worldwide. PMID:28216941

  11. Malignant Mesothelioma: Time to Translate?

    PubMed Central

    Napolitano, Andrea; Carbone, Michele

    2016-01-01

    Malignant mesothelioma is an aggressive cancer largely associated with asbestos exposure. In this review, we will discuss the significant advancements in our understanding of its genetics and molecular biology and their translational relevance. Remarkable findings included the discovery of germline and somatic mutations of BRCA1 associated protein-1 (BAP1) in patients, and the genome-wide characterization of pathways altered in mesothelioma that could be potentially exploited to design novel therapeutic approaches. Nevertheless, the clinical translation of these molecular findings has been slow and insufficient. In order to rapidly move translation from the bench to the bedside, we believe that cooperative research efforts have to be further endorsed and promoted at all levels. PMID:28603777

  12. Malignant Mesothelioma: Development to Therapy

    PubMed Central

    Thompson, Joyce; Westbom, Catherine; Shukla, Arti

    2013-01-01

    Malignant mesothelioma (MM) is an aggressive cancer of the mesothelium caused by asbestos. Asbestos use has been reduced but not completely stopped. In addition, natural or man-made disasters will continue to dislodge asbestos from old buildings into the atmosphere and as long as respirable asbestos is available, MM will continue to be a threat. Due to the long latency period of MM development, it would still take decades to eradicate this disease if asbestos was completely removed from our lives today. Therefore, there is a need for researchers and clinicians to work together to understand this deadly disease and find a solution for early diagnosis and treatment. This article focuses on developmental mechanisms as well as current therapies available for MM. PMID:23959774

  13. Management of malignant pleural effusion.

    PubMed

    Chen, Hongbin; Brahmer, Julie

    2008-07-01

    Malignant pleural effusion (MPE) often presents in patients with cancer at an advanced stage and thus carries a poor prognosis. This review updates the current knowledge on the management of MPE, focusing on recent literature about the efficacy and safety of the most common methods, including pleurodesis by either thoracoscopy with talc insufflation or thoracostomy with talc slurry, use of an indwelling pleural catheter, and intrapleural chemotherapy. Talc remains the agent of choice in pleurodesis, although the use of alternative agents continues to be explored. The choice of procedure to achieve pleurodesis depends on careful patient selection based on predictive factors and individual characteristics. Talc pleuro-desis is relatively well tolerated and safe, as is an indwelling pleural catheter, in an appropriate patient population. Because MPE is a common problem in cancer patients, future research with more randomized, prospective designs and innovative interventions is needed.

  14. Clinical Management of Malignant Glaucoma

    PubMed Central

    Foreman-Larkin, Julie; Netland, Peter A.; Salim, Sarwat

    2015-01-01

    Malignant glaucoma remains one of the most challenging complications of ocular surgery. Although it has been reported to occur spontaneously or after any ophthalmic procedure, it is most commonly encountered after glaucoma surgery in eyes with prior chronic angle closure. The clinical diagnosis is made in the setting of a patent peripheral iridotomy and axial flattening of the anterior chamber. Intraocular pressure is usually elevated, but it may be normal in some cases. Although the exact etiology of this condition is not fully understood, several mechanisms have been proposed and it is thought to result from posterior misdirection of aqueous humor into or behind the vitreous. This review discusses pathophysiology, differential diagnosis, imaging modalities, and current treatment strategies for this rare form of secondary glaucoma. PMID:26819754

  15. Glucosylceramidases and malignancies in mammals.

    PubMed

    Astudillo, Leonardo; Therville, Nicole; Colacios, Céline; Ségui, Bruno; Andrieu-Abadie, Nathalie; Levade, Thierry

    2016-06-01

    Sphingolipids represent a major class of lipids that are essential constituents of eukaryotic cells. They are predominantly located in plasma membrane microdomains, and play an important structural role in regulating membrane fluidity. They are also bioactive effectors involved in diverse key cellular functions such as apoptosis and proliferation. The implication of some sphingolipids in cancer is well established whereas that of some others is still a matter of intense investigation. Glucosylceramide is the backbone of more than 300 structurally different glycosphingolipids including gangliosides and sulfatides, and is essential for mammalian development. Therefore, glucosylceramidases (also named GBA1, GBA2 and GBA3 β-glucosidases), the enzymes that hydrolyse β-glucosylceramide, play important functions. GBA1 is a lysosomal hydrolase whose deficiency causes Gaucher disease, the most prevalent inherited lysosomal storage disorder. GBA2 is a ubiquitous non-lysosomal glucosylceramidase whose mutations have been associated with some forms of hereditary spastic paraplegia. GBA3 is a cytosolic β-glucosidase, mostly present in the kidney, liver, spleen, intestine and lymphocytes of mammals, the function of which is still unclear. Whereas glucosylceramide synthase is implicated in multidrug resistance, the role of glucosylceramide breakdown in cancer is not yet fully appreciated. Defective GBA1 enzyme activity in humans, i.e., Gaucher disease, is associated with an increased risk of multiple myeloma and other malignancies. Putative molecular links between Gaucher disease and cancer, which might implicate the malignant cell and/or its microenvironment, are reviewed. The functions of GBA2 and GBA3 in cancer progression are also discussed. Copyright © 2015 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  16. Numerical simulation and experiment on multilayer stagger-split die.

    PubMed

    Liu, Zhiwei; Li, Mingzhe; Han, Qigang; Yang, Yunfei; Wang, Bolong; Sui, Zhou

    2013-05-01

    A novel ultra-high pressure device, multilayer stagger-split die, has been constructed based on the principle of "dividing dies before cracking." Multilayer stagger-split die includes an encircling ring and multilayer assemblages, and the mating surfaces of the multilayer assemblages are mutually staggered between adjacent layers. In this paper, we investigated the stressing features of this structure through finite element techniques, and the results were compared with those of the belt type die and single split die. The contrast experiments were also carried out to test the bearing pressure performance of multilayer stagger-split die. It is concluded that the stress distributions are reasonable and the materials are utilized effectively for multilayer stagger-split die. And experiments indicate that the multilayer stagger-split die can bear the greatest pressure.

  17. Historical review of die drool phenomenon during plastics extrusion

    NASA Astrophysics Data System (ADS)

    Musil, Jan; Zatloukal, Martin

    2013-04-01

    Die drool phenomenon is defined as unwanted spontaneous accumulation of extruded polymer melt on open faces of extrusion die during extrusion process. Such accumulated material builds up on the die exit and frequently or continually sticks onto the extruded product and thus damages it. Since die drool appears, extrusion process must be shut down and die exit must be manually cleaned which is time and money consuming. Although die drool is complex phenomenon and its formation mechanism is not fully understood yet, variety of proposed explanations of its formation mechanism and also many ways to its elimination can be found in open literature. Our review presents in historical order breakthrough works in the field of die drool research, shows many ways to suppress it, introduces methods for its quantitative evaluation and composition analysis and summarizes theories of die drool formation mechanism which can be helpful for extrusion experts.

  18. Fewer Patients Die During Hospital Inspection Weeks: Study

    MedlinePlus

    ... 164254.html Fewer Patients Die During Hospital Inspection Weeks: Study Slight differences in death rates were possibly ... likely to die if they are treated during weeks that inspectors are checking on the staff, a ...

  19. Malignant transformation of breast fibroadenoma to malignant phyllodes tumor: long-term outcome of 36 malignant phyllodes tumors.

    PubMed

    Abe, Makoto; Miyata, Satoshi; Nishimura, Seiichiro; Iijima, Kotaro; Makita, Masujiro; Akiyama, Futoshi; Iwase, Takuji

    2011-10-01

    Malignant phyllodes tumor of the breast is a rare neoplasm for which clinical findings remain insufficient for determination of optimal management. We examined the clinical behavior of these lesions in an attempt to determine appropriate management. We evaluated long-term outcome and clinical characteristics of malignant phyllodes tumors arising from fibroadenomas of the breast. A total of 173 patients were given a diagnosis of phyllodes tumor and underwent surgery at the Cancer Institute Hospital in Japan between January 1980 and December 1999. Of these patients, 39 (22.5%) were given a diagnosis of malignant phyllodes tumor; in three of these cases, detailed medical records were lost. Malignant phyllodes tumors were classified into two groups based on history of malignant transformation. Of the 36 malignant cases, 11 (30.6%) were primary and were given a diagnosis of fibroadenoma, experienced recurrence during the follow-up period, and were diagnosed with malignant phyllodes tumor (cases with a history of fibroadenoma). The other group was defined as cases without history of fibroadenoma and in whom lesions initially occurred as malignant phyllodes tumors. Based on differences between the two groups, overall survival curves were plotted using the Kaplan–Meier method, and statistical comparisons were performed using the log-rank test and Peto and Peto’s test. The outcome of cases with history of fibroadenoma was significantly better than that of cases without history of fibroadenoma. Patients with malignant phyllodes tumors but without prior history of malignant transformation who exhibit rapid growth within 6 months require aggressive treatment.

  20. Interaction of Several Dies on an Elastic Half-Space

    NASA Astrophysics Data System (ADS)

    Argatov, I. I.

    2003-09-01

    A contact problem is solved for several rigid dies on an elastic half-space. Relationships between the generalized loads and generalized displacements of a large number of spaced dies are established. The interaction between flat-based dies is described in terms of their capacity characteristics. The general solution is constructed on the basis of Mossakovski's theorem. Explicit formulas are derived for a system of elliptic dies

  1. Impact of Temperature on Cooling Structural Variation of Forging Dies

    NASA Astrophysics Data System (ADS)

    Piesova, Marianna; Czan, Andrej

    2014-12-01

    The article is focused on the issue of die forging in the automotive industry. The cooling effect of temperature on the structure of forged die are under review. In the article, there is elaborated the analysis of theoretical knowledge in the field, focusing on die forging and experimentally proven effect of the cooling rate on the final structure of forged dies made of hypoeutectic carbon steel C56E2.

  2. [Clinicopathologic features and prognostic factors of malignant phyllodes tumors].

    PubMed

    Jia, Cui; Mei, Fang; Zheng, Jie; You, Jiang-feng; Liu, Jian-ying

    2013-11-01

    To study the clinicopathologic features of malignant phyllodes tumors (PT) by histopathologic analyses, immunohistochemical profiling and DNA content assay, and evaluation of the clinical outcome. Ten patients with malignant PT from 1999 to 2013 who were treated by surgery were enrolled in this study. The morphologic characteristics were studied under light microscope, standard two-step EnVision method of immunohistochemical staining was used to assess the expression of CK5/6, CKpan, 34β E12, desmin, p63, ER-α, PR, Ki-67, CD34, SMA, p53, p16, bcl-2 and CD117 in the tumors. The corresponding paraffin blocks were also used for flow cytometric DNA content assay. These data were correlated with the follow-up results. The median age of onset was 46.5 years old. The mean tumor size was 7.4 cm (2.0-25.0 cm). At the end of the follow-up period (22 to 125 months), there were tumor recurrences in 3/8 patients and the median time of recurrence was 24 months. Metastasis occurred in 3/8 patients who all died of the tumors. PT had heterogeneous histology, with stromal overgrowth with leaf-like projections, periductal stromal overgrowth, and most commonly, diffuse stromal overgrowth with sarcomatous differentiation. The mean positive index of Ki-67 was 11.4%. The stromal tumor cells were positive for CD34, SMA, p53, p16, and bcl-2 in 3/10, 9/10, 6/10, 8/10, and 4/10 cases, respectively. CD117,ER-α and PR were negative. Interpretable DNA histograms were obtained in nine cases with triploidy in two cases. The diagnosis of malignant PT should be considered based on the diversity of growth patterns and heterogeneous histology.Ki-67 and CD34 are valuable diagnostic and prognostic factors in patients with malignant PT. Tumors with diffuse stromal overgrowth, heterologous elements, Ki-67 ≥ 20% or aneuploidy are more likely to metastasize.

  3. Malignant gonadal tumour formation in intersexual states

    PubMed Central

    Pigott, H. W. S.

    1975-01-01

    Two cases of malignant tumour are reported in phenotypically male hermaphrodites. The importance of establishing the presence of persistent Müllerian duct structures in pseudo-hermaphrodites is discussed in relation to prophylactic castration in anticipation of malignant change. ImagesFig. 1Fig. 2 PMID:1197157

  4. ["Malignant" middle cerebral artery territory infarction].

    PubMed

    Mendel, Tadeusz

    2005-01-01

    The pathology, clinical course, outcome, diagnosis, treatment and prognosis of dramatic malignant middle cerebral artery territory infarction were presented. About 10% of stroke patients suffer from malignant middle cerebral artery territory infarction, mainly due to brain edema and herniation. This syndrome causes high mortality. The newest conservative and surgical treatment was presented.

  5. Rare Malignant Tumors of the Breast

    PubMed Central

    Miller, Trevor; Albarracin, Constance; Carkaci, Selin; Whitman, Gary J; Adrada, Beatriz E

    2015-01-01

    While the more common forms of breast cancer are well understood and recognized, there are many important rare malignancies that are less appreciated. Many of these cancers have imaging findings that, when understood, help to formulate a more educated differential diagnosis. In this article, the clinical features, imaging, and pathologic findings of rare breast malignancies will be discussed. PMID:26664775

  6. Rare Malignant Tumors of the Breast.

    PubMed

    Miller, Trevor; Albarracin, Constance; Carkaci, Selin; Whitman, Gary J; Adrada, Beatriz E

    2015-01-01

    While the more common forms of breast cancer are well understood and recognized, there are many important rare malignancies that are less appreciated. Many of these cancers have imaging findings that, when understood, help to formulate a more educated differential diagnosis. In this article, the clinical features, imaging, and pathologic findings of rare breast malignancies will be discussed.

  7. [Malignized dermoid cyst of the ovary].

    PubMed

    Koivisto-Korander, Riitta; Bützow, Ralf

    2016-01-01

    Mature germ cell derived cystic teratoma of the ovary, i.e. dermoid cyst, is a common ovarian neoplasm, seldom progressing to malignancy. Malignized dermoid cyst is most commonly diagnosed in a woman of approx. 50 years of age, either during or after an operation. Owing to the rarity of the disease, the lines of treatment are based on retrospective series of cases.

  8. Malignant ameloblastoma: classification, diagnostic, and therapeutic challenges.

    PubMed

    Verneuil, Andrew; Sapp, Philip; Huang, Catherine; Abemayor, Elliot

    2002-01-01

    Ameloblastoma is a benign odontogenic neoplasm of the mandible and maxilla that rarely exhibits malignant behavior. We report the case of an aggressive malignant ameloblastoma of the mandible that presented with an unusual multiphasic, histologic pattern. Initial fine needle aspiration and radiographic findings showed features consistent with a benign, fibro-osseous lesion. However, aggressive growth and the association of enlarged submandibular lymph nodes suggested a more malignant potential. Treatment consisted of an angle-to-angle composite mandibular resection, right modified neck dissection, left functional supraomohyoid neck dissection, and anterior chin skin resection with iliac crest osteocutaneous free flap reconstruction. Microscopic evaluation showed primarily malignant ameloblastoma without cellular atypia and extensive fields of fibro-osseous tissue with smaller fields of clear cell odontogenic tumor. This multiphasic, histologic arrangement may explain the perplexing preoperative microscopic diagnosis, suggesting a benign fibro-osseous lesion. Of the lymph nodes analyzed, one from the right submandibular triangle exhibited metastatic, benign-appearing ameloblastoma without fibro-osseous or clear cell features. The absence of cellular features of malignancy in the tumor mass and lymph node metastasis suggest that the lesion should be classified as malignant ameloblastoma rather than ameloblastic carcinoma or odontogenic carcinoma. A malignant ameloblastoma with all 3 of the aforementioned microscopic features has not been previously reported. We review the classification of epithelial odontogenic malignancies. Lesions showing multiphasic patterns can create diagnostic dilemmas and may require extensive surgical sampling and/or removal to establish an accurate diagnosis.

  9. Primary Ovarian Malignant PEComa: A Case Report.

    PubMed

    Westaby, Joseph D; Magdy, Nesreen; Fisher, Cyril; El-Bahrawy, Mona

    2016-09-28

    Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both melanocytic and smooth muscle markers. PEComas are rarely encountered in the female genital tract. We here report a case of malignant primary PEComa of the ovary, and discuss the differential diagnosis. This represents the first case of primary typical malignant PEComa of the ovary.

  10. [Malignant schwannoma metastasizing to the heart].

    PubMed

    Menezes Júnior, A da S; Greco, O T; Fiorini, M; Pavarino, P; Corbucci, H; Caixeta, A M

    1992-01-01

    We introduce the case of a 34-year-old male with a malignant metastasizing tumor in the heart associated with skin manifestations. The patient was submitted to heart surgery to resect the tumor. The correct diagnosis was done by pathological findings and immunohistochemical methods and showed, malignant schwannoma.

  11. [Malignant fibrous histiocytoma of the eyelid].

    PubMed

    Rossi, P; Ducasse, A; Pluot, M; Brugniart, C; Gotzamanis, A; Jouhaud, F

    2002-12-01

    Fibrous histiocytomas, mostly benign, have often been reported in the orbit, but only four lesions have been described on the eyelids, with only one malignant. The authors present a case of malignant fibrous histiocytoma of the eyelid in a 76-year-old woman with a difficult histological diagnosis. Characteristics of this pathology are explained from data in the literature.

  12. 25 CFR 304.2 - Marking and ownership of dies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Marking and ownership of dies. 304.2 Section 304.2 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.2 Marking and ownership of dies. All dies used to mark silver will be provided by...

  13. 25 CFR 304.2 - Marking and ownership of dies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Marking and ownership of dies. 304.2 Section 304.2 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.2 Marking and ownership of dies. All dies used to mark silver will be provided by...

  14. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will...

  15. 25 CFR 304.2 - Marking and ownership of dies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Marking and ownership of dies. 304.2 Section 304.2 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.2 Marking and ownership of dies. All dies used to mark silver will be provided by...

  16. 25 CFR 304.2 - Marking and ownership of dies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false Marking and ownership of dies. 304.2 Section 304.2 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.2 Marking and ownership of dies. All dies used to mark silver will be provided by...

  17. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will...

  18. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will...

  19. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will...

  20. 25 CFR 301.3 - Specifications of dies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Specifications of dies. 301.3 Section 301.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.3 Specifications of dies. Dies used are to be entirely hand-made, with no...

  1. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will...

  2. 25 CFR 301.4 - Application of dies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Application of dies. 301.4 Section 301.4 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.4 Application of dies. Dies are to be applied to the object with the aid...

  3. A Contextualist Thanatology: A Pragmatic Approach to Death and Dying

    ERIC Educational Resources Information Center

    Reck, Andrew J.

    1977-01-01

    Denying the value of death but accepting its reality, the author points to dying, not death, as the problematic phenomenon with which a pragmatist thanatology must deal. It is suggested that dying contains opportunities for growth--for the dying as well as for their surviving friends and relatives. (Author)

  4. A Contextualist Thanatology: A Pragmatic Approach to Death and Dying

    ERIC Educational Resources Information Center

    Reck, Andrew J.

    1977-01-01

    Denying the value of death but accepting its reality, the author points to dying, not death, as the problematic phenomenon with which a pragmatist thanatology must deal. It is suggested that dying contains opportunities for growth--for the dying as well as for their surviving friends and relatives. (Author)

  5. A Contingency Framework for Listening to the Dying

    ERIC Educational Resources Information Center

    Vora, Erika; Vora, Ariana

    2008-01-01

    Listening to the dying poses special challenges. This paper proposes a contingency framework for describing and assessing various circumstances when listening to the dying. It identifies current approaches to listening, applies the contingency framework toward effectively listening to the dying, and proposes a new type of listening called…

  6. Die and telescoping punch form convolutions in thin diaphragm

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Die and punch set forms convolutions in thin dished metal diaphragm without stretching the metal too thin at sharp curvatures. The die corresponds to the metal shape to be formed, and the punch consists of elements that progressively slide against one another under the restraint of a compressed-air cushion to mate with the die.

  7. 25 CFR 301.4 - Application of dies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Application of dies. 301.4 Section 301.4 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.4 Application of dies. Dies are to be applied to the object with the aid...

  8. 25 CFR 301.4 - Application of dies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Application of dies. 301.4 Section 301.4 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.4 Application of dies. Dies are to be applied to the object with the aid...

  9. 25 CFR 301.3 - Specifications of dies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Specifications of dies. 301.3 Section 301.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.3 Specifications of dies. Dies used are to be entirely hand-made, with no...

  10. 25 CFR 301.4 - Application of dies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Application of dies. 301.4 Section 301.4 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.4 Application of dies. Dies are to be applied to the object with the aid...

  11. 25 CFR 301.3 - Specifications of dies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Specifications of dies. 301.3 Section 301.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.3 Specifications of dies. Dies used are to be entirely hand-made, with no...

  12. 25 CFR 301.4 - Application of dies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false Application of dies. 301.4 Section 301.4 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.4 Application of dies. Dies are to be applied to the object with the aid...

  13. 25 CFR 301.3 - Specifications of dies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Specifications of dies. 301.3 Section 301.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.3 Specifications of dies. Dies used are to be entirely hand-made, with no...

  14. 25 CFR 301.3 - Specifications of dies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false Specifications of dies. 301.3 Section 301.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.3 Specifications of dies. Dies used are to be entirely hand-made, with no...

  15. A Contingency Framework for Listening to the Dying

    ERIC Educational Resources Information Center

    Vora, Erika; Vora, Ariana

    2008-01-01

    Listening to the dying poses special challenges. This paper proposes a contingency framework for describing and assessing various circumstances when listening to the dying. It identifies current approaches to listening, applies the contingency framework toward effectively listening to the dying, and proposes a new type of listening called…

  16. Darwin als Sehhilfe für die Psychologie - Evolutionspsychologie

    NASA Astrophysics Data System (ADS)

    Schwab, Frank

    Im Folgenden geht es um Einäugige, stereoskopisches Sehen, weite und enge Horizonte, Monokel und Sonnenbrillen. Der Beitrag versucht die Metapher des Sehens und der Sehhilfen anzuwenden, um so zu verdeutlichen, welchen Gewinn die herkömmliche Psychologie durch die Verwendung einer Darwin'schen Brille erlangen kann.

  17. Differentiating suicide decedents who died using firearms from those who died using other methods.

    PubMed

    Anestis, Michael D; Khazem, Lauren R; Anestis, Joye C

    2017-02-22

    Studies have documented a link between gun ownership and suicide, but little is known about characteristics of those most likely to use a gun in a suicide attempt rather than alternative methods. We examined which factors differentiate suicide decedents who died using a gun from those who died by other methods. We further examined whether such findings are consistent within the subcomponent of our larger sample comprised entirely of gun owning suicide decedents. Data reflect 267 suicide decedents, with data provided by individuals who identified as having lost someone to suicide (loss survivors). Within the full sample, a higher proportion of gun-owning and male suicide decedents died by firearm. Further, individuals who had previously discussed suicide or engaged in one or more non-lethal suicide attempts were less likely to die by suicide using a gun. Within the subsample of gun owning suicide decedents, a greater proportion of decedents who stored guns at home and in unsecure locations died from self-inflected gunshot wounds. These findings add clarity to the relationship between firearm ownership and death by suicide at the individual level. Furthermore, these findings are consistent with the notion that means safety implementation may represent a vital suicide prevention tool.

  18. Expression of Cellular Oncogenes in Human Malignancies

    NASA Astrophysics Data System (ADS)

    Slamon, Dennis J.; Dekernion, Jean B.; Verma, Inder M.; Cline, Martin J.

    1984-04-01

    Cellular oncogenes have been implicated in the induction of malignant transformation in some model systems in vitro and may be related to malignancies in vivo in some vertebrate species. This article describes a study of the expression of 15 cellular oncogenes in fresh human tumors from 54 patients, representing 20 different tumor types. More than one cellular oncogene was transcriptionally active in all of the tumors examined. In 14 patients it was possible to study normal and malignant tissue from the same organ. In many of these patients, the transcriptional activity of certain oncogenes was greater in the malignant than the normal tissue. The cellular fes (feline sarcoma) oncogene, not previously known to be transcribed in mammalian tissue, was found to be active in lung and hematopoietic malignancies.

  19. Management of malignant hyperthermia: diagnosis and treatment.

    PubMed

    Schneiderbanger, Daniel; Johannsen, Stephan; Roewer, Norbert; Schuster, Frank

    2014-01-01

    Malignant hyperthermia is a potentially lethal inherited disorder characterized by disturbance of calcium homeostasis in skeletal muscle. Volatile anesthetics and/or the depolarizing muscle relaxant succinylcholine may induce this hypermetabolic muscular syndrome due to uncontrolled sarcoplasmic calcium release via functionally altered calcium release receptors, resulting in hypoxemia, hypercapnia, tachycardia, muscular rigidity, acidosis, hyperkalemia, and hyperthermia in susceptible individuals. Since the clinical presentation of malignant hyperthermia is highly variable, survival of affected patients depends largely on early recognition of the symptoms characteristic of malignant hyperthermia, and immediate action on the part of the attending anesthesiologist. Clinical symptoms of malignant hyperthermia, diagnostic criteria, and current therapeutic guidelines, as well as adequate management of anesthesia in patients susceptible to malignant hyperthermia, are discussed in this review.

  20. Management of malignant hyperthermia: diagnosis and treatment

    PubMed Central

    Schneiderbanger, Daniel; Johannsen, Stephan; Roewer, Norbert; Schuster, Frank

    2014-01-01

    Malignant hyperthermia is a potentially lethal inherited disorder characterized by disturbance of calcium homeostasis in skeletal muscle. Volatile anesthetics and/or the depolarizing muscle relaxant succinylcholine may induce this hypermetabolic muscular syndrome due to uncontrolled sarcoplasmic calcium release via functionally altered calcium release receptors, resulting in hypoxemia, hypercapnia, tachycardia, muscular rigidity, acidosis, hyperkalemia, and hyperthermia in susceptible individuals. Since the clinical presentation of malignant hyperthermia is highly variable, survival of affected patients depends largely on early recognition of the symptoms characteristic of malignant hyperthermia, and immediate action on the part of the attending anesthesiologist. Clinical symptoms of malignant hyperthermia, diagnostic criteria, and current therapeutic guidelines, as well as adequate management of anesthesia in patients susceptible to malignant hyperthermia, are discussed in this review. PMID:24868161

  1. Autocrine growth factors and solid tumor malignancy.

    PubMed Central

    Walsh, J. H.; Karnes, W. E.; Cuttitta, F.; Walker, A.

    1991-01-01

    The ability of malignant cells to escape the constraint that normally regulate cell growth and differentiation has been a primary focus of attention for investigators of cancer cell biology. An outcome of this attention has been the discovery that the protein products of oncogenes play a role in the activation of growth signal pathways. A second outcome, possibly related to abnormal oncogene expression, has been the discovery that malignant cells frequently show an ability to regulate their own growth by the release of autocrine growth modulatory substances. Most important, the growth of certain malignant cell types has been shown to depend on autocrine growth circuits. A malignant tumor whose continued growth depends on the release of an autocrine growth factor may be vulnerable to treatment with specific receptor antagonists or immunoneutralizing antibodies designed to break the autocrine circuit. Information is rapidly emerging concerning autocrine growth factors in selected human solid tissue malignancy. Images PMID:1926844

  2. Malignant solitary fibrous tumor in retroperitoneum

    PubMed Central

    Zhou, Yihong; Chu, Xi; Yi, Ye; Tong, Liang; Dai, Yingbo

    2017-01-01

    Abstract Rationale: Solitary fibrous tumor (SFT) is a rare mesenchymal tumor occurs in various sites. Malignant SFT in retroperitoneum is extremely rare. Patient concerns: We report a case of malignant retroperitoneal SFT in a 59-year-old man presented with right flank pain for 1 month. Diagnoses, interventions and outcomes: A laparotomy and resection of the tumor were performed, the histopathologic and immunohistochemical findings were consistent with malignant retroperitoneal SFT. No adjuvant treatment was performed, and the patient had no signs of recurrence or metastasis at the 12 months follow-up. Lessons: Complete surgical excision is the basic treatment principle for malignant retroperitoneal SFT. The histologic features and the Ki-67 label index are helpful for the diagnosis of malignant SFT. PMID:28296778

  3. [Malignant and non-malignant cartilaginous tumours of the larynx].

    PubMed

    Garsta, Ewa; Stankiewicz, Czesław; Kowalska, Bożena; Narożny, Waldemar

    2013-01-01

    Cartilaginous tumours of the larynx are rare. They usually involve cricoid cartilage, less frequently thyroid cartilage and other cartilages. The most significant clinical manifestations are hoarseness, dyspnea, dysphagia or a neck mass. On physical examination, tumour is found as a bulge with intact mucosa or a tumour situated in a part of the larynx also with fixation. CT scanning is the mainstay of radiographic imaging. The histopathologic diagnosis is made after the surgical excision. Prognosis for survival is good. The recurrences occur very often, also with malignant transformation and require laryngectomy. We presented 11 patients (including symptoms, involved cartilage, laryngoscopy examination, histopathologic diagnosis, treatment and the follow-up). 6 patients manifested hoarseness, 5 dyspnea, 3 dysphagia, 1 neck mass as the first symptom. In laryngoscopy a tumour with intact mucosa was situated in subglottis - 5 patients, in supraglottis - 2 patients and in half of the larynx with fixation - 4 patients. The majority of tumours involved the cricoid cartilage - in 9 cases, the rest arytenoid and epiglottic cartilage. The histopathology diagnosis were given after surgery, only in one case after biopsy. There were 7 patients with chondrosarcoma and four with chondroma. We did not observe lymph node or distant metastases. All patients were treated surgically. Follow-up of patients with chondrosarcoma were 5 to 17 years without recurrence. However, two recurrences of chondroma appeared to be chondrosarcomas and required laryngectomy. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  4. Energy Saving Melting and Revert Reduction Technology (E-SMARRT): Development of Surface Engineered Coating Systems for Aluminum Pressure Die Casting Dies: Towards a 'Smart' Die Coating

    SciTech Connect

    Dr. John J. Moore; Dr. Jianliang Lin,

    2012-07-31

    The main objective of this research program was to design and develop an optimal coating system that extends die life by minimizing premature die failure. In high-pressure aluminum die-casting, the die, core pins and inserts must withstand severe processing conditions. Many of the dies and tools in the industry are being coated to improve wear-resistance and decrease down-time for maintenance. However, thermal fatigue in metal itself can still be a major problem, especially since it often leads to catastrophic failure (i.e. die breakage) as opposed to a wear-based failure (parts begin to go out of tolerance). Tooling costs remain the largest portion of production costs for many of these parts, so the ability prevent catastrophic failures would be transformative for the manufacturing industry.The technology offers energy savings through reduced energy use in the die casting process from several factors, including increased life of the tools and dies, reuse of the dies and die components, reduction/elimination of lubricants, and reduced machine down time, and reduction of Al solder sticking on the die. The use of the optimized die coating system will also reduce environmental wastes and scrap parts. Current (2012) annual energy saving estimates, based on initial dissemination to the casting industry in 2010 and market penetration of 80% by 2020, is 3.1 trillion BTU's/year. The average annual estimate of CO2 reduction per year through 2020 is 0.63 Million Metric Tons of Carbon Equivalent (MM TCE).

  5. WA30 The dying well community charter and dying matters: a united kingdom (uk) approach to public health and dying.

    PubMed

    Ali, Nuzhat; Chapman, Simon

    2015-04-01

    The Dying Matters Coalition, set up following the UK Government's End of Life Care Strategy in 2008, is led by the NCPC (UK umbrella organisation). Dying Matters supports changing knowledge, attitudes and behaviours towards dying, death and bereavement, and through this to make 'living and dying well' the norm. The Coalition has over 30,000 members, and encourages people to talk to friends and family about their end of life wishes, including how they would like to be cared for, where they want to die and their funeral plans. The Dying Well Community Charter is an innovative approach to community development work, working with Pathfinder areas to pilot this approach, rather than encouraging health and social care services to "do" end of life care "to" people, to encourage them to work with community leaders to make end of life care everyone's responsibility. Participants will discover what has worked in the UK, including many low resource options, and a community development approach to palliative care. We worked with 8 Pathfinder communities to ask them to pilot the Dying Well Community Charter approach. Dying Matters was the first national awareness and behaviour change campaign around death, dying and bereavement. Dying Matters has over 30,000 members. Outcome of the Charter work is unknown, but more will be known by the time of the conference. How communities can come together for better death, dying and bereavement. That death and dying are not subjects that need to be avoided, and can be engaged with for better outcomes. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Dying with dignity: a concept analysis.

    PubMed

    Hemati, Zeinab; Ashouri, Elaheh; AllahBakhshian, Maryam; Pourfarzad, Zahra; Shirani, Farimah; Safazadeh, Shima; Ziyaei, Marziyeh; Varzeshnejad, Maryam; Hashemi, Maryam; Taleghani, Fariba

    2016-05-01

    This article is a report of an analysis of the concept of dying with dignity. Dignity is an important component of providing care for dying patients and their families. Nevertheless, given that this concept is poorly defined, concept analysis is one of the best ways to define and clarify the concept of death with dignity with the aim to enhance its application in clinical practice, research and education. A search of multiple nursing and social sciences databases was undertaken, including Academic Search Complete, Science Direct, ProQuest, Scopus, Medline, PubMed, EBSCO, Ovid, Noormage, Cinahl, Magiran, PsycINFO and SID. After an extensive review of the literature from 1998-2014, about 14 related articles were included in the study. Based on these articles, the applications, attributes and experimental results of and references to death with dignity were recorded. Based on this analysis, the most important attributes of this concept included respect for privacy, respect, spiritual peace and hope. The antecedents of this concept included consideration of moral values during caregiving, preservation of human dignity as a patient right and professional ethics, and belief in the dignity of self and others, consideration of culture in providing end-of-life care. The consequences of this concept included a sense of peace in the patient and their family, peaceful death and provision of patient privacy and comfort. The concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. Respecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death. © 2016 John Wiley & Sons Ltd.

  7. Dying cancer patients talk about euthanasia.

    PubMed

    Eliott, Jaklin A; Olver, Ian N

    2008-08-01

    Within developed nations, there is increasing public debate about and apparent endorsement of the appropriateness of euthanasia as an autonomous choice to die in the face of intolerable suffering. Surveys report socio-demographic differences in rates of acceptance of euthanasia, but there is little in-depth analysis of how euthanasia is understood and positioned within the social and moral lives of individuals, particularly those who might be considered suitable candidates-for example, terminally-ill cancer patients. During discussions with 28 such patients in Australia regarding medical decisions at the end of life, euthanasia was raised by 13 patients, with the others specifically asked about it. Twenty-four patients spoke positively of euthanasia, 19 of these voicing some concerns. None identified euthanasia as a currently favoured option. Four were completely against it. Endorsement for euthanasia was in the context of a hypothetical future or for a hypothetical other person, or temporally associated with acute pain. Arguments supporting euthanasia framed the issue as a matter of freedom of choice, as preserving dignity in death, and as curbing intolerable pain and suffering, both of the patient and of those around them. A common analogy featured was that of euthanising a dog. These arguments were typically presented as self-evident justification for euthanasia, construed as an appropriate choice to die, with opposers positioned as morally inferior or ignorant. The difficulties of ensuring 'choice' and the moral connotations of 'choosing to die,' however, worked to problematise the appropriateness of euthanising specific individuals. We recommend further empirical investigation of the moral and social meanings associated with euthanasia.

  8. Subarachnoid hemorrhage: who dies, and why?

    PubMed

    Lantigua, Hector; Ortega-Gutierrez, Santiago; Schmidt, J Michael; Lee, Kiwon; Badjatia, Neeraj; Agarwal, Sachin; Claassen, Jan; Connolly, E Sander; Mayer, Stephan A

    2015-08-31

    Subarachnoid hemorrhage (SAH) is a devastating form of stroke. Causes and mechanisms of in-hospital death after SAH in the modern era of neurocritical care remain incompletely understood. We studied 1200 consecutive SAH patients prospectively enrolled in the Columbia University SAH Outcomes Project between July 1996 and January 2009. Analysis was performed to identify predictors of in-hospital mortality. In-hospital mortality was 18% (216/1200): 3% for Hunt-Hess grade 1 or 2, 9% for grade 3, 24% for grade 4, and 71% for grade 5. The most common adjudicated primary causes of death or neurological devastation leading to withdrawal of support were direct effects of the primary hemorrhage (55%), aneurysm rebleeding (17%), and medical complications (15%). Among those who died, brain death was declared in 42%, 50% were do-not-resuscitate at the time of cardiac death (86% of whom had life support actively withdrawn), and 8% died despite full support. Admission predictors of mortality were age, loss of consciousness at ictus, admission Glasgow Coma Scale score, large aneurysm size, Acute Physiology and Chronic Health Evaluation II (APACHE II) physiologic subscore, and Modified Fisher Scale score. Hospital complications that further increased the risk of dying in multivariable analysis included rebleeding, global cerebral edema, hypernatremia, clinical signs of brain stem herniation, hypotension of less than 90 mm Hg treated with pressors, pulmonary edema, myocardial ischemia, and hepatic failure. Delayed cerebral ischemia, defined as deterioration or infarction from vasospasm, did not predict mortality. Strategies directed toward minimizing early brain injury and aneurysm rebleeding, along with prevention and treatment of medical complication, hold the best promise for further reducing mortality after SAH.

  9. First surgical tumour reduction of peritoneal surface malignancy in a rat's model.

    PubMed

    Hartmann, Jens; Kilian, Maik; Atanassov, Vladimir; Braumann, Chris; Ordemann, Juergen; Jacobi, Christoph A

    2008-01-01

    Surgical therapy of peritoneal surface malignancy from colorectal origin in combination with Hyperthermic Intraoperative Peritoneal Chemotherapy (HIPEC) has now become an established treatment approach in very few specialised centres. A peritonectomy procedure is possible to perform with additional HIPEC in patients. An experimental model to simulate peritonectomy procedure and HIPEC does not exist so far in rats. Nevertheless, animal models seem to be very important for evaluation of new therapeutic opportunities and toxicity of different multimodal therapies. In a first step we analysed the surgical tumour debulking of peritoneal surface malignancy in rats. A peritoneal surface malignancy from colonic origin was induced in 75 male BD IX rats. Twenty one days after induction of peritoneal surface malignancy rats were randomised and animals intend to create an operation with surgical tumour debulking. There was no tumour growth in two animals. The aim of the peritonectomy procedure was the complete tumour reduction. In this study the results of the surgical approach will be described. A complete tumour reduction (R0) was achieved in 34 animals. In 39 rats a macroscopic tumour deposit was left behind (R2). The intraoperative experimental Peritoneal Cancer Index (ePCI) was used to describe tumour weight and number of tumour inoculations. Both parameters were found to be dependent factors of complete tumour reduction. Six animals died due to therapeutical interventions. Surgical tumour debulking in rats with peritoneal surface malignancy is possible with high reliability and a low mortality rate. This animal model could be an important step for investigation of multimodal treatment options and toxicity in treatment regimens of peritoneal surface malignancy.

  10. Cerebral Metastasis of a Malignant Pleural Mesothelioma: A Case Report and Review of the Literature

    PubMed Central

    Kolias, Angelos G; Allinson, Kieren; Santarius, Thomas

    2015-01-01

    Background: Malignant pleural mesothelioma (MPM) is an aggressive malignant neoplasm that was thought to be a localised disease with limited metastatic capability. However, recent post-mortem studies have identified metastases to the central nervous system (CNS) in about 3% of cases. Case Description: We present the case of a 65-year-old with a solitary supratentorial metastatic deposit of MPM treated with surgical resection and adjuvant whole brain radiotherapy. Despite a good surgical outcome with symptomatic recovery, the patient died of cardiopulmonary compromise five months postoperatively. Conclusions: Although rare, CNS metastasis of MPM is a condition that neurosurgeons should be aware of. CNS metastases may occur via three distinct mechanisms, namely perineural spread, leptomeningeal carcinomatosis and, most commonly, haematogenous spread leading to parenchymal deposits. Surgical resection of these deposits can lead to symptomatic improvement, and together with radiotherapy, to local disease control. However, the overall survival remains poor. PMID:26180665

  11. [An approach to operative treatment for acute abdomen complicated by malignant hemopathy].

    PubMed

    Min, B; Gu, D; Ding, X

    1997-01-01

    The experience of operative treatment in 14 cases of acute abdomen complicated by malignant hemopathy was reported. Primary diseases consisted of AL, NHL, MM, MH and MDS-RA, 13 cases of them were at progressing stage. The acute abdominal conditions included acute appendicitis, acute pancreatitis, acute cholecystitis, peritonitis secondary to intestinal perforation, intestinal obstruction, primary peritonitis and ileocecal syndrome. The type of acute abdomen was related with primary desease and chemotherapy. 8 cases were operated and 2 of them died of complications after operation. Biopsy of excised tissue showed tumor cells in 2 cases. The rate of correllation between preoper active and postoperative diagnosis was 62.5%. These findings suggest that malignant infiltration in the viscera, duration of abdominal pain before operation and the change of blood picture are the major factors for determining operative indication and the postoperative prognosis.

  12. Varicella-Zoster Virus Infections in Pediatric Malignancy Patients: A Seven-Year Analysis

    PubMed Central

    Düzgöl, Mine; Özek, Gülcihan; Bayram, Nuri; Oymak, Yeşim; Kara, Ahu; Demirağ, Bengü; Karapınar, Tuba Hilkay; Ay, Yılmaz; Vergin, Canan; Devrim, İlker

    2016-01-01

    Primary varicella-zoster virus (VZV) infection is a benign self-limited disease. In this study, we review our experience in focusing on the outcome and treatment of VZV infection in pediatric malignancy patients. During the study period, a total of 41 patients with pediatric malignancy had been hospitalized with the diagnosis of VZV infection. All the patients were treated with intravenous acyclovir for a median of 7 days (ranging from 5 to 21 days). The calculated attributable delay of chemotherapy due to VZV infections was 8 days (ranging from 2 to 60 days). VZV-related complications were observed in 3 of 41 patients (7%) who suffered from acute respiratory distress syndrome, and one of them with hemophagocytic lymphohistiocytosis died due to respiratory failure despite acyclovir and broad-spectrum antimicrobial treatment plus supportive treatment. VZV infections are still important contagious diseases in pediatric cancer patients, because they cause not only significant mortality but also a delay in chemotherapy. PMID:27751970

  13. [Efficacy and problems of radio- and chemo-combination therapy for malignant bone tumors].

    PubMed

    Yamawaki, S; Isu, K; Ubayama, Y; Goto, T; Goto, M; Kagami, Y; Ishii, S; Usui, M; Sasaki, T; Yagi, T

    1988-04-01

    In this study we reviewed cases of osteosarcoma, malignant lymphoma of bone and Ewing's sarcoma. Historically, osteosarcoma was unresponsive to chemotherapy. Most patients were treated by radiation or amputation alone and 80% of them died from pulmonary metastasis within 2 years. Five-year survival rate was 13%. Introduction of ADM, HD-MTX and CDDP improved dramatically the prognosis of these cases. Five-year survival rate was 60%. On the other hand, 11 cases of malignant lymphoma of bone and 4 cases of Ewing's sarcoma were treated by radiation with no local recurrence. VEPA or CHOP chemotherapy was used for the former with a five-year survival rate of 45%. For the latter, T-11 protocol (Rosen) was applied, and all patients survive with no metastasis. Other organ injuries circulatory disturbance, bone necrosis and growth-disturbance of bone in radiotherapy, myocardiopathy caused by ADM and renal toxicity of CDDP are all problematic.

  14. Malignant histiocytosis and other causes of death in Bernese mountain dogs in Denmark.

    PubMed

    Nielsen, L; Andreasen, S N; Andersen, S D; Kristensen, A T

    2010-02-13

    To determine the causes of death in Bernese mountain dogs, to assess the prevalence of malignant histiocytosis in the Danish Bernese mountain dog population, and to assess whether a hereditary pattern for this disease exists, 756 questionnaires were sent to members of the Danish Bernese Mountain Dog Club requesting information regarding the life span and causes of death of their dogs. A response rate of 57.7 per cent was achieved, giving information for 812 dogs, of which 290 had died. The average life span was 7.1 years. The most prevalent causes of death were neoplasia (42.1 per cent), old age (10.3 per cent), kidney disease (6.9 per cent), infection (5.9 per cent), skeletal problems (5.2 per cent), heart disease (3.8 per cent) and behavioural causes (3.5 per cent). Thirteen dogs were diagnosed with malignant histiocytosis, 11 of which were genealogically related.

  15. Accurate Die Design for Automotive Panel Stamping Considering the Compensation Related with Die Deflection and Blank Thinning

    NASA Astrophysics Data System (ADS)

    Chen, Jun; Xu, Dongkai; Xia, Guodong; Li, Xifeng; Chen, Jieshi; Zhang, Jian; Yan, Wei; Li, Yue

    2011-08-01

    In order to improve assembly accuracy, automotive body panels have to be fabricated with higher dimensional and surface quality requirements, therefore the die faces should be designed more accurately to consider more relevant factors. In the presented study, we proposed algorithms to realize the following functions: through forming process simulation, the thinning distribution on the deformed blank was extracted as first kind of compensation; through die structural CAE analysis which automatically mapped the boundary contact forces onto the die surfaces from process simulation results, the die deflection was calculated as second kind of compensation. These two quantitative contributions were added together to compensate the die face. The proposed methodologies were programmed and integrated with LS-Dyna and HyperWorks, and also integrated with Autoform and CATIA linear CAE functionalities separately. In addition, a software toolkit to calculate the contacting ratio was also developed to evaluate the effectiveness of die face compensation. The second toolkit developed was verified by an automotive structural part forming die design, through die compensation and geometric optimization, the predicted contact ratio between the die face and formed blank was improved a lot, and the first toolkit was testified by a fender drawing die design. It shows that the die face compensation can be realized and integrated seamlessly between CAD model, process simulation model and die structural CAE model with the help of data I/O tools developed by the authors.

  16. Euthanasia, assisted dying and the right to die in Ghana: a socio-legal analysis.

    PubMed

    Owusu-Dapaa, Ernest

    2013-12-01

    There is unanimity among states to protect the continuation of life of the individual as a safeguard against their collective extinction. The right to life is accordingly guaranteed but its antithesis, the right to die is the subject of an unending debate. The controversy over the right to die is deepened by rapid advances in medicine, creating the capability for prolongation of life beyond the span which one's natural strength can endure. Ghana's supreme law explicitly guarantees the right to life but remains ambiguous on right to die, particularly euthanasia and assisted dying. Thus, some of the other rights, such as the right to dignity and not to be tortured, can creatively be exploited to justify some instances of euthanasia. Ghana's criminal code largely proscribes euthanasia. Notwithstanding, proscription of euthanasia and assisted dying by the law, in Ghana's empirical work undertaken in some of the communities in Ghana, suggests that euthanasia is quietly practisedin health facilities and private homes, especially in the rural areas. Contrary to the popular reasons assigned in the literature of the Western world, with respect to the practice or quest for legalization of euthanasia as being a necessity for providing relief from pain or hopeless quality of life, empirical data from social and anthropological studies conducted in Ghana reveal that poverty is the motivation for informal euthanasia practice in Ghana rather than genuine desire on part of patients to die or their relatives to see to their accelerated death. Apart from poverty, traditional cultural values of African societies consider non-natural death as a taboo and ignominy to the victim and his family. Thus, any move by the government to legalize euthanasia will need to be informed by widely held consultations and a possible referendum; otherwise the law may be just a mere transplant of Western models of legislation on euthanasia without reflecting the ethos of the African people.

  17. Die Schokoladen-Diät

    NASA Astrophysics Data System (ADS)

    Ehrhardt, Matthias

    Schlankheitskuren sind einerseits ein soziales Phänomen, aber auch ein großer Zweig der Nahrungsmittelindustrie. Die Industrie bietet dabei verschiedene Produkte an, wie Diätlebensmittel, Nahrungsergänzungsmittel, Sportkleidung und -ausrüstung, Übungsvideos und -bücher, usw. Allerdings ist es bekanntermaßen sehr schwer, das einmal erreichte Wunschgewicht auch langfristig zu halten. Häufig tritt dabei der so genannte Jojo-Effekt auf, so dass man schließlich nach der Diät mehr wiegt als vorher.

  18. Do imaginary companions die? An exploratory study.

    PubMed

    Kastenbaum, Robert; Fox, Lynn

    Adults in this exploratory study usually recalled that their childhood imaginary companions faded away or were dismissed as other options for social interaction became more appealing. However, eight participants reported that their IC had died. Analysis of these deaths offers a glimpse of the child's talent for transitional thought processes that navigate between the emerging constraints of logic and the continuing appeal of fantasy. It is suggested that young children are testing the limits and possibilities of what it means to be "real" at the same time they are trying to puzzle out "alive" and "dead."

  19. Implementing California's Law on Assisted Dying.

    PubMed

    Mishra, Ruchika

    2017-03-01

    On October 5, 2015, Governor Jerry Brown approved bill ABX2 15, the End of Life Option Act, making California the fifth state in the country to allow physician-assisted dying. The law was modeled after Oregon's 1997 Death with Dignity Act. When the legislative special session ended on March 10, 2016, California health care providers had only ninety days to respond to the state mandate before the law would take effect, on June 9, 2016. Experience with the law so far suggests several challenges with implementation.

  20. Method and apparatus for die forming metal sheets and extrusions

    NASA Astrophysics Data System (ADS)

    Darter, John L.

    1986-06-01

    The invention comprises an apparatus for die forming metal sheets and extrusions which utilizes die blocks of low melting temperature metallic material. The die blocks are formed in an adjustable mold which comprises a mold box, a pivotable dam within the mold box and blocking means for locking the pivotable dam member in a desired angular position. Once a desired die block angle is ascertained for a particular joggle, the pivotable member of the mold box is adjusted to produce the desired angle in the die casting made in the mold box.

  1. Sheet metal stamping die design for warm forming

    DOEpatents

    Ghosh, Amit K.

    2003-04-22

    In metal stamping dies, by taking advantage of improved material flow by selectively warming the die, flat sections of the die can contribute to the flow of material throughout the workpiece. Local surface heating can be accomplished by placing a heating block in the die. Distribution of heating at the flat lower train central regions outside of the bend region allows a softer flow at a lower stress to enable material flow into the thinner, higher strain areas at the bend/s. The heating block is inserted into the die and is powered by a power supply.

  2. Die swell as an objective in the design of polymer extrusion dies

    NASA Astrophysics Data System (ADS)

    Siegbert, Roland; Behr, Marek; Elgeti, Stefanie

    2016-10-01

    This paper focuses on developing a suitable objective function for the inverse form of profile extrusion die design. First, the problem is motivated by introducing the extrusion die design process. After describing how Computer Aided Engineering enhances the traditional design process, a set of applicable objective functions is introduced. The main criteria for identifying the most suitable are computational applicability, robustness and smoothness of the functional. After discussing the results of several simulations, an objective function is proposed for the implementation in an existing optimization framework utilizing parameter-based optimization.

  3. Organ transplantation from donors (cadaveric or living) with a history of malignancy: review of the literature.

    PubMed

    Zhang, Sheng; Yuan, Jin; Li, Wei; Ye, Qifa

    2014-10-01

    The evolution of organ transplantation has resulted in extended lifespan as well as better life quality of patients with end-stage diseases, which in turn causes an increased demand for organs. The persistent organ shortage requires a careful reconsideration of potential donors (living or cadaveric) that have current or historical malignancies. Donors with low-grade skin tumors, carcinomas in situ of the uterine cervix, and primary central nervous system (CNS) tumors can be considered as potential donors for recipients dying on wait list longing for organ transplantation. Recently, transplant centers have turned to other types of malignancies including low grade renal cell carcinoma, prostate, ureteral, endometrial and breast cancer, and favorable outcomes have been shown in such innovations. When considering donors with a history of malignancy, general biologic behavior of the tumor type, histology and stage at the time of diagnosis, and the length of disease-free interval should be considered (Transplantation 2002;74(12):1657-1663). With the review of literatures, we illustrate the organ utilization from donors with malignancies all around the world since earlier times and give some suggestions for decision making under the circumstance of whether to choose those marginal donors or not on the basis of reviewed literatures.

  4. [Malignant intracerebral nerve sheath tumours: Two case reports and complete review of the literature cases].

    PubMed

    Le Fèvre, C; Castelli, J; Perrin, C; Hénaux, P L; Noël, G

    2016-04-01

    Malignant peripheral nerve sheath tumours are extremely rare and can be associated with neurofibramatosis type 1. Their prognosis is poor and surgery remains the mainstay of therapy and should be the first line of treatment. Radiotherapy and chemotherapy are second line treatment and their effectiveness remains to demonstrate. The diagnosis is clinical, radiological, histological and immunohistochemical. Malignant peripheral nerve sheath tumours have a potential of local tumour recurrence very high and can metastasize. They often occur in extremity of the members but also rarely into brain. We report two cases of intracerebral nerve sheath tumour. The first was a 68-year-old woman who was admitted with progressive symptoms of headache and diplopia. A left frontotemporal malignant peripheral nerve sheath tumours was diagnosed and was treated by surgery and irradiation. Ten months later, she presented a local recurrence and spine bone's metastases were treated by vertebroplasty and irradiation. The patient died 15 months after the diagnosis. The second case was a 47-year-old woman who was referred because headache and vomiting symptoms. A right frontal malignant peripheral nerve sheath tumours was diagnosed and treated by surgery and irradiation. After that, the patient had three local recurrence operated and pulmonary and cranial bone's metastases. She was still alive after 20 months. We propose a literature review with 25 cases of intracerebral nerve sheath tumour identified, including the two current cases.

  5. Is There a True Concern Regarding the Use of Hair Dye and Malignancy Development?

    PubMed Central

    Saitta, Peter; Cook, Christopher E.; Messina, Jane L.; Brancaccio, Ronald; Wu, Benedict C.; Grekin, Steven K.; Holland, Jean

    2013-01-01

    Many advances in the cosmetic industry have increased our ability to enhance youth and beauty. Hair-coloring products are one such innovation. Over the past several decades, a significant amount of work has been dedicated to understanding the possible long-term side effects associated with hair-dye use, specifically looking at cancer risk. This paper describes the hair-coloring process, highlights the potentially carcinogenic ingredients in various hair-dying products, and reviews the epidemiological evidence relating personal hair-dye use to the risk of developing several types of malignancies. PMID:23320124

  6. What's New in Malignant Mesothelioma Research and Treatment?

    MedlinePlus

    ... and Treatment? Malignant Mesothelioma About Malignant Mesothelioma What’s New in Malignant Mesothelioma Research and Treatment? There is ... that has shown promise in some studies. Other new drugs have different targets. For example, some new ...

  7. ["Good dying"--definition and current state of research].

    PubMed

    Hutter, Nico; Stößel, Ulrich; Meffert, Cornelia; Körner, Mirjam; Bozzaro, Claudia; Becker, Gerhild; Baumeister, Harald

    2015-08-01

    The advances of modern medicine did not only result in prolongation of life expectancy, but also led to a shift from dying at home to dying in public institutions. In western countries most people die at advanced age in medical facilities. Hence, the question regarding the conditions, which should be provided by society and especially medicine, to allow terminally ill people to experience "good dying" is substantial. For this purpose, an examination of patients', family members' and health care providers' understanding of the term " good dying" is required. The present paper aims at shedding light on the term "good dying" and to summarize the current state of research. Therefore, the attributes of "good dying" will be described from the perspectives of patients, family members and health care providers, which are discussed and examined in current medical-sociological research. These attributes can be illustrated on three dimensions: Quality of life at the end of life (e. g. pain relief, mental well-being), quality of dying (e. g. avoiding prolonged dying, autonomy, presence of relatives) and quality of health care at the end of life (e. g. patient-oriented health care, positive communication between health care providers and patients, availability of guidelines). Although the attributes of "good dying" are described in detail in the existing literature, further studies have to clarify the relevance and impact of these attributes as predictors of "good dying". © Georg Thieme Verlag KG Stuttgart · New York.

  8. DIE Deflection Modeling: Empirical Validation and Tech Transfer

    SciTech Connect

    R. Allen Miller

    2003-05-28

    This report summarizes computer modeling work that was designed to help understand how the die casting die and machine contribute to parting plane separation during operation. Techniques developed in earlier research (8) were applied to complete a large computational experiment that systematically explored the relationship between the stiffness of the machine platens and key dimensional and structural variables (platen area covered, die thickness, platen thickness, thickness of insert and the location of the die with respect to the platen) describing the die/machine system. The results consistently show that there are many significant interactions among the variables and it is the interactions, more than the individual variables themselves, which determine the performance of the machine/die system. That said, the results consistently show that it is the stiffness of the machine platens that has the largest single impact on die separation.

  9. [Management of malignant vulvar tumors].

    PubMed

    Mahjoub, S; Ben Brahim, F; Ben Hmid, R; Zghal, D; Kallel, N; Sébai, N; Zouari, Faouzia

    2008-12-01

    Vulva anatomy--FIGO classification--Vulva tumors anatomopathology--Tretments of vulva cancers. Our stady is a retrospective, longitudinal and continuous one. It concerns 11 malignant vulva tumors whith were treated in the département "C" of the centre of maternity of Tunis. The period of stady is fifty four months (2002-2006). The aim of our study is to analyse the charactéristics of the vulva cancer and to compare our results to littérature. Mean age of our patients is 67 years old. They are all menaused. The principal signs are vulva tuméfaction in 72.7% of the cases, vulva prurit in 27.3% of the cases and genital bleeding in 27.3% of the cases. The mean period of consultation is of 14 months. We have ten cases of vulvar epidermoid carcinoma and one melanoma. The treatment was surgical in the eleven cases (10 total vulvectomy and one hemivulvectomy) They all benefited of an inguinal bilateral curage. The adjuvant radiotérapie was indicated in 3 cases. A patient was classed stage Ib of FIGO, 7 stage II, one stage III and one stage IVa. Nine patients are in remission, 3 are dead: 2 because of their cancer and one due to a pulmonar embolism. The survival of 6 month is 72.2%. The prevention of this cancer passes by the close follow of dystrophic states and viral pathologies of the vulva.

  10. Childhood malignancies and decision making.

    PubMed

    Holder, A R

    1992-01-01

    Failure to obtain "adequate" medical care for a child constitutes child neglect, which may be used as the basis for prosecution of parents, removal of the child from the home, or court-ordered medical treatment. "Adequate" care is usually construed as that which is given by a licensed physician, but, in case of dispute, courts almost never engage in choosing one medical approach over another. The principle that parents may not refuse medical care, however, is made very difficult when children have malignancies--the long-term nature of the treatment means that, if the child is left at home, court order or not, the parents may flee with their child. Removing the child from the home, however, adds that trauma to the ill child's burdens. Questions should be asked before making a request to a court to order a therapy which will prolong but not save a child's life if the parents would prefer to spare their child the side effects. Parents, however, may always refuse to permit their child to participate in research studies, no matter how promising. Adolescents are increasingly believed to be capable of medical decision making; most courts, however, would not allow an adolescent to refuse life-saving treatment.

  11. Malignant Peripheral Nerve Sheath Tumors.

    PubMed

    Durbin, Adam D; Ki, Dong Hyuk; He, Shuning; Look, A Thomas

    2016-01-01

    Malignant peripheral nerve sheath tumors (MPNST) are tumors derived from Schwann cells or Schwann cell precursors. Although rare overall, the incidence of MPNST has increased with improved clinical management of patients with the neurofibromatosis type 1 (NF1) tumor predisposition syndrome. Unfortunately, current treatment modalities for MPNST are limited, with no targeted therapies available and poor efficacy of conventional radiation and chemotherapeutic regimens. Many murine and zebrafish models of MPNST have been developed, which have helped to elucidate the genes and pathways that are dysregulated in MPNST tumorigenesis, including the p53, and the RB1, PI3K-Akt-mTOR, RAS-ERK and Wnt signaling pathways. Preclinical results have suggested that new therapies, including mTOR and ERK inhibitors, may synergize with conventional chemotherapy in human tumors. The discovery of new genome editing technologies, like CRISPR-cas9, and their successful application to the zebrafish model will enable rapid progress in the faithful modeling of MPNST molecular pathogenesis. The zebrafish model is especially suited for high throughput screening of new targeted therapeutics as well as drugs approved for other purposes, which may help to bring enhanced treatment modalities into human clinical trials for this devastating disease.

  12. PSYCHOLOGICAL ASPECTS OF HAEMATOLOGICAL MALIGNANCIES

    PubMed Central

    Kulhara, P.; Verma, S.C.; Bambery, P.; Nehra, R.

    1990-01-01

    SUMMMARY Sixty nine patients with various types of haematological malignancies were studied. Chronic myeloid leukaemia (n =32) was the commonest diagnosis. The patients were assessed on Hamilton Rating Scale for Depression, PGI-N2 Health Questionnaire and Presumptive Stressful Life Events Scale and those who had scores above the cut off points for Hamilton Rating Scale and/or PGI-N2 Health Questionnaire were assessed on Present State Examination. The patients were followed up at 3 and 6 months interval. At 3 months 51 patients were re-assessed whilst at 6 months only 26 could be re-evaluated. There were no significant changes in scores of Hamilton Rating scale and PGI-N2 Health Questionnaire at intake and subsequent follow-up assessments. No significant correlations between stressful life experience and severity of illness emerged. Twenty nine patients were interviewed on Present State Examination and of these 20 had diagnosable depressive neuroses- From consultation liaison psychiatric point of view, provision of psychiatric help to these patients is discussed. PMID:21927472

  13. Novel immunotherapies in lymphoid malignancies

    PubMed Central

    Batlevi, Connie Lee; Matsuki, Eri; Brentjens, Renier J.; Younes, Anas

    2016-01-01

    The success of the anti-CD20 monoclonal antibody rituximab in the treatment of lymphoid malignancies provided proof-of-principle for exploiting the immune system therapeutically. Since the FDA approval of rituximab in 1997, several novel strategies that harness the ability of T cells to target cancer cells have emerged. Reflecting on the promising clinical efficacy of these novel immunotherapy approaches, the FDA has recently granted ‘breakthrough’ designation to three novel treatments with distinct mechanisms. First, chimeric antigen receptor (CAR)-T-cell therapy is promising for the treatment of adult and paediatric relapsed and/or refractory acute lymphoblastic leukaemia (ALL). Second, blinatumomab, a bispecific T-cell engager (BiTE®) antibody, is now approved for the treatment of adults with Philadelphia-chromosome-negative relapsed and/or refractory B-precursor ALL. Finally, the monoclonal antibody nivolumab, which targets the PD-1 immune-checkpoint receptor with high affinity, is used for the treatment of Hodgkin lymphoma following treatment failure with autologous-stem-cell transplantation and brentuximab vedotin. Herein, we review the background and development of these three distinct immunotherapy platforms, address the scientific advances in understanding the mechanism of action of each therapy, and assess the current clinical knowledge of their efficacy and safety. We also discuss future strategies to improve these immunotherapies through enhanced engineering, biomarker selection, and mechanism-based combination regimens. PMID:26525683

  14. Malignant mesothelioma in Hong Kong.

    PubMed

    Chang, Kwok C; Leung, Chi C; Tam, Cheuk M; Yu, Wai C; Hui, David S; Lam, Wah K

    2006-01-01

    Malignant mesothelioma (mesothelioma) is rare. We conducted the first systematic study of the epidemiology of mesothelioma in Hong Kong from 1988 to May 2002 by reviewing medical records. Mesothelioma patients were identified from the database of 12 out of 20 hospitals that would have admitted mesothelioma patients territory-wide. These 12 hospitals served 73% of the total hospital bed-years of the 20 hospitals. We identified 67 mesothelioma patients. The estimated annual incidence was one per million, which was similar to the background incidence of one to two per million among Caucasians. Occupational history was available in 43 subjects. Three quarters of mesothelioma patients with available occupational history had occupational asbestos exposure. Restricting analysis to 48 patients with accessible medical records and using 67 occupational asbestosis patients for comparison, the epidemiology of mesothelioma in Hong Kong shares similarities with the literature: mean age of 63 years upon diagnosis, mean latency of 46 years, median survival of 9.5 months, male predominance, selective presentation among women, high prevalence among workers in ships and dockyards, predominantly epithelioid type, lower prevalence of asbestos bodies, and negative association with pleural plaques. Asbestos consumption in Hong Kong rose in the 1970s and peaked in early 1980s and late 1990s. Hong Kong may encounter an epidemic of mesothelioma in the 2010s if effective occupational asbestos control measures are not in place.

  15. Adjuvant therapy of malignant melanoma.

    PubMed

    Dickler, M N; Coit, D G; Meyers, M L

    1997-10-01

    The incidence of malignant melanoma continues to rise steadily in the United States, with approximately 40,300 new cases expected in 1997. A significant number of patients with deep primary lesions or regional lymph node metastases are at high risk for developing recurrent, metastatic disease despite adequate surgical intervention. Therefore, approaches to adjuvant therapy including immunotherapy, such as interferon, levamisole, and vaccines and chemotherapy and chemoimmunotherapy have been investigated in high-risk patients. The key adjuvant trials are reviewed, with emphasis placed on randomized trials. High-dose interferon-alpha has recently been shown to modestly improve disease-free and overall survival in a prospective randomized trial of high-risk patients and has been approved by the FDA for this indication. Vaccines, which currently remain experimental, may prove to be equally effective but less toxic options for adjuvant therapy. Also, the identification of more high-risk patients who might benefit from adjuvant therapy may be facilitated by sentinel lymph node biopsy and the reverse-transcriptase polymerase chain reaction for tyrosinase.

  16. Resistin: insulin resistance to malignancy.

    PubMed

    Codoñer-Franch, Pilar; Alonso-Iglesias, Eulalia

    2015-01-01

    Adipose tissue is recognized as an endocrine organ that secretes bioactive substances known as adipokines. Excess adipose tissue and adipose tissue dysfunction lead to dysregulated adipokine production that can contribute to the development of obesity-related co-morbidities. Among the various adipokines, resistin, which was initially considered as a determinant of the emergence of insulin resistance in obesity, has appeared as an important link between obesity and inflammatory processes. Several experimental and clinical studies have suggested an association between increased resistin levels and severe conditions associated with obesity such as cardiovascular disease and malignancies. In this review, we present the growing body of evidence that human resistin is an inflammatory biomarker and potential mediator of obesity-associated diseases. A common pathway seems to involve the combined alteration of immune and inflammatory processes that favor metabolic disturbances, atherosclerosis and carcinogenesis. The mode of action and the signaling pathways utilized by resistin in its interactions with target cells could involve oxidative and nitrosative stress. Therefore, resistin could function as a key molecule in the complications of obesity development and could potentially be used as a diagnostic and prognostic marker. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Novel immunotherapies for hematological malignancies

    PubMed Central

    Nelson, Michelle H.; Paulos, Chrystal M.

    2014-01-01

    Summary The immune system is designed to discriminate between self and tumor tissue. Through genetic recombination, there is fundamentally no limit to the number of tumor antigens that immune cells can recognize. Yet, tumors use a variety of immunosuppressive mechanisms to evade immunity. Insight into how the immune system interacts with tumors is expanding rapidly and has accelerated the translation of immunotherapies into medical breakthroughs. Herein, we appraise the state of the art in immunotherapy with a focus on strategies that exploit the patient’s immune system to kill cancer. We review various forms of immune-based therapies, which have shown significant promise in patients with hematological malignancies, including (i) conventional monoclonal therapies like rituximab, (ii) engineered monoclonal antibodies called bispecific T cell engagers (BiTEs), (iii) monoclonal antibodies and pharmaceutical drugs that block inhibitory T-cell pathways (i.e. PD-1, CTLA-4 and IDO), and (iv) adoptive cell transfer (ACT) therapy with T cells engineered to express chimeric antigen receptors (CARs) or T-cell receptors (TCRs). We also assess the idea of using these therapies in combination and conclude by suggesting multi-prong approaches to improve treatment outcomes and curative responses in patients. PMID:25510273

  18. Dendritic cells in hematological malignancies.

    PubMed

    Galati, Domenico; Corazzelli, Gaetano; De Filippi, Rosaria; Pinto, Antonio

    2016-12-01

    Dendritic cells (DCs) are bone-marrow-derived immune cells accounted for a crucial role in initiating and modulating the adaptive immune response and supporting the innate immune response independently from T cells. While functioning as the most effective antigen-presenting cells within the immune system, DCs can otherwise induce tolerance in central and peripheral lymphoid organs acting therefore as suppressors rather than stimulators of the immune response. Within mechanisms regulating antitumor immunity, DCs can capture antigens from viable or damaged tumor cells and present the processed peptides to T-cells to prompt the generation and maintenance of an effective tumor-specific T-cell response. Upon a complex cross-talk with other cellular components of the tumor microenvironment, DCs can, on the other hand, exert a potent antigen-dependent and -independent tolerogenic function by favoring the process of tumor immune evasion. Due to this dual-role in balancing antitumor immunity and tolerance, possibly linked to distinct developmental stages and functional subsets, several studies have addressed the regulatory significance of DCs in different types of malignancies. This review summarizes the most significant pieces of evidence highlighting the critical relevance of bone marrow-derived DCs within the immune pathways regulating pathogenesis and progression of hemopoietic tumors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Esophageal malignancy: A growing concern

    PubMed Central

    Chai, Jianyuan; Jamal, M Mazen

    2012-01-01

    Esophageal cancer is mainly found in Asia and east Africa and is one of the deadliest cancers in the world. However, it has not garnered much attention in the Western world due to its low incidence rate. An increasing amount of data indicate that esophageal cancer, particularly esophageal adenocarcinoma, has been rising by 6-fold annually and is now becoming the fastest growing cancer in the United States. This rise has been associated with the increase of the obese population, as abdominal fat puts extra pressure on the stomach and causes gastroesophageal reflux disease (GERD). Long standing GERD can induce esophagitis and metaplasia and, ultimately, leads to adenocarcinoma. Acid suppression has been the main strategy to treat GERD; however, it has not been proven to control esophageal malignancy effectively. In fact, its side effects have triggered multiple warnings from regulatory agencies. The high mortality and fast growth of esophageal cancer demand more vigorous efforts to look into its deeper mechanisms and come up with better therapeutic options. PMID:23236223

  20. Pediatric malignancies in Bursa, Turkey.

    PubMed

    Günay, U; Meral, A; Sevinir, B

    1996-01-01

    Turkey is among the countries affected by ionizing radiation from the Chernobyl accident of April 26, 1986. The northern part of Turkey, where the city of Bursa is located, is presumed to be more influenced by the nuclear catastrophe. The radioactive elements in the atmosphere have been examined at various intervals after May 1, 1986 and barium-140 and lanthanum-140, fission agents of uranium-235, have been found in the atmosphere. Their exact concentration could not be measured. The aim of this report is to review the pediatric malignancies diagnosed in our institution between 1986 and 1995, with a view on any significant increase in the number of these cases. The patients were divided into three groups: acute leukemia patients (101 cases), lymphomas (44 cases), and solid tumors (31 cases). All three groups showed a tendency to increase after 1986; the increase in leukemia cases between 1986 and 1995 was found to be significantly higher (p < 0.001) when compared with the years before 1986. The increase in lymphoma and solid tumor cases after 1986 was not found to be significant (p > 0.05). We cannot rule out environmental causes other than the effects of the Chernobyl accident, and we feel that more intense epidemiological studies should be carried out on this subject in other areas of Turkey.

  1. Improved radioimmunotherapy of hematologic malignancies

    SciTech Connect

    Press, O.W.

    1992-03-24

    This research project proposes to develop novel new approaches of improving the radioimmunodetection and radioimmunotherapy of malignancies by augmenting retention of radioimmunoconjugates by tumor cells. The approaches shown to be effective in these laboratory experiments will subsequently be incorporated into out ongoing clinical trials in patients. Specific project objectives include: to study the rates of endocytosis, intracellular routing, and metabolic degradation of radiolabeled monoclonal antibodies targeting tumor-associated antigens on human leukemia and lymphoma cells; To examine the effects of lysosomotropic amines (e.g. chloroquine, amantadine), carboxylic ionophores (monensin, nigericin), and thioamides (propylthiouracil), on the retention of radiolabeled MoAbs by tumor cells; to examine the impact of newer radioiodination techniques (tyramine cellobiose, paraiodobenzoyl) on the metabolic degradation of radioiodinated antibodies; to compare the endocytosis, intracellular routing, and degradation of radioimmunoconjugates prepared with different radionuclides ({sup 131}Iodine, {sup 111}Indium, {sup 90}Yttrium, {sup 99m}Technetium, {sup 186}Rhenium); and to examine the utility of radioimmunoconjugates targeting oncogene products for the radioimmunotherapy and radioimmunoscintigraphy of cancer.

  2. Eyelid Malignancies- Always Quite Challenging

    PubMed Central

    Balasubramanian, Arumugham

    2017-01-01

    The diagnosis and management of eyelid cancers are quite challenging. Eyelid tumours are relatively rare diverse group of diseases varied in their presentation and extent. Many benign tumours and inflammatory conditions quite frequently masquerade eyelid cancers. Eyelid cancers are not single entity but comprise a wide range of tumours with extremes of tumour biology from indolent to very aggressive histopathologic types. Compromise on aesthetics and eyelids’ indispensable function of protecting the eyes during management, may lead to untoward cosmetic disfigurement and loss of vision. On the other hand, inadequate cancer clearance will also be vision threatening and life threatening due to loco regional recurrence and metastasis. To strike an optimal balance is a challenging task, to achieve ‘cancer cure’ with maximum preservation of function and cosmetics. In addition, the integration of other modalities of treatment, judicious selection and their sequencing require multidisciplinary discussion and joint management by different specialists. We are presenting four case scenarios, we met with in our teaching hospital with reference to literature review to emphasize that eyelid malignancies are not always simple with respect to diagnosis and management. PMID:28511494

  3. Noncoding RNAs in endocrine malignancy.

    PubMed

    Kentwell, Jessica; Gundara, Justin S; Sidhu, Stan B

    2014-05-01

    Only recently has it been uncovered that the mammalian transcriptome includes a large number of noncoding RNAs (ncRNAs) that play a variety of important regulatory roles in gene expression and other biological processes. Among numerous kinds of ncRNAs, short noncoding RNAs, such as microRNAs, have been extensively investigated with regard to their biogenesis, function, and importance in carcinogenesis. Long noncoding RNAs (lncRNAs) have only recently been implicated in playing a key regulatory role in cancer biology. The deregulation of ncRNAs has been demonstrated to have important roles in the regulation and progression of cancer development. In this review, we describe the roles of both short noncoding RNAs (including microRNAs, small nuclear RNAs, and piwi-interacting RNAs) and lncRNAs in carcinogenesis and outline the possible underlying genetic mechanisms, with particular emphasis on clinical applications. The focus of our review includes studies from the literature on ncRNAs in traditional endocrine-related cancers, including thyroid, parathyroid, adrenal gland, and gastrointestinal neuroendocrine malignancies. The current and potential future applications of ncRNAs in clinical cancer research is also discussed, with emphasis on diagnosis and future treatment.

  4. Impression cytology diagnosis of ulcerative eyelid malignancy.

    PubMed

    Sen, S; Lyngdoh, A D; Pushker, N; Meel, R; Bajaj, M S; Chawla, B

    2015-02-01

    The utility of impression cytology in ocular diseases has predominantly been restricted to the diagnosis of dry eye, limbal stem cell deficiency and conjunctival neoplasias. Its role in malignant eyelid lesions remains largely unexplored. Although scrape cytology is more popular for cutaneous lesions, impression cytology, being non-traumatic, has an advantage in small and delicate areas such as the eyelid. The present study has been designed to evaluate its role in the diagnosis and management of malignant eyelid lesions. Thirty-two histopathologically proven malignant eyelid lesions diagnosed over a 2-year period, including 13 basal cell carcinomas, 11 sebaceous carcinomas, four squamous cell carcinomas, two malignant melanomas and two poorly differentiated carcinomas, formed the study group. The results of impression cytology were compared with those of histopathology in the study group and with an age- and sex-matched group of benign cases as controls. The sensitivity of impression cytology was 84% (27/32) for the diagnosis of malignancy and 28% (9/32) for categorization of the type of malignancy. Impression cytology is a simple, useful, non-invasive technique for the detection of malignant ulcerative eyelid lesions. It is especially useful as a follow-up technique for the detection of recurrences. © 2014 John Wiley & Sons Ltd.

  5. [The debate about the right to die].

    PubMed

    Beca, Juan Pablo; Ortiz, Armando; Solar, Sebastián

    2005-05-01

    The Right to Die is a debatable issue and some basic notions need to be clarified to discuss it. Death needs to be recognized as part of human life. The goal of medicine is to avoid pain and alleviate suffering, to prevent premature death and when this is not possible, to let it occur peacefully. The concept of euthanasia is unclear, which increases the confusion on end-of-life topics. The term euthanasia should be used only when referring to medical acts performed to produce the patient's death, with the intention of terminating his/her suffering. It is what is usually called "active" euthanasia, which can be voluntary or involuntary. It is essential to understand the difference between producing and allowing death. This will permit timely decisions about limiting or withdrawing treatments, that can be disproportionate or that are only prolonging suffering. Limiting treatments does not mean to abandon the patient but rather to redefine his needs, such as pain treatment, prevention of complications, and relief of suffering. The ethic rationale for these decisions is the respect to the dignity of human life, and the estimation of proportionality or futility of each treatment. The physician's duty with the patient at the end of his life is to assist him in dying according to his values and to minimize his distress.

  6. Dying, mourning, and spirituality: a psychological perspective.

    PubMed

    Marrone, R

    1999-09-01

    Based in an unfortunate tradition that stretches back in time to Watson's behaviorism and Freud's psychoanalysis, psychology has tended to reject and to pathologize matters of the spirit. In the past 30 years, however, with the advent of what has been termed the cognitive revolution, psychology has greatly expanded the scope of its subject matter. Psychologists and thanatologists have begun to unravel the cognitive underpinnings of our assumptive world and the transformation of those underpinnings in times of crisis and stress. This article examines the cognitive basis of the spiritual experience and the use of cognitive assimilation, accommodation strategies during the process of mourning the death of a loved one, as well as during the process of living our own dying. Of special importance to mental health professionals and clergy, new research on dying, mourning, and spirituality suggests that the specific ways in which people rediscover meaning--such as belief in traditional religious doctrine, the afterlife, reincarnation, philanthropy, or a spiritual order to the universe--may be less important than the process itself. In other words, in the midst of dealing with profound loss in our lives, the ability to reascribe meaning to a changed world through spiritual transformation, religious conversion, or existential change may be more significant than the specific content by which that need is filled.

  7. The dying child and surviving family members.

    PubMed

    Shrier, D K

    1980-12-01

    This overview of death and dying focuses on the dying child and surviving family members. Children's concepts of death at different developmental stages are reviewed. These range from an inability to distinguish death from other forms of separation prior to age 3, through partial concepts of death until, by age 10 to 15 years, children are able to conceptualize death as universal, inevitable and final. The importance of adults assisting in the child's growing comprehension of death is stressed. The stages of grief and mourning, as outlined by Kubler-Ross, are reviewed from the perspective of the child and family: denial, anger, bargaining, depression and acceptance. Recognition is given to the variations in coping styles among different family members. The special circumstances related to the death of an infant and the impact of the death of a child on the surviving siblings are discussed. Specific helpful interventions to assist families in coping with mourning are described. The death of a child remains one of the most painful and difficult events for a family and its physician to accept.

  8. Dying or living?: The double bind.

    PubMed

    Longhofer, J

    1980-06-01

    Describing the behaviors of terminally ill patients, their families and those charged with their care has received considerable attention during the past decade. This study of comprehensive cancer treatment and research facility indicates that the prevailing theory is limited to explanation at the intra-psychic level. In her work with hundreds of terminal cases, Dr. Elizabeth Kubler-Ross found that patients typically progress through five stages: 1) denial, 2) anger, 3) bargaining, 4) depression, and 5) acceptance. She concludes that the majority of her patients die in a stage of acceptance--a state of equanimity. Recently, scholars have claimed that this five stage scheme has limited applicability and may in fact contribute to the formalization of a dying person's behavior. This preliminary report proposes that the stage theory, if it has any descriptive validity, becomes meaningful only when used to describe behaviors occurring among patients, families, and medical practitioners. A plausible explanation of these behaviors is accomplished by examination of communication patterns containing the structure of paradox or double bind. Patients are forced to perceive realities about their physical conditions not as they appear to them, but as they are defined by those in their environment. This paper explores these communication patterns in relation to the structure of social relationships and the specific contents of messages being transmitted and received.

  9. Death and dying: what the patient wants.

    PubMed

    Balducci, L

    2012-04-01

    A good death and a death with dignity may be achieved when death is congruent with the personal values of the patient. It behooves the practitioner to recognize these values and to cater to them. This paper describes effective communication with the dying person, and the partnership of treatment team, patient and family in face of the patient death. To identify and define the patient wishes it is necessary to learn how to interpret the patient's non verbal as often patients are unable to formulate the questions they wish to ask concerning their passing. These difficulties stem from several cultural factors including concern about disturbing the practitioner. It is the treatment team's responsibility to facilitate this discussion. A good death is achieved when symptoms are controlled and when patients and family recognize death as a unique living experience to be treasured as any other living experience. A death with dignity brings healing, that is always possible even when cure is out of reach. Patient's and practitioner's values may be at odd in face of controversial issues including euthanasia, assisted suicide and terminal sedation. Though he/she should not be compelled to execute these requests, the practitioner should be able to entertain an open discussion with the patient concerning these issues. Open communication and reflective listening even in presence of disagreements are the venue of healing. The study of death and dying requires novel approaches including personal narrative and qualitative research to complement traditional research instrument, such as questionnaire that cannot embrace the whole human dimension.

  10. Die-target for dynamic powder consolidation

    DOEpatents

    Flinn, J.E.; Korth, G.E.

    1985-06-27

    A die/target is disclosed for consolidation of a powder, especially an atomized rapidly solidified metal powder, to produce monoliths by the dynamic action of a shock wave, especially a shock wave produced by the detonation of an explosive charge. The die/target comprises a rectangular metal block having a square primary surface with four rectangular mold cavities formed therein to receive the powder. The cavities are located away from the geometrical center of the primary surface and are distributed around such center while also being located away from the geometrical diagonals of the primary surface to reduce the action of reflected waves so as to avoid tensile cracking of the monoliths. The primary surface is covered by a powder retention plate which is engaged by a flyer plate to transmit the shock wave to the primary surface and the powder. Spawl plates are adhesively mounted on other surfaces of the block to act as momentum traps so as to reduce reflected waves in the block. 4 figs.

  11. Die-target for dynamic powder consolidation

    DOEpatents

    Flinn, John E.; Korth, Gary E.

    1986-01-01

    A die/target is disclosed for consolidation of a powder, especially an atomized rapidly solidified metal powder, to produce monoliths by the dynamic action of a shock wave, especially a shock wave produced by the detonation of an explosive charge. The die/target comprises a rectangular metal block having a square primary surface with four rectangular mold cavities formed therein to receive the powder. The cavities are located away from the geometrical center of the primary surface and are distributed around such center while also being located away from the geometrical diagonals of the primary surface to reduce the action of reflected waves so as to avoid tensile cracking of the monoliths. The primary surface is covered by a powder retention plate which is engaged by a flyer plate to transmit the shock wave to the primary surface and the powder. Spawl plates are adhesively mounted on other surfaces of the block to act as momentum traps so as to reduce reflected waves in the block.

  12. Malignant transformation in an anal condyloma acuminatum.

    PubMed

    Ejeckam, G C; Idikio, H A; Nayak, V; Gardiner, J P

    1983-03-01

    A 61-year-old man had malignant transformation of an anal condyloma acuminatum, demonstrated by light and electron microscopic studies. Intranuclear virus-like particles were seen in the benign condylomatous koilocytotic cells but these were absent in the malignant cells. Multinucleation, syncytial giant cells and nuclear atypia in a condyloma acuminatum are considered features of in-situ carcinomatous change. Anal condyloma acuminatum requires wide excision and thorough examination of anorectal canal in order to exclude hidden disease, which will predispose to recurrence. Homosexuality is considered a predisposing factor. The authors stress the importance of histopathologic examination of all anorectal warts to exclude malignant change.

  13. Malignant tumours in patients with HIV infection.

    PubMed Central

    Tirelli, U.; Franceschi, S.; Carbone, A.

    1994-01-01

    One of the most important though somewhat neglected aspects of research in HIV infection concerns the development, clinicopathological characteristics, and treatment of malignant tumours in infected patients. With the improved survival of patients with AIDS owing to the better prevention and treatment of infectious complications there may well be an increase in AIDS related malignancies. This paper reviews the epidemiology, pathology, and treatment of malignant tumours in patients with HIV. Images p1149-a p1149-b p1149-c FIG 1 FIG 2 FIG 3 p1151-a p1151-b p1151-c PMID:8173459

  14. Update on Malignant Sweat Gland Tumors.

    PubMed

    van der Horst, Michiel P J; Brenn, Thomas

    2017-06-01

    Malignant sweat gland tumors are rare cutaneous neoplasms, traditionally separated according to their behavior into low- and high-grade malignant. There is significant morphologic overlap, and outright malignant tumors may show relatively bland histologic features. They may, therefore, be mistaken easily for benign neoplasms. Recognition of these tumors and accurate diagnosis is important for early treatment to prevent aggressive behavior and adverse outcome. This article provides an overview of 4 important entities with emphasis on diagnostic pitfalls, differential diagnosis and recent developments. Microcystic adnexal carcinoma, squamoid eccrine ductal carcinoma, aggressive digital papillary adenocarcinoma, and spiradenocarcinoma are discussed in detail. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Radioisotope diagnosis and therapy of malignant pheochromocytoma.

    PubMed

    Shapiro, B; Gross, M D; Shulkin, B

    2001-12-01

    The availability of radiopharmaceuticals to depict primary malignant pheochromocytoma and its metastases has markedly changed the approach to these unusual cancers. Whole body screening afforded by scintigraphy allows remote tumor involvement to be identified and provides staging information necessary to guide subsequent therapy. The avid accumulation by malignant pheochromocytoma of some radiopharmaceuticals used for scanning has shown promise in therapeutic trials. In this paper, we discuss radiopharmaceuticals presently employed in malignant pheochromocytoma for both diagnostic and therapeutic uses and potential future compounds that may find their way into clinical practice in the approach to these and other related neoplasms.

  16. Cutaneous malignancies in immunosuppressed organ transplant recipients.

    PubMed

    Seda, Ivette M Sosa; Zubair, Adeel; Brewer, Jerry D

    2014-01-01

    During the past century, organ transplantation has delivered the miracle of life to more than 500,000 patients in need. Secondary malignancies have developed as an unforeseen consequence of intense immunosuppressive regimens. Cutaneous malignancies have been recognized as the most frequent cancer that arises post-transplantation. Among organ transplant recipients (OTRs), skin cancer is a substantial cause of morbidity and potential mortality. The authors discuss epidemiology and clinical presentation of cutaneous malignancies; associated risk factors; recommendation for the care of immunosuppressed OTRs, and emerging therapies on the horizon.

  17. Benign breast lesions that mimic malignancy.

    PubMed

    Torous, Vanda F; Schnitt, Stuart J; Collins, Laura C

    2017-02-01

    Many benign and reactive lesions of the breast show morphological overlap with malignant lesions. These benign mimics of malignancy often present diagnostic challenges to even the most experienced pathologists. This review focuses on several benign lesions of the breast that mimic malignant entities. For each of these lesions, we describe the key morphological and immunohistochemical features, potential diagnostic pitfalls, and our approach to arriving at the correct diagnosis. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  18. Metastatic malignant phyllodes tumor involving the cerebellum.

    PubMed

    Rowe, J Jordi; Prayson, Richard A

    2015-01-01

    Brain metastases from malignant phyllodes tumors of the breast are a rare occurrence. We report a patient with a malignant phyllodes tumor of the right breast which subsequently metastasized to the right lower lobe of the lung 1 year after initial presentation, and to the right cerebellar hemisphere 2 years after diagnosis of her breast mass. After both chemotherapy and whole brain radiotherapy the patient is tumor free at most recent follow-up, 116 months after the breast tumor diagnosis was made. The literature is briefly reviewed and the differential diagnosis of malignant spindle cell brain tumors is discussed.

  19. Canine olfactory detection of malignant melanoma

    PubMed Central

    Campbell, Leon Frederick; Farmery, Luke; George, Susannah Mary Creighton; Farrant, Paul B J

    2013-01-01

    Our patient is a 75-year-old man who presented after his pet dog licked persistently at an asymptomatic lesion behind his right ear. Examination revealed a nodular lesion in the postauricular sulcus. Histology confirmed malignant melanoma, which was subsequently excised. Canine olfactory detection of human malignancy is a well-documented phenomenon. Advanced olfaction is hypothesised to explain canine detection of bladder, breast, colorectal, lung, ovarian, prostate and skin cancers. Further research in this area may facilitate the development of a highly accurate aid to diagnosis for many malignancies, including melanoma. PMID:24127369

  20. Caregivers in Death, Dying, and Bereavement Situations: International Work Group on Death, Dying, and Bereavement

    ERIC Educational Resources Information Center

    Papadatou, Danai

    2006-01-01

    This document examines issues related to the work of both formal and informal caregivers as they are involved in caring for dying and/or bereaved individuals. The examination is organized around five central questions: what brings individuals to this work?; what enables them to develop effective caregiving relationships?; what sustains them in…