Science.gov

Sample records for entire oropharyngeal packing

  1. Candidiasis (oropharyngeal)

    PubMed Central

    2012-01-01

    Introduction Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent and treat oropharyngeal candidiasis in: adults having treatment causing immunosuppression; infants and children; people with diabetes; people with dentures; and people with HIV infection? Which treatments reduce the risk of acquiring resistance to antifungal drugs? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 51 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antifungals (absorbed or partially absorbed, and topical absorbed/partially absorbed/non-absorbed: e.g., amphotericin B, clotrimazole, fluconazole, itraconazole, ketoconazole, miconazole, nystatin, posaconazole) used for intermittent or continuous prophylaxis or treatment, and denture hygiene. PMID:22348417

  2. Candidiasis (oropharyngeal)

    PubMed Central

    2013-01-01

    Introduction Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent and treat oropharyngeal candidiasis in: adults undergoing treatments that cause immunosuppression; infants and children; people with dentures; and people with HIV infection? Which antifungal regimens reduce the risk of acquiring resistance to antifungal drugs? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 47 RCTs or systematic reviews of RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antifungals (absorbed, partially or topically absorbed, or non-absorbed; for example, imidazole [ketoconazole, clotrimazole, toiconazole, miconazole], polyene [amphotericin B, nystatin], triazole [fluconazole, itraconazole], melaleuca and posaconazole), intermittent or continuous prophylaxis, or treatment, and denture hygiene. PMID:24209593

  3. Candidiasis (oropharyngeal)

    PubMed Central

    2009-01-01

    Introduction Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent and treat oropharyngeal candidiasis in: adults having treatment causing immunosuppression; infants and children; people with diabetes; people with dentures; and people with HIV infection? Which treatments reduce the risk of acquiring resistance to antifungal drugs? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 46 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antifungals (absorbed or partially absorbed, and topical absorbed/partially absorbed/non-absorbed: e.g., amphotericin B, fluconazole, itraconazole, miconazole, and nystatin) used for intermittent or continuous prophylaxis or therapy, and denture hygiene. PMID:19445752

  4. [Oropharyngeal candidiasis and radiotherapy].

    PubMed

    Pinel, B; Cassou-Mounat, T; Bensadoun, R-J

    2012-05-01

    The oropharyngeal candidiasis is a common condition in cancer patients treated by irradiation, during and after their treatment. For example, almost 70% of patients treated with chemoradiation for head and neck cancer are colonized, and 40% of symptomatic patients have an oropharyngeal candidiasis. Furthermore, we noticed an increase in non-albicans Candida strains, which are present in almost 50% of samples. Cancer treatments, especially radiation therapy, and comorbidities are risk factors of oropharyngeal candidiasis. Oropharyngeal candidiasis has substantial effects on quality of life, and may limit treatment. Epidemiologic data, physiopathology, clinical diagnosis criteria, consequences and treatment of oropharyngeal candidiasis will be discussed in this article.

  5. [Oropharyngeal dysphagia and aspiration].

    PubMed

    Barroso, Julia

    2009-11-01

    Oropharyngeal dysphagia, or inability to swallow liquids and/or solids, is one of the less well known geriatric syndromes, despite its enormous impact on functional ability, quality of life and health in affected individuals. The origin of oropharyngeal dysphagia can be structural or functional. Patients with neurodegenerative or cerebrovascular diseases and the frail elderly are the most vulnerable. The complications of oropharyngeal dysphagia are malnutrition, dehydration and aspiration, all of which are serious and provoke high morbidity and mortality. Oropharyngeal aspiration causes frequent respiratory infections and aspiration pneumonias. Antibiotic therapy must cover the usual microorganisms of the oropharyngeal flora. Oropharyngeal dysphagia should be identified early in risk groups through the use of screening methods involving clinical examination of swallowing and diagnostic confirmation methods. The simplest and most effective therapeutic intervention is adaptation of the texture of the solid and the viscosity of the liquid.

  6. Oral sex and oropharyngeal cancer

    PubMed Central

    Nguyen, Nam P.; Nguyen, Ly M.; Thomas, Sroka; Hong-Ly, Bevan; Chi, Alexander; Vos, Paul; Karlsson, Ulf; Vinh-Hung, Vincent

    2016-01-01

    Abstract Background: We aimed to study the prevalence of oral sex and its possible association with human papillomavirus (HPV) 16 infection in the development of oropharyngeal cancer in the US population for possible prevention. Methods: We conduct a systemic review on the prevalence of oral sex among Americans among different age groups, the prevalence of HPV 16 infection reported in oropharyngeal cancer, and correlation between oral sex and oropharyngeal cancer. Results: Oral sex is prevalent among adolescents and sexually active adults. Sixty percent of oropharyngeal cancer reported in the United States is associated with HPV 16 infections. Individuals who practiced oral sex with multiple partners are at risk for developing oropharyngeal cancer and need to be informed about practicing safe sex or getting vaccination. Conclusion: Family physicians will play a key role in prevention and educating the public about the risk of oral sex. PMID:27428229

  7. Worldwide trends show oropharyngeal cancer rates increasing

    Cancer.gov

    NCI scientists report that the incidence of oropharyngeal cancer significantly increased during the period 1983-2002 among people in countries that are economically developed. Oropharyngeal cancer occurs primarily in the middle part of the throat behind t

  8. Teledynamic Evaluation of Oropharyngeal Swallowing

    ERIC Educational Resources Information Center

    Malandraki, Georgia A.; McCullough, Gary; He, Xuming; McWeeny, Elizabeth; Perlman, Adrienne L.

    2011-01-01

    Purpose: The objective of the present investigation was to test the feasibility and clinical utility of a real-time Internet-based protocol for remote, telefluoroscopic evaluation of oropharyngeal swallowing. Method: In this prospective cohort study, the authors evaluated 32 patients with a primary diagnosis of stroke or head/neck cancer. All…

  9. Oropharyngeal dysphagia: screening and assessment.

    PubMed

    Speyer, Renée

    2013-12-01

    This article provides an overview of bedside screening and assessment tools in patients with oropharyngeal dysphagia including the diagnostic performance of screening tools; the gold standards in assessment of dysphagia (videofluoroscopic and fiberoptic endoscopic evaluation of swallowing); a variety of clinical assessment tools; patient self-evaluation questionnaires; and a list of supplementary methods. In addition, some methodologic issues are discussed, and the need for standardization of terminology, screening and assessment protocols, and the call for evidence-based clinical guidelines.

  10. Radiation Therapy and Docetaxel in Treating Patients With HPV-Related Oropharyngeal Cancer

    ClinicalTrials.gov

    2016-12-20

    Human Papillomavirus Infection; Stage I Oropharyngeal Squamous Cell Carcinoma; Stage II Oropharyngeal Squamous Cell Carcinoma; Stage III Oropharyngeal Squamous Cell Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma

  11. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  12. Reduced-Dose Intensity-Modulated Radiation Therapy With or Without Cisplatin in Treating Patients With Advanced Oropharyngeal Cancer

    ClinicalTrials.gov

    2017-03-02

    Stage III Oropharyngeal Squamous Cell Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma; Tongue Carcinoma

  13. Miconazole mucoadhesive tablet for oropharyngeal candidiasis

    PubMed Central

    Lalla, Rajesh V; Bensadoun, René-Jean

    2011-01-01

    Oropharyngeal candidiasis is a commonly encountered problem in daily clinical practice. Topical therapies for oropharyngeal candidiasis are considered preferable to systemic therapies in most patient populations. However, traditional topical therapies have limitations including short contact time with the oral mucosa and the need for multiple doses each day. Miconazole mucoadhesive tablet has recently been approved in Europe (Loramyc®) and the USA (Oravig™) for the treatment of oropharyngeal candidiasis. This tablet adheres to the oral mucosa and provides sustained local release of miconazole over a period of several hours with just one daily application. This article reviews the pharmacology, safety and efficacy of this novel agent. PMID:21171872

  14. Oropharyngeal styloids: an unusual presentation.

    PubMed

    Thotappa, Lathadevi Hassan; Doni, Bharati R

    2012-01-01

    The close proximity of the styloid process to many of the vital neurovascular structures in the neck makes it clinically significant. The styloid process is said to be elongated if it is longer than 3.0 cm in length. Anatomical variations are very common and clinical symptoms arising from such variations have to be recognized. Elongated styloid processes may cause chronic throat pain along with foreign body sensation, dysphagia, vague facial pain, and otalgia. Surgical excision of an elongated styloid is considered as a satisfactory treatment for such cases. Here, we present a unique case of bilaterally elongated styloids that could be visualized just by depressing the tongue, when they appeared like the tusks of an elephant in the oropharyngeal region.

  15. [Oropharyngeal candidiasis in elderly patients].

    PubMed

    Laurent, Marie; Gogly, Bruno; Tahmasebi, Farzad; Paillaud, Elena

    2011-03-01

    Oropharyngeal candidiasis is a common opportunistic infection of the oral cavity caused by an overgrowth of candida species, the commonest being Candida albicans. The prevalence in the hospital or institution varies from 13 to 47% of elderly persons. The main clinical types are denture stomatitis, acute atrophic glossitis, thrush and angular cheilitis. Diagnosis is usually made on clinical ground. Culture and sensitivity testing should be undertaken if initial therapy is unsuccessful. Predisposing factors of oral candidiasis could be local and/or systemic. Local factors include wearing dentures, impaired salivary gland function and poor oral health. Systemic factors include antibiotics and some other drugs, malnutrition, diabetes, immunosuppression and malignancies. Management involves an appropriate antifungal treatment and oral hygiene. Predisposing factors should be treated or eliminated where feasible. Oral hygiene involves cleaning the teeth and dentures. Dentures should be disinfected daily and left out overnight.

  16. Rehabilitation needs of patients with oropharyngeal cancer.

    PubMed

    Tippett, Donna C; Webster, Kimberly T

    2012-08-01

    Swallowing and swallowing-related impairments present important posttreatment challenges in individuals undergoing organ preservation therapy for head and neck cancer. Literature pertinent to this topic is reviewed. A protocol for treatment of speech and swallowing deficits related to oropharyngeal cancer and treatment performed at Johns Hopkins Hospital is described. Data collected from a sample of oropharyngeal patients with cancer, with and without human papillomavirus-related disease, are summarized. Future directions for further study of this population are discussed.

  17. Radon exposure and oropharyngeal cancer risk.

    PubMed

    Salgado-Espinosa, Tania; Barros-Dios, Juan Miguel; Ruano-Ravina, Alberto

    2015-12-01

    Oropharyngeal cancer is a multifactorial disease. Alcohol and tobacco are the main risk factors. Radon is a human carcinogen linked to lung cancer risk, but its influence in other cancers is not well known. We aim to assess the effect of radon exposure on the risk of oral and pharyngeal cancer through a systematic review of the scientific literature. This review performs a qualitative analysis of the available studies. 13 cohort studies were included, most of them mortality studies, which analysed the relationship between occupational or residential radon exposure with oropharyngeal cancer mortality or incidence. Most of the included studies found no association between radon exposure and oral and pharyngeal cancer. This lack of effect was observed in miners studies and in general population studies. Further research is necessary to quantify if this association really exists and its magnitude, specially performing studies in general population, preferably living in areas with high radon levels.

  18. Management of dysphagia in advanced oropharyngeal cancer.

    PubMed

    Penner, Jamie L; McClement, Susan E; Sawatzky, Jo-Ann V

    2007-05-01

    Individuals with advanced oropharyngeal cancer often experience dysphagia as a result of their illness and its treatment. Research consistently demonstrates that dysphagia and difficulty with oral intake have many implications, including a negative impact on quality of life. Nurses are in a key position to provide support and initiate appropriate interventions for individuals with dysphagia. Using the Human Response to Illness model (Mitchell et al, 1991) as an organising framework, this paper presents a critical review of the empirical literature regarding dysphagia in individuals with advanced oropharyngeal cancer that will: i) provide the reader with a comprehensive understanding of dysphagia; ii) identify current gaps in our knowledge; and iii) establish the foundation for appropriate evidence-based interventions to optimise functioning and quality of life in this patient population.

  19. Complications of oropharyngeal dysphagia: aspiration pneumonia.

    PubMed

    Almirall, Jordi; Cabré, Mateu; Clavé, Pere

    2012-01-01

    The incidence and prevalence of aspiration pneumonia (AP) are poorly defined. They increase in direct relation with age and underlying diseases. The pathogenesis of AP presumes the contribution of risk factors that alter swallowing function and predispose to the oropharyngeal bacterial colonization. The microbial etiology of AP involves Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumoniae for community-acquired AP and Gram-negative aerobic bacilli in nosocomial pneumonia. It is worth bearing in mind the relative unimportance of anaerobic bacteria in AP. When we choose the empirical antibiotic treatment, we have to consider some pathogens identified in oropharyngeal flora. Empirical treatment with antianaerobics should only be used in certain patients. According to some known risks factors, the prevention of AP should include measures in order to avoid it.

  20. Active Tobacco Smoking and Distant Metastasis in Patients With Oropharyngeal Cancer

    SciTech Connect

    McBride, Sean M.; Ali, Nawal N.; Margalit, Danielle N.; Chan, Annie W.

    2012-09-01

    Purpose: Distant metastasis is the site of first relapse in approximately one-third of patients with locally advanced oropharyngeal carcinoma, irrespective of human papillomavirus status. Yet the risk factors associated with distant metastasis are not well characterized. We sought to characterize the relationship between smoking status and distant metastasis. Methods and Materials: We evaluated the association between tobacco smoking status and distant metastasis in a retrospective cohort study of 132 patients who underwent definitive radiation therapy and chemotherapy for Stage III-IVA/B oropharyngeal cancer. Information on tobacco smoking was prospectively collected by patient questionnaires and physician notes at the time of diagnosis. Thirty-three percent of the patients were nonsmokers, 51% were former smokers, 16% were active smokers. The cumulative lifetime tobacco smoking in pack-years was 20 (range, 0-150). Results: With a median follow-up time of 52 months, the overall rate of distant metastasis at 4 years was 8%. Distant metastasis was the most common first site of relapse, occurring in 56% of the patients with recurrences. Active smokers had higher rates of distant metastasis than non-active smokers (including never- and former smokers; 31% vs. 4%, p < 0.001) and former smokers (31% vs. 3%, p < 0.001). There was no statistically significant difference in the risk of distant metastasis for patients with lifetime cumulative pack-years >20 and {<=}20 (10% vs. 4%, p = 0.19). In univariate analysis, active smoking (p = 0.0004) and N category (p = 0.009) were predictive of increased risk of distant metastasis. In multivariate analysis, active smoking was the most significant predictive factor for increased risk of distant metastasis (hazard ratio, 12.7, p < 0.0001). Conclusions: This study identified a strong association between active smoking and distant metastasis in patients with oropharyngeal cancer.

  1. Valve stem and packing assembly

    DOEpatents

    Wordin, John J.

    1991-01-01

    A valve stem and packing assembly is provided in which a rotatable valve stem includes a first tractrix surface for sliding contact with a stem packing and also includes a second tractrix surface for sliding contact with a bonnet. Force is applied by means of a spring, gland flange, and gland on the stem packing so the stem packing seals to the valve stem and bonnet. This configuration serves to create and maintain a reliable seal between the stem packing and the valve stem. The bonnet includes a second complementary tractrix surface for contacting the second sliding tractrix surface, the combination serving as a journal bearing for the entire valve stem and packing assembly. The journal bearing so configured is known as a Schiele's pivot. The Schiele's pivot also serves to maintain proper alignment of the valve stem with respect to the bonnet. Vertical wear between the surfaces of the Schiele's pivot is uniform at all points of contact between the second sliding tractrix surface and the second complementary tractrix surface of a bonnet. The valve stem is connected to a valve plug by means of a slip joint. The valve is opened and closed by rotating the valve stem. The slip joint compensates for wear on the Schiele's pivot and on the valve plug. A ledge is provided on the valve bonnet for the retaining nut to bear against. The ledge prevents overtightening of the retaining nut and the resulting excessive friction between stem and stem packing.

  2. Valve stem and packing assembly

    DOEpatents

    Wordin, J.J.

    1991-09-03

    A valve stem and packing assembly is provided in which a rotatable valve stem includes a first tractrix surface for sliding contact with a stem packing and also includes a second tractrix surface for sliding contact with a bonnet. Force is applied by means of a spring, gland flange, and gland on the stem packing so the stem packing seals to the valve stem and bonnet. This configuration serves to create and maintain a reliable seal between the stem packing and the valve stem. The bonnet includes a second complementary tractrix surface for contacting the second sliding tractrix surface, the combination serving as a journal bearing for the entire valve stem and packing assembly. The journal bearing so configured is known as a Schiele's pivot. The Schiele's pivot also serves to maintain proper alignment of the valve stem with respect to the bonnet. Vertical wear between the surfaces of the Schiele's pivot is uniform at all points of contact between the second sliding tractrix surface and the second complementary tractrix surface of a bonnet. The valve stem is connected to a valve plug by means of a slip joint. The valve is opened and closed by rotating the valve stem. The slip joint compensates for wear on the Schiele's pivot and on the valve plug. A ledge is provided on the valve bonnet for the retaining nut to bear against. The ledge prevents over tightening of the retaining nut and the resulting excessive friction between stem and stem packing. 2 figures.

  3. Valve Packing

    NASA Technical Reports Server (NTRS)

    1992-01-01

    "S Glass" yarn was originally developed by NASA for high temperature space and aeronautical applications. When John Crane, Inc. required material that would withstand temperatures higher than 1,200 degrees Fahrenheit, they contacted Owens-Corning, which had developed a number of applications for the material. John Crane combines the yarn with other components to make Style 287-I packing. The product can be used in chemical processing operations, nuclear power stations, petroleum products, etc. Advantages include increased service life and reduced maintenance costs.

  4. Packed Bed Reactor Experiment

    NASA Video Gallery

    The purpose of the Packed Bed Reactor Experiment in low gravity is to determine how a mixture of gas and liquid flows through a packed bed in reduced gravity. A packed bed consists of a metal pipe ...

  5. HPV-Associated Oropharyngeal Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... Ethnicity, and Sex, United States, 2008–2012 The graph above shows age-adjusted incidence rates for HPV- ... were diagnosed with HPV-associated oropharyngeal cancer. This graph was adapted from Viens LJ, Henley SJ, Watson ...

  6. Functional outcome assessment of adults with oropharyngeal dysphagia.

    PubMed

    McHorney, C A; Rosenbek, J C

    1998-01-01

    Neurologic and mechanical abnormalities of the oropharynx often result in oropharyngeal dysphagia. Assessment of dysphagia and its treatment has been limited largely to measurement of the biomechanical aspects of bolus flow. This article reviews the measurement tools in current use and in development for assessing oropharyngeal dysphagia in terms of the "value compass" for health services. A number of measurement needs for this clinical population are identified and discussed.

  7. Racial Survival Disparity in Head and Neck Cancer Results from Low Prevalence of Human Papillomavirus Infection in Black Oropharyngeal Cancer Patients

    PubMed Central

    Settle, Kathleen; Posner, Marshall R.; Schumaker, Lisa M.; Tan, Ming; Suntharalingam, Mohan; Goloubeva, Olga; Strome, Scott E.; Haddad, Robert I.; Patel, Shital S.; Cambell, Earl V.; Sarlis, Nicholas; Lorch, Jochen; Cullen, Kevin J.

    2015-01-01

    The burden of squamous cell carcinoma of the head and neck (SCCHN) is greater for blacks than for whites, especially in oropharyngeal cases. We previously showed retrospectively that disease-free survival was significantly greater in white than in black SCCHN patients treated with chemoradiation, the greatest difference occurring in the oropharyngeal subgroup. Oropharyngeal cancer is increasing in incidence and in its association with human papillomavirus (HPV) infection; HPV-positive oropharyngeal cancer patients have significantly better outcomes (versus HPV-negative). These collective data led to the present analyses of overall survival (OS) in our retrospective cohort and of OS and HPV status (tested prospectively in pretreatment biopsy specimens) in the phase 3, multicenter TAX 324 trial of induction chemotherapy followed by concurrent chemoradiation in SCCHN patients. Median OS in the retrospective cohort of 106 white and 95 black SCCHN patients was 52.1 months (white) versus only 23.7 months (black; P = 0.009), due entirely to OS in the subgroup of patients with oropharyngeal cancer—69.4 months (whites) versus 25.2 months (blacks; P = 0.0006); no significant difference by race occurred in survival of non-oropharyngeal SCCHN (P = 0.58). In TAX 324, 196 white patients and 28 black patients could be assessed for HPV status. Median OS was significantly worse for black patients (20.9 months) than for white patients (70.6 months; P = 0.03) and dramatically improved in HPV-positive (not reached) versus HPV-negative (26.6 months, 5.1 hazard ratio) oropharyngeal patients (P < 0.0001), 49% of whom were HPV-16 positive. Overall, HPV positivity was 34% in white versus 4% in black patients (P = 0.0004). Survival was similar for black and white HPV-negative patients (P = 0.56). This is the first prospective assessment of confirmed HPV status in black versus white SCCHN patients. Worse OS for black SCCHN patients was driven by oropharyngeal cancer outcomes, and that for

  8. Racial survival disparity in head and neck cancer results from low prevalence of human papillomavirus infection in black oropharyngeal cancer patients.

    PubMed

    Settle, Kathleen; Posner, Marshall R; Schumaker, Lisa M; Tan, Ming; Suntharalingam, Mohan; Goloubeva, Olga; Strome, Scott E; Haddad, Robert I; Patel, Shital S; Cambell, Earl V; Sarlis, Nicholas; Lorch, Jochen; Cullen, Kevin J

    2009-09-01

    The burden of squamous cell carcinoma of the head and neck (SCCHN) is greater for blacks than for whites, especially in oropharyngeal cases. We previously showed retrospectively that disease-free survival was significantly greater in white than in black SCCHN patients treated with chemoradiation, the greatest difference occurring in the oropharyngeal subgroup. Oropharyngeal cancer is increasing in incidence and in its association with human papillomavirus (HPV) infection; HPV-positive oropharyngeal cancer patients have significantly better outcomes (versus HPV-negative). These collective data led to the present analyses of overall survival (OS) in our retrospective cohort and of OS and HPV status (tested prospectively in pretreatment biopsy specimens) in the phase 3, multicenter TAX 324 trial of induction chemotherapy followed by concurrent chemoradiation in SCCHN patients. Median OS in the retrospective cohort of 106 white and 95 black SCCHN patients was 52.1 months (white) versus only 23.7 months (black; P = 0.009), due entirely to OS in the subgroup of patients with oropharyngeal cancer--69.4 months (whites) versus 25.2 months (blacks; P = 0.0006); no significant difference by race occurred in survival of non-oropharyngeal SCCHN (P = 0.58). In TAX 324, 196 white patients and 28 black patients could be assessed for HPV status. Median OS was significantly worse for black patients (20.9 months) than for white patients (70.6 months; P = 0.03) and dramatically improved in HPV-positive (not reached) versus HPV-negative (26.6 months, 5.1 hazard ratio) oropharyngeal patients (P < 0.0001), 49% of whom were HPV-16 positive. Overall, HPV positivity was 34% in white versus 4% in black patients (P = 0.0004). Survival was similar for black and white HPV-negative patients (P = 0.56). This is the first prospective assessment of confirmed HPV status in black versus white SCCHN patients. Worse OS for black SCCHN patients was driven by oropharyngeal cancer outcomes, and that for

  9. Oropharyngeal leprosy in art, history, and medicine.

    PubMed

    Scollard, D M; Skinsnes, O K

    1999-04-01

    Advanced lesions of the face, nasopharynx, and oropharynx have played an important role in the medical and social history of Hansen's disease. Renaissance artists included detailed portrayals of these lesions in some of their paintings, a testimony not only to their artistic skill and powers of observation but also to the common presence of these patients in European cities and towns of the period. The disease is now understood as a broad immunologic spectrum of host responses to Mycobacterium leprae, with a variety of clinical and pathologic manifestations in nerve, soft tissues, and bone. This review incorporates the findings of 2 extraordinary studies (one from Europe and the other from Japan) of pharyngeal and facial lesions. In the 1950s, studies of skeletal remains from the churchyard of a Danish leprosarium revealed a triad of maxillofacial lesions unique to leprosy and designated facies leprosa. In pre-World War II Japan, before effective treatment had been discovered, a prominent otorhinolaryngologist studying oropharyngeal and nasopharyngeal lesions prepared watercolor illustrations of the natural progression of untreated Hansen's disease. As a result of effective antimicrobial therapy, such advanced lesions are now rarely seen, but the presenting signs and symptoms of leprosy still occasionally arise in the nasal and oral mucosa. The nasopharynx and oropharynx may be important early sites of inoculation and infection by M leprae, and they require additional emphasis in worldwide efforts toward early diagnosis and treatment of Hansen's disease.

  10. Photodynamic inactivation of oropharyngeal Candida strains.

    PubMed

    Postigo, Agustina; Bulacio, Lucía; Sortino, Maximiliano

    2014-09-25

    Oropharyngeal candidiasis (OPC) is an infection frequent in immunocompromised patients. Photodynamic therapy is an alternative to conventional treatments, based on the utilization of compounds that inhibit or kill microorganisms only under the effect of light, process known as Photodynamic Inactivation (PDI). In the present study, PDI of Candida spp. by the natural product α-terthienyl (α-T) was investigated following the guidelines of CLSI M27-A3, under UV-A light irradiation. The optimal values of two variables, exposure irradiation time (ET) and distance to the irradiation source (DIS) were established by employing Design Expert Software (DES). For this purpose, a panel of Candida strains isolated from OPC (C. albicans, C. tropicalis, C. parapsilosis and C. krusei) was employed and optimal values were 5 min (ET) and between 6.06 and 6.43 cm (DIS) with a desirability factor of 0.989. α-T plus UV-A light in the optimal conditions caused a complete reduction in viable cells in 5 min which was demonstrated by viable cells reduction assays and confocal microscopy after vital staining (propidium iodide/fluorescein diacetate). The germ tube formation of C. albicans was inhibited by α-T at sub-inhibitory concentrations. Results showed that α-T plus UV-A light could constitute an alternative for OPC treatments at the optimal conditions determined here.

  11. What Are the Key Statistics about Oral Cavity and Oropharyngeal Cancers?

    MedlinePlus

    ... Cavity and Oropharyngeal Cancer What Are the Key Statistics About Oral Cavity and Oropharyngeal Cancers? The American ... increase the risk for these second cancers. For statistics related to survival, see the section Survival Rates ...

  12. Cryostimulation improves recovery from oropharyngeal dysphagia after stroke

    PubMed Central

    Zart, Patrícia; Levy, Deborah Salle; Bolzan, Geovana de Paula; Mancopes, Renata; da Silva, Ana Maria Toniolo

    2013-01-01

    Summary Introduction: Stroke is considered one of the most frequent neurological causes of oropharyngeal dysphagia. Aim: To determine the effect of cryostimulation on oropharyngeal sensitivity and, subsequently, on the swallowing reaction and premature escape of food in patients with neurogenic dysphagia after stroke. Methods: Clinical and experimental study. The study enrolled 7 adult subjects, 6 men and 1 woman ranging from 28 to 64 years of age, with a diagnosis of stroke and current oropharyngeal dysphagia without any other underlying disease. The selected subjects underwent speech-language pathology evaluation and videofluoroscopic assessment of the dysphagia. The subjects were then treated with cryostimulation consisting of 10 applications to each structure (anterior faucial pillar, posterior oropharyngeal wall, soft palate, and back tongue) 3 times a day (for a total of 30 daily applications per structure) for 4 consecutive days. The patients were then re-evaluated based on the same criteria. The pre- and post-cryostimulation results of the clinical and videofluoroscopic evaluations were analyzed descriptively and statistically using Student's t-test and Fisher's exact test. Results: Cryostimulation had beneficial effects on oropharyngeal sensitivity in 6 of the 7 subjects. There was also a significant improvement in swallowing and in the premature escape in six subjects. Conclusion: Cryostimulation increased sensitivity and subsequently improved the swallowing reaction and premature escape of food in patients with neurogenic dysphagia after stroke. These effects were evident by both speech-language pathology and videofluoroscopic evaluation. PMID:25991991

  13. Electrophysiological evaluation of oropharyngeal swallowing in myotonic dystrophy

    PubMed Central

    Ertekin, C; Yuceyar, N; Aydogdu, I; Karasoy, H

    2001-01-01

    OBJECTIVE—Oropharyngeal dysphagia is a common feature of patients with myotonic dystrophy and is not usually perceived due to their emotional deficits and lack of interest. The aim was to show the existence and frequency of subclinical electrophysiological abnormalities in oropharyngeal swallowing and to clarify the mechanisms of dysphagia in myotonic dystrophy.
METHODS—Eighteen patients with myotonic dystrophy were examined for oropharyngeal phase of swallowing by clinical and electrophysiological methods. Ten patients had dysphagia whereas 11 patients had signs and symptoms reflecting CNS involvement. Four patients with myotonia congenita and 30 healthy volunteers served as controls. Laryngeal movements were detected by means of a piezoelectric sensor. EMG activities of the submental muscle (SM-EMG) and needle EMG of the cricopharyngeal muscle of the upper eosophageal sphincter (CP-EMG) were also recorded during swallowing.
RESULTS—In about 70% of the patients with myotonic dystrophy, the existence of oropharyngeal dysphagia was indicated objectively by means of the technique of "dysphagia limit" and by clinical evaluation. Duration of the swallowing reflex as defined by the laryngeal relocation time (0-2 time interval) and submental muscle excitation as a part of the swallowing reflex (A-C interval) were significantly prolonged in patients with myotonic dystrophy, especially in dysphagic patients. Triggering time of the swallowing reflex (A-0 interval) also showed significant prolongation, especially in the patients having both dysphagia and CNS involvement. During swallowing, CP muscle activity was abnormal in 40% of the patients with myotonic dystrophy.
CONCLUSION—Both myopathic weakness and myotonia encountered in oropharyngeal muscles play an important part in the oral and the pharyngeal phases of swallowing dysfunction in myotonic dystrophy. It was also suggested that CNS involvement might contribute to the delay of the triggering of the

  14. Rhinosporidiosis presenting as an oropharyngeal mass: A clinical predicament?

    PubMed Central

    Rath, Rachna; Baig, Shadab Ali; Debata, Tribikram

    2015-01-01

    Rhinosporidiosis, is a chronic granulomatous disease presenting as a polypoidal mass in the nasal cavity and nasopharynx caused by Rhinosporidium seeberi and is endemic in India and Sri Lanka. Diagnosis is mainly by clinical observations and is confirmed by histopathology. We report a case of atypical rhinosporidiosis that presented as an oropharyngeal mass and mimicked chronic tonsillitis. Hence possibility of this atypical rhinosporidiosis should be included in the clinical differential diagnosis of any posterior oral or oropharyngeal mass, particularly when managing patients from rural endemic areas. PMID:25810674

  15. Pack Artillery, A Bibliography

    DTIC Science & Technology

    1980-03-01

    Washington, DC: American Untv Soro, 1965. UC300 Parrino , Michael Francis. An Introduction to Pack P3 Transport and Pack Artillery; the Role of the Mule...Field for the Territorial Force," JORAj 37:15, 1910. " Parrino , Michael F. "Development of Pack Artillery and Its Signi- ficance in Modern Warfare

  16. Temporal Sequence of Swallow Events during the Oropharyngeal Swallow

    ERIC Educational Resources Information Center

    Mendell, Dorie A.; Logemann, Jeri A.

    2007-01-01

    Purpose: To (a) identify and characterize the temporal relation of selected structural movements during the oropharyngeal swallow across participants, (b) determine whether patterns of movement could be identified, and (c) determine whether the temporal relations were affected by aging and bolus characteristics. Method: Retrospective analysis of…

  17. Electronically configured battery pack

    SciTech Connect

    Kemper, D.

    1997-03-01

    Battery packs for portable equipment must sometimes accommodate conflicting requirements to meet application needs. An electronically configurable battery pack was developed to support two highly different operating modes, one requiring very low power consumption at a low voltage and the other requiring high power consumption at a higher voltage. The configurable battery pack optimizes the lifetime and performance of the system by making the best use of all available energy thus enabling the system to meet its goals of operation, volume, and lifetime. This paper describes the cell chemistry chosen, the battery pack electronics, and tradeoffs made during the evolution of its design.

  18. Bidispersed Sphere Packing on Spherical Surfaces

    NASA Astrophysics Data System (ADS)

    Atherton, Timothy; Mascioli, Andrew; Burke, Christopher

    Packing problems on spherical surfaces have a long history, originating in the classic Thompson problem of finding the ground state configuration of charges on a sphere. Such packings contain a minimal number of defects needed to accommodate the curvature; this is predictable using the Gauss-Bonnet theorem from knowledge of the topology of the surface and the local symmetry of the ordering. Famously, the packing of spherical particles on a sphere contains a 'scar' transition, where additional defects over those required by topology appear above a certain critical number of particles and self-organize into chains or scars. In this work, we study the packing of bidispersed packings on a sphere, and hence determine the interaction of bidispersity and curvature. The resultant configurations are nearly crystalline for low values of bidispersity and retain scar-like structures; these rapidly become disordered for intermediate values and approach a so-called Appollonian limit at the point where smaller particles can be entirely accommodated within the voids left by the larger particles. We connect our results with studies of bidispersed packings in the bulk and on flat surfaces from the literature on glassy systems and jamming. Supported by a Cottrell Award from the Research Corporation for Science Advancement.

  19. TLC Pack Unpacked

    ERIC Educational Resources Information Center

    Oberhofer, Margret; Colpaert, Jozef

    2015-01-01

    TLC Pack stands for Teaching Languages to Caregivers and is a course designed to support migrants working or hoping to work in the caregiving sector. The TLC Pack resources range from A2 to B2 level of the Common European Framework of Reference for Languages (CEFR), and will be made available online in the six project languages: Dutch, English,…

  20. Flat Pack Toy Design

    ERIC Educational Resources Information Center

    Hutcheson, Brian

    2007-01-01

    In this article, the author introduces the concept of flat pack toys. Flat pack toys are designed using a template on a single sheet of letter-sized card stock paper. Before being cut out and built into a three-dimensional toy, they are scanned into the computer and uploaded to a website. With the template accessible from the website, anyone with…

  1. Radiosensitization of Oropharyngeal Squamous Cell Carcinoma Cells by Human Papillomavirus 16 Oncoprotein E6*I

    SciTech Connect

    Pang, Ervinna; Delic, Naomi C.; Hong, Angela; Zhang Mei; Rose, Barbara R.; Lyons, J. Guy

    2011-03-01

    Purpose: Patients with oropharyngeal squamous cell carcinoma (OSCC) whose disease is associated with high-risk human papillomavirus (HPV) infection have a significantly better outcome than those with HPV-negative disease, but the reasons for the better outcome are not known. We postulated that they might relate to an ability of HPV proteins to confer a better response to radiotherapy, a commonly used treatment for OSCC. Methods and Materials: We stably expressed the specific splicing-derived isoforms, E6*I and E6*II, or the entire E6 open reading frame (E6total), which gives rise to both full length and E6*I isoforms, in OSCC cell lines. Radiation resistance was measured in clonogenicity assays, p53 activity was measured using transfected reporter genes, and flow cytometry was used to analyze cell cycle and apoptosis. Results: E6*I and E6total sensitized the OSCC cells to irradiation, E6*I giving the greatest degree of radiosensitization (approximately eightfold lower surviving cell fraction at 10 Gy), whereas E6*II had no effect. In contrast to radiosensitivity, E6*I was a weaker inhibitor than E6total of tumor suppressor p53 transactivator activity in the same cells. Flow cytometric analyses showed that irradiated E6*I expressing cells had a much higher G2M:G1 ratio than control cells, indicating that, after G2, cells were diverted from the cell cycle to programmed cell death. Conclusion: This study supports a role for E6*I in the enhanced responsiveness of HPV-positive oropharyngeal carcinomas to p53-independent radiation-induced death.

  2. Evaluation of Microbial Load in Oropharyngeal Mucosa from Tannery Workers

    PubMed Central

    Castellanos-Arévalo, Diana C.; Castellanos-Arévalo, Andrea P.; Camarena-Pozos, David A.; Colli-Mull, Juan G.; Maldonado-Vega, María

    2014-01-01

    Background Animal skin provides an ideal medium for the propagation of microorganisms and it is used like raw material in the tannery and footware industry. The aim of this study was to evaluate and identify the microbial load in oropharyngeal mucosa of tannery employees. Methods The health risk was estimated based on the identification of microorganisms found in the oropharyngeal mucosa samples. The study was conducted in a tanners group and a control group. Samples were taken from oropharyngeal mucosa and inoculated on plates with selective medium. In the samples, bacteria were identified by 16S ribosomal DNA analysis and the yeasts through a presumptive method. In addition, the sensitivity of these microorganisms to antibiotics/antifungals was evaluated. Results The identified bacteria belonged to the families Enterobacteriaceae, Pseudomonadaceae, Neisseriaceae, Alcaligenaceae, Moraxellaceae, and Xanthomonadaceae, of which some species are considered as pathogenic or opportunistic microorganisms; these bacteria were not present in the control group. Forty-two percent of bacteria identified in the tanners group are correlated with respiratory diseases. Yeasts were also identified, including the following species: Candida glabrata, Candida tropicalis, Candida albicans, and Candida krusei. Regarding the sensitivity test of bacteria identified in the tanners group, 90% showed sensitivity to piperacillin/tazobactam, 87% showed sensitivity to ticarcillin/clavulanic acid, 74% showed sensitivity to ampicillin/sulbactam, and 58% showed sensitivity to amoxicillin/clavulanic acid. Conclusion Several of the bacteria and yeast identified in the oropharyngeal mucosa of tanners have been correlated with infections in humans and have already been reported as airborne microorganisms in this working environment, representing a health risk for workers. PMID:25830072

  3. Review of paraneoplastic syndromes associated with oropharyngeal squamous cell carcinoma

    PubMed Central

    Mathew, Deepu George; Rooban, T; Janani, V; Joshua, E; Rao, UK; Ranganathan, K

    2010-01-01

    Malignancies are usually preceded by the presence of various paraneoplastic syndromes (PNS), which could be the indirect and/or remote effects of the metabolites produced by neoplastic cells. PNS manifested by oropharyngeal squamous cell carcinomas, which is the most common head and neck malignancy, are highlighted in this review. Knowledge of the clinical spectrum of these syndromes will equip the oral physician for early diagnosis and management of these hidden malignancies, especially of the pharyngeal region. PMID:21731261

  4. [18F]Fluorodeoxyglucose uptake by positron emission tomography predicts outcomes for oropharyngeal and hypopharyngeal cancer treated with definitive radiotherapy

    PubMed Central

    Ishihara, Takeaki; Kitajima, Kazuhiro; Suenaga, Yuko; Ejima, Yasuo; Komatsu, Hirokazu; Otsuki,, Naoki; Nibu, Ken-ichi; kiyota, Naomi; Takahashi, Satoru; Sasaki, Ryohei

    2017-01-01

    ABSTRACT This study evaluated the prognostic significance of the maximum standardized uptake value of the primary site (pSUVmax) in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans of patients with oropharyngeal or hypopharyngeal cancer who were treated using definitive radiotherapy. The study included 86 patients who were primarily treated with radiotherapy for oropharyngeal or hypopharyngeal cancer. Sixty-nine patients underwent concurrent chemotherapy. The associations between pre-treatment pSUVmax and treatment outcomes were evaluated. The most appropriate pSUVmax cut-off value for predicting disease-free survival (DFS) and local control (LC) was selected using receiver operating characteristic (ROC) curves. The median follow-up time for surviving patients was 60 months, while the median survival time in the entire patient cohort was 55 months. A pSUVmax cut-off value of 9.0 showed the best discriminative performance. Five-year OS and DFS rates were 65.9% and 60.0%, respectively. In univariate analyses, pSUVmax (p = 0.009), T-stage (p = 0.001), N-stage (p = 0.039), and clinical stage (p = 0.017) were identified as significant prognostic predictors for DFS. The multivariate analysis did not identify any statistically significant factors, but the association between pSUVmax and DFS was borderline significant (p = 0.055). Interestingly, pSUVmax was predictive of local controllability in T1–T2 disease (p = 0.024), but there was no significant association for T3–T4 disease (p = 0.735). In this study, pSUVmax was predictive of DFS and LC in patients with oropharyngeal or hypopharyngeal cancer that was treated with definitive radiotherapy. pSUVmax was strongly associated with LC in T1–T2 disease. PMID:28303058

  5. Oropharyngeal Dysphagia after Anterior Cervical Spine Surgery: A Review

    PubMed Central

    Anderson, Karen K.; Arnold, Paul M.

    2013-01-01

    Study Design Review. Objective Postoperative oropharyngeal dysphagia is one of the most common complications following anterior cervical spine surgery (ACSS). We review and summarize recent literature in order to provide a general overview of clinical signs and symptoms, assessment, incidence and natural history, pathophysiology, risk factors, treatment, prevention, and topics for future research. Methods A search of English literature regarding dysphagia following anterior cervical spine surgery was conducted using PubMed and Google Scholar. The search was focused on articles published since the last review on this topic was published in 2005. Results Patients who develop dysphagia after ACSS show significant alterations in swallowing biomechanics. Patient history, physical examination, X-ray, direct or indirect laryngoscopy, and videoradiographic swallow evaluation are considered the primary modalities for evaluating oropharyngeal dysphagia. There is no universally accepted objective instrument for assessing dysphagia after ACSS, but the most widely used instrument is the Bazaz Dysphagia Score. Because dysphagia is a subjective sensation, patient-reported instruments appear to be more clinically relevant and more effective in identifying dysfunction. The causes of oropharyngeal dysphagia after ACSS are multifactorial, involving neuronal, muscular, and mucosal structures. The condition is usually transient, most often beginning in the immediate postoperative period but sometimes beginning more than 1 month after surgery. The incidence of dysphagia within one week after ACSS varies from 1 to 79% in the literature. This wide variance can be attributed to variations in surgical techniques, extent of surgery, and size of the implant used, as well as variations in definitions and measurements of dysphagia, time intervals of postoperative evaluations, and relatively small sample sizes used in published studies. The factors most commonly associated with an

  6. Graphitic packing removal tool

    DOEpatents

    Meyers, Kurt Edward; Kolsun, George J.

    1997-01-01

    Graphitic packing removal tools for removal of the seal rings in one piece. he packing removal tool has a cylindrical base ring the same size as the packing ring with a surface finish, perforations, knurling or threads for adhesion to the seal ring. Elongated leg shanks are mounted axially along the circumferential center. A slit or slits permit insertion around shafts. A removal tool follower stabilizes the upper portion of the legs to allow a spanner wrench to be used for insertion and removal.

  7. Graphitic packing removal tool

    DOEpatents

    Meyers, K.E.; Kolsun, G.J.

    1997-11-11

    Graphitic packing removal tools for removal of the seal rings in one piece are disclosed. The packing removal tool has a cylindrical base ring the same size as the packing ring with a surface finish, perforations, knurling or threads for adhesion to the seal ring. Elongated leg shanks are mounted axially along the circumferential center. A slit or slits permit insertion around shafts. A removal tool follower stabilizes the upper portion of the legs to allow a spanner wrench to be used for insertion and removal. 5 figs.

  8. Graphitic packing removal tool

    SciTech Connect

    Meyers, K.E.; Kolsun, G.J.

    1996-12-31

    Graphitic packing removal tools are described for removal of the seal rings in one piece from valves and pumps. The packing removal tool has a cylindrical base ring the same size as the packing ring with a surface finish, perforations, knurling or threads for adhesion to the seal ring. Elongated leg shanks are mounted axially along the circumferential center. A slit or slits permit insertion around shafts. A removal tool follower stabilizes the upper portion of the legs to allow a spanner wrench to be used for insertion and removal.

  9. Nasal packing and stenting

    PubMed Central

    Weber, Rainer K.

    2011-01-01

    Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue. PMID:22073095

  10. Bilateral Blindness Following Chemoradiation for Locally Advanced Oropharyngeal Carcinoma

    PubMed Central

    Zeng, K. Liang; Kuruvilla, Sara; Sanatani, Michael

    2015-01-01

    Wernicke's encephalopathy is a life-threatening neurologic complication of thiamine deficiency. Though the presentation of symptoms can vary widely, the classical triad is founded on ophthalmoplegia, alteration of mental status, and gait disturbance. We describe a case of Wernicke's encephalopathy in an oncology patient shortly after concurrent 5-fluorouracil, carboplatin, and radiotherapy for locally advanced oropharyngeal cancer, presenting as complete bilateral blindness, ataxia, nystagmus, and confusion. Thiamine was given based on clinical suspicion and rapid improvement of clinical findings occurred. An MRI performed later supported the diagnosis of Wernicke's encephalopathy. A multifactorial etiology of thiamine deficiency from nutritional deficits and neurotoxic effects of chemotherapy are hypothesized. PMID:26623207

  11. Role of posaconazole in the treatment of oropharyngeal candidiasis

    PubMed Central

    Ianas, Voichita; Matthias, Kathryn R; Klotz, Stephen A

    2010-01-01

    Posaconazole is the newest azole antifungal approved by the US Food and Drug Administration, and possesses a broad spectrum of activity against numerous yeasts and filamentous fungi. It is available as an oral suspension and is generally well tolerated by patients, but gastrointestinal absorption is sometimes inadequate and remains a clinical concern in treating deep-seated infections. It is used routinely and effectively for the prophylaxis of invasive fungal infections in immunosuppressed hosts and is an effective treatment of oropharyngeal candidiasis, including azole-resistant disease. PMID:21694893

  12. The packing of particles

    SciTech Connect

    Cumberland, D.J.; Crawford, R.J.

    1987-01-01

    The wide range of information currently available on the packing of particles is brought together in this monograph. The authors' interest in the subject was initially aroused by the question of whether there is an optimum particle size distribution which would maximise the packing density of particles - a question which has attracted the interest of scientists and engineers for centuries. The densification of a powder mass is of relevance in a great many industries, among them the pharmaceutical, ceramic, powder metallurgy and civil engineering industries. In addition, the packing of regular - or irregular - shaped particles is also of relevance to a surprisingly large number of other industries and subject areas, i.e. the foundry industry, nuclear engineering, chemical engineering, crystallography, geology, biology, telecommunications, and so on. Accordingly, this book is written for a wide audience.

  13. Spiral disk packings

    NASA Astrophysics Data System (ADS)

    Yamagishi, Yoshikazu; Sushida, Takamichi

    2017-04-01

    It is shown that van Iterson's metric for disk packings, proposed in 1907 in the study of a centric model of spiral phyllotaxis, defines a bounded distance function in the plane. This metric is also related to the bifurcation of Voronoi tilings for logarithmic spiral lattices, through the continued fraction expansion of the divergence angle. The phase diagrams of disk packings and Voronoi tilings for logarithmic spirals are dual graphs to each other. This gives a rigorous proof that van Iterson's diagram in the centric model is connected and simply connected. It is a nonlinear analog of the duality between the phase diagrams for disk packings and Voronoi tilings on the linear lattices, having the modular group symmetry.

  14. Battery Pack Thermal Design

    SciTech Connect

    Pesaran, Ahmad

    2016-06-14

    This presentation describes the thermal design of battery packs at the National Renewable Energy Laboratory. A battery thermal management system essential for xEVs for both normal operation during daily driving (achieving life and performance) and off-normal operation during abuse conditions (achieving safety). The battery thermal management system needs to be optimized with the right tools for the lowest cost. Experimental tools such as NREL's isothermal battery calorimeter, thermal imaging, and heat transfer setups are needed. Thermal models and computer-aided engineering tools are useful for robust designs. During abuse conditions, designs should prevent cell-to-cell propagation in a module/pack (i.e., keep the fire small and manageable). NREL's battery ISC device can be used for evaluating the robustness of a module/pack to cell-to-cell propagation.

  15. Sun Packs Double Punch

    NASA Video Gallery

    On August 3, the sun packed a double punch, emitting a M6.0-class flare at 9:43 am EDT. This video is of the second, slightly stronger M9.3-class flare at 11:41 pm EDT. Both flares had significant ...

  16. Nutrition Action Pack.

    ERIC Educational Resources Information Center

    Sockut, Joanne; Stumpe, Stephanie

    One of five McDonald's Action Packs, these instructional materials integrate elementary school-level nutrition education into other disciplines--biology, sociology, physiology, mathematics, and art. Contents include four units consisting of twelve activities. Unit 1, Why You Need Food, is a self-examination of what is needed for growth, health,…

  17. DIY Fraction Pack.

    ERIC Educational Resources Information Center

    Graham, Alan; Graham, Louise

    2003-01-01

    Describes a very successful attempt to teach fractions to year 5 pupils based on pupils making their own fraction pack. Children decided for themselves how to make the fractional slices used in the activity using colored cardboard sheets and templates of a paper circle consisting of 24 equal slices. (Author/NB)

  18. Economics Action Pack.

    ERIC Educational Resources Information Center

    McDonald's Corp., Oak Brook, IL.

    One of five McDonald's Action Packs, this learning package introduces intermediate grade students to basic economic concepts. The fourteen activities include the topics of consumption (4 activities), production (5), the market system (3), a pretest, and a posttest. Specific titles under consumption include The Wonderful Treasure Tree (introduction…

  19. CE: Human Papillomavirus-Related Oropharyngeal Cancer: A Review of Nursing Considerations.

    PubMed

    McKiernan, Janet; Thom, Bridgette

    2016-08-01

    : The overall incidence of head and neck cancer-which includes laryngeal, hypopharyngeal, nasal cavity, paranasal sinus, nasopharyngeal, oral, oropharyngeal, and salivary gland cancers-has declined in the United States over the past 30 years with the concomitant reduction in tobacco use. Over that same period, however, the worldwide incidence of oropharyngeal cancer has escalated significantly, most notably among men and women under age 60 who live in developed countries. This epidemic rise in oropharyngeal cancer is largely attributed to certain genotypes of the human papillomavirus (HPV). In the United States, HPV prevalence in oropharyngeal tumors increased dramatically, from roughly 16% between 1984 and 1989 to nearly 73% between 2000 and 2004, and the annual incidence of HPV-positive oropharyngeal cancer is expected to surpass that of HPV-related cervical cancer by 2020.This article provides an overview of head and neck cancer-its incidence, risk factors, treatment, and posttreatment sequelae-with a focus on HPV-related oropharyngeal cancer. Unlike other forms of head and neck cancer, HPV-related oropharyngeal cancer tends to affect younger patients with few or none of the traditional risk factors and has a distinctive presentation, histology, and natural course. In order to provide appropriate patient education and to help these patients monitor and manage late and long-term treatment effects, it is important for nurses to be aware of this disease and its treatment, and of the unique survivorship issues that arise for affected patients.

  20. Radiographic apparatus for photographing entire jaws

    SciTech Connect

    Nakano, K.

    1985-01-22

    This disclosure relates to a dental radiographic apparatus for photographing the entire jaw designed to control the rotation of a rotary arm such that the film surface of a film holder mounted at one end of the rotary arm may rotate and move substantially at equal speed substantially equidistantly along the dental arch and that the X-ray beams irradiated upon the film surface from an X-ray generator mounted at the other end of the arm may fall on the dental arch at any point thereof at right angles with the arch. The apparatus makes it possible to obtain a very clear tomographic picture of a curved plane of the entire jaws, the picture being free of a double image of the teeth, partial change in enlargement ratio of the image obtained, and partial difference in the shade of the image obtained.

  1. Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life.

    PubMed

    Paris, G; Martinaud, O; Petit, A; Cuvelier, A; Hannequin, D; Roppeneck, P; Verin, E

    2013-03-01

    Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31-82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL-QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non-dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non-dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non-dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.

  2. CT appearance of omental packs

    SciTech Connect

    Sefczek, R.J.; Lupetin, A.R.; Beckman, I.; Dash, N.

    1985-08-01

    Liver lacerations may be surgically treated by using the omentum as packing. A radiologist can differentiate potential postoperative complications, such as abscess, hematoma, and biloma, from these packs on computed tomographic scans by noting attenuation values.

  3. Oropharyngeal dysphagia in myotonic dystrophy type 1: a systematic review.

    PubMed

    Pilz, Walmari; Baijens, Laura W J; Kremer, Bernd

    2014-06-01

    A systematic review was conducted to investigate the pathophysiology of and diagnostic procedures for oropharyngeal dysphagia in myotonic dystrophy (MD). The electronic databases Embase, PubMed, and The Cochrane Library were used. The search was limited to English, Dutch, French, German, Spanish, and Portuguese publications. Sixteen studies met the inclusion criteria. Two independent reviewers assessed the methodological quality of the included articles. Swallowing assessment tools, the corresponding protocols, the studies' outcome measurements, and main findings are summarized and presented. The body of literature on pathophysiology of swallowing in dysphagic patients with MD type 1 remains scant. The included studies are heterogeneous with respect to design and outcome measures and hence are not directly comparable. More importantly, most studies had methodological problems. These are discussed in detail and recommendations for further research on diagnostic examinations for swallowing disorders in patients with MD type 1 are provided.

  4. A case of amyotrophic lateral sclerosis presented as oropharyngeal Dysphagia.

    PubMed

    Noh, Eun Ji; Park, Moo In; Park, Seun Ja; Moon, Won; Jung, Hyun Joo

    2010-07-01

    Amyotrophic lateral sclerosis is a rare disease. It is a fatal neurodegenerative disease characterized by progressive muscular paralysis reflecting degeneration of motor neurons which leads to muscle weakness and muscle wasting. Respiratory failure limits survival to 2-5 years after disease onset. Several clinical manifestations including dysphagia can result in reductions in both the quality of life and life expectancy. Dysphagia occurs at onset in about one third of case, although generally it occurs in later stage of the disease. Evaluation of dysphagia includes video-fluoroscopic swallow study, radiological esophagogram, flexible endoscopic examination, ultrasound examination, conventional manometry and electromyography. We report a case of amyotrophic lateral sclerosis in a 54-year-old man presenting oropharyngeal dysphagia which was diagnosed by high resolution esophageal manometry presenting abnormality of the upper esophageal sphincter.

  5. Prepacking perforations improves gravel packs

    SciTech Connect

    Hall, B.E.; Pace, J.R. )

    1990-05-21

    Productivity can be increased by prepacking perforations with gravel before a major gravel pack is pumped. The main gravel-pack treatment follows immediately after the prepack. This procedure can increase perforation permeability due to a more complete gravel fill of the perforation. The gravel pack prevents perforations from collapsing or filling with formation sand.

  6. Patterns of Locoregional Failure After Exclusive IMRT for Oropharyngeal Carcinoma

    SciTech Connect

    Sanguineti, Giuseppe Gunn, G. Brandon; Endres, Eugene J.; Chaljub, Gregory; Cheruvu, Praveena; Parker, Brent

    2008-11-01

    Purpose: To assess the patterns of failure after intensity-modulated radiotherapy (IMRT) for oropharyngeal squamous cell carcinoma (SCC). Methods and Materials: We analyzed patients treated at the University of Texas Medical Branch between May 2002 and February 2006 who met the following criteria: (1) definitive IMRT without chemotherapy for oropharyngeal SCC; (2) no pretreatment radical surgery; (3) minimal follow-up of 1 year. The location of each nodal/primary failure was co-registered to the pretreatment planning computed tomography scan and then expanded by 5 mm to a planning target volume (PTV) of the failure (PTV-f). We then investigated whether the prescription dose to the PTV-f had been appropriate for the amount of disease present before treatment and whether the PTV-f had been adequately covered. Results: A total of 50 patients were eligible. With a median follow-up of 32.6 months (range, 12.1-58.6), three local and six regional failures were observed in 8 patients. All but one failure, that had been neglected, were recorded within 14 months of the treatment end. Of the nine failures, four developed in the neck treated electively to the lowest dose level; in all of them, we could retrospectively identify initial positive lymph nodes that might have justified the subsequent failure. The remaining five failures developed in proximity of the high-dose volume. In all but one, the volume of region of interest receiving {>=}95% of the dose of the PTV-f was >95%, suggesting adequate coverage. In 1 patient, about 20% of PTV-f was outside the 95% isodose, so that marginal underdosing could not be ruled out. Conclusions: A potential cause could be identified in all the failures in the lowest dose level. The implications and possible remedies are discussed. Most failures around the high-dose region were 'true failures' with no apparent technical caus000.

  7. Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

    SciTech Connect

    Watkins, E.B.; Findlay, P.; Gelmann, E.; Lane, H.C.; Zabell, A.

    1987-09-01

    The oropharynx and hypopharynx are common sites of involvement in AIDS patients with mucocutaneous Kaposi's sarcoma. The radiotherapist is often asked to intervene with these patients due to problems with pain, difficulty in swallowing, or impending airway obstruction. We have noted an unexpected decrease in normal tissue tolerance of the oropharyngeal mucosa to irradiation in AIDS patients treated in our department. Data on 12 patients with AIDS and Kaposi's sarcoma receiving oropharyngeal irradiation are presented here. Doses ranged from 1000 cGy to 1800 cGy delivered in 150-300 cGy fractions. Seven of eight patients receiving doses of 1200 cGy or more developed some degree of mucositis, four of these developed mucositis severe enough to require termination of treatment. All patients in this study received some form of systemic therapy during the course of their disease, but no influence on mucosal response to irradiation was noted. Four patients received total body skin electron treatments, but no effect on degree of mucositis was seen. Presence or absence of oral candidiasis was not an obvious factor in the radiation response of the oral mucosa in these patients. T4 counts were done on 9 of the 12 patients. Although the timing of the T4 counts was quite variable, no correlation with immune status and degree of mucositis was found. The degree of mucositis seen in these patients occurred at doses much lower than expected based on normal tissue tolerances seen in other patient populations receiving head and neck irradiations. We believe that the ability of the oral mucosa to repair radiation damage is somehow altered in patients with AIDS.

  8. Diagnosis and Management of Oropharyngeal Dysphagia and Its Nutritional and Respiratory Complications in the Elderly

    PubMed Central

    Rofes, Laia; Arreola, Viridiana; Almirall, Jordi; Cabré, Mateu; Campins, Lluís; García-Peris, Pilar; Speyer, Renée; Clavé, Pere

    2011-01-01

    Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration—half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach. PMID:20811545

  9. FLUOROSCOPIC EVALUATION OF ORO-PHARYNGEAL DYSPHAGIA: ANATOMY, TECHNIQUE, AND COMMON ETIOLOGIES

    PubMed Central

    Edmund, Dr; Au, Frederick Wing-Fai; Steele, Catriona M.

    2015-01-01

    Target Audience Radiologists and other professionals involved in imaging of oropharyngeal swallowing Objectives To review anatomy of the upper GI tract To review techniques and contrast agents used in the fluoroscopic examination of the oropharynx and hypopharynx To provide a pictorial review of some important causes of oropharyngeal dysphagia, and to link these to key findings in the clinical history to assist in establishing a clinical diagnosis To provide self-assessment questions to reinforce key learning points PMID:25539237

  10. Genotype-oropharyngeal phenotype correlation in Mexican patients with dystrophic epidermolysis bullosa.

    PubMed

    Fortuna, G; Pollio, A; Aria, M; Moreno-Trevino, M G; Marasca, F; Salas-Alanís, J C

    2014-04-01

    Previous investigations have attempted to correlate the genotype with the cutaneous phenotype in patients with epidermolysis bullosa (EB), but never with the oropharyngeal phenotype. Seventeen dystrophic EB (DEB) patients were genotyped for COL7A1 gene mutations and divided into five distinct groups. Oropharyngeal disease severity was assessed with the Epidermolysis Bullosa Oropharyngeal Severity (EBOS) score by an oral medicine specialist. The genotype-phenotype correlation was calculated by Kruskal-Wallis analysis of variance using the Mann-Whitney test, applying the Bonferroni correction. The most severe oropharyngeal phenotype was found in the group with the 2470insG/3948insT mutation, with a mean disease severity score of 18.50 ± 2.12; the mildest was found in the 6862del16 mutation group, with a mean disease severity score of 0.57 ± 1.13. The most significant difference in median score was found in the total score (P = 0.009), followed by tongue (P = 0.02) and upper lip (P = 0.021), but no correlation was found between disease severity and the groups (P>0.005, after Bonferroni correction). Multiple comparisons among the five different genotypic groups revealed no statistically significant genotype-oropharyngeal phenotype correlation; it was not possible to establish which group was more severe, or to associate a specific mutation to a specific oropharyngeal phenotype.

  11. Screening of active lyssavirus infection in wild bat populations by viral RNA detection on oropharyngeal swabs.

    PubMed

    Echevarría, J E; Avellón, A; Juste, J; Vera, M; Ibáñez, C

    2001-10-01

    Brain analysis cannot be used for the investigation of active lyssavirus infection in healthy bats because most bat species are protected by conservation directives. Consequently, serology remains the only tool for performing virological studies on natural bat populations; however, the presence of antibodies merely reflects past exposure to the virus and is not a valid marker of active infection. This work describes a new nested reverse transcription (RT)-PCR technique specifically designed for the detection of the European bat virus 1 on oropharyngeal swabs obtained from bats but also able to amplify RNA from the remaining rabies-related lyssaviruses in brain samples. The technique was successfully used for surveillance of a serotine bat (Eptesicus serotinus) colony involved in a case of human exposure, in which 15 out of 71 oropharyngeal swabs were positive. Lyssavirus infection was detected on 13 oropharyngeal swabs but in only 5 brains out of the 34 animals from which simultaneous brain and oropharyngeal samples had been taken. The lyssavirus involved could be rapidly identified by automatic sequencing of the RT-PCR products obtained from 14 brains and three bat oropharyngeal swabs. In conclusion, RT-PCR using oropharyngeal swabs will permit screening of wild bat populations for active lyssavirus infection, for research or epidemiological purposes, in line not only with conservation policies but also in a more efficient manner than classical detection techniques used on the brain.

  12. Oropharyngeal gonorrhoea: rate of co-infection with sexually transmitted infection, antibiotic susceptibility and treatment outcome.

    PubMed

    Manavi, K; Zafar, F; Shahid, H

    2010-02-01

    The aim of the present study is to investigate the rate of co-infections with other sexually transmitted infections (STIs), antibiotic susceptibility and management of oropharyngeal gonorrhoea diagnosed in a busy genitourinary medicine clinic. The method involved a retrospective study on consecutive patients diagnosed with oropharyngeal gonorrhoea. A total of 131 patients were diagnosed with oropharyngeal gonorrhoea over the study period. The median age of the infected patients was 28 (interquartile range: 22 to 35) years. Forty-one (31%) of patients were younger than 24 years. High rates of co-infection with urethral gonorrhoea (37%), rectal gonorrhoea (37%) or chlamydial infection (16%) were identified. Thirty patients (23%) had only oropharyngeal infection. Twenty-two (17%) patients' isolates showed resistance to at least one antibiotic. Antibiotic resistance among oropharyngeal gonococcal isolates was above 5% between 2000 and 2009. Test-of-cure (TOC) was carried out for only 63 (48%) of patients; none had positive culture. Among 46 isolates treated with cefixime 400 mg/stat, 27 (59%) had TOC; all were negative. Repeat TOC was not carried out for any of the patients. In conclusion, successful management of oropharyngeal gonorrhoea should comprise of counselling, partner notification and TOC after treatment with appropriate antibiotic regimen.

  13. Evaluation of steam resistance of gravel-packing materials

    SciTech Connect

    Weaver, J.D.; Knox, J.A. )

    1992-05-01

    This paper compares the steam stability of common gravel-packing materials. The scope was limited to one set of downhole conditions. Results indicated that none of the commonly used materials were entirely satisfactory, but another material not normally used in the petroleum industry was found to give excellent results.

  14. Packing of hard spheres in cylinders and applications

    NASA Astrophysics Data System (ADS)

    Mughal, Adil; Weaire, Denis; Hutzler, Stefan; Chan, Ho Kei

    2014-03-01

    We study the optimal packing of hard spheres in an infinitely long cylinder. Our simulations have yielded dozens of periodic, mechanically stable, structures as the ratio of the cylinder (D) to sphere (d) diameter is varied. Up to D/d =2.715 the densest structures are composed entirely of spheres which are in contact with the cylinder. The density reaches a maximum at discrete values of D/d when a maximum number of contacts are established. These maximal contact packings are of the classic ``phyllotactic'' type, familiar in biology. However, between these points we observe another type of packing, termed line-slip. An analytic understanding of these rigid structures follows by recourse to a yet simpler problem: the packing of disks on a cylinder. We show that maximal contact packings correspond to the perfect wrapping of a honeycomb arrangement of disks around a cylindrical tube. While line-slip packings are inhomogeneous deformations of the honeycomb lattice modified to wrap around the cylinder. Beyond D/d =2.715 the structures are more complex, since they incorporate internal spheres. We review some relevant experiments with hard spheres, small bubbles and discuss similar structures found in nature. We discuss the chirality of these packings and potential applications in photonics.

  15. Consolidatable gravel pack method

    SciTech Connect

    Friedman, R.H.; Surles, B.W.

    1989-01-31

    A method is described for forming a consolidated gravel pack in a washed-out cavity adjacent to a producing well penetrating a subterranean oil formation comprising the steps of: (a) forming a quantity of resin coated gravel comprising granular mineral particles including gravel, the gravel particles being coated with a resin fluid containing a polymerizable oligomer of furfuryl alcohol resin, a catalyst comprising an oil soluble, very slightly water soluble organic acid and an ester of a weak organic acid to consume water produced by the polymerization of resin, the polymer coated gravel comprising a sticky solid material; (b) preparing an aqueous saline carrier fluid comprising water which is from 70 to 100% saturated with sodium chloride; (c) suspending the resin-coated gravel in the carrier fluid, forming a fluid mixture of resin-coated gravel and carrier fluid; (d) introducing the fluid mixture comprising the resin coated gravel particles suspended in the aqueous saline carrier fluid into the washed-out cavity of the formation adjacent to the producing well and shutting in the well for sufficient period of time to allow polymerization of the resin, forming the permeable gravel pack in the washed-out cavity of the formation.

  16. ExactPack Documentation

    SciTech Connect

    Singleton, Jr., Robert; Israel, Daniel M.; Doebling, Scott William; Woods, Charles Nathan; Kaul, Ann; Walter, Jr., John William; Rogers, Michael Lloyd

    2016-05-09

    For code verification, one compares the code output against known exact solutions. There are many standard test problems used in this capacity, such as the Noh and Sedov problems. ExactPack is a utility that integrates many of these exact solution codes into a common API (application program interface), and can be used as a stand-alone code or as a python package. ExactPack consists of python driver scripts that access a library of exact solutions written in Fortran or Python. The spatial profiles of the relevant physical quantities, such as the density, fluid velocity, sound speed, or internal energy, are returned at a time specified by the user. The solution profiles can be viewed and examined by a command line interface or a graphical user interface, and a number of analysis tools and unit tests are also provided. We have documented the physics of each problem in the solution library, and provided complete documentation on how to extend the library to include additional exact solutions. ExactPack’s code architecture makes it easy to extend the solution-code library to include additional exact solutions in a robust, reliable, and maintainable manner.

  17. Teeing Off With an Entirely New Material

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Liquidmetal(R) alloy is part of an entirely new class of vitrified metals, and is also known as metallic glass, or Vitreloy(R). A vitrified metal is a frozen liquid that fails to crystallize during solidification, unlike common metals such as titanium, steel, and aluminum. The technology takes the non-crystalline structure of glass and combines it with the properties of metal, a combination not found in nature, allowing for a product that offers the strength of a metal with the elasticity of a polymer. This unique technology is more than twice as strong as titanium and has a higher elastic limit. Liquidmetal(R) Golf presents this space-age development in a complete line golf clubs. Clubs made with this technology have a lower vibration response along with a softer, more solid feel. Because less energy is absorbed by the club's head upon impact, more energy is transferred directly to the ball. Vitreloy has potential commercial uses in sporting equipment: tennis rackets, bicycle frames, and baseball bats. The material may find applications in the medical industry for the manufacturing of surgical instruments and prosthetics. The Liquidmetal alloy is projected to replace many high performance materials, such as titanium, in the industries of aerospace, defense, military, automotives, medical instrumentation, and sporting goods

  18. Numerical simulation of gravel packing

    SciTech Connect

    Winterfeld, P.H.; Schroeder, D.E. Jr. )

    1992-08-01

    To obtain maximum productivity from unconsolidated formations where sand control is required, it is important to understand the mechanics of gravel packing. This paper describes a finite-element, numerical simulator that can predict gravel placement in the perforations and annulus of a wellbore. The equations for the simulator include mass and momentum conservation. Wellbore geometry, physical properties, and fluid and gravel-pack properties are simulator input. Experiments in a 100-ft full-scale wellbore model for three gravel-packing configurations have been successfully simulated. These configurations are a circulating pack with a washpipe, a squeeze pack, and a circulating/squeeze pack with a washpipe and a lower telltale screen. The low cost, speed, and extrapolation capabilities of the numerical simulator will greatly enhance our ability to predict gravel placement in a wellbore.

  19. Past sexual behaviors and risks of oropharyngeal squamous cell carcinoma: a case-case comparison.

    PubMed

    Schnelle, Christoph; Whiteman, David C; Porceddu, Sandro V; Panizza, Benedict J; Antonsson, Annika

    2017-03-01

    The incidence of oropharyngeal squamous cell carcinomas (SCCs) is increasing and is believed to reflect changing sexual practices in recent decades. For this case-case comparative study, we collected medical and life-style information and data on sexual behavior from 478 patients treated at the head and neck clinic of a tertiary hospital in Brisbane, Australia. Patients were grouped as (i) oropharyngeal SCC (n = 96), (ii) oral cavity, larynx and hypopharynx SCC ("other HNSCCs," n = 96), (iii) other SCCs (n = 141), and (iv) other diagnoses (n = 145). We fitted multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) associated with lifestyle factors and sexual behaviors. Compared to the other three patient groups, the oropharyngeal SCC patients had overall more sexual lifetime partners (kissing, oral sex and sexual intercourse). Oropharyngeal SCC patients were significantly more likely to have ever given oral sex compared to the other three patient groups-93% of oropharyngeal SCC patients, 64% of other HNSCC patients, and 58% of patients with other SCC or other diagnoses. Oropharyngeal SCC patients were significantly more likely to have given oral sex to four or more partners when compared to patients with other HNSCC (odds ratio [OR] 11.9; 95% CI 3.5-40.1), other SCC (OR 16.6; 95% CI 5.3-52.0) or patients with other diagnoses (OR 25.2; 95% CI 7.8-81.7). The very strong associations reported here between oral sex practices and risks of oropharyngeal SCC support the hypothesis that sexually transmitted HPV infections cause some of these cancers.

  20. Granular Packings and Fault Zones

    NASA Astrophysics Data System (ADS)

    Åström, J. A.; Herrmann, H. J.; Timonen, J.

    2000-01-01

    The failure of a two-dimensional packing of elastic grains is analyzed using a numerical model. The packing fails through formation of shear bands or faults. During failure there is a separation of the system into two grain-packing states. In a shear band, local ``rotating bearings'' are spontaneously formed. The bearing state is favored in a shear band because it has a low stiffness against shearing. The ``seismic activity'' distribution in the packing has the same characteristics as that of the earthquake distribution in tectonic faults. The directions of the principal stresses in a bearing are reminiscent of those found at the San Andreas Fault.

  1. Immunopathogenesis of Oropharyngeal Candidiasis in Human Immunodeficiency Virus Infection

    PubMed Central

    de Repentigny, Louis; Lewandowski, Daniel; Jolicoeur, Paul

    2004-01-01

    Oropharyngeal and esophageal candidiases remain significant causes of morbidity in human immunodeficiency virus (HIV)-infected patients, despite the dramatic ability of antiretroviral therapy to reconstitute immunity. Notable advances have been achieved in understanding, at the molecular level, the relationships between the progression of HIV infection, the acquisition, maintenance, and clonality of oral candidal populations, and the emergence of antifungal resistance. However, the critical immunological defects which are responsible for the onset and maintenance of mucosal candidiasis in patients with HIV infection have not been elucidated. The devastating impact of HIV infection on mucosal Langerhans' cell and CD4+ cell populations is most probably central to the pathogenesis of mucosal candidiasis in HIV-infected patients. However, these defects may be partly compensated by preserved host defense mechanisms (calprotectin, keratinocytes, CD8+ T cells, and phagocytes) which, individually or together, may limit Candida albicans proliferation to the superficial mucosa. The availability of CD4C/HIV transgenic mice expressing HIV-1 in immune cells has provided the opportunity to devise a novel model of mucosal candidiasis that closely mimics the clinical and pathological features of candidal infection in human HIV infection. These transgenic mice allow, for the first time, a precise cause-and-effect analysis of the immunopathogenesis of mucosal candidiasis in HIV infection under controlled conditions in a small laboratory animal. PMID:15489345

  2. Serum trace elements in elderly frail patients with oropharyngeal dysphagia.

    PubMed

    Leibovitz, Arthur; Lubart, Emilia; Wainstein, Julio; Dror, Yosef; Segal, Refael

    2009-01-01

    Microelements have an important role in many vital enzymatic functions. Their optimal intake and serum concentration are not properly defined. For nursing home residents, this issue is further complicated by the high prevalence of oropharyngeal dysphagia. The purpose of this study was to measure microelement concentrations in 3 groups of elderly subjects that differ in their feeding methods and functional state. Forty-six frail elderly patients, in stable clinical condition, 15 on naso-gastric tube (NGT) feeding, 15 orally fed (OF), from skilled nursing departments were recruited to this study. As controls, we studied a group of 16 elderly independent ambulatory patients. A battery of 16 microelements was examined using the Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The OF frail elderly patients had significantly lower levels of chromium as compared to the NGT fed and the control group. Both frail elderly groups had lower levels of zinc and copper as compared to the controls. In contrast, in the nursing groups, we found higher levels of aluminum, boron, barium, bromine and nickel. Elderly, in particular frail and disabled subjects, are vulnerable to insufficiency or overload of microelements. There is a need to evaluate the actual requirements for each microelement for this population.

  3. Tumor Staging and HPV-Related Oropharyngeal Cancer.

    PubMed

    Wittekindt, Claus; Klussmann, Jens Peter

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

  4. Th17 Inflammation Model of Oropharyngeal Candidiasis in Immunodeficient Mice

    PubMed Central

    Bhaskaran, Natarajan; Weinberg, Aaron; Pandiyan, Pushpa

    2015-01-01

    Oropharyngeal Candidiasis (OPC) disease is caused not only due to the lack of host immune resistance, but also the absence of appropriate regulation of infection-induced immunopathology. Although Th17 cells are implicated in antifungal defense, their role in immunopathology is unclear. This study presents a method for establishing oral Th17 immunopathology associated with oral candidal infection in immunodeficient mice. The method is based on reconstituting lymphopenic mice with in vitro cultured Th17 cells, followed by oral infection with Candida albicans (C. albicans). Results show that unrestrained Th17 cells result in inflammation and pathology, and is associated with several measurable read-outs including weight loss, pro-inflammatory cytokine production, tongue histopathology and mortality, showing that this model may be valuable in studying OPC immunopathology. Adoptive transfer of regulatory cells (Tregs) controls and reduces the inflammatory response, showing that this model can be used to test new strategies to counteract oral inflammation. This model may also be applicable in studying oral Th17 immunopathology in general in the context of other oral diseases. PMID:25742163

  5. Th17 inflammation model of oropharyngeal candidiasis in immunodeficient mice.

    PubMed

    Bhaskaran, Natarajan; Weinberg, Aaron; Pandiyan, Pushpa

    2015-02-18

    Oropharyngeal Candidiasis (OPC) disease is caused not only due to the lack of host immune resistance, but also the absence of appropriate regulation of infection-induced immunopathology. Although Th17 cells are implicated in antifungal defense, their role in immunopathology is unclear. This study presents a method for establishing oral Th17 immunopathology associated with oral candidal infection in immunodeficient mice. The method is based on reconstituting lymphopenic mice with in vitro cultured Th17 cells, followed by oral infection with Candida albicans (C. albicans). Results show that unrestrained Th17 cells result in inflammation and pathology, and is associated with several measurable read-outs including weight loss, pro-inflammatory cytokine production, tongue histopathology and mortality, showing that this model may be valuable in studying OPC immunopathology. Adoptive transfer of regulatory cells (Tregs) controls and reduces the inflammatory response, showing that this model can be used to test new strategies to counteract oral inflammation. This model may also be applicable in studying oral Th17 immunopathology in general in the context of other oral diseases.

  6. Toward an Ensemble Streamflow Forecast Over the Entire France

    NASA Astrophysics Data System (ADS)

    Rousset, F.; Habets, F.; Noilhan, J.; Morel, S.; Le Moigne, P.

    2004-12-01

    Since the year 2003, the French National Weather Service (Meteo-France) uses an operationnal real-time system that provides a daily monitoring of the water budget, streamflows and aquifer levels over the entire France : the SAFRAN-ISBA-MODCOU (SIM) system. This coupled model is composed of the ISBA surface scheme and of the distributed hydrological model MODCOU. The system is used in a forced mode, with the atmospheric forcing derived from observations through the use of the SAFRAN analysis system. Such a system has been validated over 3 large french basins~: the Rhone, the Adour-Garonne and the Seine basins. It was shown that the system satisfactorily reproduces the water and energy budgets, as well as the observed streamflows, aquifer levels and snow-packs. In particular, the main long-duration floods of the Seine are well simulated. The SIM system is also used for streamflow forecasting. As a first step, experiments of determinist forecasts have been performed over the Rhone basin, using 2- and 3-day quantitive precipitation forecast. The encouraging results showed the potential of SIM for flood forecasting. As a next step, an ensemble streamflow prediction system is now being built. The forecasts from the Ensemble Prediction System of the ECMWF are used to force the system. The initial conditions of soil moisture, aquifer levels, etc. are given by the operationnal run of SIM, and the results are analysed for each forecast day. This system is expected to give 10-day forecasts of the streamflow of the main french rivers with a measure of the associated confidence, which is greatly valuable for flood warning and water management.

  7. The first glacier inventory for entire Greenland

    NASA Astrophysics Data System (ADS)

    Rastner, P.; Bolch, T.; Mölg, N.; Le Bris, R.; Paul, F.

    2012-04-01

    approximately 1'684'000 km2. The entire ice-covered area on Greenland is thus 1'813'000 km2. We will present the results of the GIC mapping along with an analysis of glacier inventory statistics.

  8. Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains?

    PubMed

    Lewis, D A

    2015-06-01

    Gonorrhoea is an important sexually transmitted infection associated with serious complications and enhanced HIV transmission. Oropharyngeal infections are often asymptomatic and will only be detected by screening. Gonococcal culture has low sensitivity (<50%) for detecting oropharyngeal gonorrhoea, and, although not yet approved commercially, nucleic acid amplification tests (NAAT) are the assay of choice. Screening for oropharyngeal gonorrhoea should be performed in high-risk populations, such as men-who-have-sex-with-men(MSM). NAATs have a poor positive predictive value when used in low-prevalence populations. Gonococci have repeatedly thwarted gonorrhoea control efforts since the first antimicrobial agents were introduced. The oropharyngeal niche provides an enabling environment for horizontal transfer of genetic material from commensal Neisseria and other bacterial species to Neisseria gonorrhoeae. This has been the mechanism responsible for the generation of mosaic penA genes, which are responsible for most of the observed cases of resistance to extended-spectrum cephalosporins (ESC). As antimicrobial-resistant gonorrhoea is now an urgent public health threat, requiring improved antibiotic stewardship, laboratory-guided recycling of older antibiotics may help reduce ESC use. Future trials of antimicrobial agents for gonorrhoea should be powered to test their efficacy at the oropharynx as this is the anatomical site where treatment failure is most likely to occur. It remains to be determined whether a combination of frequent screening of high-risk individuals and/or laboratory-directed fluoroquinolone therapy of oropharyngeal gonorrhoea will delay the further emergence of drug-resistant N. gonorrhoeae strains.

  9. Antarctic pack ice: boundaries established from nimbus I pictures.

    PubMed

    Predoehl, M C

    1966-08-19

    Television and photofacsimile constructed infrared pictures taken by the Nimbus I meteorological satellite between 28 August and 22 September 1964 were analyzed for indications of the pack-ice boundary around Antarctica. Mean ice boundaries were established around the entire continent from both TV and infrared pictures, from which were estimated pack-ice areas of 19.81 by 10(6) and16.78 by 10(6) square kilometers, respectively; the difference is attributed to difference in subjective discernment of a boundary.

  10. Packing Products: Polystyrene vs. Cornstarch

    ERIC Educational Resources Information Center

    Starr, Suzanne

    2009-01-01

    Packing materials such as polystyrene take thousands of years to decompose, whereas packing peanuts made from cornstarch, which some companies are now using, can serve the same purpose, but dissolve in water. The author illustrates this point to her class one rainy day using the sculptures students made from polystyrene and with the cornstarch…

  11. 7 CFR 51.310 - Packing requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARDS) United States Standards for Grades of Apples Packing Requirements § 51.310 Packing requirements. (a) Apples tray packed or cell packed in cartons shall be arranged according to approved and... that apples are of the proper size for molds or cell compartments in which they are packed, and...

  12. 7 CFR 51.310 - Packing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARDS) United States Standards for Grades of Apples Packing Requirements § 51.310 Packing requirements. (a) Apples tray packed or cell packed in cartons shall be arranged according to approved and... that apples are of the proper size for molds or cell compartments in which they are packed, and...

  13. 7 CFR 51.310 - Packing requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARDS) United States Standards for Grades of Apples Packing Requirements § 51.310 Packing requirements. (a) Apples tray packed or cell packed in cartons shall be arranged according to approved and... that apples are of the proper size for molds or cell compartments in which they are packed, and...

  14. Human papillomavirus (HPV) and oropharyngeal squamous cell carcinoma.

    PubMed

    Dalianis, Tina

    2014-12-01

    Numerous reports in recent decades have shown that, in addition to smoking and alcohol, human papillomavirus (HPV) is also associated with the development of oropharyngeal squamous cell carcinoma (OPSCC), predominantly in the tonsils and base of the tongue. In 2007, the International Agency on Research against Cancer (IARC) therefore declared HPV to be a risk factor for OPSCC and noted that 80% of those affected are men. In addition, patients with HPV-positive OPSCC, in particular never-smokers, have a much better clinical response to therapy than patients with HPV-negative OPSCC and other head and neck cancers. Most patients with HPV-positive OPSCC may thus not need the increasingly intensive chemo-radiotherapy currently administered today to most patients with head neck cancers and associated with many adverse effects. Furthermore, an increase in the incidence of OPSCC has been observed in many western countries, accompanied by a rise in the proportion of HPV-positive tumors. Patients with HPV-positive OPSCC, like those with cervical cancer, more often have an earlier sexual debut and have more sexual partners. It has therefore been proposed that the increased incidence of OPSCC observed might be due to an epidemic of sexually transmitted HPV. The important issues today regarding this growing cohort of patients with HPV-positive OPSCC are therefore individualized treatment and prevention. More specifically, selected HPV-positive OPSCC patients with biomarkers of good prognosis might be included in randomized trials with less intensive treatment. HPV vaccination should also be considered for boys, in addition to the current recommendations for immunization of girls.

  15. Oropharyngeal Dysphagia in patients with obstructive sleep apnea syndrome.

    PubMed

    Schindler, Antonio; Mozzanica, Francesco; Sonzini, Giulia; Plebani, Daniela; Urbani, Emanuele; Pecis, Marica; Montano, Nicola

    2014-02-01

    Although previous studies demonstrated that patients with obstructive sleep apnea syndrome (OSAS) may present subclinical manifestations of dysphagia, in not one were different textures and volumes systematically studied. The aim of this study was to analyze the signs and symptoms of oropharyngeal dysphagia using fiberoptic endoscopic evaluation of swallowing (FEES) with boluses of different textures and volumes in a large cohort of patients with OSAS. A total of 72 OSAS patients without symptoms of dysphagia were enrolled. The cohort was divided in two groups: 30 patients with moderate OSAS and 42 patients with severe OSAS. Each patient underwent a FEES examination using 5, 10 and 20 ml of liquids and semisolids, and solids. Spillage, penetration, aspiration, retention, and piecemeal deglutition were considered. The penetration-aspiration scale (PAS), pooling score (PS), and dysphagia outcome and severity scale (DOSS) were used for quantitative analysis. Each patient completed the SWAL-QOL questionnaire. Forty-six patients (64 %) presented spillage, 20 (28 %) piecemeal deglutition, 26 (36 %) penetration, and 30 (44 %) retention. No differences were found in the PAS, PS, and DOSS scores between patients with moderate and severe OSAS. Patients with severe OSAS scored higher General Burden and Food selection subscales of the SWAL-QOL. Depending on the DOSS score, the cohort of patients was divided into those with and those without signs of dysphagia. Patients with signs of dysphagia scored lower in the General Burden and Symptoms subscales of the SWAL-QOL. OSAS patients show signs of swallowing impairment in about half of the population; clinicians involved in the management of these patients should include questions on swallowing when taking the medical history.

  16. The Impact of Radiographic Retropharyngeal Adenopathy in Oropharyngeal Cancer

    PubMed Central

    Gunn, G. Brandon; Debnam, J. Matthew; Fuller, Clifton D.; Morrison, William H.; Frank, Steven J.; Beadle, Beth M.; Sturgis, Erich M.; Glisson, Bonnie S.; Phan, Jack; Rosenthal, David I.; Garden, Adam S.

    2013-01-01

    Background We carried out this study to define the incidence of radiographic retropharyngeal lymph node (RPLN) involvement in oropharyngeal cancer (OPC) and its impact on clinical outcomes, which have not been well established to date. Methods Our departmental database was queried for patients irradiated for OPC from 2001–2007. Analyzable patients were those with imaging data available for review to determine radiographic RPLN status. Demographic, clinical, and outcomes data were retrieved and analyzed. Results The cohort consisted of 981 patients. Median follow up was 69 months. The base of tongue (47%) and tonsil (46%) were the most common primary sites. The majority of patients had T1-2 primaries (64%) and 94% stage 3-4B disease. IMRT was used in 77%, and systemic therapy was delivered to 58%. The incidence of radiographic RPLN involvement was 10% and highest for pharyngeal wall (23%) and lowest for base of tongue tumors (6%). RPLN adenopathy correlated with a number of patient and tumor factors. RPLN involvement was associated with poorer 5-year outcomes on univariate analysis (p <.001 for all): local control (79% vs. 92%), nodal control (80% vs. 93%), recurrence-free (51% vs. 81%), distant metastases-free (66% vs. 89%), and overall survival (52% vs. 82%), and maintained significance for local control (p=.023), recurrence-free (p=.001), distant metastases-free (p=.003), and overall survival (p=.001) on multivariate analysis. Conclusions In this cohort of nearly 1000 patients investigating radiographic RPLN adenopathy in OPC, RPLN involvement was observed in 10% of patients and portends a negative influence on disease recurrence, distant relapse, and survival. PMID:23733178

  17. Randomized trial of neoadjuvant chemotherapy in oropharyngeal carcinoma

    PubMed Central

    Domenge, C; Hill, C; Lefebvre, J L; De Raucourt, D; Rhein, B; Wibault, P; Marandas, P; Coche-Dequeant, B; Stromboni-Luboinski, M; Sancho-Garnier, H; Luboinski, B

    2000-01-01

    The objective of the study was to evaluate the effect of neoadjuvant chemotherapy on the survival of patients with oropharyngeal cancer. Patients with a squamous cell carcinoma of the oropharynx for whom curative radiotherapy or surgery was considered feasible were entered in a multicentric randomized trial comparing neoadjuvant chemotherapy followed by loco-regional treatment to the same loco-regional treatment without chemotherapy. The loco-regional treatment consisted either of surgery plus radiotherapy or of radiotherapy alone. Three cycles of chemotherapy consisting of Cisplatin (100 mg/m2) on day 1 followed by a 24-hour i.v. infusion of fluorouracil (1000 mg/m2/day) for 5 days were delivered every 21 days. 2–3 weeks after the end of chemotherapy, local treatment was performed. The trial was conducted by the Groupe d'Etude des Tumeurs de la Tête Et du Cou (GETTEC). A total of 318 patients were enrolled in the study between 1986 and 1992. Overall survival was significantly better (P = 0.03) in the neoadjuvant chemotherapy group than in the control group, with a median survival of 5.1 years versus 3.3 years in the no chemotherapy group. The effect of neoadjuvant chemotherapy on event-free survival was smaller and of borderline significance (P = 0.11). Stratification of the results on the type of local treatment, surgery plus radiotherapy or radiotherapy alone, did not reveal any heterogeneity in the effect of chemotherapy. © 2000 Cancer Research Campaign http://www.bjcancer.com PMID:11189100

  18. Oropharyngeal acid reflux and motility abnormalities of the proximal esophagus

    PubMed Central

    Passaretti, Sandro; Mazzoleni, Giorgia; Vailati, Cristian; Testoni, Pier Alberto

    2016-01-01

    AIM To investigate the relationship between pathological oropharyngeal (OP) acid exposure and esophageal motility in patients with extra-esophageal syndromes. METHODS In this prospective study we enrolled consecutive outpatients with extra-esophageal symptoms suspected to be related to gastroesophageal reflux disease (GERD). We enrolled only patients with a reflux symptom index (RSI) score-higher than 13 and with previous lung, allergy and ear, nose and throat evaluations excluding other specific diagnoses. All patients underwent 24-h OP pH-metry with the Dx probe and esophageal high-resolution manometry (HRM). Patients were divided into two groups on the basis of a normal or pathological pH-metric finding (Ryan Score) and all manometric characteristics of the two groups were compared. RESULTS We examined 135 patients with chronic extra-esophageal syndromes. Fifty-one were considered eligible for the study. Of these, 42 decided to participate in the protocol. Patients were divided into two groups on the basis of normal or pathological OP acid exposure. All the HRM parameters were compared for the two groups. Significant differences were found in the median upper esophageal sphincter resting pressure (median 71 mmHg vs 126 mmHg, P = 0.004) and the median proximal contractile integral (median 215.5 cm•mmHg•s vs 313.5 cm•mmHg•s, P = 0.039), both being lower in the group with pathological OP acid exposure, and the number of contractions with small or large breaks, which were more frequent in the same group. This group also had a larger number of peristaltic contractions with breaks in the 20 mmHg isobaric contour (38.7% vs 15.38%, P < 0.0001). CONCLUSION In patients with suspected GERD-related extra-esophageal syndromes pathological OP acid exposure was associated with weaker proximal esophageal motility. PMID:27833390

  19. Human papillomavirus prevalence in oropharyngeal cancer before vaccine introduction, United States.

    PubMed

    Steinau, Martin; Saraiya, Mona; Goodman, Marc T; Peters, Edward S; Watson, Meg; Cleveland, Jennifer L; Lynch, Charles F; Wilkinson, Edward J; Hernandez, Brenda Y; Copeland, Glen; Saber, Maria S; Hopenhayn, Claudia; Huang, Youjie; Cozen, Wendy; Lyu, Christopher; Unger, Elizabeth R

    2014-05-01

    We conducted a study to determine prevalence of HPV types in oropharyngeal cancers in the United States and establish a prevaccine baseline for monitoring the impact of vaccination. HPV DNA was extracted from tumor tissue samples from patients in whom cancer was diagnosed during 1995-2005. The samples were obtained from cancer registries and Residual Tissue Repository Program sites in the United States. HPV was detected and typed by using PCR reverse line blot assays. Among 557 invasive oropharyngeal squamous cell carcinomas, 72% were positive for HPV and 62% for vaccine types HPV16 or 18. Prevalence of HPV-16/18 was lower in women (53%) than in men (66%), and lower in non-Hispanic Black patients (31%) than in other racial/ethnic groups (68%-80%). Results indicate that vaccines could prevent most oropharyngeal cancers in the United States, but their effect may vary by demographic variables.

  20. Bedside screening to detect oropharyngeal dysphagia in patients with neurological disorders: an updated systematic review.

    PubMed

    Kertscher, Berit; Speyer, Renée; Palmieri, Maria; Plant, Chris

    2014-04-01

    Oropharyngeal dysphagia is a highly prevalent comorbidity in neurological patients and presents a serious health threat, which may le to outcomes of aspiration pneumonia ranging from hospitalization to death. Therefore, an early identification of risk followed by an accurate diagnosis of oropharyngeal dysphagia is fundamental. This systematic review provides an update of currently available bedside screenings to identify oropharyngeal dysphagia in neurological patients. An electronic search was carried out in the databases PubMed, Embase, CINAHL, and PsychInfo (formerly PsychLit), and all hits from 2008 up to December 2012 were included in the review. Only studies with sufficient methodological quality were considered, after which the psychometric characteristics of the screening tools were determined. Two relevant bedside screenings were identified, with a minimum sensitivity and specificity of ≥70 and ≥60 %, respectively.

  1. Human Papillomavirus Prevalence in Oropharyngeal Cancer before Vaccine Introduction, United States

    PubMed Central

    Saraiya, Mona; Goodman, Marc T.; Peters, Edward S.; Watson, Meg; Cleveland, Jennifer L.; Lynch, Charles F.; Wilkinson, Edward J.; Hernandez, Brenda Y.; Copeland, Glen; Saber, Maria S.; Hopenhayn, Claudia; Huang, Youjie; Cozen, Wendy; Lyu, Christopher; Unger, Elizabeth R.

    2014-01-01

    We conducted a study to determine prevalence of HPV types in oropharyngeal cancers in the United States and establish a prevaccine baseline for monitoring the impact of vaccination. HPV DNA was extracted from tumor tissue samples from patients in whom cancer was diagnosed during 1995–2005. The samples were obtained from cancer registries and Residual Tissue Repository Program sites in the United States. HPV was detected and typed by using PCR reverse line blot assays. Among 557 invasive oropharyngeal squamous cell carcinomas, 72% were positive for HPV and 62% for vaccine types HPV16 or 18. Prevalence of HPV-16/18 was lower in women (53%) than in men (66%), and lower in non-Hispanic Black patients (31%) than in other racial/ethnic groups (68%–80%). Results indicate that vaccines could prevent most oropharyngeal cancers in the United States, but their effect may vary by demographic variables. PMID:24751181

  2. [Evaluation of capillary chromatographic columns packed by electrokinetic packing method].

    PubMed

    Li, Z; You, H; Hu, S; Wei, W; Luo, G

    1997-01-01

    In this paper, a method for electrokinetic packing capillary columns is reported. A higher column effeciency was obtained by performing electrochromatography on electrokinetic packing columns. The highest column efficiency in number of theoretical plate per meter was more than 200000, corresponding to reduced plate height less than 2. The reproducibilities of the same column in different intervals and different columns prepared from the same or different batches were compared. The relative standard deviations of the number of theoretical plate and retention time were less than 10% and 8%, respectively. The results indicated that high column efficiency and good reproducibility can be obtained on these new capillary packed columns.

  3. Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients.

    PubMed

    Awan, Mohammad Sohail; Iqbal, Moghira

    2008-11-01

    The once-common practice of packing the nose after septoplasty was based on a desire to prevent postoperative complications such as bleeding, septal hematoma, and adhesion formation. However, it was since found that not only is nasal packing ineffective in this regard, it can actually cause these complications. Although the consensus in the world literature is that packing should be avoided, to the best of our knowledge, no truly randomized study has been undertaken in Southwest Asia upon which to justify this recommendation here. Therefore, we conducted a prospective randomized comparison of the incidence of a variety of postoperative signs and symptoms in 88 patients, 15 years of age and older, who did (n = 44) and did not (n = 44) undergo nasal packing following septoplasty. We found that the patients who underwent packing experienced significantly more postoperative pain, headache, epiphora, dysphagia, and sleep disturbance on the night of surgery. Oral and nasal examinations 7 days postoperatively revealed no significant difference between the two groups in the incidence of bleeding, septal hematoma, adhesion formation, and local infection. Finally, the packing group reported a moderate to high level of pain during removal of the packing. Our findings confirm that nasal packing after septoplasty is not only unnecessary, it is actually a source of patient discomfort and other signs and symptoms.

  4. Oropharyngeal dysphagia and language delay in partial trisomy 9p: case report.

    PubMed

    Rossi, N F; Gatto, A R; Cola, P C; Souza, D H; Moretti-Ferreira, D; Giacheti, C M

    2009-09-22

    The phenotype of partial trisomy 9p includes global developmental delay, microcephaly, bulbous nose, downturned oral commissures, malformed ears, hypotonia, and severe cognitive and language disorders. We present a case report and a comparative review of clinical findings on this condition, focusing on speech-language development, cognitive abilities and swallowing evaluation. We suggest that oropharyngeal dysphagia should be further investigated, considering that pulmonary and nutritional disorders affect the survival and quality of life of the patient. As far as we know, this is the first study of a patient with partial trisomy 9p described with oropharyngeal dysphagia.

  5. Method for packing chromatographic beds

    DOEpatents

    Freeman, David H.; Angeles, Rosalie M.; Keller, Suzanne

    1991-01-01

    Column chromatography beds are packed through the application of static force. A slurry of the chromatography bed material and a non-viscous liquid is filled into the column plugged at one end, and allowed to settle. The column is transferred to a centrifuge, and centrifuged for a brief period of time to achieve a predetermined packing level, at a range generally of 100-5,000 gravities. Thereafter, the plug is removed, other fixtures may be secured, and the liquid is allowed to flow out through the bed. This results in an evenly packed bed, with no channeling or preferential flow characteristics.

  6. Dog pack attack: hunting humans.

    PubMed

    Avis, S P

    1999-09-01

    Dog bite-related fatalities, although unusual, accounted for 304 deaths in the United States between 1979 and 1996 and 6 fatalities in Canada between 1994 and 1996. Fatal dog pack attacks and attacks involving human predation are less common. The following describes a dog pack attack on a family of four involving 2 fatalities with predation of the victims. Factors previously identified that contribute to pack attacks and predation, including prior group hunting, social feeding, territorial defense, lack of human interaction, and prey stimuli, are discussed.

  7. Storing Chemicals in Packed Spheres

    NASA Technical Reports Server (NTRS)

    Wang, T. G.; Elleman, D. D.

    1986-01-01

    Reactants released by crushing or puncturing. Agglomerated gas-filled spheres hexagonally close packed and sintered or glued together into rods strung together at ends. Rods fed into crushing machine to release material in spheres as needed.

  8. Pattern formations and optimal packing.

    PubMed

    Mityushev, Vladimir

    2016-04-01

    Patterns of different symmetries may arise after solution to reaction-diffusion equations. Hexagonal arrays, layers and their perturbations are observed in different models after numerical solution to the corresponding initial-boundary value problems. We demonstrate an intimate connection between pattern formations and optimal random packing on the plane. The main study is based on the following two points. First, the diffusive flux in reaction-diffusion systems is approximated by piecewise linear functions in the framework of structural approximations. This leads to a discrete network approximation of the considered continuous problem. Second, the discrete energy minimization yields optimal random packing of the domains (disks) in the representative cell. Therefore, the general problem of pattern formations based on the reaction-diffusion equations is reduced to the geometric problem of random packing. It is demonstrated that all random packings can be divided onto classes associated with classes of isomorphic graphs obtained from the Delaunay triangulation. The unique optimal solution is constructed in each class of the random packings. If the number of disks per representative cell is finite, the number of classes of isomorphic graphs, hence, the number of optimal packings is also finite.

  9. A Geometric-Structure Theory for Maximally Random Jammed Packings

    PubMed Central

    Tian, Jianxiang; Xu, Yaopengxiao; Jiao, Yang; Torquato, Salvatore

    2015-01-01

    Maximally random jammed (MRJ) particle packings can be viewed as prototypical glasses in that they are maximally disordered while simultaneously being mechanically rigid. The prediction of the MRJ packing density ϕMRJ, among other packing properties of frictionless particles, still poses many theoretical challenges, even for congruent spheres or disks. Using the geometric-structure approach, we derive for the first time a highly accurate formula for MRJ densities for a very wide class of two-dimensional frictionless packings, namely, binary convex superdisks, with shapes that continuously interpolate between circles and squares. By incorporating specific attributes of MRJ states and a novel organizing principle, our formula yields predictions of ϕMRJ that are in excellent agreement with corresponding computer-simulation estimates in almost the entire α-x plane with semi-axis ratio α and small-particle relative number concentration x. Importantly, in the monodisperse circle limit, the predicted ϕMRJ = 0.834 agrees very well with the very recently numerically discovered MRJ density of 0.827, which distinguishes it from high-density “random-close packing” polycrystalline states and hence provides a stringent test on the theory. Similarly, for non-circular monodisperse superdisks, we predict MRJ states with densities that are appreciably smaller than is conventionally thought to be achievable by standard packing protocols. PMID:26568437

  10. An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side

    PubMed Central

    Sahin, Idris; Kaya, Demet; Oksuz, Sukru; Ozdemir, Davut; Karabay, Oguz

    2009-01-01

    Purpose We describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey. Materials and Methods Between March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests. Results Oropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 ± 22.8 (10 - 90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days. Conclusion This report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept in mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the 1eft side were found, which had not been previously reported. PMID:19259348

  11. Chronic Inflammation-Related HPV: A Driving Force Speeds Oropharyngeal Carcinogenesis

    PubMed Central

    Liu, Xin; Ma, Xiangrui; Lei, Zhengge; Feng, Hao; Wang, Shasha; Cen, Xiao; Gao, Shiyu; Jiang, Yaping; Jiang, Jian; Chen, Qianming; Tang, Yajie; Tang, Yaling; Liang, Xinhua

    2015-01-01

    Oropharyngeal squamous cell carcinoma (OPSCC) has been known to be a highly aggressive disease associated with human papilloma virus (HPV) infection. To investigate the relationship between HPV and chronic inflammation in oropharyngeal carcinogenesis, we collected 140 oral mucous fresh specimens including 50 OPSCC patients, 50 cancer in situ, 30 precancerous lesions, and 10 normal oral mucous. Our data demonstrated that there was a significantly higher proportion of severe chronic inflammation in dysplastic epithelia in comparison with that in normal tissues (P<0.001). The positive rate of HPV 16 was parallel with the chronic inflammation degrees from mild to severe inflammation (P<0.05). The positive rate of HPV 16 was progressively improved with the malignant progression of oral mucous (P<0.05). In addition, CD11b+ LIN- HLA-DR-CD33+ MDSCs were a critical cell population that mediates inflammation response and immune suppression in HPV-positive OPSCC. These indicated that persistent chronic inflammation-related HPV infection might drive oropharyngeal carcinogenesis and MDSCs might pay an important role during this process. Thus, a combination of HPV infection and inflammation expression might become a helpful biomedical marker to predict oropharyngeal carcinogenesis. PMID:26193368

  12. Oropharyngeal Tularemia Outbreak Associated with Drinking Contaminated Tap Water, Turkey, July–September 2013

    PubMed Central

    Celebi, Bekir; Isik, Mehmet Emirhan; Tutus, Celal; Ozturk, Huseyin; Temel, Fehminaz; Kizilaslan, Mecit; Zhu, Bao-Ping

    2015-01-01

    In 2013, an oropharyngeal tularemia outbreak in Turkey affected 55 persons. Drinking tap water during the likely exposure period was significantly associated with illness (attack rate 27% vs. 11% among non–tap water drinkers). Findings showed the tap water source had been contaminated by surface water, and the chlorination device malfunctioned. PMID:26584074

  13. Leptin receptor expression and Gln223Arg polymorphism as prognostic markers in oral and oropharyngeal cancer.

    PubMed

    Rodrigues, P R S; Maia, L L; Santos, M; Peterle, G T; Alves, L U; Takamori, J T; Souza, R P; Barbosa, W M; Mercante, A M C; Nunes, F D; Carvalho, M B; Tajara, E H; Louro, I D; Silva-Conforti, A M A

    2015-11-25

    The leptin gene product is released into the blood stream, passes through the blood-brain barrier, and finds the leptin receptor (LEPR) in the central nervous system. This hormone regulates food intake, hematopoiesis, inflammation, immunity, differentiation, and cell proliferation. The LEPR Gln223Arg polymorphism has been reported to alter receptor function and expression, both of which have been related with prognostics in several tumor types. Furthermore, several studies have shown a relationship between the Gln223Arg polymorphism and tumor development, and its role in oral and oropharyngeal squamous cell carcinoma is now well understood. In this study, 315 DNA samples were used for LEPR Gln223Arg genotyping and 87 primary oral and oropharyngeal squamous cell carcinomas were used for immunohistochemical expression analysis, such that a relationship between these and tumor development and prognosis could be established. Homozygous LEPR Arg223 was found to be associated with a 2-fold reduction in oral and oropharyngeal cancer risk. In contrast, the presence of the Arg223 allele in tumors was associated with worse disease-free and disease-specific survival. Low LEPR expression was found to be an independent risk factor, increasing the risk for lymph node metastasis 4-fold. In conclusion, the Gln223Arg polymorphism and LEPR expression might be valuable markers for oral and oropharyngeal cancer, suggesting that LEPR might serve as a potential target for future therapies.

  14. Endovascular Treatment of Carotid Artery Blowout Syndrome Caused by Oropharyngeal Carcinoma

    PubMed Central

    Ergun, Onur; Celtikci, Pinar; Durmaz, Hasan Ali; Birgi, Erdem; Hekimoglu, Baki

    2014-01-01

    Summary A 64-year-old man was admitted with massive hemoptysis caused by oropharyngeal carcinoma. Angiography revealed active extravasation from the left carotid bulb. Covered stent-graft placement resolved the bleeding, but the patient presented with recurrent hemorrhage two hours later and was treated with another stent-graft. PMID:25207916

  15. The Utility of Pitch Elevation in the Evaluation of Oropharyngeal Dysphagia: Preliminary Findings

    ERIC Educational Resources Information Center

    Malandraki, Georgia A.; Hind, Jacqueline A.; Gangnon, Ronald; Logemann, Jeri A.; Robbins, JoAnne

    2011-01-01

    Purpose: To evaluate the utility of a pitch elevation task in the assessment of oropharyngeal dysphagia. Method: This study was a pilot prospective cohort study including 40 consecutive patients (16 male and 24 female) who were referred by their physician for a swallowing evaluation. Patients were evaluated with a noninstrumental clinical…

  16. Chronic Inflammation-Related HPV: A Driving Force Speeds Oropharyngeal Carcinogenesis.

    PubMed

    Liu, Xin; Ma, Xiangrui; Lei, Zhengge; Feng, Hao; Wang, Shasha; Cen, Xiao; Gao, Shiyu; Jiang, Yaping; Jiang, Jian; Chen, Qianming; Tang, Yajie; Tang, Yaling; Liang, Xinhua

    2015-01-01

    Oropharyngeal squamous cell carcinoma (OPSCC) has been known to be a highly aggressive disease associated with human papilloma virus (HPV) infection. To investigate the relationship between HPV and chronic inflammation in oropharyngeal carcinogenesis, we collected 140 oral mucous fresh specimens including 50 OPSCC patients, 50 cancer in situ, 30 precancerous lesions, and 10 normal oral mucous. Our data demonstrated that there was a significantly higher proportion of severe chronic inflammation in dysplastic epithelia in comparison with that in normal tissues (P<0.001). The positive rate of HPV 16 was parallel with the chronic inflammation degrees from mild to severe inflammation (P<0.05). The positive rate of HPV 16 was progressively improved with the malignant progression of oral mucous (P<0.05). In addition, CD11b+ LIN- HLA-DR-CD33+ MDSCs were a critical cell population that mediates inflammation response and immune suppression in HPV-positive OPSCC. These indicated that persistent chronic inflammation-related HPV infection might drive oropharyngeal carcinogenesis and MDSCs might pay an important role during this process. Thus, a combination of HPV infection and inflammation expression might become a helpful biomedical marker to predict oropharyngeal carcinogenesis.

  17. Modeling of oropharyngeal articulatory adaptation to compensate for the acoustic effects of nasalization.

    PubMed

    Rong, Panying; Kuehn, David P; Shosted, Ryan K

    2016-09-01

    Hypernasality is one of the most detrimental speech disturbances that lead to declines of speech intelligibility. Velopharyngeal inadequacy, which is associated with anatomic defects such as cleft palate or neuromuscular disorders that affect velopharygneal function, is the primary cause of hypernasality. A simulation study by Rong and Kuehn [J. Speech Lang. Hear. Res. 55(5), 1438-1448 (2012)] demonstrated that properly adjusted oropharyngeal articulation can reduce nasality for vowels synthesized with an articulatory model [Mermelstein, J. Acoust. Soc. Am. 53(4), 1070-1082 (1973)]. In this study, a speaker-adaptive articulatory model was developed to simulate speaker-customized oropharyngeal articulatory adaptation to compensate for the acoustic effects of nasalization on /a/, /i/, and /u/. The results demonstrated that (1) the oropharyngeal articulatory adaptation effectively counteracted the effects of nasalization on the second lowest formant frequency (F2) and partially compensated for the effects of nasalization on vowel space (e.g., shifting and constriction of vowel space) and (2) the articulatory adaptation strategies generated by the speaker-adaptive model might be more efficacious for counteracting the acoustic effects of nasalization compared to the adaptation strategies generated by the standard articulatory model in Rong and Kuehn. The findings of this study indicated the potential of using oropharyngeal articulatory adaptation as a means to correct maladaptive articulatory behaviors and to reduce nasality.

  18. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    PubMed

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  19. Oropharyngeal tularemia in father and son after consumption of under-cooked rabbit meat.

    PubMed

    Djordjevic-Spasic, Marina; Potkonjak, Aleksandar; Kostic, Velimir; Lako, Branislav; Spasic, Zivojin

    2011-12-01

    Tularemia has been recognized for more than 10 y in Serbia, since the first epidemic of tularemia occurred in Sokobanja region in 1999. We report 2 cases of oropharyngeal tularemia in a father and son after the consumption of under-cooked rabbit meat. Both presented with fever, unilateral tonsillopharyngitis and cervical lymphadenitis.

  20. Use of the Primitive Unit Cell in Understanding Subtle Features of the Cubic Closest-Packed Structure

    ERIC Educational Resources Information Center

    Hawkins, John A.; Rittenhouse, Jeffrey L.; Soper, Linda M.; Rittenhouse, Robert C.

    2008-01-01

    One of the most important crystal structures adopted by metals is characterized by the "abcabc"...stacking of close-packed layers. This structure is commonly referred to in textbooks as the cubic close-packed (ccp) or face-centered cubic (fcc) structure, since the entire lattice can be generated by replication of a face-centered cubic unit cell…

  1. 7 CFR 51.310 - Packing requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (INSPECTION, CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Packing Requirements § 51.310 Packing requirements. (a) Apples tray packed or cell packed in cartons shall be arranged.... 3 2 “Fairly tight” means that apples are of the proper size for molds or cell compartments in...

  2. 7 CFR 51.310 - Packing requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (INSPECTION, CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Packing Requirements § 51.310 Packing requirements. (a) Apples tray packed or cell packed in cartons shall be arranged.... 3 2 “Fairly tight” means that apples are of the proper size for molds or cell compartments in...

  3. 7 CFR 51.1311 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 51.1311 Section 51.1311 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Winter Pears 1 Standard Pack § 51.1311 Packing. (a) Each package shall be packed so that...

  4. 7 CFR 51.1270 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 51.1270 Section 51.1270 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Summer and Fall Pears 1 Standard Pack § 51.1270 Packing. (a) Each package shall be packed...

  5. 7 CFR 51.1217 - Standard pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Standards for Grades of Peaches Standard Pack § 51.1217 Standard pack. (a) Each package shall be packed so that the peaches in the shown face shall be reasonably representative in size, color and quality of the contents of the package. (b) Peaches packed in U.S. Standard bushel baskets, or half-bushel baskets,...

  6. 7 CFR 51.1217 - Standard pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Standards for Grades of Peaches Standard Pack § 51.1217 Standard pack. (a) Each package shall be packed so that the peaches in the shown face shall be reasonably representative in size, color and quality of the contents of the package. (b) Peaches packed in U.S. Standard bushel baskets, or half-bushel baskets,...

  7. 7 CFR 51.1217 - Standard pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Peaches Standard Pack § 51.1217 Standard pack. (a) Each package shall be packed so that the peaches in the shown face shall be reasonably representative in size, color and quality of the contents of the package. (b) Peaches packed in U.S....

  8. 7 CFR 51.1217 - Standard pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Peaches Standard Pack § 51.1217 Standard pack. (a) Each package shall be packed so that the peaches in the shown face shall be reasonably representative in size, color and quality of the contents of the package. (b) Peaches packed in U.S....

  9. 7 CFR 51.1527 - Standard pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Standards for Grades of Fresh Plums and Prunes Standard Pack § 51.1527 Standard pack. (a) Packing. (1) All... plums or prunes in the top layer of any package shall be reasonably representative in quality and size of those in the remainder of the package. (3) “Well filled” means that the plums or prunes packed...

  10. 7 CFR 51.1527 - Standard pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Standards for Grades of Fresh Plums and Prunes Standard Pack § 51.1527 Standard pack. (a) Packing. (1) All... plums or prunes in the top layer of any package shall be reasonably representative in quality and size of those in the remainder of the package. (3) “Well filled” means that the plums or prunes packed...

  11. 7 CFR 51.1527 - Standard pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Standards for Grades of Fresh Plums and Prunes Standard Pack § 51.1527 Standard pack. (a) Packing. (1) All... plums or prunes in the top layer of any package shall be reasonably representative in quality and size of those in the remainder of the package. (3) “Well filled” means that the plums or prunes packed...

  12. 7 CFR 51.3055 - Standard pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Florida Avocados Standard Pack § 51.3055 Standard pack. (a) The avocados shall be packed in accordance with good commercial practice and the pack shall be at... of the weight of the largest fruit in the container. Size of the avocados may be specified by...

  13. 7 CFR 966.11 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Pack. 966.11 Section 966.11 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and... Handling Definitions § 966.11 Pack. Pack means any of the packs of tomatoes as defined and set forth in...

  14. Valve packings conquer fugitive emissions

    SciTech Connect

    1995-11-01

    In the early 1990s, when the US Environmental Protection Agency (EPA; Washington, D.C.) declared its intent to regulate fugitive emissions from valve-stem leakage, much of the chemical process industries (CPI) responded with fear and uncertainty. The biggest fear was that valve packing would not meet the required limits on leak rates and that expensive bellows seals may be required on many applications. The uncertainly was about how much it would cost. Today, for the most part, these concerns have been mitigated. It is estimated that about 80--90% of valves satisfy the emission requirements. The rest need some improvement in their packing systems to meet the regulations. Generally, these valves can be brought within compliance if the packing designers follow a few basic principles: Employ less-pliable outer rings and more-pliable inner rings; and don`t use excessive packing. While interest in valve packing remains high, mechanical seals continue to become more user-friendly. Many of those covered below are designed to run dry, and some can even tolerate high shaft-wobble without damage. Also look for improved flange gaskets and a host of seals to protect bearings. Twenty-one summaries are presented on new products and services.

  15. Sleeping distance in wild wolf packs

    USGS Publications Warehouse

    Knick, S.T.; Mech, L.D.

    1980-01-01

    Sleeping distances were observed among members of 13 wild wolf (Canis lupus) packs and 11 pairs in northeastern Minnesota to determine if the distances correlated with pack size and composition. The study utilized aerial radio-tracking and observation during winter. Pack size and number of adults per pack were inversely related to pack average sleeping distance and variability. No correlation between sleeping distance and microclimate was observed. Possible relationships between social bonding and our results are discussed.

  16. Meal Module, Tray Pack 36-Persons

    DTIC Science & Technology

    1987-08-27

    Velocity Airdrop ( LVAD ) of the Meal Module, Tray Pack, 36-Persons L3 E. External Air Transport (EAT) Procedures for the Meal Module, Tray Pack, 36-Persons...Pack, 36-Persons, Expandable Box -- 9 Tray Dinner 57 D-1 LVAD A-22 Honeycomb Confiquration for the Meal Module, Tray Pack, 36-Persons 65 D-2 LVAD A...Meal Module, Tray Pack, 36-Persons may have to be airdropped along with the KCLFF, airdrop rigging procedures for Low Velocity Airdrop ( LVAD ) and

  17. Cylinder valve packing nut studies

    SciTech Connect

    Blue, S.C.

    1991-12-31

    The design, manufacture, and use of cylinder valve packing nuts have been studied to improve their resistance to failure from stress corrosion cracking. Stress frozen photoelastic models have been analyzed to measure the stress concentrations at observed points of failure. The load effects induced by assembly torque and thermal expansion of stem packing were observed by strain gaging nuts. The effects of finishing operations and heat treatment were studied by the strain gage hole boring and X-ray methods. Modifications of manufacturing and operation practices are reducing the frequency of stress corrosion failures.

  18. 1. Aerial view, looking northeast up Newark Bay, showing entire ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Aerial view, looking northeast up Newark Bay, showing entire island Charles Wisniewski, photographer, January 1985 - Shooters Island, Ships Graveyard, Newark Bay, Staten Island (subdivision), Richmond County, NY

  19. Wire and Packing Tape Sandwiches

    ERIC Educational Resources Information Center

    Rabinowitz, Sandy

    2009-01-01

    In this article, the author describes how students can combine craft wire with clear packing tape to create a two-dimensional design that can be bent and twisted to create a three-dimensional form. Students sandwich wire designs between two layers of tape. (Contains 1 online resource.)

  20. Teflon-packed flexible joint

    NASA Technical Reports Server (NTRS)

    Belmont, G. E.

    1969-01-01

    Teflon-packed flexible joint separates the movement of the shaker from the liquid nitrogen hose during the ground testing of cryogenic zero-g equipment. The joint allows the hose to lie on the floor in a stationary position as the shaker moves back and forth, thus, the hose is not subject to violent motion.

  1. Pack cementation coatings for alloys

    SciTech Connect

    He, Yi-Rong; Zheng, Minhui; Rapp, R.A.

    1996-08-01

    The halide-activated pack cementation process was modified to produce a Ge-doped silicide diffusion coating on a Cr-Cr{sub 2}Nb alloy in a single processing step. The morphology and composition of the coating depended both on the composition of the pack and on the composition and microstructure of the substrate. Higher Ge content in the pack suppressed the formation of CrSi{sub 2} and reduced the growth kinetics of the coating. Ge was not homogeneously distributed in the coatings. In cyclic and isothermal oxidation in air at 700 and 1050{degrees}C, the Ge-doped silicide coating protected the Cr-Nb alloys from significant oxidation by the formation of a Ge-doped silica film. The codeposition and diffusion of aluminum and chromium into low alloy steel have been achieved using elemental Al and Cr powders and a two-step pack cementation process. Sequential process treatments at 925{degrees}C and 1150{degrees}C yield dense and uniform ferrite coatings, whose compositions are close to either Fe{sub 3}Al or else FeAl plus a lower Cr content, when processed under different conditions. The higher content of Al in the coatings was predicted by thermodynamic calculations of equilibrium in the gas phase. The effect of the particle size of the metal powders on the surface composition of the coating has been studied for various combinations of Al and Cr powders.

  2. Ecology and Energy Action Pack.

    ERIC Educational Resources Information Center

    McDonald's Corp., Oak Brook, IL.

    One of five McDonald's Action Packs, these elementary school-level instructional materials are for use as an introduction to existing units of study, supplements to a textbook, or a source of special projects for environmental education. Contents include these six units: Make Your Own Ecology Mini-spinner, Let's Look at a Food Chain, Drip the…

  3. Dense crystalline packings of ellipsoids

    NASA Astrophysics Data System (ADS)

    Jin, Weiwei; Jiao, Yang; Liu, Lufeng; Yuan, Ye; Li, Shuixiang

    2017-03-01

    An ellipsoid, the simplest nonspherical shape, has been extensively used as a model for elongated building blocks for a wide spectrum of molecular, colloidal, and granular systems. Yet the densest packing of congruent hard ellipsoids, which is intimately related to the high-density phase of many condensed matter systems, is still an open problem. We discover an unusual family of dense crystalline packings of self-dual ellipsoids (ratios of the semiaxes α : √{α }:1 ), containing 24 particles with a quasi-square-triangular (SQ-TR) tiling arrangement in the fundamental cell. The associated packing density ϕ exceeds that of the densest known SM2 crystal [ A. Donev et al., Phys. Rev. Lett. 92, 255506 (2004), 10.1103/PhysRevLett.92.255506] for aspect ratios α in (1.365, 1.5625), attaining a maximal ϕ ≈0.758 06 ... at α = 93 /64 . We show that the SQ-TR phase derived from these dense packings is thermodynamically stable at high densities over the aforementioned α range and report a phase diagram for self-dual ellipsoids. The discovery of the SQ-TR crystal suggests organizing principles for nonspherical particles and self-assembly of colloidal systems.

  4. 46 CFR 78.37-10 - Official log entires.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 3 2012-10-01 2012-10-01 false Official log entires. 78.37-10 Section 78.37-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Logbook Entries § 78.37-10 Official log entires. (a) In addition to other items required to be entered in the...

  5. 46 CFR 78.37-10 - Official log entires.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Official log entires. 78.37-10 Section 78.37-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Logbook Entries § 78.37-10 Official log entires. (a) In addition to other items required to be entered in the...

  6. 46 CFR 78.37-10 - Official log entires.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 3 2011-10-01 2011-10-01 false Official log entires. 78.37-10 Section 78.37-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Logbook Entries § 78.37-10 Official log entires. (a) In addition to other items required to be entered in the...

  7. Oropharyngeal airway changes after rapid maxillary expansion: the state of the art

    PubMed Central

    Ortu, Eleonora; Giannoni, Mario; Ortu, Maurizio; Gatto, Roberto; Monaco, Annalisa

    2014-01-01

    The aim of this article is to elucidate the state of the art about how rapid maxillary expansion (RME) produces changes in the oropharyngeal airways in terms of CBCT (Cone Beam Computed Tomography) data during the growth period, according to the available literature. Electronic search was done from January 2009 to April 2014 on PubMed and Scopus databases; in addition manual search was conducted as well. According to keywords, seven papers were eligible for our purpose, but definitely five papers were selected in agreement with the inclusion/exclusion criteria. The current literature suggests that the potential relationship between RME and oropharyngeal airway changes is still unclear. In fact, although the pharyngeal airway changes after the rapid palatal expansion are evident clinically, current orthodontic literature does not provide conclusive evidence about the nature of this relationship. PMID:25126159

  8. Influence of the oropharyngeal microflora on the measurement of exhaled breath hydrogen.

    PubMed

    Thompson, D G; O'Brien, J D; Hardie, J M

    1986-10-01

    We investigated the possible contribution made by oropharyngeal microfloral fermentation of ingested carbohydrate to the generation of the early, transient exhaled breath hydrogen rise seen after carbohydrate ingestion. Ten subjects ate or were sham fed carbohydrate-containing meals with and without prior chlorhexidine mouthwash during serial collection of exhaled breath and mouth hydrogen samples. Meal ingestion and sham feeding both induced significant (p less than 0.01) elevations of breath and mouth hydrogen that were virtually abolished by prior chlorhexidine mouthwash. In 7 subjects, delivery of the meal directly into the stomach via an orogastric tube did not cause a breath or mouth hydrogen rise. Oral contents incubated anaerobically in vitro with carbohydrate generated hydrogen that was again inhibited by chlorhexidine. These studies indicate that fermentation of ingested carbohydrate by oropharyngeal bacteria can contribute significantly to measured breath hydrogen values soon after meal ingestion, and may introduce avoidable error into the interpretation of serial breath hydrogen data.

  9. From HPV-positive towards HPV-driven oropharyngeal squamous cell carcinomas.

    PubMed

    Boscolo-Rizzo, Paolo; Pawlita, Michael; Holzinger, Dana

    2016-01-01

    The incidence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC), which is both biologically and clinically distinct from tobacco- and alcohol-related OPSCC, is dramatically increasing. The finding that individuals with HPV-positive local/regionally advanced OPSCC have a significantly better prognosis than their negative counterparts have led to efforts to de-escalate treatment in those patients to avoid serious side effects and to improve their long-term quality of life, while maintaining treatment efficacy. Identifying diagnostic tests that are able to distinguish cancers etiologically associated with HPV is thus becoming a pressing challenge for researchers. The purpose of this review is to provide an overview of the diagnostic tools presently available to evaluate HPV status in patients with OPSCC and, in particular, to discuss their strengths and weaknesses in identifying those infections that are the real driving force in the oropharyngeal carcinogenesis process.

  10. Oropharyngeal cancers: relationship between epidermal growth factor receptor alterations and human papillomavirus status.

    PubMed

    Mirghani, H; Amen, F; Moreau, F; Guigay, J; Hartl, D M; Lacau St Guily, J

    2014-04-01

    High-risk human papillomavirus (HR-HPV), particularly type 16, is now recognised as a causative agent in a subset of oropharyngeal squamous cell carcinomas (OPSCCs). These tumours are on the increase and generally have a better prognosis than their HPV negative counterparts. This raises the question of de escalation therapy to reduce long term consequences in a younger cohort of patients with a long life expectancy. Several clinical trials with anti-epidermal growth factor receptor (EGFR) therapies, particularly cetuximab, are ongoing. Few data exist on the relationship between EGFR and HPV induced oropharyngeal cancers. We summarise the main studies in relation to EGFR alterations (gene copy number, protein expression and mutations) and the impact on prognosis of HPV positive tumours that express high levels of EGFR. We also discuss the opportunity of targeting this pathway in light of recent studies.

  11. Use of Lugol's iodine in the resection of oral and oropharyngeal squamous cell carcinoma.

    PubMed

    McMahon, Jeremy; Devine, John C; McCaul, James A; McLellan, Douglas R; Farrow, Adrian

    2010-03-01

    We evaluated the use of Lugol's iodine in achieving surgical margins free from dysplasia, carcinoma in situ, and invasive carcinoma by an observational study of two series of 50 consecutive patients having resection of oral and oropharyngeal squamous cell carcinoma (SCC) between November 2004 and March 2007. The standard group had resection of the primary tumour with a macroscopic 1cm margin and removal of adjacent visibly abnormal mucosa. The Lugol's iodine group had identical treatment with resection of any adjacent mucosa that did not stain after the application of Lugol's iodine (where this was feasible). In the standard group 16 patients (32%) had dysplasia, carcinoma in situ, or invasive SCC at a surgical margin. In the Lugol's iodine group two patients (4%) had dysplasia or carcinoma in situ; none had invasive SCC. Lugol's iodine is a simple, inexpensive, and apparently effective means of reducing the likelihood of unsatisfactory surgical margins in the resection of oral and oropharyngeal SCC.

  12. Rhinological, laryngological, oropharyngeal and other head and neck side effects of drugs.

    PubMed

    Lee, C A; Mistry, D; Sharma, R; Coatesworth, A P

    2006-02-01

    Following a previous paper in which we documented the otological side effects of drug therapy, we here review other drug side effects that ENT surgeons may encounter when dealing with patients. Although otological drug side effects such as hearing loss and tinnitus are well recognized there are many rhinological, laryngeal, oropharyngeal and other head and neck drug side effects. Our data were sourced from the British National Formulary and Electronic Medical Compendium websites.

  13. The oropharyngeal morphology in the semiaquatic giant Asian pond turtle, Heosemys grandis, and its evolutionary implications.

    PubMed

    Lintner, Monika; Weissenbacher, Anton; Heiss, Egon

    2012-01-01

    The oropharynx as a functional entity plays a fundamental role in feeding. Transitions from aquatic to terrestrial lifestyles in vertebrates demanded major changes of the oropharynx for the required adaptations to a different feeding environment. Extant turtles evolved terrestrial feeding modes in three families (testudinids, emydids, geoemydids)-independently from other amniotes-and are therefore important model organisms to reconstruct morpho-functional changes behind aquatic-terrestrial transitions. In this study we hypothesized that the oropharyngeal morphology in semiaquatic turtles of the geoemydid family shows parallels to testudinids, the only purely terrestrial extant lineage. We provide an in-depth description of the oropharynx in the semiaquatic geoemydid Heosemys grandis by using a combination of micro computed tomography (micro-CT) and subsequent digital in situ 3-D reconstruction, scanning electron microscopy (SEM), and histology. We show that H. grandis has a large tongue with rough papillose surface and well-developed lingual muscles. The attachment sites of the lingual muscles on the hyolingual skeleton and their courses within the tongue are nearly identical with testudinids. The hyolingual skeleton itself is mainly cartilaginous and shows distinct-but compared to testudinids rather small-anterior extensions of the hyoid body and hypoglossum. Oral glands are well developed in H. grandis but are smaller and simpler than in testudinids. Similarly, oropharyngeal keratinization was minimal and found only in the anterior palate, regions close to the beak, and tongue tip. We conclude that H. grandis shows distinct oropharyngeal morpho-functional adaptations for a terrestrial lifestyle but still retains characters typical for aquatic forms. This makes this species an important example showing the oropharyngeal adaptations behind aquatic-terrestrial transitions in turtles.

  14. Comparison of molecular methods for detection of HPV in oral and oropharyngeal squamous cell carcinoma.

    PubMed

    Kingma, Douglas W; Allen, Richard A; Caughron, Samuel K; Melby, Melissa; Moore, William E; Gillies, Elizabeth M; Marlar, Richard A; Dunn, Terence S

    2010-12-01

    Substantial molecular evidence exists to implicate human papillomavirus (HPV) in the pathogenesis of a subset of oral and oropharyngeal squamous cell carcinomas. Several studies have shown that HPV-associated oral/oropharyngeal tumors differ etiologically, biologically, and clinically from those that lack the virus. HPV infection confers a significant survival benefit; therefore, HPV detection in tumors could be used to risk-stratify patients and drive optimum treatment strategies. We explored the clinical utility of 6 polymerase chain reaction (PCR)-based or signal amplification-based methods in the detection of HPV in 68 invasive oral/oropharyngeal SSCs and 10 reactive tonsil specimens. Agreement for HPV16 results among the 5 different assays capable of detecting this genotype was substantial (multirater κ=0.72). Only moderate agreement was noted for the 3 assays capable of detecting HPV18 (multirater κ=0.43). HPV results for each assay were evaluated relative to a "majority" HPV result derived from the results of all the detection methods. An HPV16 E6 PCR assay showed the highest concordance with adjudicated consensus HPV16 results (98.7%; κ=0.97), followed by the TaqMan (93.4%; κ=0.87), Linear Array (92.1%; κ=0.84), and E7 PCR (92.1%; κ=0.84) assays, all of which had agreements exceeding 90%, whereas the HPV16/18 Invader assay was lower (85.5%; κ=0.71). The presence of high-risk HPV in a minority of "normal" tonsillar tissues may confound assessment of the virus in oral/oropharyngeal squamous cell carcinoma biopsies using in vitro amplification methods.

  15. Maté: a risk factor for oral and oropharyngeal cancer.

    PubMed

    Goldenberg, David

    2002-10-01

    Maté is a tea-like beverage consumed mainly in Argentina, Uruguay, Paraguay, southern Brazil and to a lesser degree in other areas of the world such as Germany, Syria, Lebanon and Northern Israel. It is brewed from the dried leaves and stemlets of the perennial tree Ilex paraguarensis ("yerba mate") a species that belongs to the Aquifoliaceae family. Maté consumption has been associated with an increased rate of oral and oropharyngeal cancers. The purpose of this study is to review the literature and discuss the role of Maté consumption in the development of oral and oropharyngeal cancer and the potential carcinogenic mechanisms. A review of the relevant literature linking Maté consumption with oral and oropharyngeal cancer and the carcinogenicity of Maté was performed. The search was performed using Medline, library catalogues, OCLC first search and ISI web of science databases. Case control studies on Maté drinking populations and, in vivo and in vitro studies on the carcinogenicity of Maté were reviewed. The populations reviewed in many of these studies also used alcohol and tobacco products confounding the influence of Maté as an independent risk factor. There is evidence in the literature that Maté consumption is in itself carcinogenic and plays a role in the development of cancers of the oral cavity and oropharynx. Although the exact mechanism of carcinogenesis is still unknown, available information suggests that Maté drinking should be considered one of the risk factors for oral and oropharyngeal cancer.

  16. Prognostic significance of NDRG1 expression in oral and oropharyngeal squamous cell carcinoma.

    PubMed

    Dos Santos, Marcelo; da Cunha Mercante, Ana Maria; Nunes, Fábio Daumas; Leopoldino, Andréia Machado; de Carvalho, Marcos Brasilino; Gazito, Diana; López, Rossana Verónica Mendoza; Chiappini, Paula Blandina Olga; de Carvalho Neto, Paulo Bentes; Fukuyama, Erica Erina; Tajara, Eloiza Helena; Louro, Iúri Drumond; da Silva, Adriana Madeira Álvares

    2012-12-01

    Human N-myc downstream-regulated gene 1 (NDRG1) is a metastasis suppressor gene with several potential functions, including cell differentiation, cell cycle regulation and response to hormones, nickel and stress. The purpose of this study was to investigate the immunoexpression of NDRG1 in oral and oropharyngeal squamous cell carcinomas searching for its role in the clinical course of these tumors. We investigated immunohistochemical expression of NDRG1 protein in 412 tissue microarray cores of tumor samples from 103 patients with oral and oropharyngeal squamous cell carcinomas and in 110 paraffin-embedded surgical margin sections. The results showed NDRG1 up-regulation in 101/103 (98.1 %) tumor samples, but no expression in any normal tissue sample. Western blot assays confirmed the immunohistochemical findings, suggesting that lower levels of NDRG1 are associated with a high mortality rate. NDRG1 overexpression was related to long-term specific survival (HR = 0.38; p = 0.009), whereas the presence of lymph-node metastasis showed the opposite association with survival (HR = 2.45; p = 0.013). Our findings reinforce the idea that NDRG1 plays a metastasis suppressor role in oral and oropharyngeal squamous cell carcinomas and may be a useful marker for these tumors.

  17. Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features

    PubMed Central

    Su, William; Liu, Jerry; Miles, Brett A.; Genden, Eric M.; Misiukiewicz, Krzysztof J.; Posner, Marshall; Gupta, Vishal; Bakst, Richard L.

    2016-01-01

    Background Current standard of care for oropharyngeal cancers with positive surgical margins and/or extracapsular extension is adjuvant chemoradiotherapy. It is unknown whether HPV+ oropharyngeal cancer benefits from this treatment intensification. Objective To investigate the outcomes of HPV+ patients treated with adjuvant radiotherapy alone when chemoradiotherapy was indicated based on high risk pathological features. They were compared with high risk HPV+ patients treated with adjuvant chemoradiotherapy. Methods All high risk HPV+ oropharyngeal cancer patients (9) who received radiotherapy alone were identified. We also identified 17 patients who received chemoradiotherapy as a comparison group. Median follow up time was 37.3 months. Results No local failures developed in adjuvant radiotherapy group. There was 1 distant recurrence in this cohort and 3 in CRT cohort. Regarding toxicity, 8 (47.1%) chemoradiotherapy patients had >10 lb. weight loss (p = 0.013), despite 75% of them having a percutaneous endoscopic gastrostomy tube placed. No individuals in radiotherapy group experienced a >10 lb. weight loss and none required a gastrostomy tube. Conclusions This series provides preliminary evidence suggesting that the omission of concurrent chemotherapy to adjuvant radiotherapy may offer comparative local control rates with a lower toxicity profile in the setting of HPV+ patients with traditional high risk features. PMID:27930732

  18. Validation in French of the SWAL-QOL scale in patients with oropharyngeal dysphagia.

    PubMed

    Khaldoun, E; Woisard, V; Verin, E

    2009-03-01

    A quality-of-life (QOL) questionnaire specifically designed for patients with oropharyngeal dysphagia (SWAL-QOL) has been elaborated and validated by Colleen McHorney. The aim of the present study was to validate the French translation of the SWAL-QOL in 73 patients with either post-stroke or post-surgical oropharyngeal dysphagia. The French version was considered understandable and acceptable by the study patients, who completed the questionnaire in approximately 20 minutes. However, 32 patients needed help in filling out the questionnaire-mostly in reading the questions and writing the answers. Completion was excellent, although seven patients missed one item. Analysis of convergent validity of the French version showed good correlation between items and the corresponding scale. Validity convergence was excellent for all the different items, with a correlation between each item and its own scale that was always greater than 0.40. Internal coherence was also excellent, with Cronbach's alpha coefficient greater than 0.7. Patients with oropharyngeal dysphagia have a poor QOL, as reflected by their very low scores. The lowest scores were related to the impact of swallowing disorders on the QOL (47+/-30) and on mental health (51+/-31). This study also demonstrated the linguistic and psychometric validity of the French version of the SWAL-QOL questionnaire.

  19. Pathophysiology, relevance and natural history of oropharyngeal dysphagia among older people.

    PubMed

    Clavé, Pere; Rofes, Laia; Carrión, Silvia; Ortega, Omar; Cabré, Mateu; Serra-Prat, Mateu; Arreola, Viridiana

    2012-01-01

    Oropharyngeal dysphagia (OD) is a very frequent condition among older people with a prevalence ranging from mild symptoms in 25% of the independently living to severe symptoms in more than 50% living in nursing homes. There are several validated methods of screening, and clinical assessment and videofluoroscopy are the gold standard for the study of the mechanisms of OD in the elderly. Oropharyngeal residue is mainly caused by weak bolus propulsion forces due to tongue sarcopenia. The neural elements of swallow response are also impaired in older persons, with prolonged and delayed laryngeal vestibule closure and slow hyoid movement causing oropharyngeal aspirations. OD causes malnutrition, dehydration, impaired quality of life, lower respiratory tract infections, aspiration pneumonia, and poor prognosis including prolonged hospital stay and enhanced morbidity and mortality in several phenotypes of older patients ranging from independently living older people, hospitalized older patients and nursing home residents. Enhancing bolus viscosity of fluids greatly improves safety of swallow in all these patients. We believe OD should be recognized as a major geriatric syndrome, and we recommend a policy of systematic and universal screening and assessment of OD among older people to prevent its severe complications.

  20. An evaluation of the University of Washington Quality of Life swallowing domain following oropharyngeal cancer.

    PubMed

    Thomas, L; Jones, T M; Tandon, S; Katre, C; Lowe, D; Rogers, S N

    2008-07-01

    Oropharyngeal cancer and its treatment have debilitating effect on swallowing function which can impact on quality of life. The aims of this study were to assess swallowing dysfunction in patients treated for oropharyngeal cancer by both patient and observer assessed tools and to assess the suitability of University of Washington Quality of Life (UW-QOL) swallowing domain as a potential screening tool in routine clinic practice. This was a cross-sectional study of disease free survivors following radical treatment for oropharyngeal squamous cell carcinoma at a tertiary care centre between 1999 and May 2005. Evaluation included three questionnaires--the M. D. Anderson Dysphagia Inventory (MDADI), the SWALQOL, the University of Washington Quality of Life (UWQOL) and Fibreoptic Endoscopic Evaluation of Swallowing (FEES). Of 117 patients 77 (66%) participated. On the UW-QOL, 18% could only swallow liquids whilst 11% could not swallow at all. There is a clear demarcation between UW-QOL levels and food consistency and texture as measured by the SWALQOL (r= -0.86, P<0.001). There was a graduation in respect to function with correlations of r=0.61 with overall MDADI and SWALQOL and r= -0.45 for FEES. Patients scoring 70 or better in the UW-QOL were notably better in MDADI and the SWALQOL hence a cut off of below 70 could be regarded as a quick screening tool for swallowing dysfunction.

  1. Comparison between bioluminescence imaging technique and CFU count for the study of oropharyngeal candidiasis in mice.

    PubMed

    Gabrielli, Elena; Roselletti, Elena; Luciano, Eugenio; Sabbatini, Samuele; Mosci, Paolo; Pericolini, Eva

    2015-05-01

    We recently described a bioluminescence in vivo imaging technique, representing a powerful tool to test the real-time progression of oropharyngeal candidiasis, hence potentially useful to evaluate the efficacy of antifungal therapies. In this study, the in vivo imaging technique was compared with CFU measurement of target organs (tongue, esophagus and stomach) for monitoring and quantifying oropharyngeal candidiasis. We have correlated these two analytical methods at different times post-infection using engineered, luminescent Candida albicans in mice rendered susceptible to oral candidiasis by cortisone-acetate. Scatter plots, Pearson correlation and Student's t test were used to compare the methods. We observed that the bioluminescence in vivo imaging technique was more reliable than CFU counts in detecting early infection of, and its extent in, the oral cavity of the mouse. This was also evident following the introduction of a variable such as treatment with fluconazole. The results described in this study could validate the bioluminescence in vivo imaging technique as a method to monitor and quantify oropharyngeal candidiasis and to assess early discovery of active compounds in vivo.

  2. Geographic variation in human papillomavirus–related oropharyngeal cancer: Data from 4 multinational randomized trials

    PubMed Central

    Franklin, Natalie; Compton, Natalie; Robinson, Max; Powell, Ned; Biswas–Baldwin, Nigel; Paleri, Vindh; Hartley, Andrew; Fresco, Lydia; Al‐Booz, Hoda; Junor, Elizabeth; El‐Hariry, Iman; Roberts, Sally; Harrington, Kevin; Ang, K. Kian; Dunn, Janet; Woodman, Ciaran

    2016-01-01

    Abstract Background There are variations in the proportions of head and neck cancers caused by the human papillomavirus (HPV) between countries and regions. It is unclear if these are true variations or due to different study designs and assays. Methods We tested formalin‐fixed paraffin‐embedded diagnostic biopsies for p16 immunohistochemistry and HPV‐DNA (by polymerase chain reaction [PCR] and in situ hybridization [ISH]) using validated protocols on samples from 801 patients with head and neck cancer recruited prospectively between 2006 and 2011 in 4 randomized controlled trials (RCTs). Results Twenty‐one percent of patients (170 of 801) showed both HPV‐DNA and p16‐positivity, detected almost exclusively in oropharyngeal cancer (55%; 15 of 302); and only 1% of the patients (5 of 499) with nonoropharyngeal cancer were HPV positive. HPV‐positive oropharyngeal cancer differed between Western and Eastern Europe (37%, 155 of 422 vs 6%, 8 of 144; p < .0001) and between Western Europe and Asia (37% vs 2%; 4 of 217; p < .0001). Other independent determinants of HPV positivity were tumor site and smoking. Conclusion This is the first study to establish geographic variability as an independent risk factor in HPV‐positive oropharyngeal cancer prevalence, with higher prevalence in Western Europe. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck 38: E1863–E1869, 2016 PMID:26749143

  3. Optimal management of oropharyngeal and esophageal candidiasis in patients living with HIV infection

    PubMed Central

    Vazquez, Jose A

    2010-01-01

    Mucocutaneous candidiasis is frequently one of the first signs of human immunodeficiency virus (HIV) infection. Over 90% of patients with AIDS will develop oropharyngeal candidiasis (OPC) at some time during their illness. Although numerous antifungal agents are available, azoles, both topical (clotrimazole) and systemic (fluconazole, itraconazole, voriconazole, posaconazole) have replaced older topical antifungals (gentian violet and nystatin) in the management of oropharyngeal candidiasis in these patients. The systemic azoles, are generally safe and effective agents in HIV-infected patients with oropharyngeal candidiasis. A constant concern in these patients is relapse, which is dependent on the degree of immunosuppression commonly seen after topical therapy, rather than with systemic azole therapy. Candida esophagitis (CE) is also an important concern since it occurs in more than 10% of patients with AIDS and can lead to a decrease in oral intake and associated weight loss. Fluconazole has become the most widely used antifungal in the management of mucosal candidiasis. However, itraconazole and posaconazole have similar clinical response rates as fluconazole and are also effective alternative agents. In patients with fluconazole-refractory mucosal candidiasis, treatment options now include itraconazole solution, voriconazole, posaconazole, and the newer echinocandins (caspofungin, micafungin, and anidulafungin). PMID:22096388

  4. 7 CFR 984.15 - Pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE WALNUTS GROWN IN CALIFORNIA Order Regulating Handling Definitions § 984.15 Pack. Pack means to bleach, clean, grade, shell or otherwise prepare walnuts for market as inshell or shelled walnuts....

  5. 7 CFR 984.15 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE WALNUTS GROWN IN CALIFORNIA Order Regulating Handling Definitions § 984.15 Pack. Pack means to bleach, clean, grade, shell or otherwise prepare walnuts for market as inshell or shelled walnuts....

  6. 7 CFR 984.15 - Pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE WALNUTS GROWN IN CALIFORNIA Order Regulating Handling Definitions § 984.15 Pack. Pack means to bleach, clean, grade, shell or otherwise prepare walnuts for market as inshell or shelled walnuts....

  7. 7 CFR 984.15 - Pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE WALNUTS GROWN IN CALIFORNIA Order Regulating Handling Definitions § 984.15 Pack. Pack means to bleach, clean, grade, shell or otherwise prepare walnuts for market as inshell or shelled walnuts....

  8. 7 CFR 984.15 - Pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE WALNUTS GROWN IN CALIFORNIA Order Regulating Handling Definitions § 984.15 Pack. Pack means to bleach, clean, grade, shell or otherwise prepare walnuts for market as inshell or shelled walnuts....

  9. Designing gravel pack for uranium ISL wells

    NASA Astrophysics Data System (ADS)

    Ber, A. A.; Minaev, K. M.; Ber, L. M.; Isaev, Ye D.; Ulyanova, O. S.

    2016-09-01

    The paper describes the improvement of gravel packing technique applied for the production wells. The authors have suggested new design of gravel pack for gravel packing of productive formations. The issue is currently topical because gravel packing at drillhole ISL is less time- and money-consuming. The subject of the research is gravel pack design and content. The purpose defined by the authors is to design the gravel pack and to suggest the composition of gravel cement agent. As a result of the research, the authors have described different designs of the gravel pack, its optimal shape, as well as a choice and justification of cement agents, a hold cover of the gravel pack, and suggested the methods of experimental research.

  10. Cell aggregation: Packing soft grains

    NASA Astrophysics Data System (ADS)

    Åström, J. A.; Karttunen, M.

    2006-06-01

    Cellular aggregates may be considered as collections of membrane enclosed units with a pressure difference between the internal and external liquid phases. Cells are kept together by membrane adhesion and/or confined space compression. Pattern formation and, in particular, intercellular spacing have important roles in controlling solvent diffusion within such aggregates. A physical approach is used to study generic aspects of cellular packings in a confined space. Average material properties are derived from the free energy. The appearance of penetrating intercellular void channels is found to be critically governed by the cell wall adhesion mechanisms during the formation of dense aggregates. A fully relaxed aggregate efficiently hinders solvent diffusion at high hydrostatic pressures, while a small fraction (˜0.1) of adhesion related packing frustration is sufficient for breaking such a blockage even at high a pressure.

  11. 7 CFR 51.1527 - Standard pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Fresh Plums and Prunes Standard Pack § 51... the approved and recognized methods. (2) The plums or prunes in the top layer of any package shall be...” means that the plums or prunes packed in loose or volume filled containers are packed within 1 inch...

  12. 7 CFR 51.1527 - Standard pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Fresh Plums and Prunes Standard Pack § 51... the approved and recognized methods. (2) The plums or prunes in the top layer of any package shall be...” means that the plums or prunes packed in loose or volume filled containers are packed within 1 inch...

  13. 7 CFR 966.11 - Pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE TOMATOES GROWN IN FLORIDA Order Regulating Handling Definitions § 966.11 Pack. Pack means any of the packs of tomatoes as defined and set forth in the United States Standards for Fresh Tomatoes issued by the United States Department of Agriculture (§§...

  14. Characteristics of fluidized-packed beds

    NASA Technical Reports Server (NTRS)

    Gabor, J. D.; Mecham, W. J.

    1968-01-01

    Study of fluidized-packed bed includes investigation of heat transfer, solids-gas mixing, and elutriation characteristics. A fluidized-packed bed is a system involving the fluidization of small particles in the voids of a packed bed of larger nonfluidized particles.

  15. Diffusion in Jammed Particle Packs.

    PubMed

    Bolintineanu, Dan S; Grest, Gary S; Lechman, Jeremy B; Silbert, Leonardo E

    2015-08-21

    Using random walk simulations we explore diffusive transport through monodisperse sphere packings over a range of packing fractions ϕ in the vicinity of the jamming transition at ϕ(c). Various diffusion properties are computed over several orders of magnitude in both time and packing pressure. Two well-separated regimes of normal "Fickian" diffusion, where the mean squared displacement is linear in time, are observed. The first corresponds to diffusion inside individual spheres, while the latter is the long-time bulk diffusion. The intermediate anomalous diffusion regime and the long-time value of the diffusion coefficient are both shown to be controlled by particle contacts, which in turn depend on proximity to ϕ(c). The time required to recover normal diffusion t* scales as (ϕ-ϕ(c))(-0.5) and the long-time diffusivity D(∞)∼(ϕ-ϕ(c))0.5, or D(∞)∼1/t*. It is shown that the distribution of mean first passage times associated with the escape of random walkers between neighboring particles controls both t* and D(∞) in the limit ϕ→ϕ(c).

  16. Vibrational Collapse of Hexapod Packings

    NASA Astrophysics Data System (ADS)

    Zhao, Yuchen; Ding, Jingqiu; Barés, Jonathan; Dierichs, Karola; Behringer, Robert

    2016-11-01

    Columns made of convex noncohesive grains like sand collapse after being released from a confining container. However, structures built from concave grains can be stable without external support. Previous research show that the stability of the columns depends on column diameter and height, by observing column stability after carefully lifting their confinement tubes. Thinner and taller columns collapse with higher probability. While the column stability weakly depends on packing density, it strongly depends on inter-particle friction. Experiments that cause the column to collapse also reveal similar trends, as more effort (such as heavier loading or shearing) is required to destabilize columns that are intrinsically more stable. In the current experiments, we invesitage the effect of vibration on destructing a column. Short columns collapse following the relaxation dynamics of disorder systems, which coincides with similar experiments on staple packings. However, tall columns collapse faster at the beginning, in addition to the relaxation process coming after. Using high-speed imaging, we analyze column collapse data from different column geometries. Ongoing work is focusing on characterizing the stability of hexapod packings to vibration. We thanks NSF-DMR-1206351 and the William M. Keck Foundation.

  17. 72. PHOTOCOPY OF DRAWING, CONCENTRATING MILL, GENERAL SECTION OF ENTIRE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    72. PHOTOCOPY OF DRAWING, CONCENTRATING MILL, GENERAL SECTION OF ENTIRE MILL, CONSTRUCTION 1911-1912 - Kennecott Copper Corporation, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  18. 70. PHOTOCOPY OF DRAWING, CONCENTRATING MILL, GENERAL SECTION OF ENTIRE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    70. PHOTOCOPY OF DRAWING, CONCENTRATING MILL, GENERAL SECTION OF ENTIRE MILL, CONSTRUCTION 1911-1912 - Kennecott Copper Corporation, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  19. 71. PHOTOCOPY OF DRAWING, CONCENTRATING MILL, GENERAL SECTION OF ENTIRE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    71. PHOTOCOPY OF DRAWING, CONCENTRATING MILL, GENERAL SECTION OF ENTIRE MILL, CONSTRUCTION 1911-1912 - Kennecott Copper Corporation, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  20. 3. AERIAL VIEW SHOWING THE ENTIRE BRIDGE FROM EAST CABLE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. AERIAL VIEW SHOWING THE ENTIRE BRIDGE FROM EAST CABLE ANCHORAGE (EXTREME LEFT) TO WEST CABLE ANCHORAGE (UPPER RIGHT CORNER). March 1987. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  1. 3. Looking West, view of the entire bridge from the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. Looking West, view of the entire bridge from the downstream side of thomes creek. The ends of structure are concealed by natural vegetation on the stream banks. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  2. 8. The entire south face of the Broad Street bridge ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. The entire south face of the Broad Street bridge as seen from the flood levy in front of Central High School. - Broad Street Bridge, Spanning Scioto River at U.S. Route 40 (Broad Street), Columbus, Franklin County, OH

  3. Crane 55 at Drydock No. 2. View includes entire bone. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Crane 55 at Drydock No. 2. View includes entire bone. Building 43 is in background - Puget Sound Naval Shipyard, Portal Gantry Crane No. 55, Central Industrial Area, Farragut Avenue, Bremerton, Kitsap County, WA

  4. South side, entire, looking north across the quadrangle from the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South side, entire, looking north across the quadrangle from the courtyard between the library and the life sciences building. - San Bernardino Valley College, Auditorium, 701 South Mount Vernon Avenue, San Bernardino, San Bernardino County, CA

  5. Aerial view of entire LTA base after completion of both ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Aerial view of entire LTA base after completion of both LTA ship hangars. Date unknown but probably circa 1945. - Marine Corps Air Station Tustin, Northern Lighter Than Air Ship Hangar, Meffett Avenue & Maxfield Street, Tustin, Orange County, CA

  6. 5 CFR 213.3202 - Entire executive civil service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... EXCEPTED SERVICE Excepted Schedules Schedule B § 213.3202 Entire executive civil service. (a)-(i) (j... under 5 U.S.C. 3594(b). (2) Appointment in a different agency without a break in service of...

  7. 5 CFR 213.3202 - Entire executive civil service.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... EXCEPTED SERVICE Excepted Schedules Schedule B § 213.3202 Entire executive civil service. (a)-(i) (j... under 5 U.S.C. 3594(b). (2) Appointment in a different agency without a break in service of...

  8. Homogeneous sphere packings with triclinic symmetry.

    PubMed

    Fischer, W; Koch, E

    2002-11-01

    All homogeneous sphere packings with triclinic symmetry have been derived by studying the characteristic Wyckoff positions P -1 1a and P -1 2i of the two triclinic lattice complexes. These sphere packings belong to 30 different types. Only one type exists that has exclusively triclinic sphere packings and no higher-symmetry ones. The inherent symmetry of part of the sphere packings is triclinic for 18 types. Sphere packings of all but six of the 30 types may be realized as stackings of parallel planar nets.

  9. Kinetics of pack aluminization of nickel

    NASA Technical Reports Server (NTRS)

    Seigle, L. L.; Gupta, B. K.; Shankar, R.; Sarkhel, A. K.

    1978-01-01

    The kinetics of pack aluminization of unalloyed nickel in packs of varying aluminum activity with various halide activators were studied. Surface compositions of the coatings as functions of time, temperature, and pack composition were obtained in order to establish the boundary conditions for diffusion in the system. The structure of the packs was also examined in order to clarify the mechanism of aluminum transport. The results indicate that the kinetics of pack aluminization are controlled jointly by gas diffusion in the pack and solid diffusion in the coating. Levine and Caves' model for gas diffusion was combined with calculations of rates of diffusion in the solid to formulate a more complete theory for the kinetics of pack aluminization.

  10. Oropharyngeal morphology in the basal tortoise Manouria emys emys with comments on form and function of the testudinid tongue.

    PubMed

    Heiss, Egon; Natchev, Nikolay; Schwaha, Thomas; Salaberger, Dietmar; Lemell, Patrick; Beisser, Christian; Weisgram, Josef

    2011-10-01

    In tetrapods, the ability to ingest food on land is based on certain morphological features of the oropharynx in general and the feeding apparatus in particular. Recent paleoecological studies imply that terrestrial feeding has evolved secondarily in turtles, so they had to meet the morphological oropharyngeal requirements independently to other amniotes. This study is designed to improve our limited knowledge about the oropharyngeal morphology of tortoises by analyzing in detail the oropharynx in Manouria emys emys. Special emphasis is placed on the form and function of the tongue. Even if Manouria is considered a basal member of the only terrestrial turtle clade and was hypothesized to have retained some features reflecting an aquatic ancestry, Manouria shows oropharyngeal characteristics found in more derived testudinids. Accordingly, the oropharyngeal cavity in Manouria is richly structured and the glands are large and complexly organized. The tongue is large and fleshy and bears numerous slender papillae lacking lingual muscles. The hyolingual skeleton is mainly cartilaginous, and the enlarged anterior elements support the tongue and provide insertion sides for the well-developed lingual muscles, which show striking differences to other reptiles. We conclude that the oropharyngeal design in Manouria differs clearly from semiaquatic and aquatic turtles, as well as from other reptilian sauropsids.

  11. Administration of bleomycin via the oropharyngeal aspiration route leads to sustained lung fibrosis in mice and rats as quantified by UTE-MRI and histology.

    PubMed

    Egger, Christine; Cannet, Catherine; Gérard, Christelle; Jarman, Elizabeth; Jarai, Gabor; Feige, Agnès; Suply, Thomas; Micard, Arthur; Dunbar, Andrew; Tigani, Bruno; Beckmann, Nicolau

    2013-01-01

    Pulmonary fibrosis can be experimentally induced in small rodents by bleomycin. The antibiotic is usually administered via the intratracheal or intranasal routes. In the present study, we investigated the oropharyngeal aspiration of bleomycin as an alternative route for the induction of lung fibrosis in rats and mice. The development of lung injury was followed in vivo by ultrashort echo time magnetic resonance imaging (UTE-MRI) and by post-mortem analyses (histology of collagen, hydroxyproline determination, and qRT-PCR). In C57BL/6 mice, oropharyngeal aspiration of bleomycin led to more prominent lung fibrosis as compared to intranasal administration. Consequently, the oropharyngeal aspiration route allowed a dose reduction of bleomycin and, therewith, a model refinement. Moreover, the distribution of collagen after oropharyngeal aspiration of bleomycin was more homogenous than after intranasal administration: for the oropharyngeal aspiration route, fibrotic areas appeared all over the lung lobes, while for the intranasal route fibrotic lesions appeared mainly around the largest superior airways. Thus, oropharyngeal aspiration of bleomycin induced morphological changes that were more comparable to the human disease than the intranasal administration route did. Oropharyngeal aspiration of bleomycin led to a homogeneous fibrotic injury also in rat lungs. The present data suggest oropharyngeal aspiration of bleomycin as a less invasive means to induce homogeneous and sustained fibrosis in the lungs of mice and rats.

  12. Proteus mirabilis abscess involving the entire neural axis.

    PubMed

    Kamat, A S; Thango, N S; Husein, M Ben

    2016-08-01

    Intramedullary spinal cord abscesses are rare and potentially devastating lesions usually associated with other infective processes such as bacterial endocarditis, or pulmonary or urogenital infection. We describe a 2-year-old girl who presented with an infected dermal sinus leading to an intraspinal abscess. This abscess eventually spread and involved the entire neural axis leaving her quadriparetic. Drainage of the abscess resulted in recovery and the child regained normal function of her limbs. To our knowledge this is the first documented case of an intramedullary abscess involving the entire neural axis.

  13. A videofluoroscopic study comparing severe swallowing disorders in patients treated surgically or with radiation for oropharyngeal cancer.

    PubMed

    Santini, L; Robert, D; Lagier, A; Giovanni, A; Dessi, P; Fakhry, N

    2015-06-01

    The aim of this study was to analyze the causal mechanisms of severe swallowing disorders after the treatment of oropharyngeal cancer. Twenty-six patients with severe swallowing disorders at ≥12 months after treatment for oropharyngeal cancer were analyzed retrospectively using videofluoroscopy. Fourteen patients (54%) had been treated with surgery (±postoperative radiotherapy), while 12 patients (46%) had been treated with (chemo)radiotherapy. Videofluoroscopy analysis showed a localized alteration in the surgical excision area resulting in impaired tongue root retraction in the surgical group (P=0.012), while general impairment of the pharyngeal, laryngeal, and upper oesophagus sphincter was found in the non-surgical group. Aspirations in the surgical group most often occurred after swallowing, while in the non-surgical group, they occurred during and after swallowing (P=0.039). This analysis by videofluoroscopy provides important insights into the mechanisms giving rise to swallowing disorders after the treatment of oropharyngeal cancer.

  14. HPV Status and second primary tumours in Oropharyngeal Squamous Cell Carcinoma

    PubMed Central

    2013-01-01

    Introductions The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCCs) is rising in developed nations. Studies have shown that these virally mediated tumours are epidemiologically, clinically, and biologically different than other head and neck squamous cell carcinomas and traditional concepts of field cancerization may not apply to HPV-related oropharyngeal cancer. Objective The purpose of this study was to evaluate the rate of second primary tumors and the diagnostic yield of field cancerization work up in the upper aerodigestive tract in patients with HPV-related and HPV-unrelated oropharyngeal squamous cell carcinoma. Design Retrospective review. Setting Tertiary cancer care centers in Alberta. Methods Retrospective review of 406 patients diagnosed with OPSCC in Alberta between 2005 and 2009. HPV-status of tumours was determined by tissue microarray using immunohistochemistry staining for p16. Main outcome measures Primary outcome: incidence of upper aerodigestive tract second primary tumours in p16-positive versus p16-negative OPSCC. Secondary outcomes: diagnostic yield of traditional field cancerization work-up in p16-positive versus negative patients. Results The overall rate of SPTs was 7.4% (30/406). The incidence rate of SPTs was significantly lower in p16-positive patients (0.7 per 100 patient-yrs vs. 8.5 in p16-negative, p < 0.0001). Field cancerization work-up for synchronous lesions in the upper aerodigestive tract, including panendoscopy and whole-body PET-CT, had decreased diagnostic yield in p16-positive patients (2.8% vs. 10.2% in HPV-negative patients, p=0.02). Conclusions Patients with HPV-related OPSCC, who are non-smokers have decreased risk of developing second primary tumours in the upper aerodigestive tract and have low yield on field cancerization work-up. This study provides further evidence that virally mediated OPSCC are distinct and may benefit from alternate diagnostic pathways. PMID:23718873

  15. Sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma.

    PubMed

    Stoeckli, Sandro J; Alkureishi, Lee W T; Ross, Gary L

    2009-06-01

    The appearance of lymph node metastases represents the most important adverse prognostic factor in head and neck squamous cell carcinoma. Therefore, accurate staging of the cervical nodes is crucial in these patients. The management of the clinically and radiologically negative neck in patients with early oral and oropharyngeal squamous cell carcinoma is still controversial, though most centers favor elective neck dissection for staging of the neck and removal of occult disease. As only approximately 30% of patients harbor occult disease in the neck, most of the patients have to undergo elective neck dissection with no benefit. The sentinel node biopsy concept has been adopted from the treatment of melanoma and breast cancer to early oral and oropharyngeal squamous cell carcinoma during the last decade with great success. Multiple validation studies in the context of elective neck dissections revealed sentinel node detection rates above 95% and negative predictive values for negative sentinel nodes of 95%. Sentinel node biopsy has proven its ability to select patients with occult lymphatic disease for elective neck dissection, and to spare the costs and morbidity to patients with negative necks. Many centers meanwhile have abandoned routine elective neck dissection and entered in observational trials. These trials so far were able to confirm the high accuracy of the validation trials with less than 5% of the patients with negative sentinel nodes developing lymph node metastases during observation. In conclusion, sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma can be considered as safe and accurate, with success rates in controlling the neck comparable to elective neck dissection. This concept has the potential to become the new standard of care in the near future.

  16. Risk Factors and Dose-Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients

    SciTech Connect

    Lee, Ik Jae; Koom, Woong Sub; Lee, Chang Geol; Kim, Yong Bae; Yoo, Sei Whan; Keum, Ki Chang; Kim, Gwi Eon; Choi, Eun Chang; Cha, In Ho

    2009-11-15

    Purpose: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. Materials and Methods: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. The median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED{sub late}) in bone was 114 Gy{sub 2} (range, 30-167 Gy{sub 2}). Results: The frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery, eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. The median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). In multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy{sub 2} (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. Conclusions: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy{sub 2} or higher to the mandible also significantly increases the risk of ORN.

  17. Concurrent Chemoradiotherapy With Helical Tomotherapy for Oropharyngeal Cancer: A Preliminary Result

    SciTech Connect

    Shueng, Pei-Wei; Wu, Le-Jung; Chen, Shiou-Yi

    2010-07-01

    Purpose: To review the experience with and evaluate the treatment plan for helical tomotherapy for the treatment of oropharyngeal cancer. Methods and Materials: Between November 1, 2006 and January 31, 2009, 10 histologically confirmed oropharyngeal cancer patients were enrolled. All patients received definitive concurrent chemoradiation with helical tomotherapy. The prescription dose to the gross tumor planning target volume, the high-risk subclinical area, and the low-risk subclinical area was 70Gy, 63Gy, and 56Gy, respectively. During radiotherapy, all patients were treated with cisplatin, 30mg/m{sup 2}, plus 5-fluorouracil (425mg/m{sup 2})/leucovorin (30mg/m{sup 2}) intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. Several parameters, including maximal or median dose to critical organs, uniformity index, and conformal index, were evaluated from dose-volume histograms. Results: The mean survival was 18 months (range, 7-22 months). The actuarial overall survival, disease-free survival, locoregional control, and distant metastasis-free rates at 18 months were 67%, 70%, 80%, and 100%, respectively. The average for uniformity index and conformal index was 1.05 and 1.26, respectively. The mean of median dose for right side and left side parotid glands was 23.5 and 23.9Gy, respectively. No Grade 3 toxicity for dermatitis and body weight loss and only one instance of Grade 3 mucositis were noted. Conclusion: Helical tomotherapy achieved encouraging clinical outcomes in patients with oropharyngeal carcinoma. Treatment toxicity was acceptable, even in the setting of concurrent chemotherapy. Long-term follow-up is needed to confirm these preliminary findings.

  18. Diffusion in jammed particle packs

    NASA Astrophysics Data System (ADS)

    Bolintineanu, Dan S.; Silbert, Leonardo E.; Grest, Gary S.; Lechman, Jeremy B.

    2015-03-01

    Diffusive transport in jammed particle packs is of interest for a number of applications, as well as being a potential indicator of structural properties near the jamming point. To this end, we report stochastic simulations of equilibrium diffusion through monodisperse sphere packs near the jamming point in the limit of a perfectly insulating surrounding medium. The time dependence of various diffusion properties is resolved over several orders of magnitude. Two time regimes of expected Fickian diffusion are observed, separated by an intermediate regime of anomalous diffusion. This intermediate regime grows as the particle volume fraction approaches the critical jamming transition. The diffusion behavior is fully controlled by the extent of the contacts between neighboring particles, which in turn depend on proximity to the jamming point. In particular, the mean first passage time associated with the escape of random walkers between neighboring particles is shown to control both the time to recover Fickian diffusion and the long time diffusivity. Scaling laws are established that relate these quantities to the difference between the actual and critical jamming volume fractions. Sandia National Laboratories is a multiprogram laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's NNSA under Contract DE- AC04-94AL85000.

  19. A new tongue plate for use in oropharyngeal KTP laser surgery.

    PubMed

    Ayshford, C A; Kabbani, M; Reddy, T N

    2000-01-01

    The KTP laser is used in both uvulopalatopharyngoplasty and tonsillectomy. However the need to use laser guarded endotracheal tubes represents a sizeable expense to the procedure. The authors describe a modified tongue plate to the oropharyngeal gag that covers all of the endo-tracheal tube, thus enabling the safe use of a non-laser guarded, PVC endotracheal tube. In over a hundred such procedures there has been no laser-related complications. The authors consider that the one off cost of this tongue plate and gag allows a more cost-effective method for performing laser-assisted uvulopalatopharyngoplasty and tonsillectomy.

  20. [Neurogenic oropharyngeal dysphagia is a frequent condition in patients admitted to the ICU].

    PubMed

    Pedersen, Anette Barbre; Kjærsgaard, Annette; Larsen, Jens Kjærgaard Rolighed; Nielsen, Lars Hedemann

    2015-03-02

    Neurogenic oropharyngeal dysphagia (NOD) is a frequent condition in neurological patients admitted to the ICU, particularly in patients with brainstem lesions. The CNS damage itself can predispose to dysphagia, but also the treatment and preventive measures may predispose to and exacerbate the condition. Frequent pneumonia in a neurological patient is a warning signal that should cause screening for dysphagia. Complications are serious and can be fatal. Neurological patients should be examined for NOD before decannulation. Treatment is difficult, so prevention and multidisciplinary neurological rehabilitation is important.

  1. The Oropharyngeal Airway in Young Adults with Skeletal Class II and Class III Deformities: A 3-D Morphometric Analysis

    PubMed Central

    Jayaratne, Yasas Shri Nalaka; Zwahlen, Roger Arthur

    2016-01-01

    Objectives 1) To determine the accuracy and reliability of an automated anthropometric measurement software for the oropharyngeal airway and 2) To compare the anthropometric dimensions of the oropharyngeal airway in skeletal class II and III deformity patients. Methods Cone-beam CT (CBCT) scans of 62 patients with skeletal class II or III deformities were used for this study. Volumetric, linear and surface area measurements retroglossal (RG) and retropalatal (RP) compartments of the oropharyngeal airway was measured with the 3dMDVultus software. Accuracy of automated anthropometric pharyngeal airway measurements was assessed using an airway phantom. Results The software was found to be reasonably accurate for measuring dimensions of air passages. The total oropharyngeal volume was significantly greater in the skeletal class III deformity group (16.7 ± 9.04 mm3) compared with class II subjects (11.87 ± 4.01 mm3). The average surface area of both the RG and RP compartments were significantly larger in the class III deformity group. The most constricted area in the RG and RP airway was significantly larger in individuals with skeletal class III deformity. The anterior-posterior (AP) length of this constriction was significantly greater in skeletal class III individuals in both compartments, whereas the width of the constriction was not significantly different between the two groups in both compartments. The RP compartment was larger but less uniform than the RG compartment in both skeletal deformities. Conclusion Significant differences were observed in morphological characteristics of the oropharyngeal airway in individuals with skeletal class II and III deformities. This information may be valuable for surgeons in orthognathic treatment planning, especially for mandibular setback surgery that might compromise the oropharyngeal patency. PMID:26901313

  2. Maté drinking and oral and oro-pharyngeal cancer: a systematic review and meta-analysis.

    PubMed

    Dasanayake, Ananda P; Silverman, Amanda J; Warnakulasuriya, Saman

    2010-02-01

    In Latin America, maté is consumed as a beverage regularly. Among the cancers that are associated with maté drinking is oral and oro-pharyngeal cancer, incidence of which is high in the region. In order to further understand this association between maté drinking and the risk of oral and oro-pharyngeal cancer, we performed a systematic review and meta-analysis of related studies. All relevant studies published in English as original articles up to June 2009 were identified through a literature search using PubMed and Medline and by reviewing the references from the retrieved articles. Four case-control studies done in Latin America were identified. There were 879 maté users and 1128 non- or low-maté users in those studies with a total of 566 oral and oro-pharyngeal cancers. The adjusted association between maté drinking and oral and oro-pharyngeal cancer was significant within 3 of those studies. Meta-analysis yielded a significant summary odds ratio (OR) of 2.11 (95% confidence interval=1.39-3.19). Population Attributable Risk for maté drinking was 16%. While the epidemiological data indicate that maté users have an increased risk of oral and oro-pharyngeal cancer, little is known about whether this increased risk is due to the high temperature of the beverage when it is consumed or due to certain carcinogenic constituents that are present in maté. More human and animal studies are needed before a conclusion can be made on the oral and oro-pharyngeal carcinogenic risk of maté to humans.

  3. Entirely passive heat pipe apparatus capable of operating against gravity

    DOEpatents

    Koenig, Daniel R.

    1982-01-01

    The disclosure is directed to an entirely passive heat pipe apparatus capable of operating against gravity for vertical distances in the order of 3 to 7 meters and more. A return conduit into which an inert gas is introduced is used to lower the specific density of the working fluid so that it may be returned a greater vertical distance from condenser to evaporator.

  4. Teaching Discrete Mathematics Entirely from Primary Historical Sources

    ERIC Educational Resources Information Center

    Barnett, Janet Heine; Bezhanishvili, Guram; Lodder, Jerry; Pengelley, David

    2016-01-01

    We describe teaching an introductory discrete mathematics course entirely from student projects based on primary historical sources. We present case studies of four projects that cover the content of a one-semester course, and mention various other courses that we have taught with primary source projects.

  5. Aerial view of the entire bridge crossing the Tennessee River ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Aerial view of the entire bridge crossing the Tennessee River looking up river. The swing bridge, when open, permits river navigational traffic to ply the river. Construction of a replacement bridge, to be located 93.27 feet down river, has now started. - Bridgeport Swing Span Bridge, Spanning Tennessee River, Bridgeport, Jackson County, AL

  6. 21. AERIAL VIEW TO SOUTHWEST OF ENTIRE COAST GUARD AIR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. AERIAL VIEW TO SOUTHWEST OF ENTIRE COAST GUARD AIR STATION SAN FRANCISCO, SHOWING BUILDING F AT RIGHT AND BUILDING H (HAER No. CA-329-B) AT UPPER LEFT. 30X24 inch black and white silver gelatin print. Photographers unknown. Date unknown. - U.S. Coast Guard Air Station San Francisco, Warehouse, 1020 North Access Road, San Francisco, San Francisco County, CA

  7. 22. AERIAL VIEW TO NORTH OF ENTIRE COAST GUARD AIR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. AERIAL VIEW TO NORTH OF ENTIRE COAST GUARD AIR STATION SAN FRANCISCO, SHOWING BUILDING H AT LEFT AND BUILDING F AT UPPER LEFT. 30X24 inch black and white silver gelatin print. Photographers unknown. Date unknown. - U.S. Coast Guard Air Station San Francisco, Warehouse, 1020 North Access Road, San Francisco, San Francisco County, CA

  8. Thermodynamics of Quantum Gases for the Entire Range of Temperature

    ERIC Educational Resources Information Center

    Biswas, Shyamal; Jana, Debnarayan

    2012-01-01

    We have analytically explored the thermodynamics of free Bose and Fermi gases for the entire range of temperature, and have extended the same for harmonically trapped cases. We have obtained approximate chemical potentials for the quantum gases in closed forms of temperature so that the thermodynamic properties of the quantum gases become…

  9. 4. AERIAL VIEW TO SOUTHEAST OF ENTIRE COAST GUARD AIR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. AERIAL VIEW TO SOUTHEAST OF ENTIRE COAST GUARD AIR STATION SAN FRANCISCO. 8X10 black and white silver gelatin print. United States Coast Guard Official Photograph, 12th District, File No. 62751-22 A.S. Date unknown. - U.S. Coast Guard Air Station San Francisco, 1020 North Access Road, San Francisco, San Francisco County, CA

  10. 5. AERIAL VIEW TO NORTHEAST OF ENTIRE COAST GUARD AIR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. AERIAL VIEW TO NORTHEAST OF ENTIRE COAST GUARD AIR STATION SAN FRANCISCO. 8X10 black and white silver gelatin print. United States Coast Guard Official Photograph, 12th Coast Guard District, San Francisco. 1960. - U.S. Coast Guard Air Station San Francisco, 1020 North Access Road, San Francisco, San Francisco County, CA

  11. The Packing of Granular Polymer Chains

    NASA Astrophysics Data System (ADS)

    Zou, Ling-Nan; Cheng, Xiang; Rivers, Mark L.; Jaeger, Heinrich M.; Nagel, Sidney R.

    2009-10-01

    Rigid particles pack into structures, such as sand dunes on the beach, whose overall stability is determined by the average number of contacts between particles. However, when packing spatially extended objects with flexible shapes, additional concepts must be invoked to understand the stability of the resulting structure. Here, we examine the disordered packing of chains constructed out of flexibly connected hard spheres. Using x-ray tomography, we find that long chains pack into a low-density structure whose mechanical rigidity is mainly provided by the backbone. On compaction, randomly oriented, semi-rigid loops form along the chain, and the packing of chains can be understood as the jamming of these elements. Finally, we uncover close similarities between the packing of chains and the glass transition in polymers.

  12. Rotations in shear bands and polydisperse packings

    NASA Astrophysics Data System (ADS)

    Herrmann, H. J.; Astrøm, J. A.; Mahmoodi Baram, R.

    2004-12-01

    High resistance concrete or hard ceramics needs extremely dense granular packings which can only be realised when the size distribution of grains follows a powerlaw. We discuss the perfectly dense limit, namely Apollonian packings in three dimensions and show in particular the existence of space filling bearings rotating without slip and without torsion. When a dense packing like tectonic gouge is deformed, it glides internally on shear bands. The existence of rotations in shearbands is evidenced by molecular dynamics simulations of disks.

  13. Close-packing of growing discs

    SciTech Connect

    Bursill, L.A.; Xudong, F. . School of Physics)

    1988-12-01

    Spiral lattices are derived by allowing growing discs to aggregate under a close-packing rule. Both Fibonacci and Lucas numbers of visible spirals arise naturally, dependent only on the choice of growth centre. Both the rate of convergence towards an ideal spiral, and chirality, are determined by the initial placement of the first few discs (initial conditions). Thus the appearance of spiral packings is no more or less mysterious than the appearance of hexagonal packed arrays of equal discs.

  14. Random close packing of polydisperse jammed emulsions

    NASA Astrophysics Data System (ADS)

    Brujic, Jasna

    2010-03-01

    Packing problems are everywhere, ranging from oil extraction through porous rocks to grain storage in silos and the compaction of pharmaceutical powders into tablets. At a given density, particulate systems pack into a mechanically stable and amorphous jammed state. Theoretical frameworks have proposed a connection between this jammed state and the glass transition, a thermodynamics of jamming, as well as geometric modeling of random packings. Nevertheless, a simple underlying mechanism for the random assembly of athermal particles, analogous to crystalline ordering, remains unknown. Here we use 3D measurements of polydisperse packings of emulsion droplets to build a simple statistical model in which the complexity of the global packing is distilled into a local stochastic process. From the perspective of a single particle the packing problem is reduced to the random formation of nearest neighbors, followed by a choice of contacts among them. The two key parameters in the model, the available space around a particle and the ratio of contacts to neighbors, are directly obtained from experiments. Remarkably, we demonstrate that this ``granocentric'' view captures the properties of the polydisperse emulsion packing, ranging from the microscopic distributions of nearest neighbors and contacts to local density fluctuations and all the way to the global packing density. Further applications to monodisperse and bidisperse systems quantitatively agree with previously measured trends in global density. This model therefore reveals a general principle of organization for random packing and lays the foundations for a theory of jammed matter.

  15. 7 CFR 982.11 - Pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON... according to size, internal quality, and external appearance and condition of hazelnuts packed in...

  16. 7 CFR 982.11 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON... according to size, internal quality, and external appearance and condition of hazelnuts packed in...

  17. 7 CFR 982.11 - Pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON... according to size, internal quality, and external appearance and condition of hazelnuts packed in...

  18. 7 CFR 982.11 - Pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON... according to size, internal quality, and external appearance and condition of hazelnuts packed in...

  19. 7 CFR 982.11 - Pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON... according to size, internal quality, and external appearance and condition of hazelnuts packed in...

  20. Minimally packed phases in holography

    NASA Astrophysics Data System (ADS)

    Donos, Aristomenis; Gauntlett, Jerome P.

    2016-03-01

    We numerically construct asymptotically AdS black brane solutions of D = 4 Einstein-Maxwell theory coupled to a pseudoscalar. The solutions are holographically dual to d = 3 CFTs at finite chemical potential and in a constant magnetic field, which spontaneously break translation invariance leading to the spontaneous formation of abelian and momentum magnetisation currents flowing around the plaquettes of a periodic Bravais lattice. We analyse the three-dimensional moduli space of lattice solutions, which are generically oblique, and show, for a specific value of the magnetic field, that the free energy is minimised by the triangular lattice, associated with minimal packing of circles in the plane. We show that the average stress tensor for the thermodynamically preferred phase is that of a perfect fluid and that this result applies more generally to spontaneously generated periodic phases. The triangular structure persists at low temperatures indicating the existence of novel crystalline ground states.

  1. Fetal Oropharyngeal and Neck Tumors: Determination of the Need for Ex-Utero Intrapartum Treatment Procedure

    PubMed Central

    Özgünen, Fatma Tuncay; Güleç, Ümran Küçükgöz; Evrüke, İsmail Cüneyt; Demir, Süleyman Cansun; Büyükkurt, Selim; Yapıcıoğlu, Hacer; İskit, Serdar

    2015-01-01

    Background: The aim of this study was to assess the ex-utero intrapartum therapy (EXIT) applied to 3 of the 7 cases with oropharyngeal or neck masses and review the indicators of the need for an EXIT procedure. Case Report: Prenatal presentation, size and localization of the masses, existence of fetal hydrops and associated findings such as polyhydramnios, intraoperative managements, complications, and maternal and neonatal outcomes were evaluated through a retrospective analysis. Four cases had neck masses and three cases had oropharyngeal masses. Prenatal sonography was used as the main diagnostic tool for all patients. The median gestational age was 34.5 weeks at the time of diagnosis and 36 weeks at delivery. Polyhydramnios was observed in three of the seven cases and they were delivered prematurely. Interventions such as endotracheal intubation or tracheostomy were performed to provide patency of the airway during delivery by the EXIT procedure in three cases. Hemangioma was found in two cases, teratoma in two cases, lymphangioma in two cases and hamartoma in one case following pathological examination of the masses. Conclusion: The localization of mass, its characteristics, invasion (if it exists), and relation to the airway are the main factors used to determine the need for EXIT. The presence of polyhydramnios may be an important indicator to predict both the need for EXIT and fetal outcomes. PMID:26167350

  2. Volumetric Change of Selected Organs at Risk During IMRT for Oropharyngeal Cancer

    SciTech Connect

    Ricchetti, Francesco; Wu Binbin; McNutt, Todd; Wong, John; Forastiere, Arlene; Marur, Shanthi; Starmer, Heather; Sanguineti, Giuseppe

    2011-05-01

    Purpose: To assess volumetric changes of selected organs at risk (OAR) during intensity-modulated radiotherapy (IMRT) for oropharyngeal carcinoma. Materials and Methods: Twenty-six consecutive patients that were treated with definitive IMRT {+-} chemotherapy between November 2007 and November 2008 were selected for the present study. As part of an internal quality assurances program, a repeat kilovolt (KV) computed tomography was planned weekly during the 7-week treatment course. On each available scan, a single observer contoured the parotid submandibular, and thyroid glands (PG/SMG/TG), larynx (L), and constrictor, masticatory, and sternocleidomastoid muscles (CM/MM/SCM) as appropriate. The volume at each scan was compared with the one at planning CT in a pair-wise fashion. p values <0.05 after correction for multiple testing were considered significant. Results: A total of 159 scans was obtained during treatment for a total of 185 scans, including the baseline imaging. All OARs showed statistically significant changes over baseline by week 5. At week 7, the PG showed the largest absolute change with an average reduction of {approx}10 mL followed by both the SCM and MM ({approx}-5 mL). The largest ({approx}-30%) relative change was observed for the salivary glands. L and CM showed a {approx}15% increase in volume during treatment. Conclusion: All selected OAR undergo significant volumetric changes during a course of IMRT for oropharyngeal squamous cell carcinoma.

  3. Post-operative radiation therapy for advanced-stage oropharyngeal cancer.

    PubMed

    Hansen, Eric; Panwala, Kathryn; Holland, John

    2002-11-01

    Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

  4. Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia.

    PubMed

    Fattori, B; Giusti, P; Mancini, V; Grosso, M; Barillari, M R; Bastiani, L; Molinaro, S; Nacci, A

    2016-10-01

    The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues.

  5. Physiology of oropharyngeal swallow in the cat: a videofluoroscopic and electromyographic study.

    PubMed

    Kobara-Mates, M; Logemann, J A; Larson, C; Kahrilas, P J

    1995-02-01

    The majority of animal studies of deglutition have examined electrically stimulated swallows in sedated animals. This present investigation examined oropharyngeal and cervical esophageal swallow physiology in three awake normal domestic cats using concurrent electromyography (EMG) and videofluorography (VFG). Hooked wire electrodes were surgically implanted into six oropharyngeal muscles in each cat. During collection of VFG and EMG data, each cat ate barium-impregnated cat food while the fluorography tube focused on a lateral view of the oral cavity, pharynx, and cervical esophagus. A number of significant differences in the physiology of swallowing were found between the cat and human adult. The oral stage of swallow is much longer in the cat with bolus accumulation in the valleculae. Duration and components of the pharyngeal stage of swallow are much faster, and the pharyngeal stage occurs earlier in relation to bolus passage through the cricopharyngeus. In addition, the cat exhibits a marked superior constrictor bulge at the onset of the pharyngeal contractile wave and summation of the peristaltic waves in the esophagus, whereas the human adult does not. Feline swallow physiology is more similar to that of the human infant than that of human adults.

  6. Human papilloma virus testing in oropharyngeal squamous cell carcinoma: what the clinician should know.

    PubMed

    Mirghani, Haïtham; Amen, Furrat; Moreau, Frederique; Guigay, Joel; Ferchiou, Malek; Melkane, Antoine E; Hartl, Dana M; Lacau St Guily, Jean

    2014-01-01

    High risk Human Papilloma virus (HR-HPV) associated oropharyngeal cancers are on the increase. Although, the scientific community is aware of the importance of Human Papilloma Virus (HPV) testing, there is no consensus on the assays that are required to reliably identify HR-HPV related tumors. A wide range of methods have been developed. The most widely used techniques include viral DNA detection, with polymerase chain reaction (PCR) or In Situ Hybridization, and p16 detected by immunohistochemistry. However, these tests provide different information and have their own specific limitations. In this review, we summarize these different techniques, in light of the recent literature. p16 Overexpression, which is an indirect marker of HPV infection, is considered by many head and neck oncologists to be the most important marker for patient stratification. We describe the frequent lack of concordance of this marker with other assays and the possible reasons for this. The latest developments in HPV testing are also reported, such as the RNAscope™ HPV test, and how they fit into the existing framework of techniques. HPV testing must not be considered in isolation, as there are important interactions with other parameters, such as tobacco exposure. This is an important and rapidly evolving field and is likely to become pivotal to staging and choice of treatment of oropharyngeal carcinoma in the future.

  7. Genomic Integration of High-Risk HPV Alters Gene Expression in Oropharyngeal Squamous Cell Carcinoma.

    PubMed

    Walline, Heather M; Komarck, Christine M; McHugh, Jonathan B; Bellile, Emily L; Brenner, J Chad; Prince, Mark E; McKean, Erin L; Chepeha, Douglas B; Wolf, Gregory T; Worden, Francis P; Bradford, Carol R; Carey, Thomas E

    2016-10-01

    High-risk HPV (hrHPV) is the leading etiologic factor in oropharyngeal cancer. HPV-positive oropharyngeal tumors generally respond well to therapy, with complete recovery in approximately 80% of patients. However, it remains unclear why some patients are nonresponsive to treatment, with 20% of patients recurring within 5 years. In this study, viral factors were examined for possible clues to differences in tumor behavior. Oropharynx tumors that responded well to therapy were compared with those that persisted and recurred. Viral oncogene alternate transcripts were assessed, and cellular sites of viral integration were mapped and sequenced. Effects of integration on gene expression were assessed by transcript analysis at the integration sites. All of the tumors demonstrated active viral oncogenesis, indicated by expression of HPV E6 and E7 oncogenes and alternate E6 splicing. In the responsive tumors, HPV integration occurred exclusively in intergenic chromosome regions, except for one tumor with viral integration into TP63. Each recurrent tumor exhibited complex HPV integration patterns into cancer-associated genes, including TNFRSF13B, SCN2A, SH2B1, UBE2V2, SMOC1, NFIA, and SEMA6D Disrupted cellular transcripts were identified in the region of integration in four of the seven affected genes.

  8. Chemoradiotherapy-induced upregulation of PD-1 antagonizes immunity to HPV-related oropharyngeal cancer.

    PubMed

    Parikh, Falguni; Duluc, Dorothée; Imai, Naoko; Clark, Amelia; Misiukiewicz, Krzys; Bonomi, Marcello; Gupta, Vishal; Patsias, Alexis; Parides, Michael; Demicco, Elizabeth G; Zhang, David Y; Kim-Schulze, Seunghee; Kao, Johnny; Gnjatic, Sacha; Oh, Sangkon; Posner, Marshall R; Sikora, Andrew G

    2014-12-15

    While viral antigens in human papillomavirus (HPV)-related oropharyngeal cancer (HPVOPC) are attractive targets for immunotherapy, the effects of existing standard-of-care therapies on immune responses to HPV are poorly understood. We serially sampled blood from patients with stage III-IV oropharyngeal cancer undergoing concomitant chemoradiotherapy with or without induction chemotherapy. Circulating immunocytes including CD4(+) and CD8(+) T cells, regulatory T cells (Treg), and myeloid-derived suppressor cells (MDSC) were profiled by flow cytometry. Antigen-specific T-cell responses were measured in response to HPV16 E6 and E7 peptide pools. The role of PD-1 signaling in treatment-related immunosuppression was functionally defined by performing HPV-specific T-cell assays in the presence of blocking antibody. While HPV-specific T-cell responses were present in 13 of 18 patients before treatment, 10 of 13 patients lost these responses within 3 months after chemoradiotherapy. Chemoradiotherapy decreased circulating T cells and markedly elevated MDSCs. PD-1 expression on CD4(+) T cells increased by nearly 2.5-fold after chemoradiotherapy, and ex vivo culture with PD-1-blocking antibody enhanced HPV-specific T-cell responses in 8 of 18 samples tested. Chemoradiotherapy suppresses circulating immune responses in patients with HPVOPC by unfavorably altering effector:suppressor immunocyte ratios and upregulating PD-1 expression on CD4(+) T cells. These data strongly support testing of PD-1-blocking agents in combination with standard-of-care chemoradiotherapy for HPVOPC.

  9. Entire hemithorax irradiation for Masaoka stage IVa thymomas.

    PubMed

    Soares, André; Louro, Luís Vasco; Almeida, Marta; Sousa, Olga

    2012-01-01

    Thymomas are rare neoplasms that have an indolent growth with a preferentially intra-thoracic dissemination pattern. Surgery is currently the standard treatment of thymomas; however radiotherapy is often used in an adjuvant setting due to a high sensitivity of these tumors to such treatment. Postoperative entire hemithoracic irradiation has been used in selected Masaoka stage IVa cases after complete surgical excision of metastatic lesions. In the present article, the authors report three cases of Masaoka stage IVa thymoma that underwent entire hemithorax irradiation after surgical excision of metastatic lesions. The first two patients presented as stage IVa thymomas. The third case consisted of a pleural recurrence of a thymoma. Hemithoracic irradiation with low doses has been used by different authors; the available data shows that it is a well-tolerated treatment that could potentially lead to better loco-regional control and increased overall survival.

  10. Confined disordered strictly jammed binary sphere packings

    NASA Astrophysics Data System (ADS)

    Chen, D.; Torquato, S.

    2015-12-01

    Disordered jammed packings under confinement have received considerably less attention than their bulk counterparts and yet arise in a variety of practical situations. In this work, we study binary sphere packings that are confined between two parallel hard planes and generalize the Torquato-Jiao (TJ) sequential linear programming algorithm [Phys. Rev. E 82, 061302 (2010), 10.1103/PhysRevE.82.061302] to obtain putative maximally random jammed (MRJ) packings that are exactly isostatic with high fidelity over a large range of plane separation distances H , small to large sphere radius ratio α , and small sphere relative concentration x . We find that packing characteristics can be substantially different from their bulk analogs, which is due to what we term "confinement frustration." Rattlers in confined packings are generally more prevalent than those in their bulk counterparts. We observe that packing fraction, rattler fraction, and degree of disorder of MRJ packings generally increase with H , though exceptions exist. Discontinuities in the packing characteristics as H varies in the vicinity of certain values of H are due to associated discontinuous transitions between different jammed states. When the plane separation distance is on the order of two large-sphere diameters or less, the packings exhibit salient two-dimensional features; when the plane separation distance exceeds about 30 large-sphere diameters, the packings approach three-dimensional bulk packings. As the size contrast increases (as α decreases), the rattler fraction dramatically increases due to what we call "size-disparity" frustration. We find that at intermediate α and when x is about 0.5 (50-50 mixture), the disorder of packings is maximized, as measured by an order metric ψ that is based on the number density fluctuations in the direction perpendicular to the hard walls. We also apply the local volume-fraction variance στ2(R ) to characterize confined packings and find that these

  11. 7 CFR 51.1217 - Standard pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... peaches within the packages when lidded. (c) Peaches packed in standard western boxes shall be reasonably... overfilled packages. The number of peaches in the box shall not vary more than 4 from the number indicated on the box. (d) Peaches packed in other type boxes such as wire-bound boxes and fiber-board boxes may...

  12. Pack Density Limitations of Hybrid Parachutes

    NASA Technical Reports Server (NTRS)

    Zwicker, Matthew L.; Sinclair, Robert J.

    2013-01-01

    The development and testing of the Orion crew capsule parachute system has provided a unique opportunity to study dense parachute packing techniques and limits, in order to establish a new baseline for future programs. The density of parachute packs has a significant influence on vibration loads, retention system stresses, and parachute mortar performance. Material compositions and pack densities of existing designs for space capsule recovery were compared, using the pack density of the Apollo main parachutes as the current baseline. The composition of parachutes has changed since Apollo, incorporating new materials such as Kevlar , Vectran , Teflon and Spectra . These materials have different specific densities than Nylon, so the densities of hybrid parachute packs cannot be directly compared to Nylon parachutes for determination of feasibility or volume allocation. Six parachute packs were evaluated in terms of weighted average solid density in order to achieve a non-dimensional comparison of packing density. Means of mitigating damage due to packing pressure and mortar firing were examined in light of the Capsule Parachute Assembly System (CPAS) and Apollo experience. Parachute design improvements including incorporation of modern materials and manufacturing processes serves to make CPAS the new knowledge base on which future spacecraft parachute systems will be built.

  13. 7 CFR 29.2289 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 29.2289 Section 29.2289 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Packing. A lot of tobacco consisting of a number of packages submitted as one definite unit for...

  14. 7 CFR 29.1048 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 29.1048 Section 29.1048 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1048 Packing. A lot of tobacco consisting of a number of packages submitted as...

  15. 7 CFR 29.6031 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 29.6031 Section 29.6031 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Standards Definitions § 29.6031 Packing. A lot of tobacco consisting of a number of...

  16. 7 CFR 29.2541 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 29.2541 Section 29.2541 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing...-Cured Tobacco (u.s. Types 22, 23, and Foreign Type 96) § 29.2541 Packing. A lot of tobacco consisting...

  17. 7 CFR 29.3538 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 29.3538 Section 29.3538 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3538 Packing. A lot of tobacco consisting of a number of packages submitted as...

  18. 7 CFR 29.3048 - Packing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Packing. 29.3048 Section 29.3048 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Packing. A lot of tobacco consisting of a number of packages submitted as one definite unit for...

  19. Pack formation in cycling and orienteering.

    PubMed

    Ackland, G J; Butler, D

    2001-09-13

    In cycling and orienteering competitions, competitors can become bunched into packs, which may mask an individual's true ability. Here we model this process with a view to determining when competitors' times are determined more by others than by their own ability. Our results may prove useful in helping to stage events so that pack formation can be avoided.

  20. Cluster and constraint analysis in tetrahedron packings.

    PubMed

    Jin, Weiwei; Lu, Peng; Liu, Lufeng; Li, Shuixiang

    2015-04-01

    The disordered packings of tetrahedra often show no obvious macroscopic orientational or positional order for a wide range of packing densities, and it has been found that the local order in particle clusters is the main order form of tetrahedron packings. Therefore, a cluster analysis is carried out to investigate the local structures and properties of tetrahedron packings in this work. We obtain a cluster distribution of differently sized clusters, and peaks are observed at two special clusters, i.e., dimer and wagon wheel. We then calculate the amounts of dimers and wagon wheels, which are observed to have linear or approximate linear correlations with packing density. Following our previous work, the amount of particles participating in dimers is used as an order metric to evaluate the order degree of the hierarchical packing structure of tetrahedra, and an order map is consequently depicted. Furthermore, a constraint analysis is performed to determine the isostatic or hyperstatic region in the order map. We employ a Monte Carlo algorithm to test jamming and then suggest a new maximally random jammed packing of hard tetrahedra from the order map with a packing density of 0.6337.

  1. 21 CFR 890.5700 - Cold pack.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cold pack. 890.5700 Section 890.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5700 Cold pack. (a) Identification....

  2. 21 CFR 890.5700 - Cold pack.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cold pack. 890.5700 Section 890.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5700 Cold pack. (a) Identification....

  3. 21 CFR 890.5700 - Cold pack.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cold pack. 890.5700 Section 890.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5700 Cold pack. (a) Identification....

  4. 7 CFR 51.2338 - Standard pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... (c) Boxes, flats, lugs, or cartons: (1) Fruit packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed...” means the greatest dimension measured at right angles to a line from stem to blossom end. (f) In...

  5. 7 CFR 51.2338 - Standard pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed, and conform to the marked count. (2) In... angles to a line from stem to blossom end. (f) In order to allow for variations incident to proper...

  6. 7 CFR 51.2338 - Standard pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... (c) Boxes, flats, lugs, or cartons: (1) Fruit packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed...” means the greatest dimension measured at right angles to a line from stem to blossom end. (f) In...

  7. 7 CFR 51.3152 - Standard pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Nectarines packed in containers equipped with cell compartments, cardboard fillers or molded trays shall be of the proper size for the cells, fillers, or molds in which they are packed, and the number of... angles to a line from stem to blossom end of the fruit. (h) Tolerances. In order to allow for...

  8. 7 CFR 51.3152 - Standard pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) Nectarines packed in containers equipped with cell compartments, cardboard fillers or molded trays shall be of the proper size for the cells, fillers, or molds in which they are packed, and the number of... angles to a line from stem to blossom end of the fruit. (h) Tolerances. In order to allow for...

  9. 21 CFR 890.5700 - Cold pack.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cold pack. 890.5700 Section 890.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5700 Cold pack. (a) Identification....

  10. 21 CFR 890.5700 - Cold pack.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cold pack. 890.5700 Section 890.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5700 Cold pack. (a) Identification....

  11. Probe with integrated heater and thermocouple pack

    SciTech Connect

    McCulloch, R.W.; Dial, R.E.; Finnell, W.F.R.

    1988-02-16

    This patent describes a gamma thermometer probe for detecting heat produced within the thermometer probe. It comprises: an outer elongate thermometer sheath; an elongate rod; annular recesses; a longitudinal bore; and an integrated thermocouple pack. The thermocouple pack comprises: a first type wire, and second type wires. The second type wires comprises: an outer section; and an inner segment.

  12. Development of an effective valve packing program

    SciTech Connect

    Hart, K.A.

    1996-12-01

    Current data now shows that graphite valve packing installed within the guidance of a controlled program produces not only reliable stem sealing but predictable running loads. By utilizing recent technological developments in valve performance monitoring for both MOV`s and AOV`s, valve packing performance can be enhanced while reducing maintenance costs. Once known, values are established for acceptable valve packing loads, the measurement of actual valve running loads via the current MOV/AOV diagnostic techniques can provide indication of future valve stem sealing problems, improper valve packing installation or identify the opportunity for valve packing program improvements. At times the full benefit of these advances in material and predictive technology remain under utilized due to simple past misconceptions associated with valve packing. This paper will explore the basis for these misconceptions, provide general insight into the current understanding of valve packing and demonstrate how with this new understanding and current valve diagnostic equipment the key aspects required to develop an effective, quality valve packing program fit together. The cost and operational benefits provided by this approach can be significant impact by the: elimination of periodic valve repacking, reduction of maintenance costs, benefits of leak-free valve operation, justification for reduced Post Maintenance Test Requirements, reduced radiation exposure, improved plant appearance.

  13. Pack rats (Neotoma spp.): Keystone ecological engineers?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The potential role of two species of pack rats (Neotoma albigula and Neotoma micropus) as keystone ecological engineers was examined by estimating the species diversity of invertebrates living in the nest middens, and nitrogen mineralization rates in soils associated with the middens. Although pack-...

  14. 7 CFR 51.2338 - Standard pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed, and conform to the marked count. (2) In... angles to a line from stem to blossom end. (f) In order to allow for variations incident to proper...

  15. 7 CFR 51.2338 - Standard pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed, and conform to the marked count. (2) In... angles to a line from stem to blossom end. (f) In order to allow for variations incident to proper...

  16. Slimhole frac pack tools overcome erosion problems

    SciTech Connect

    Stout, G.; Matte, T.; Rogers, B.

    1997-04-01

    The application of frac pack technology for stimulation and sand control in the Gulf of Mexico`s unconsolidated formations has steadily increased during the past several years. In addition, re-entry drilling has been one of the fastest growing development techniques used by operators for optimizing reservoir productivity. As such, smaller casing sizes are becoming more common in oil and gas producing wells. Gravel pack tools were being used for frac packing in 7-in. casing sizes and larger, but no tools were available to frac pack in the smaller 5-in. and 5{1/2}-in. casing. The erosion problems operators were experiencing in 7-in. gravel pack tools heightened concerns about fracturing through 5-in. tools with even smaller flow areas. Flow cutting in the 7-in. tools was so severe that it caused fluid communication between the gravel pack ports and the return flow holes in the crossover tool. This allowed fluid and proppant to return to the annulus above the packer, which could cause possible early screen-out and sticking of the crossover tool. The flow cutting could also reduce the tool`s pressure and tensile ratings. Any one of these problems could jeopardize the success of the frac pack operation. Therefore, an erosion resistant crossover tool for slimhole casing was developed to address these problems and optimize frac pack success.

  17. Does post septoplasty nasal packing reduce complications?

    PubMed

    Naghibzadeh, Bijan; Peyvandi, Ali Asghar; Naghibzadeh, Ghazal

    2011-01-01

    The main issues in nasal surgery are to stabilize the nose in the good position after surgery and preserve the cartilages and bones in the favorable situation and reduce the risk of deviation recurrence. Also it is necessary to avoid the synechia formation, nasal valve narrowing, hematoma and bleeding. Due to the above mentioned problems and in order to solve and minimize them nasal packing, nasal splint and nasal mold have been advised. Patients for whom the nasal packing used may faced to some problems like naso-pulmonary reflex, intractable pain, sleep disorder, post operation infection and very dangerous complication like toxic shock syndrome. We have two groups of patients and three surgeons (one of the surgeons used post operative nasal packing in his patients and the two others surgeons did not).Complications and morbidities were compared in these two groups. Comparing the two groups showed that the rate of complication and morbidities between these two groups were same and the differences were not valuable, except the pain and discomfort post operatively and at the time of its removal. Nasal packing has several risks for the patients while its effects are not studied. Septoplasty can be safely performed without postoperative nasal packing. Nasal packing had no main findings that compensated its usage. Septal suture is one of the procedures that can be used as alternative method to nasal packing. Therefore the nasal packing after septoplasty should be reserved for the patients with increased risk of bleeding.

  18. Emergence of fluconazole-resistant strains of Candida albicans in patients with recurrent oropharyngeal candidosis and human immunodeficiency virus infection.

    PubMed Central

    Ruhnke, M; Eigler, A; Tennagen, I; Geiseler, B; Engelmann, E; Trautmann, M

    1994-01-01

    After repeated use of fluconazole for therapy of oropharyngeal candidosis, the emergence of in vitro fluconazole-resistant Candida albicans isolates (MIC, > or = 25 micrograms/ml) together with oral candidosis unresponsive to oral dosages of up to 400 mg of fluconazole were observed in patients with human immunodeficiency virus (HIV) infection. Antifungal susceptibility testing was done by broth microdilution and agar dilution techniques on C. albicans isolates recovered from a cohort of patients with symptomatic HIV infection who were treated repeatedly with fluconazole for oropharyngeal candidosis. In vitro findings did show a gradual increase in the MICs for C. albicans isolates recovered from selected patients with repeated episodes of oropharyngeal candidosis. Primary resistance of C. albicans to fluconazole was not seen. Cross-resistance in vitro occurred between fluconazole and other azoles (ketoconazole, itraconazole), but to a lesser extent. The results of the study suggest that the development of clinical resistance to fluconazole could be clearly correlated to in vitro resistance to fluconazole. Itraconazole may still serve as an effective antifungal agent in patients with HIV infection and oropharyngeal candidosis nonresponsive to fluconazole. PMID:7814530

  19. Discussing a diagnosis of human papillomavirus oropharyngeal cancer with patients: An exploratory qualitative study of health professionals

    PubMed Central

    Dodd, Rachael H.; Marlow, Laura A. V.

    2015-01-01

    Abstract Background The role of human papillomavirus (HPV) in oropharyngeal squamous cell cancer (SCC) has now been well established. Clinicians' experiences and challenges of talking to patients about HPV have yet to be explored. Methods Fifteen health professionals caring for patients with oropharyngeal SCC were interviewed. Interviews were analyzed thematically. Results Participants expressed mixed views about explaining the causal role of HPV to their patients. Normalizing HPV and emphasizing the positive prognosis associated with it were regarded as key messages to be communicated. Challenging experiences included managing couples in a consultation and patients' concerns about transmitting HPV to their partners. Some participants described limitations to their HPV knowledge and identified the need for further information and training. Conclusion This study identified challenges experienced by health professionals working with patients with oropharyngeal SCC and highlights some key messages to convey to patients. Clinical guidance for health professionals and further information for patients about HPV‐positive oropharyngeal SCC are needed. © 2015 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck 38: 394–401, 2016 PMID:25351993

  20. Dimensional and volumetric analysis of the oropharyngeal region in obstructive sleep apnea patients: A cone beam computed tomography study

    PubMed Central

    Tikku, Tripti; Khanna, Rohit; Sachan, Kiran; Agarwal, Akhil; Srivastava, Kamna; Lal, Anubha

    2016-01-01

    Background: Obstructive Sleep Apnea (OSA) is a potentially life-threatening condition in which there is a periodic cessation of breathing (for 10 sec or longer) that occurs during sleep in the presence of inspiratory effort. The aim of the study was to assess volumetric and dimensional differences between OSA patients and normal individuals in the upright posture. Material and Method: The present study was conducted on CBCT scans of 32 patients who were divided into two groups -Group I (control group) and Group II (OSA subjects). Group I consisted of 16 patients with normal airway with ESS score from 2 to 10, STOP BANG Questionnaire score of <3 and who had undergone CBCT for various diagnostic reasons. Group II had patients with ESS score >10, STOP BANG Questionnaire score of > 3, AHI index >5. Linear and angular parameters, volume and minimum cross-section area (MCA) of oropharyngeal airway, anteroposterior length and lateral width at MCA was compared amongst the groups. Results: The oropharyngeal volume, MCA, and the anteroposterior and lateral width of the airway at MCA of the OSA subjects was significantly lesser than that of normal subjects. The length of both soft palate and tongue was significantly more in Group II. The angle between the nasopharyngeal airway and the oropharyngeal airway was significantly more obtuse in Group II. Conclusion: The reduction in oropharyngeal volume in OSA patients could be attributed to different anatomical and pathophysiological factors that were corroborated with the findings of the present study. PMID:27857764

  1. HPV genotypes detected in the oropharyngeal mucosa of HIV-infected men who have sex with men in Northern Italy.

    PubMed

    Martinelli, M; Mazza, F; Frati, E R; Fasolo, M M; Colzani, D; Bianchi, S; Fasoli, E; Amendola, A; Orlando, G; Tanzi, E

    2016-09-01

    The aim of this study was to investigate the epidemiological profile of HPV oropharyngeal infections in HIV-infected men who have sex with men. A total of 135 subjects were enrolled at the L. Sacco University Hospital (Milan, Italy) to evaluate their HPV oropharyngeal infection status at baseline and at a follow-up visit at least 12 months later. HPV DNA was detected from oropharyngeal swabs using an in-house nested PCR that amplifies a segment of the L1 gene. The PCR products were then sequenced and genotyped. A greater percentage of high-risk genotypes was identified compared to low-risk genotypes (13·7% vs. 6·9%, P < 0·05), and two uncommon alpha-HPV genotypes were detected, i.e. HPV-102 and HPV-114. HPV infection prevalence was 24·4% and the cumulative incidence was 24·1%. During the follow-up period, one case of HPV infection (HPV-33) persisted, while the overall rate of infection clearance was 58·3%. HPV oropharyngeal infection was widespread in the cohort examined, and most of the infections were transient and cleared within 12 months. These results may help to clarify the role of HPV in the oropharynx and may also improve our understanding of the need to implement preventive strategies in at-risk populations.

  2. Coalescence preference in densely packed microbubbles

    SciTech Connect

    Kim, Yeseul; Lim, Su Jin; Gim, Bopil; Weon, Byung Mook

    2015-01-13

    A bubble merged from two parent bubbles with different size tends to be placed closer to the larger parent. This phenomenon is known as the coalescence preference. Here we demonstrate that the coalescence preference can be blocked inside a densely packed cluster of bubbles. We utilized high-speed high-resolution X-ray microscopy to clearly visualize individual coalescence events inside densely packed microbubbles with a local packing fraction of ~40%. Thus, the surface energy release theory predicts an exponent of 5 in a relation between the relative coalescence position and the parent size ratio, whereas our observation for coalescence in densely packed microbubbles shows a different exponent of 2. We believe that this result would be important to understand the reality of coalescence dynamics in a variety of packing situations of soft matter.

  3. Coalescence preference in densely packed microbubbles

    DOE PAGES

    Kim, Yeseul; Lim, Su Jin; Gim, Bopil; ...

    2015-01-13

    A bubble merged from two parent bubbles with different size tends to be placed closer to the larger parent. This phenomenon is known as the coalescence preference. Here we demonstrate that the coalescence preference can be blocked inside a densely packed cluster of bubbles. We utilized high-speed high-resolution X-ray microscopy to clearly visualize individual coalescence events inside densely packed microbubbles with a local packing fraction of ~40%. Thus, the surface energy release theory predicts an exponent of 5 in a relation between the relative coalescence position and the parent size ratio, whereas our observation for coalescence in densely packed microbubblesmore » shows a different exponent of 2. We believe that this result would be important to understand the reality of coalescence dynamics in a variety of packing situations of soft matter.« less

  4. Nuclear PRMT5, cyclin D1 and IL-6 are associated with poor outcome in oropharyngeal squamous cell carcinoma patients and is inversely associated with p16-status.

    PubMed

    Kumar, Bhavna; Yadav, Arti; Brown, Nicole V; Zhao, Songzhu; Cipolla, Michael J; Wakely, Paul E; Schmitt, Alessandra C; Baiocchi, Robert A; Teknos, Theodoros N; Old, Matthew; Kumar, Pawan

    2017-01-17

    Protein arginine methyltransferase-5 (PRMT5) plays an important role in cancer progression by repressing the expression of key tumor suppressor genes via the methylation of transcriptional factors and chromatin-associated proteins. However, very little is known about the expression and biological role of PRMT5 in head and neck cancer. In this study, we examined expression profile of PRMT5 at subcellular levels in oropharyngeal squamous cell carcinoma (OPSCC) and assessed its correlation with disease progression and patient outcome. Our results show that nuclear PRMT5 was associated with poor overall survival (p < 0.012) and these patients had 1.732 times higher hazard of death (95% CI: 1.127-2.661) as compared to patients in whom PRMT5 was not present in the nucleus of the tumors. Nuclear PRMT5 expression was inversely correlated with p16-status (p < 0.001) and was significantly higher in tumor samples from patients who smoked > 10 pack-years (p = 0.013). In addition, nuclear PRMT5 was directly correlated with cyclin D1 (p = 0.0101) and IL-6 expression (p < 0.001). In a subgroup survival analysis, nuclear PRMT5-positive/IL-6-positive group had worst survival, whereas nuclear PRMT5-negative/IL-6-negative group had the best survival. Similarly, patients with p16-negative/nuclear PRMT5-positive tumors had worse survival compared to patients with p16-positive/nuclear PRMT5-negative tumors. Our mechanistic results suggest that IL-6 promotes nuclear translocation of PRMT5. Taken together, our results demonstrate for the first time that nuclear PRMT5 expression is associated with poor clinical outcome in OPSCC patients and IL-6 plays a role in the nuclear translocation of PRMT5.

  5. ENGINES: exploring single nucleotide variation in entire human genomes

    PubMed Central

    2011-01-01

    Background Next generation ultra-sequencing technologies are starting to produce extensive quantities of data from entire human genome or exome sequences, and therefore new software is needed to present and analyse this vast amount of information. The 1000 Genomes project has recently released raw data for 629 complete genomes representing several human populations through their Phase I interim analysis and, although there are certain public tools available that allow exploration of these genomes, to date there is no tool that permits comprehensive population analysis of the variation catalogued by such data. Description We have developed a genetic variant site explorer able to retrieve data for Single Nucleotide Variation (SNVs), population by population, from entire genomes without compromising future scalability and agility. ENGINES (ENtire Genome INterface for Exploring SNVs) uses data from the 1000 Genomes Phase I to demonstrate its capacity to handle large amounts of genetic variation (>7.3 billion genotypes and 28 million SNVs), as well as deriving summary statistics of interest for medical and population genetics applications. The whole dataset is pre-processed and summarized into a data mart accessible through a web interface. The query system allows the combination and comparison of each available population sample, while searching by rs-number list, chromosome region, or genes of interest. Frequency and FST filters are available to further refine queries, while results can be visually compared with other large-scale Single Nucleotide Polymorphism (SNP) repositories such as HapMap or Perlegen. Conclusions ENGINES is capable of accessing large-scale variation data repositories in a fast and comprehensive manner. It allows quick browsing of whole genome variation, while providing statistical information for each variant site such as allele frequency, heterozygosity or FST values for genetic differentiation. Access to the data mart generating scripts and to

  6. A general elevation view of the entire railroad bridge crossing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    A general elevation view of the entire railroad bridge crossing the Tennessee River with the center/pivot pier of the 364' - 0-1/2' swing bridge positioned in the center of the river. With the bridge in the open position, navigational river traffic can continue down river by going through a 145-foot horizontal opening on each side of the pivot pier, provided the opening provides the necessary clearance required. Note: The two (2) middle supports on the center/pivot round pier. - Bridgeport Swing Span Bridge, Spanning Tennessee River, Bridgeport, Jackson County, AL

  7. Differences in Imaging Characteristics of HPV-Positive and HPV-Negative Oropharyngeal Cancers: A Blinded Matched-Pair Analysis

    PubMed Central

    Cantrell, Sarah C.; Peck, Brandon W.; Li, Guojun; Wei, Qingyi; Sturgis, Erich M.; Ginsberg, Lawrence E.

    2014-01-01

    BACKGROUND AND PURPOSE Human papillomavirus–positive oropharyngeal cancers typically have younger age of onset, limited tobacco exposure, and more favorable prognosis than HPV-negative oropharyngeal cancers. We assessed whether HPV-positive and HPV-negative oropharyngeal cancers have consistent differences in pretreatment imaging characteristics. MATERIALS AND METHODS A retrospective review of 136 pretreatment CT examinations of paired HPV-positive and HPV-negative oropharyngeal cancers matched for T stage, tumor subsite, and smoking status was performed with the reviewing radiologist blinded to HPV status and clinical stage. Demographic/clinical characteristics and imaging characteristics of primary lesions and metastatic nodal disease were compared by use of Fisher exact testing. The McNemar χ2 test was used for the matched-pair analysis. RESULTS By imaging, HPV-negative tumors were more likely to demonstrate invasion of adjacent muscle (26% versus 6%, P = .013). HPV-positive primary tumors were more likely to be enhancing and exophytic with well-defined borders, whereas HPV-negative primary tumors were more likely to be isoattenuated and demonstrate ill-defined borders, though these results were not statistically significant. HPV-positive tumors were more likely to demonstrate cystic nodal metastases than HPV-negative tumors (36% versus 9%, P = .002). CONCLUSIONS In this matched and blinded analysis of the imaging differences between HPV-positive and HPV-negative oropharyngeal cancers, HPV-positive carcinomas often had primary lesions with well-defined borders and cystic nodal metastases, whereas HPV-negative primaries more often had poorly defined borders and invasion of adjacent muscle. PMID:23660291

  8. Electromechanics of packed granular beds

    SciTech Connect

    Robinson, K.S.

    1982-01-01

    Strong, electrical, interparticle forces are induced by applied electric fields within packed beds of dielectric particles. Proposed applications utilizing electropacked beds (EPBs) or electrofluidized beds (EFBs) include air filtration and gas clean-up, fine particle separation, commercial drying and coating processes, heat and mass transfer, and bulk bed control. A new distributed circuit model of the electrical interparticle force is presented that identifies the role of surface roughness as determining the interparticle spacing. The dc steady state force is predicted to increase nearly linearly with the applied electric field and is theoretically independent of particle surface conductivity. The electric stress is found to vary nearly linearly with the applied electric field. Data are generally consistent with the theoretical contention that increased surface roughness decreases electromechanical effects. Surface conductivity variations of three to four times have no measurable effect on the dc steady state electric stress. The electric stress is insensitive to the dielectric properties of the interstitial gas eliminating Townsend discharge as a candidate for the nonlinear charge transport process thought to occur near interparticle contacts. The theoretical upper bound of the electric stress calculated using the distributed circuit model falls within the scatter of the data if a limit on the electric field in the interparticle gap which models nonlinear charge transport is in the range of 1 to 6 x 10/sup 7/ V/m. Estimates of the charge relaxation time using transient angle of repose experiments are somewhat smaller but comparable with theoretical values calculated by ignoring nonlinear charge transport.

  9. Method for gravel packing wells

    SciTech Connect

    Jones, L.G.

    1990-08-07

    This patent describes a method for gravel packing a well that penetrates an unconsolidated or poorly consolidated subterranean oil or gas reservoir. It comprises: providing a borehole casing through the reservoir; perforating the casing at preselected intervals therealong to form at least one set of longitudinal, perforation tunnels adjacent a substantial portion of the reservoir; locating a sand screen inside the casing and in juxtaposition with the perforation tunnels, an annulus being formed between the sand screen and the casing; positioning a conduit in juxtaposition with the sand screen extending substantially the length of the sand screen and having its upper extremity open to fluids; injecting a fluid slurry containing gravel down through the annulus and conduit whereby the fluid portion of the slurry is forced out of the annulus through the perforation tunnels into the reservoir and the gravel portion of the slurry deposited in the annulus and forced into the perforation tunnels into the formation; sizing the cross-sectional area of the conduit and the annulus so that if gravel forms a bridge in a portion of the annulus thereby blocking the flow of fluid slurry through the the annulus, fluid slurry containing gravel will continue to flow through the conduit and into the annulus around the gravel bridge; and terminating the injection of the slurry.

  10. Condensation in Nanoporous Packed Beds.

    PubMed

    Ally, Javed; Molla, Shahnawaz; Mostowfi, Farshid

    2016-05-10

    In materials with tiny, nanometer-scale pores, liquid condensation is shifted from the bulk saturation pressure observed at larger scales. This effect is called capillary condensation and can block pores, which has major consequences in hydrocarbon production, as well as in fuel cells, catalysis, and powder adhesion. In this study, high pressure nanofluidic condensation studies are performed using propane and carbon dioxide in a colloidal crystal packed bed. Direct visualization allows the extent of condensation to be observed, as well as inference of the pore geometry from Bragg diffraction. We show experimentally that capillary condensation depends on pore geometry and wettability because these factors determine the shape of the menisci that coalesce when pore filling occurs, contrary to the typical assumption that all pore structures can be modeled as cylindrical and perfectly wetting. We also observe capillary condensation at higher pressures than has been done previously, which is important because many applications involving this phenomenon occur well above atmospheric pressure, and there is little, if any, experimental validation of capillary condensation at such pressures, particularly with direct visualization.

  11. Viewing The Entire Sun With STEREO And SDO

    NASA Astrophysics Data System (ADS)

    Thompson, William T.; Gurman, J. B.; Kucera, T. A.; Howard, R. A.; Vourlidas, A.; Wuelser, J.; Pesnell, D.

    2011-05-01

    On 6 February 2011, the two Solar Terrestrial Relations Observatory (STEREO) spacecraft were at 180 degrees separation. This allowed the first-ever simultaneous view of the entire Sun. Combining the STEREO data with corresponding images from the Solar Dynamics Observatory (SDO) allows this full-Sun view to continue for the next eight years. We show how the data from the three viewpoints are combined into a single heliographic map. Processing of the STEREO beacon telemetry allows these full-Sun views to be created in near-real-time, allowing tracking of solar activity even on the far side of the Sun. This is a valuable space-weather tool, not only for anticipating activity before it rotates onto the Earth-view, but also for deep space missions in other parts of the solar system. Scientific use of the data includes the ability to continuously track the entire lifecycle of active regions, filaments, coronal holes, and other solar features. There is also a significant public outreach component to this activity. The STEREO Science Center produces products from the three viewpoints used in iPhone/iPad and Android applications, as well as time sequences for spherical projection systems used in museums, such as Science-on-a-Sphere and Magic Planet.

  12. Internal packing of helical membrane proteins

    PubMed Central

    Eilers, Markus; Shekar, Srinivasan C.; Shieh, Ted; Smith, Steven O.; Fleming, Patrick J.

    2000-01-01

    Helix packing is important in the folding, stability, and association of membrane proteins. Packing analysis of the helical portions of 7 integral membrane proteins and 37 soluble proteins show that the helices in membrane proteins have higher packing values (0.431) than in soluble proteins (0.405). The highest packing values in integral membrane proteins originate from small hydrophobic (G and A) and small hydroxyl-containing (S and T) amino acids, whereas in soluble proteins large hydrophobic and aromatic residues have the highest packing values. The highest packing values for membrane proteins are found in the transmembrane helix–helix interfaces. Glycine and alanine have the highest occurrence among the buried amino acids in membrane proteins, whereas leucine and alanine are the most common buried residue in soluble proteins. These observations are consistent with a shorter axial separation between helices in membrane proteins. The tight helix packing revealed in this analysis contributes to membrane protein stability and likely compensates for the lack of the hydrophobic effect as a driving force for helix–helix association in membranes. PMID:10823938

  13. [The thin ALT perforator flap for oropharyngeal robotic-assisted reconstruction].

    PubMed

    Qassemyar, Q; Aguilar, P; Temam, S; Kolb, F; Gorphe, P

    2017-02-01

    Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb. The aim of our work was to prove the feasibility and the benefits in terms of reducing sequelae when using a thin anterolateral perforator flap harvested above the plane of the superficial fascia. We present this new original method in detail and the advantages it offers to patients after surgery.

  14. Population-based p16 and HPV positivity rates in oropharyngeal cancer in Southeast Scotland.

    PubMed

    Wells, L A R; Junor, E J; Conn, B; Pattle, S; Cuschieri, K

    2015-10-01

    We assessed a population-based cohort of patients diagnosed with oropharyngeal squamous cell carcinoma in Southeast Scotland over 13 months. p16 and human papilloma virus (HPV) expression were determined, and correlated with stage, treatment, smoking and alcohol history, and disease outcomes. Retrospective analysis was performed on 60 patients. p16 immunohistochemistry and HPV genotyping were performed on formalin-fixed paraffin-embedded tissues. HPV infection (as defined by p16 positivity and/or HPV PCR positivity) was identified in 57% of samples, while dual positives were detected in 45% of cases. HPV16 was most prevalent of the HPV types and was associated with 90% of positive samples. Cause-specific 1-year and 2-year survivals were 82.5% and 78.2%, respectively. The p16-positive and HPV-positive groups demonstrated significantly increased cause-specific survival in comparison with their negative counterparts.

  15. Oropharyngeal pemphigus in a patient with chronic hepatitis C during interferon alpha-2a therapy.

    PubMed

    Marinho, R T; Johnson, N W; Fatela, N M; Serejo, F S; Glória, H; Raimundo, M O; Velosa, J F; Ramalho, F J; Moura, M C

    2001-07-01

    There are a few reports in the literature concerning pemphigus induced by interferon given for hepatitis C. We present the case of a 28-year-old woman with post-transfusional chronic hepatitis C who developed ulcers and vesicles on her tongue, cheeks, posterior oropharynx and vocal cords 5 months after beginning treatment with recombinant interferon alpha-2a. The direct and indirect immunofluorescence was diagnostic of pemphigus vulgaris. The drug was promptly withdrawn; the patient was medicated with prednisolone and azathioprine and recovered only 3 months later. Although there are several publications describing the occurrence of other autoimmune diseases in patients receiving interferon alpha therapy, this is the first report of a pemphigus induced by interferon in hepatitis C patients involving oropharyngeal and laryngeal mucosae without cutaneous involvement.

  16. The physiology of deglutition and the pathophysiology and complications of oropharyngeal dysphagia.

    PubMed

    Steele, Catriona M

    2012-01-01

    The opening session of the 2nd International Conference on Oropharyngeal Dysphagia featured a series of invited talks reviewing the definition of dysphagia, its prevalence and its pathophysiology. The discussion arising from these talks focused heavily on the current underrecognition of dysphagia as a significant concern for older adults, particularly those over 75. The burdens associated with dysphagia in this sector of the population were recognized to be substantial, both in social/psychological terms and in terms of economic consequences for the healthcare system. The importance of developing swallow screening protocols as a routine method for the early identification of dysphagia and aspiration was explored. The idea of launching political initiatives aimed at increasing awareness and the utilization of appropriate dysphagia healthcare codes was also discussed.

  17. Videofluoroscopy and oropharyngeal manometry for evaluation of swallowing in elderly patients.

    PubMed

    Reginelli, Alfonso; D'Amora, Marilina; Del Vecchio, Lucia; Monaco, Luigi; Barillari, Maria Rosaria; Di Martino, Natale; Barillari, Umberto; Motta, Gaetano; Cappabianca, Salvatore; Grassi, Roberto

    2016-09-01

    Presbyphagia represents the physiological aging evolution of the swallowing function. It is related to the natural changes of the anatomical structures involved in the swallowing process. These age-related modifications can be asymptomatic in the early stages of life, but in the late stages, they could lead to dysphagia, aspiration pneumonia, dehydration, or malnutrition, reducing the quality of life. Videofluoromanometry (VFM) is the combined study of videofluoroscopy (VFS) and oropharyngeal manometry that allows simultaneous identification of functional and morphological features of the presbyphagia, also in asymptomatic otherwise healthy elderly adults. This study retrospectively evaluated the effectiveness of the VFM and the role of a multidisciplinary team of specialists in the analysis of a large cohort of old patients with presbyphagia, with the objective of achieving early diagnosis of the disease and the best therapy to delay the development of complications such as aspiration pneumonia, malnutrition, and dehydration.

  18. Management of locally advanced HPV-related oropharyngeal squamous cell carcinoma: where are we?

    PubMed

    Samuels, Stuart E; Eisbruch, Avraham; Beitler, Jonathan J; Corry, June; Bradford, Carol R; Saba, Nabil F; van den Brekel, Michiel W M; Smee, Robert; Strojan, Primož; Suárez, Carlos; Mendenhall, William M; Takes, Robert P; Rodrigo, Juan P; Haigentz, Missak; Rapidis, Alexander D; Rinaldo, Alessandra; Ferlito, Alfio

    2016-10-01

    HPV-related (HPV+) oropharyngeal cancer (OPC) has a better prognosis compared to HPV unrelated (HPV-) OPC. This review summarizes and discusses several of the controversies regarding the management of HPV+ OPC, including the mechanism of its treatment sensitivity, modern surgical techniques, chemotherapy regimens, and treatment de-intensification protocols. We also discuss and reconsider potential adverse prognostic factors such as tumor EGFR expression, tumor hypoxia, and patient smoking history, as well as the significance of retropharyngeal adenopathy. Finally, we discuss elective nodal treatment of uninvolved lymph node stations. While this review does not exhaust all controversies related to the management of HPV+ OPC, it aims to highlight some of the most clinically relevant ones.

  19. [Oropharyngeal tumors of dogs--a clinical study of 79 cases].

    PubMed

    Hörsting, N; von Reiswitz, A; Wohlsein, P; Bullerdiek, J; Reimann, N; Nolte, I

    1998-01-01

    This study presents the data on incidence, TNM-classification and therapy outcome of 79 dogs with oropharyngeal tumors, which were admitted to the Clinic of Small Animals, Hannover School of Veterinary Medicine. 52 neoplasms were examined histologically. The most common tumors were malignant melanoma (n = 17), fibrosarcoma (n = 5), squamous cell carcinoma and peripheral odontogenic fibroma (n = 4). It could be determined that dogs treated by surgery, regardless of tumor type and type of surgery, had longer survival times than untreated dogs. With regard to survival time and the rate of local tumor recurrence, radical surgery (partial mandibulectomy/maxillectomy) led to good results in squamous cell carcinomas and invasive odontogenic tumors, but, keeping in mind the small number of cases, showed no advantage over conservative surgery in malignant melanomas, fibrosarcomas, neurofibrosarcomas and non invasive odontogenic tumors. It could be shown that the clinical staging of the patients was of prognostic relevance.

  20. A patient with Loeys-Dietz syndrome treated with chemoradiotherapy for an oropharyngeal carcinoma.

    PubMed

    Chan, Andrew K; Teoh, Daren; Matthews, Paul; Fresco, Lydia

    2013-09-17

    We present the first published case of a patient with Loeys-Dietz syndrome (LDS) who was treated with radical chemoradiotherapy for an oropharyngeal carcinoma. In view of this newly recognised connective tissue disease, the uncertainty of severe toxicity from chemoradiotherapy to treat a potentially curative cancer posed a management challenge. The patient was treated with chemoradiotherapy and remains well with no evidence of recurrence at 3 years. Furthermore, we have observed minimal late effects secondary to chemoradiotherapy at 3 years following the completion of treatment suggesting that the underlying pathogenesis of LDS may provide an interesting human model to further elucidate the complex interactions of transforming growth factor β1 (TGF-β1) and tissue fibrosis secondary to chemoradiotherapy. A review of LDS as well as the association of TGF-β1 expression and tissue fibrosis is presented.

  1. HPV vaccination to prevent oropharyngeal carcinoma: What can be learned from anogenital vaccination programs?

    PubMed

    Takes, Robert P; Wierzbicka, Małgorzata; D'Souza, Gypsyamber; Jackowska, Joanna; Silver, Carl E; Rodrigo, Juan P; Dikkers, Frederik G; Olsen, Kerry D; Rinaldo, Alessandra; Brakenhoff, Ruud H; Ferlito, Alfio

    2015-12-01

    Human papillomavirus (HPV) infections are well known causes of anogenital cancers. Recent studies show that HPV also plays a role in oropharyngeal cancer (OPC). A review on the role of HPV vaccination in the prevention of head and neck squamous cell carcinoma (HNSCC) with special emphasis on OPC was conducted and available vaccines and vaccination strategies in HNSCC and OPC are discussed. Prophylactic vaccination is known to be effective for prevention of anogenital HPV infection and precursor lesions in the cervix and anus. While the value of vaccination for prevention of OPC and possibly as an adjuvant treatment is still an open question, evidence to date supports the possibility that HPV vaccination may prove to be effective in reducing the incidence of this malignancy.

  2. Treatment de-escalation in HPV-positive oropharyngeal carcinoma: ongoing trials, critical issues and perspectives.

    PubMed

    Mirghani, H; Amen, F; Blanchard, P; Moreau, F; Guigay, J; Hartl, D M; Lacau St Guily, J

    2015-04-01

    Due to the generally poor prognosis of head and neck squamous cell carcinoma (HNSCC), treatment has been intensified, these last decades, leading to an increase of serious side effects. High-risk human papillomavirus (HR-HPV) infection has been recently etiologically linked to a subset of oropharyngeal squamous cell carcinoma (OPSCC), which is on the increase. These tumors are different, at the clinical and molecular level, when compared to tumors caused by traditional risk factors. Additionally, their prognosis is much more favorable which has led the medical community to consider new treatment strategies. Indeed, it is possible that less intensive treatment regimens could achieve similar efficacy with less toxicity and improved quality of life. Several clinical trials, investigating different ways to de-escalate treatment, are currently ongoing. In this article, we review these main approaches, discuss the rationale behind them and the issues raised by treatment de-escalation in HPV-positive OPSCC.

  3. Primary chemotherapy and radiation as a treatment strategy for HPV-positive oropharyngeal cancer.

    PubMed

    Lui, Vivian Wai Yan; Grandis, Jennifer Rubin

    2012-07-01

    The incidence of human papillomavirus-positive oropharyngeal cancer (HPV/OPSCC) is rapidly increasing, which will represent a major public health burden for decades to come. Although HPV/OPSCC is generally associated with a better prognosis than HPV-negative OPSCC, the survival rate of individuals with higher-risk clinical and pathologic features remains unchanged. Emerging evidence suggests that HPV/OPSCC is pathologically and molecularly distinct from HPV-negative OPSCC. This review focuses on summarizing treatment strategies for HPV/OPSCC by reviewing the peer-reviewed literature and noting ongoing and planned clinical trials in this disease. We also discuss the potential of designing targeted therapy based on the recent genomic findings of HPV/OPSCC.

  4. Alimentation impact of treatments of 254 oropharyngeal cancers (1998-2003).

    PubMed

    Buiret, Guillaume; Daveau, Clémentine; Landry, Guillaume; Colin, Carole; Pignat, Jean-Christian; Poupart, Marc

    2011-01-01

    Objective. To analyze the functional impact of the various possible treatments of oropharyngeal squamous cell carcinomas to find the main prognostic factors of dysphagia induced by these treatments. Patients. Clinical data from 254 patients treated for squamous cell carcinoma of the oropharynx between 1998 and 2003 were retrospectively analyzed. A multivariate model enabled us to evaluate the role of each potentially harmful factor on swallowing. Main Outcome Measures. The significant factors influencing the consumption of liquid, pasty, and normal food were the same: the initial T stage and the type of treatment. Conclusion. Whatever the possible and selected treatment was, the impact on the functional capacities, and thus, the quality of life of the patients was considerable. Even though we could not significantly demonstrate exclusive radiotherapy caused more long-term undesirable effects than surgery followed by radiotherapy, our daily practice has shown that we should favour the latter.

  5. Metastasis occurring eleven years after diagnosis of human papilloma virus-related oropharyngeal squamous cell carcinoma

    PubMed Central

    Ley, Jessica; Wildes, Tanya; El-Mofty, Samir; Adkins, Douglas

    2014-01-01

    Human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is associated with a favourable prognosis, although approximately 20–25% of patients ultimately develop recurrent cancer. Most disease recurrence events appear within 3 years; however, long-term follow-up of reported studies are limited, and the risk of late recurrence is unknown. We present a case report of a patient who developed distant metastases of HPV-related SCC 11 years after initial diagnosis and treatment of HPV-related OPSCC. Late disease recurrence may occur after initial diagnosis of HPV-related OPSCC. This observation has implications on the appropriate duration of follow-up and surveillance of these patients. PMID:25435908

  6. Improved Taxation Rate for Bin Packing Games

    NASA Astrophysics Data System (ADS)

    Kern, Walter; Qiu, Xian

    A cooperative bin packing game is a N-person game, where the player set N consists of k bins of capacity 1 each and n items of sizes a 1, ⋯ ,a n . The value of a coalition of players is defined to be the maximum total size of items in the coalition that can be packed into the bins of the coalition. We present an alternative proof for the non-emptiness of the 1/3-core for all bin packing games and show how to improve this bound ɛ= 1/3 (slightly). We conjecture that the true best possible value is ɛ= 1/7.

  7. Leadership in wolf, Canis lupus, packs

    USGS Publications Warehouse

    Mech, L. David

    2000-01-01

    I examine leadership in Wolf (Canis lupus) packs based on published observations and data gathered during summers from 1986 to 1998 studying a free-ranging pack of Wolves on Ellesmere Island that were habituated to my presence. The breeding male tended to initiate activities associated with foraging and travel, and the breeding female to initiate, and predominate in, pup care and protection. However, there was considerable overlap and interaction during these activities such that leadership could be considered a joint function. In packs with multiple breeders, quantitative information about leadership is needed.

  8. A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia.

    PubMed

    Vilardell, N; Rofes, L; Arreola, V; Speyer, R; Clavé, P

    2016-04-01

    Thickeners are used in post-stroke oropharyngeal dysphagia (OD) as a compensatory therapeutic strategy against aspirations. To compare the therapeutic effects of modified starch (MS) and xanthan gum (XG) thickeners on swallow safety and efficacy in chronic post-stroke OD patients using clinical and videofluoroscopic (VFS) assessment. Patients were studied by clinical assessment (volume-viscosity swallow test, V-VST) and VFS using 3 volumes (5, 10, 20 mL) and 3 viscosities (liquid, nectar and spoon thick), comparing MS and XG. We studied 122 patients (46MS, 76XG). (A) V-VST showed that both thickeners similarly improved safety of swallow. Prevalence of safe swallowing significantly increased with enhanced viscosity (P < 0.001 vs liquid), MS: 47.83 % at liquid, 84.93 % at nectar and 92.96 % at spoon thick; XG: 55.31 % at liquid, 77.78 % at nectar and 97.84 % at spoon thick. Patients on MS reported higher prevalence of pharyngeal residue at spoon-thick viscosities. (B) VFS: increasing bolus viscosity with either thickener increased prevalence of safe swallows (P < 0.001 vs liquid), MS: 30.25 % liquid, 61.07 % nectar and 92.64 % spoon thick; XG: 29.12 % liquid, 71.30 % nectar and 89.91 % spoon thick. Penetration-aspiration scale score was significantly reduced with increased viscosity with both thickeners. MS increased oral and pharyngeal residues at nectar and spoon-thick viscosities but XG did not. Timing of airway protection mechanisms and bolus velocity were not affected by either thickener. Increasing bolus viscosity with MS and XG thickeners strongly and similarly improved safety of swallow in chronic post-stroke OD by a compensatory mechanism; in contrast only MS thickeners increased oropharyngeal residue.

  9. Candidate Dosimetric Predictors of Long-Term Swallowing Dysfunction After Oropharyngeal Intensity-Modulated Radiotherapy

    SciTech Connect

    Schwartz, David L.; Hutcheson, Katherine; Barringer, Denise; Tucker, Susan L.; Kies, Merrill; Ang, K. Kian; Morrison, William H.; Rosenthal, David I.; Garden, Adam S.; Dong Lei; Lewin, Jan S.

    2010-12-01

    Purpose: To investigate long-term swallowing function in oropharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT), and to identify novel dose-limiting criteria predictive for dysphagia. Methods and Materials: Thirty-one patients with Stage IV oropharyngeal squamous carcinoma enrolled on a Phase II trial were prospectively evaluated by modified barium swallow studies at baseline, and 6, 12, and 24 months post-IMRT treatment. Candidate dysphagia-associated organs at risk were retrospectively contoured into original treatment plans. Twenty-one (68%) cases were base of tongue and 10 (32%) were tonsil. Stage distribution was T1 (12 patients), T2 (10), T3 (4), T4 (2), and TX (3), and N2 (24), N3 (5), and NX (2). Median age was 52.8 years (range, 42-78 years). Thirteen patients (42%) received concurrent chemotherapy during IMRT. Thirteen (42%) were former smokers. Mean dose to glottic larynx for the cohort was limited to 18 Gy (range, 6-39 Gy) by matching IMRT to conventional low-neck fields. Results: Dose-volume constraints (V30 < 65% and V35 < 35% for anterior oral cavity and V55 < 80% and V65 < 30% for high superior pharyngeal constrictors) predictive for objective swallowing dysfunction were identified by univariate and multivariate analyses. Aspiration and feeding tube dependence were observed in only 1 patient at 24 months. Conclusions: In the context of glottic laryngeal shielding, we describe candidate oral cavity and superior pharyngeal constrictor organs at risk and dose-volume constraints associated with preserved long-term swallowing function; these constraints are currently undergoing prospective validation. Strict protection of the glottic larynx via beam-split IMRT techniques promises to make chronic aspiration an uncommon outcome.

  10. Monitoring of microvascular free flaps following oropharyngeal reconstruction using infrared thermography: first clinical experiences.

    PubMed

    Just, Maren; Chalopin, Claire; Unger, Michael; Halama, Dirk; Neumuth, Thomas; Dietz, Andreas; Fischer, Miloš

    2016-09-01

    The aim of this study is to investigate static and dynamic infrared (IR) thermography for intra- and postoperative free-flap monitoring following oropharyngeal reconstruction. Sixteen patients with oropharyngeal reconstruction by free radial forearm flap were included in this prospective, clinical study (05/2013-08/2014). Prior ("intraop_pre") and following ("intraop_post") completion of the microvascular anastomoses, IR thermography was performed for intraoperative flap monitoring. Further IR images were acquired one day ("postop_1") and 10 days ("postop_10") after surgery for postoperative flap monitoring. Of the 16, 15 transferred free radial forearm flaps did not show any perfusion failure. A significant decreasing mean temperature difference (∆T: temperature difference between the flap surface and the surrounding tissue in Kelvin) was measured at all investigation points in comparison with the temperature difference at "intraop_pre" (mean values on all patients: ∆T intraop_pre = -2.64 K; ∆T intraop_post = -1.22 K, p < 0.0015; ∆T postop_1 = -0.54 K, p < 0.0001; ∆T postop_10 = -0.58 K, p < 0.0001). Intraoperative dynamic IR thermography showed typical pattern of non-pathological rewarming due to re-established flap perfusion after completion of the microvascular anastomoses. Static and dynamic IR thermography is a promising, objective method for intraoperative and postoperative monitoring of free-flap reconstructions in head and neck surgery and to detect perfusion failure, before macroscopic changes in the tissue surface are obvious. A lack of significant decrease of the temperature difference compared to surrounding tissue following completion of microvascular anastomoses and an atypical rewarming following a thermal challenge are suggestive of flap perfusion failure.

  11. Markers of squamocolumnar junction cells in normal tonsils and oropharyngeal cancer with and without HPV infection.

    PubMed

    Morbini, Patrizia; Capello, Gian Luca; Alberizzi, Paola; Benazzo, Marco; Paglino, Chiara; Comoli, Patrizia; Pedrazzoli, Paolo

    2015-07-01

    HPV infection has been identified recently as the causative agent of a subset of squamous cell carcinomas arising in oropharyngeal tonsils. Factors influencing the susceptibility of tonsillar epithelium to HPV-induced oncogenesis are far from being elucidated. A 5-protein signature including cytokeratin (CK)7, anterior gradient (AGR)2, cluster differentiation (CD)63, matrix metalloproteinase (MMP)7, and guanine deaminase (GDA) has recently been found to identify a residual embryonic cell population in the squamocolumnar (SC) junction of the cervix, susceptible to HPV infection, and cancers originating from these cells. The expression of SC junction markers was investigated with immunohistochemistry in normal tonsils and in oropharyngeal carcinomas (OPC) fully characterised for HPV. All markers were constantly expressed in the reticulated epithelial cells of the tonsillar crypts, with variable diffusion and intensity; in OPC, positivity was observed in 36,5%, 29,2%, 39%, 17%, and 25% of cases with respectively AGR2, CK7, GDA, CD63, and MMP7 antibodies. No OPC was positive for all markers; 6 were completely negative. AGR2 and CK7 showed significant association with tumor- and HPV-related parameters. AGR2 expression was associated with tumor origin in the tongue base (p=0.013); CK7 was associated with non-keratinising morphology (p=0.013). p16 tumor cell expression was associated with AGR2 (p=0.021); transcriptionally active HPV infection was associated with AGR2 and CK7 (p=0.024 and 0.043). Expression of SC junction markers in tonsillar crypt cells might be related to the embryological development of tonsillar structures; their partial association with HPV oncogenic infection could help to identify HPV-susceptible cells and related OPC.

  12. Patterns of Disease Recurrence Following Treatment of Oropharyngeal Cancer With Intensity Modulated Radiation Therapy

    SciTech Connect

    Garden, Adam S.; Dong, Lei; Morrison, William H.; Stugis, Erich M.; Glisson, Bonnie S.; Schwartz, David L.; Kies, Merill S.; Ang, K. Kian; Rosenthal, David I.

    2013-03-15

    Purpose: To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT). Methods and Materials: The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed. Results: The cohort consisted of 776 patients. One hundred fifty-nine patients (21%) were current smokers, 279 (36%) former smokers, and 337 (43%) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37%); T2, 288 (37%); T3, 113 (15%); T4, 87 (11%); N0, 88(12%); N1/x, 140 (18%); N2a, 101 (13%); N2b, 269 (35%); N2c, 122 (16%); and N3, 56 (7%); stage I, 18(2%); stage II, 40(5%); stage III, 150(19%); and stage IV, 568(74%). Seventy-one patients (10%) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84%, 90%, and 82%, respectively. Primary site recurrence developed in 7% of patients, and neck recurrence with primary site control in 3%. We could only identify 12 patients (2%) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease. Conclusions: Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.

  13. Fourier transform infrared for noninvasive optical diagnosis of oral, oropharyngeal, and laryngeal cancer.

    PubMed

    Menzies, Georgina E; Fox, Hannah R; Marnane, Conor; Pope, Laysan; Prabhu, Vinod; Winter, Stuart; Derrick, Anna V; Lewis, Paul D

    2014-01-01

    The 5-year survival rate for advanced head and neck cancers is 50%. There is currently no noninvasive method or effective screening procedure available to diagnose head and neck cancer at the earliest stages when it is still highly curable. This study aims to show how Fourier transform infrared (FTIR) spectroscopy could be used as a sensitive, noninvasive, low cost technique to diagnose head and neck cancer at an earlier stage and, thus, increase the likelihood of survival. Sputum samples were collected from 16 cases with oral or oropharyngeal cancer, 8 cases with laryngeal cancer patients and 15 normal controls. Cell pellets were produced from each of these samples and used to generate FTIR spectra within the 'biochemical fingerprint' wavenumber region of 1800 to 950 cm(-1). Discrimination between cancer and normal sputum was achieved using infrared wavenumbers 1650 cm(-1), 1550 cm(-1), and 1042 cm(-1) determined by robust feature selection. These 3 wavenumbers were used to develop potential models to discriminate both oropharyngeal and laryngeal cancer from normal control. In cancer cases, the absorbance levels for 1550 cm(-1) were increased relative to controls, whereas 1042 cm(-1) absorbance was decreased suggesting changes to protein and glycoprotein structure within sputa cells. This preliminary study shows potential for how FTIR could be developed into a simplistic diagnostic tool that could easily be implemented by a nonspecialist to diagnose and monitor head and neck cancer. The method could especially provide a means for detecting laryngeal cancer hidden from noninvasive observation.

  14. Psychometric characteristics of health-related quality-of-life questionnaires in oropharyngeal dysphagia.

    PubMed

    Timmerman, Angelique A; Speyer, Renée; Heijnen, Bas J; Klijn-Zwijnenberg, Iris R

    2014-04-01

    Dysphagia can have severe consequences for the patient's health, influencing health-related quality of life (HRQoL). Sound psychometric properties of HRQoL questionnaires are a precondition for assessing the impact of dysphagia, the focus of this study, resulting in recommendations for the appropriate use of these questionnaires in both clinical practice and research contexts. We performed a systematic review starting with a search for and retrieval of all full-text articles on the development of HRQoL questionnaires related to oropharyngeal dysphagia and/or their psychometric validation from the electronic databases PubMed and Embase published up to June 2011. Psychometric properties were judged according to quality criteria proposed for health status questionnaires. Eight questionnaires were included in this study. Four are aimed solely at HRQoL in oropharyngeal dysphagia: the deglutition handicap index (DHI), dysphagia handicap index (DHI'), M.D. Anderson Dysphagia Inventory (MDADI), and SWAL-QOL, while the EDGQ, EORTC QLQ-STO 22, EORTC QLQ-OG 25 and EORTC QLQ-H&N35 focus on other primary diseases resulting in dysphagia. The psychometric properties of the DHI, DHI', MDADI, and SWAL-QOL were evaluated. For appropriate applicability of HRQoL questionnaires, strong scores on the psychometric criteria face validity, criterion validity, and interpretability are prerequisites. The SWAL-QOL has the strongest ratings for these criteria, while the DHI' is the most easy to apply given its 25 items and the use of a uniform scoring format. For optimal use of HRQoL questionnaires in diverse settings, it is necessary to combine psychometric and utility approaches.

  15. Prognostic value of pre-therapy platelet elevation in oropharyngeal cancer patients treated with chemoradiation

    PubMed Central

    Shoultz-Henley, Sara; Garden, Adam S.; Mohamed, Abdallah S. R.; Sheu, Tommy; Kroll, Michael H.; Rosenthal, David I.; Gunn, G. Brandon; Hayes, Amos J.; French, Chloe; Eichelberger, Hillary; Kalpathy-Cramer, Jayashree; Smith, Blaine D.; Phan, Jack; Ayoub, Zeina; Lai, Stephen Y.; Pham, Brian; Kies, Merrill; Gold, Kathryn A.; Sturgis, Erich; Fuller, Clifton D.

    2016-01-01

    The purpose of this study is to evaluate potential associations between increased platelets and oncologic outcomes in oropharyngeal cancer patients receiving concurrent chemoradiation. 433 oropharyngeal cancer patients (OPC) treated with intensity modulated radiation therapy (IMRT) with concurrent chemotherapy between 2002 and 2012 were included under an approved IRB protocol. Complete blood count (CBC) data was extracted. Platelet and hemoglobin from the last phlebotomy (PLTpre-chemoRT, Hgbpre-chemoRT) before start of treatment were identified. Patients were risk-stratified using Dahlstrom-Sturgis criteria and were tested for association with survival and disease-control outcomes. Locoregional control (LRC), freedom from distant metastasis (FDM) and overall survival (OS) were decreased (p<0.03, p<0.04, and p<0.0001, respectively) for patients with PLT pre-chemoRT value of ≥350 × 109/L. Actuarial 5-year locoregional control (LRC) and FDM were 83% and 85% for non-thrombcythemic patients while patient with high platelets had 5-year LRC and FDM of 73% and 74%, respectively. Likewise, 5- year OS were better for patients with normal platelet counts by comparison (76% vs. 57%; p<0.0001). Comparison of univariate parametric models demonstrated PLTpre-chemoRT was better among tested models. Multivariate assessment demonstrated improved performance of models which included pre-therapy platelet indices. On Bayesian information criteria analysis, the optimal prognostic model was then used to develop nomograms predicting 3-, 5-, and 10-year OS. In conclusion, pre-treatment platelet elevation is a promising predictor of prognosis, and further work should be done to elucidate the utility of anti-platelets in modifying risk in OPC patients. PMID:26414107

  16. Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson's disease.

    PubMed

    Lee, Kyung Duck; Koo, Jung Hoi; Song, Sun Hong; Jo, Kwang Deog; Lee, Moon Kyu; Jang, Wooyoung

    2015-11-01

    Dysphagia is an important issue in the prognosis of Parkinson's disease (PD). Although several studies have reported that oropharyngeal dysphagia may be associated with cognitive dysfunction, the exact relationship between cortical function and swallowing function in PD patients is unclear. Therefore, we investigated the association between an electrophysiological marker of central cholinergic function, which reflected cognitive function, and swallowing function, as measured by videofluoroscopic studies (VFSS). We enrolled 29 early PD patients. Using the Swallowing Disturbance Questionnaire (SDQ), we divided the enrolled patients into two groups: PD with dysphagia and PD without dysphagia. The videofluoroscopic dysphagia scale (VDS) was applied to explore the nature of the dysphagia. To assess central cholinergic dysfunction, short latency afferent inhibition (SAI) was evaluated. We analyzed the relationship between central cholinergic dysfunction and oropharyngeal dysphagia and investigated the characteristics of the dysphagia. The SAI values were significantly different between the two groups. The comparison of each VFSS component between the PD with dysphagia group and the PD without dysphagia group showed statistical significance for most of the oral phase components and for a single pharyngeal phase component. The total score on the VDS was higher in the PD with dysphagia group than in the PD without dysphagia group. The Mini-Mental State Examination and SAI values showed significant correlations with the total score of the oral phase components. According to binary logistic regression analysis, SAI value independently contributed to the presence of dysphagia in PD patients. Our findings suggest that cholinergic dysfunction is associated with dysphagia in early PD and that an abnormal SAI value is a good biomarker for predicting the risk of dysphagia in PD patients.

  17. Ipsilateral Irradiation for Oral and Oropharyngeal Carcinoma Treated With Primary Surgery and Postoperative Radiotherapy

    SciTech Connect

    Vergeer, Marije R.; Doornaert, Patricia; Jonkman, Anja; Kaanders, Johannes H.A.M.; Ende, Piet L.A. van den; Jong, Martin A. de; Leemans, C. Rene; Langendijk, Johannes A.

    2010-11-01

    Purpose: The purpose was to evaluate the contralateral nodal control (CLNC) in postoperative patients with oral and oropharyngeal cancer treated with ipsilateral irradiation of the neck and primary site. Late radiation-induced morbidity was also evaluated. Methods and Materials: The study included 123 patients with well-lateralized squamous cell carcinomas treated with surgery and unilateral postoperative irradiation. Most patients had tumors of the gingiva (41%) or buccal mucosa (21%). The majority of patients underwent surgery of the ipsilateral neck (n = 102 [83%]). The N classification was N0 in 73 cases (59%), N1 or N2a in 23 (19%), and N2b in 27 cases (22%). Results: Contralateral metastases developed in 7 patients (6%). The 5-year actuarial CLNC was 92%. The number of lymph node metastases was the only significant prognostic factor with regard to CLNC. The 5-year CLNC was 99% in N0 cases, 88% in N1 or N2a cases, and 73% in N2b cases (p = 0.008). Borderline significance (p = 0.06) was found for extranodal spread. Successful salvage could be performed in 71% of patients with contralateral metastases. The prevalence of Grade 2 or higher xerostomia was 2.6% at 5 years. Conclusions: Selected patients with oral or oropharyngeal carcinoma treated with primary surgery and postoperative ipsilateral radiotherapy have a very high CLNC with a high probability of successful salvage in case of contralateral metastases. However, bilateral irradiation should be applied in case of multiple lymph node metastases in the ipsilateral neck, particularly in the presence of extranodal spread. The incidence of radiation-induced morbidity is considerably lower as observed after bilateral irradiation.

  18. No turnover in lens lipids for the entire human lifespan.

    PubMed

    Hughes, Jessica R; Levchenko, Vladimir A; Blanksby, Stephen J; Mitchell, Todd W; Williams, Alan; Truscott, Roger J W

    2015-03-11

    Lipids are critical to cellular function and it is generally accepted that lipid turnover is rapid and dysregulation in turnover results in disease (Dawidowicz 1987; Phillips et al., 2009; Liu et al., 2013). In this study, we present an intriguing counter-example by demonstrating that in the center of the human ocular lens, there is no lipid turnover in fiber cells during the entire human lifespan. This discovery, combined with prior demonstration of pronounced changes in the lens lipid composition over a lifetime (Hughes et al., 2012), suggests that some lipid classes break down in the body over several decades, whereas others are stable. Such substantial changes in lens cell membranes may play a role in the genesis of age-related eye disorders. Whether long-lived lipids are present in other tissues is not yet known, but this may prove to be important in understanding the development of age-related diseases.

  19. A Versatile, Automatic Chromatographic Column Packing Device

    ERIC Educational Resources Information Center

    Barry, Eugene F.; And Others

    1977-01-01

    Describes an inexpensive apparatus for packing liquid and gas chromatographic columns of high efficiency. Consists of stainless steel support struts, an Automat Getriebmotor, and an associated three-pulley system capable of 10, 30, and 300 rpm. (MLH)

  20. Contact breaking in frictionless granular packings

    NASA Astrophysics Data System (ADS)

    Wu, Qikai; Bertrand, Thibault; O'Hern, Corey; Shattuck, Mark

    We numerically study the breaking of interparticle contact networks in static granular packings of frictionless bidisperse disks that are subjected to vibrations. The packings are created using an isotropic compression protocol at different values of the total potential energy per particle Ep. We first add displacements along a single vibrational mode i of the dynamical matrix to a given packing and calculate the minimum amplitude Ai of the perturbation at which the first interparticle contact breaks. We then identify the minimum amplitude Amin over all perturbations along each mode and study the distribution of Amin from an ensemble of packings at each Ep. We then study two-, three-, and multi-mode excitations and determine the dependence of Amin on the number of modes that are included in the perturbation. W. M. Keck Foundation Science and Engineering Grant.

  1. Groundwater well with reactive filter pack

    DOEpatents

    Gilmore, T.J.; Holdren, G.R. Jr.; Kaplan, D.I.

    1998-09-08

    A method and apparatus are disclosed for the remediation of contaminated soil and ground water wherein a reactive pack material is added to the annular fill material utilized in standard well construction techniques. 3 figs.

  2. Groundwater well with reactive filter pack

    DOEpatents

    Gilmore, Tyler J.; Holdren, Jr., George R.; Kaplan, Daniel I.

    1998-01-01

    A method and apparatus for the remediation of contaminated soil and ground water wherein a reactive pack material is added to the annular fill material utilized in standard well construction techniques.

  3. Radiotherapy and Concomitant Intra-Arterial Docetaxel Combined With Systemic 5-Fluorouracil and Cisplatin for Oropharyngeal Cancer: A Preliminary Report-Improvement of Locoregional Control of Oropharyngeal Cancer

    SciTech Connect

    Oikawa, Hirobumi Nakamura, Ryuji; Nakasato, Tatsuhiko; Nishimura, Kohji; Sato, Hiroaki; Ehara, Shigeru

    2009-10-01

    Purpose: To confirm the advantage of chemoradiotherapy using intra-arterial docetaxel with intravenous cisplatin and 5-fluorouracil. Patients and Methods: A total of 26 oropharyngeal cancer patients (1, 2, 2, and 21 patients had Stage I, II, III, and IVa-IVc, respectively) were treated with two sessions of this chemoradiotherapy regimen. External beam radiotherapy was delivered using large portals that included the primary site and the regional lymph nodes initially (range, 40-41.4 Gy) and the metastatic lymph nodes later (60 or 72 Gy). All tumor-supplying branches of the carotid arteries were cannulated, and 40 mg/m{sup 2} docetaxel was individually infused on Day 1. The other systemic chemotherapy agents included 60 mg/m{sup 2} cisplatin on Day 2 and 500 mg/m{sup 2} 5-fluorouracil on Days 2-6. Results: The primary response of the tumor was complete in 21 (81%), partial in 4 (15%), and progressive in 1 patient. Grade 4 mucositis, leukopenia, and dermatitis was observed in 3, 2, and 1 patients, respectively. During a median follow-up of 10 months, the disease recurred at the primary site and at a distant organ in 2 (8%) and 3 (12%) patients, respectively. Three patients died because of cancer progression. Two patients (8%) with a partial response were compromised by lethal bleeding from the tumor bed or chemotherapeutic toxicity. The 3-year locoregional control rate and the 3-year overall survival rate was 73% and 77%, respectively. Conclusion: This method resulted in an excellent primary tumor response rate (96%) and moderate acute toxicity. Additional follow-up is required to ascertain the usefulness of this modality.

  4. Granular packing as model glass formers

    NASA Astrophysics Data System (ADS)

    Wang, Yujie

    2017-01-01

    Static granular packings are model hard-sphere glass formers. The nature of glass transition has remained a hotly debated issue. We review recent experimental progresses in using granular materials to study glass transitions. We focus on the growth of glass order with five-fold symmetry in granular packings and relate the findings to both geometric frustration and random first-order phase transition theories.

  5. Software For Nearly Optimal Packing Of Cargo

    NASA Technical Reports Server (NTRS)

    Fennel, Theron R.; Daughtrey, Rodney S.; Schwaab, Doug G.

    1994-01-01

    PACKMAN computer program used to find nearly optimal arrangements of cargo items in storage containers, subject to such multiple packing objectives as utilization of volumes of containers, utilization of containers up to limits on weights, and other considerations. Automatic packing algorithm employed attempts to find best positioning of cargo items in container, such that volume and weight capacity of container both utilized to maximum extent possible. Written in Common LISP.

  6. Phyllotaxis, disk packing, and Fibonacci numbers

    NASA Astrophysics Data System (ADS)

    Mughal, A.; Weaire, D.

    2017-02-01

    We consider the evolution of the packing of disks (representing the position of buds) that are introduced at the top of a surface which has the form of a growing stem. They migrate downwards, while conforming to three principles, applied locally: dense packing, homogeneity, and continuity. We show that spiral structures characterized by the widely observed Fibonacci sequence (1, 1, 2, 3, 5, 8, 13, ...), as well as related structures, occur naturally under such rules. Typical results are presented in an animation.

  7. Phyllotaxis, disk packing, and Fibonacci numbers.

    PubMed

    Mughal, A; Weaire, D

    2017-02-01

    We consider the evolution of the packing of disks (representing the position of buds) that are introduced at the top of a surface which has the form of a growing stem. They migrate downwards, while conforming to three principles, applied locally: dense packing, homogeneity, and continuity. We show that spiral structures characterized by the widely observed Fibonacci sequence (1, 1, 2, 3, 5, 8, 13, ...), as well as related structures, occur naturally under such rules. Typical results are presented in an animation.

  8. Experimental Visualization of Flows in Packed Beds of Spheres

    NASA Technical Reports Server (NTRS)

    Hendricks, R. C.; Lattime, S.; Braun, M. J.; Athavale, M. M.

    1997-01-01

    The flow experiment consisted of an oil tunnel, 76 x 76 mm in cross-section, packed with lucite spheres. The index of refraction of the working fluid and the spheres were matched such that the physical spheres invisible to the eye and camera. By seeding the oil and illuminating the packed bed with planar laser light sheet, aligned in the direction of the bulk flow, the system fluid dynamics becomes visible and the 2-D projection was recorded at right angles to the bulk flow. The planar light sheet was traversed from one side of the tunnel to the other providing a simulated 3-D image of the entire flow field. The boundary interface between the working fluid and the sphere rendered the sphere black permitting visualization of the exact locations of the circular interfaces in both the axial and transverse directions with direct visualization of the complex interstitial spaces between the spheres within the bed. Flows were observed near the surfaces of a plane and set of spheres as well as minor circles that appear with great circles and not always uniformly ordered. In addition to visualizing a very complex flow field, it was observed that flow channeling in the direction of the bulk flow occurs between sets of adjacent spheres. Still photographs and video recordings illustrating the flow phenomena will be presented.

  9. Packing of elastic wires in flexible shells

    NASA Astrophysics Data System (ADS)

    Vetter, R.; Wittel, F. K.; Herrmann, H. J.

    2015-11-01

    The packing problem of long thin filaments that are injected into confined spaces is of fundamental interest for physicists and biologists alike. How linear threads pack and coil is well known only for the ideal case of rigid containers, though. Here, we force long elastic rods into flexible spatial confinement borne by an elastic shell to examine under which conditions recently acquired knowledge on wire packing in rigid spheres breaks down. We find that unlike in rigid cavities, friction plays a key role by giving rise to the emergence of two distinct packing patterns. At low friction, the wire densely coils into an ordered toroidal bundle with semi-ellipsoidal cross-section, while at high friction, it packs into a highly disordered, hierarchic structure. These two morphologies are shown to be separated by a continuous phase transition. Our findings demonstrate the dramatic impact of friction and confinement elasticity on filamentous packing and might drive future research on such systems in physics, biology and even medical technology toward including these mutually interacting effects.

  10. Decontamination of pesticide packing using ionizing radiation

    NASA Astrophysics Data System (ADS)

    Duarte, C. L.; Mori, M. N.; Kodama, Yasko; Oikawa, H.; Sampa, M. H. O.

    2007-11-01

    The Brazilian agriculture activities have consumed about 288,000 tons of pesticides per year conditioned in about 107,000,000 packing with weight of approximately 23,000 tons. The discharge of empty plastic packing of pesticides can be an environmental concern causing problems to human health, animals, and plants if done without inspection and monitoring. The objective of this work is to study the ionizing radiation effect in the main pesticides used in Brazil for plastic packing decontamination. Among the commercial pesticides, chlorpyrifos has significant importance because of its wide distribution and extensive use and persistence. The radiation-induced degradation of chlorpyrifos in liquid samples and in polyethylene pack was studied by gamma radiolysis. Packing of high-density polyethylene (HDPE) three layer coextruded, named COEX, contaminated with chlorpyrifos, were irradiated using both a multipurpose Co-60 gamma irradiator and a gamma source with 5000 Ci total activity Gamma cell type. The chemical analysis of the chlorpyrifos was made using a gas chromatography associated to the Mass Spectrometry—GCMS from Shimadzu Model QP 5000. Gamma radiation was efficient for removing chlorpyrifos from the plastic packing, in all studied cases.

  11. Packed storage extension for ScaLAPACK

    SciTech Connect

    D'Azevedo, E.F.; Dongarra, J.J.

    1997-01-01

    The authors describe a new extension to ScaLAPACK for computing with symmetric (Hermitian) matrices stored in a packed form. The new code is built upon the ScaLAPACK routines for full dense storage for a high degree of software reuse. The original ScaLAPACK stores a symmetric matrix as a full matrix but accesses only the lower or upper triangular part. The new code enables more efficient use of memory by storing only the lower or upper triangular part of a symmetric (Hermitian) matrix. The packed storage scheme distributes the matrix by block column panels. Within each panel, the matrix is stored as a regular ScaLAPACK matrix. This storage arrangement simplifies the subroutine interface and code reuse. Routines PxPPTRF/PxPPTRS implement the Cholesky factorization and solution for symmetric (Hermitian) linear systems in packed storage. Routines PxSPEV/PxSPEVX (PxHPEV/PxHPEVX) implement the computation of eigenvalues and eigenvectors for symmetric (Hermitian) matrices in packed storage. Routines PxSPGVX (PxHPGVX) implement the expert driver for the generalized eigenvalue problem for symmetric (Hermitian) matrices in packed storage. Performance results on the Intel Paragon suggest that the packed storage scheme incurs only a small time overhead over the full storage scheme.

  12. No turnover in lens lipids for the entire human lifespan

    PubMed Central

    Hughes, Jessica R; Levchenko, Vladimir A; Blanksby, Stephen J; Mitchell, Todd W; Williams, Alan; Truscott, Roger JW

    2015-01-01

    Lipids are critical to cellular function and it is generally accepted that lipid turnover is rapid and dysregulation in turnover results in disease (Dawidowicz 1987; Phillips et al., 2009; Liu et al., 2013). In this study, we present an intriguing counter-example by demonstrating that in the center of the human ocular lens, there is no lipid turnover in fiber cells during the entire human lifespan. This discovery, combined with prior demonstration of pronounced changes in the lens lipid composition over a lifetime (Hughes et al., 2012), suggests that some lipid classes break down in the body over several decades, whereas others are stable. Such substantial changes in lens cell membranes may play a role in the genesis of age-related eye disorders. Whether long-lived lipids are present in other tissues is not yet known, but this may prove to be important in understanding the development of age-related diseases. DOI: http://dx.doi.org/10.7554/eLife.06003.001 PMID:25760082

  13. Spacecraft Conceptual Design for Returning Entire Near-Earth Asteroids

    NASA Technical Reports Server (NTRS)

    Brophy, John R.; Oleson, Steve

    2012-01-01

    In situ resource utilization (ISRU) in general, and asteroid mining in particular are ideas that have been around for a long time, and for good reason. It is clear that ultimately human exploration beyond low-Earth orbit will have to utilize the material resources available in space. Historically, the lack of sufficiently capable in-space transportation has been one of the key impediments to the harvesting of near-Earth asteroid resources. With the advent of high-power (or order 40 kW) solar electric propulsion systems, that impediment is being removed. High-power solar electric propulsion (SEP) would be enabling for the exploitation of asteroid resources. The design of a 40-kW end-of-life SEP system is presented that could rendezvous with, capture, and subsequently transport a 1,000-metric-ton near-Earth asteroid back to cislunar space. The conceptual spacecraft design was developed by the Collaborative Modeling for Parametric Assessment of Space Systems (COMPASS) team at the Glenn Research Center in collaboration with the Keck Institute for Space Studies (KISS) team assembled to investigate the feasibility of an asteroid retrieval mission. Returning such an object to cislunar space would enable astronaut crews to inspect, sample, dissect, and ultimately determine how to extract the desired materials from the asteroid. This process could jump-start the entire ISRU industry.

  14. An Exon-Capture System for the Entire Class Ophiuroidea

    PubMed Central

    Hugall, Andrew F.; O’Hara, Timothy D.; Hunjan, Sumitha; Nilsen, Roger; Moussalli, Adnan

    2016-01-01

    Exon-capture studies have typically been restricted to relatively shallow phylogenetic scales due primarily to hybridization constraints. Here, we present an exon-capture system for an entire class of marine invertebrates, the Ophiuroidea, built upon a phylogenetically diverse transcriptome foundation. The system captures approximately 90% of the 1,552 exon target, across all major lineages of the quarter-billion-year-old extant crown group. Key features of our system are 1) basing the target on an alignment of orthologous genes determined from 52 transcriptomes spanning the phylogenetic diversity and trimmed to remove anything difficult to capture, map, or align; 2) use of multiple artificial representatives based on ancestral state reconstructions rather than exemplars to improve capture and mapping of the target; 3) mapping reads to a multi-reference alignment; and 4) using patterns of site polymorphism to distinguish among paralogy, polyploidy, allelic differences, and sample contamination. The resulting data give a well-resolved tree (currently standing at 417 samples, 275,352 sites, 91% data-complete) that will transform our understanding of ophiuroid evolution and biogeography. PMID:26474846

  15. Recent advances in the entirely subcutaneous ICD System

    PubMed Central

    Reinke, Florian; Rath, Benjamin; Köbe, Julia; Eckardt, Lars

    2015-01-01

    The entirely subcutaneous implantable cardioverter defibrillator (S-ICD®) is emerging as a widely accepted therapeutic alternative to a conventional implantable cardioverter defibrillator (ICD) for prevention of sudden cardiac death. Essentially, the S-ICD® is promising in terms of reduction of electrode-related complications such as lead failure and infections. The conventional transvenous ICD has proven efficacy in various randomized clinical trials. The first results of S-ICD® studies confirm efficacy and safety in primary and secondary prevention as well. Owing to basic differences between S-ICD® and transvenous ICD—such as limited programming options and lack of pacing—not all patients are eligible for the S-ICD®. Concerns exist regarding inappropriate shocks due to T-wave oversensing, dimensions of the device, and shorter battery longevity. However, the S-ICD® should be considered a useful supplementation of ICD therapy in those patients at risk for sudden cardiac death who are not expected to require pacing due to bradycardia or antitachycardic pacing. PMID:26097719

  16. Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

    PubMed Central

    Omolehinwa, Temitope T.; Mupparapu, Mel

    2016-01-01

    In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain. PMID:28035308

  17. Engaging the Entire Care Cascade in Western Kenya

    PubMed Central

    Vedanthan, Rajesh; Kamano, Jemima H.; Bloomfield, Gerald S.; Manji, Imran; Pastakia, Sonak; Kimaiyo, Sylvester N.

    2015-01-01

    Cardiovascular disease (CVD) is the leading cause of death in the world, with a substantial health and economic burden confronted by low- and middle-income countries. In low-income countries such as Kenya, there exists a double burden of communicable and noncommunicable diseases, and the CVD profile includes many nonatherosclerotic entities. Socio-politico-economic realities present challenges to CVD prevention in Kenya, including poverty, low national spending on health, significant out-of-pocket health expenditures, and limited outpatient health insurance. In addition, the health infrastructure is characterized by insufficient human resources for health, medication stock-outs, and lack of facilities and equipment. Within this socio-politico-economic reality, contextually appropriate programs for CVD prevention need to be developed. We describe our experience from western Kenya, where we have engaged the entire care cascade across all levels of the health system, in order to improve access to high-quality, comprehensive, coordinated, and sustainable care for CVD and CVD risk factors. We report on several initiatives: 1) population-wide screening for hypertension and diabetes; 2) engagement of community resources and governance structures; 3) geographic decentralization of care services; 4) task redistribution to more efficiently use of available human resources for health; 5) ensuring a consistent supply of essential medicines; 6) improving physical infrastructure of rural health facilities; 7) developing an integrated health record; and 8) mobile health (mHealth) initiatives to provide clinical decision support and record-keeping functions. Although several challenges remain, there currently exists a critical window of opportunity to establish systems of care and prevention that can alter the trajectory of CVD in low-resource settings. PMID:26704963

  18. 46 CFR 160.043-6 - Marking and packing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Marking and packing. 160.043-6 Section 160.043-6... Marking and packing. (a) General. Jackknives specified by this subpart shall be stamped or otherwise... opener. (c) Packing. Each jackknife, complete with lanyard attached, shall be packed in a heat-sealed...

  19. 48 CFR 1846.672-6 - Packing list instructions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Packing list instructions... ADMINISTRATION CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports 1846.672-6 Packing list instructions. Copies of the MIRR may be used as a packing list. The packing list copies shall...

  20. 21 CFR 880.5760 - Chemical cold pack snakebite kit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Chemical cold pack snakebite kit. 880.5760 Section... Therapeutic Devices § 880.5760 Chemical cold pack snakebite kit. (a) Identification. A chemical cold pack snakebit kit is a device consisting of a chemical cold pack and tourniquet used for first-aid treatment...

  1. 21 CFR 880.5760 - Chemical cold pack snakebite kit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Chemical cold pack snakebite kit. 880.5760 Section... Therapeutic Devices § 880.5760 Chemical cold pack snakebite kit. (a) Identification. A chemical cold pack snakebit kit is a device consisting of a chemical cold pack and tourniquet used for first-aid treatment...

  2. 21 CFR 880.5760 - Chemical cold pack snakebite kit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Chemical cold pack snakebite kit. 880.5760 Section... Therapeutic Devices § 880.5760 Chemical cold pack snakebite kit. (a) Identification. A chemical cold pack snakebit kit is a device consisting of a chemical cold pack and tourniquet used for first-aid treatment...

  3. 21 CFR 880.5760 - Chemical cold pack snakebite kit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Chemical cold pack snakebite kit. 880.5760 Section... Therapeutic Devices § 880.5760 Chemical cold pack snakebite kit. (a) Identification. A chemical cold pack snakebit kit is a device consisting of a chemical cold pack and tourniquet used for first-aid treatment...

  4. 27 CFR 24.308 - Bottled or packed wine record.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Bottled or packed wine... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Records and Reports § 24.308 Bottled or packed wine record. A proprietor who bottles, packs, or receives bottled or packed beverage wine in bond...

  5. 27 CFR 24.308 - Bottled or packed wine record.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Bottled or packed wine... BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Records and Reports § 24.308 Bottled or packed wine record. A proprietor who bottles, packs, or receives bottled or packed beverage wine in bond...

  6. 27 CFR 24.308 - Bottled or packed wine record.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Bottled or packed wine... BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Records and Reports § 24.308 Bottled or packed wine record. A proprietor who bottles, packs, or receives bottled or packed beverage wine in bond...

  7. 27 CFR 24.308 - Bottled or packed wine record.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Bottled or packed wine... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Records and Reports § 24.308 Bottled or packed wine record. A proprietor who bottles, packs, or receives bottled or packed beverage wine in bond...

  8. 27 CFR 24.308 - Bottled or packed wine record.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Bottled or packed wine... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Records and Reports § 24.308 Bottled or packed wine record. A proprietor who bottles, packs, or receives bottled or packed beverage wine in bond...

  9. Longitudinal evaluation of restricted mouth opening (trismus) in patients following primary surgery for oral and oropharyngeal squamous cell carcinoma.

    PubMed

    Scott, B; D'Souza, J; Perinparajah, N; Lowe, D; Rogers, S N

    2011-03-01

    Trismus is a serious problem for some patients after oral and oropharyngeal cancer, and it has a detrimental impact on quality of life and function. We know of few published papers that include preoperative assessment in reports on the longitudinal outcomes of mouth opening after oral and oropharyngeal surgery. We prospectively measured mouth opening in patients who had primary surgery for oral and oropharyngeal cancer from baseline to six months to find out the characteristics at baseline and at discharge of those who develop trismus at six months. Ninety-eight patients were eligible between February 2007 and March 2008, and 64 (65%) were recruited into the study. The range of mouth opening was measured on three occasions: before operation, on the ward before discharge from hospital, and at follow-up six months after operation. Using a criterion of 35 mm or less as an indication of trismus, 30% (19/63) had trismus before operation, 65% (37/57) at hospital discharge, and 54% (26/48) at six month follow-up. Patients at high risk of trismus were those with T stage 3 or 4 cancers who required free flap reconstruction and adjuvant radiotherapy; radiotherapy was the most significant factor at six months. Trismus at discharge was a prediction of trismus at six months. Interventions such as spatulas or a passive jaw mobiliser should be targeted at patients at high risk early in the postoperative phase. The efficacy of such interventions needs further research.

  10. Evaluation of an Accelerated Chemoradiotherapy Protocol for Oropharyngeal Squamous Cell Carcinoma in 5 Cats and 3 Dogs.

    PubMed

    Rejec, Ana; Benoit, Jerome; Tutt, Cedric; Crossley, David; Butinar, Janos; Hren, Natasa Ihan

    2015-01-01

    Accelerated radiation therapy protocols address the specific biology of aggressive oropharyngeal squamous cell carcinoma and this approach was applied in 5 feline and 3 canine oropharyngeal squamous cell carcinoma patients where surgery was not possible (4/5 feline and 2/3 canine cases) or was declined (1/5 feline and 1/3 canine cases). A protocol using 14 fractions of 3.5 Gy over 9-days, combined with carboplatin chemotherapy as a radiosensitiser (total dose 180 mg/m2 in feline and 300 mg/m2 in canine cases) resulted in a complete tumor response in most cases (4/5 feline and 3/3 canine cases) with acceptable acute and long-term side effects. Results achieved in feline cases correspond with published data where these specific radiotherapy protocols were employed. A complete response and long-term survival (> 2-years) was achieved in all canine patients. Although no standardized chemoradiotherapy protocols currently exist, this therapeutic approach can be a useful addition for the management of oropharyngeal squamous cell carcinoma of cats and dogs when the goals of treatment include maximizing tumor control while maintaining function and quality of life.

  11. Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

    PubMed Central

    Hirata, Gisela Carmona; Santos, Rosane Sampaio

    2012-01-01

    Summary Introduction: There are an estimated 30,000–40,000 new cases of cerebral palsy per year in Brazil. Motor disorders caused by cerebral palsy can lead to dysphagia as they may alter the preparatory, oral, pharyngeal, and esophageal phases. Aim: To identify existing rehabilitation methods of swallowing disorders in cerebral palsy, with emphasis on the pursuit of research using the Bobath concept, the Castillo Morales concept, oral sensorimotor therapy, and continuing education. Summary of the findings: We performed a systematic review of the medical and speech therapy literature on the rehabilitation of oropharyngeal dysphagia in children with cerebral palsy spanning 1977–2010 and from all languages and nations. Among the 310 articles retrieved, only 22 (7.09%) addressed therapeutic rehabilitation of oropharyngeal dysphagia in children with cerebral palsy. Of the 22 reports, 12 (54.5%) were from Canada, 3 (13.6%) were from Japan, 2 (9%) were from Brazil, 2 (9%) were from Germany, 1 (4.5%) was from the USA, 1 (4.5%) was from the United Kingdom, and 1 (4.5%) was from Poland. Of these reports, 63.6% used oral sensorimotor therapy as a therapeutic method, 36.3% reported continuing education as a therapeutic approach, and only 18.1% and 9% used the Bobath concept and Castillo Morales concept, respectively. Conclusion: Even with a constantly increasing cerebral palsy population, few studies include (re)habilitation in the treatment of oropharyngeal dysphagia in these children. PMID:25991964

  12. Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke.

    PubMed

    Hägg, Mary; Tibbling, Lita

    2016-07-01

    Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro® screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.

  13. Quasistatic packings of droplets in flat microfluidic channels

    NASA Astrophysics Data System (ADS)

    Kadivar, Erfan

    2016-02-01

    As observed in recent experiments, monodisperse droplets self-assemble spontaneously in different ordered packings. In this work, we present a numerical study of the droplet packings in the flat rectangular microfluidic channels. Employing the boundary element method, we numerically solve the Stokes equation in two-dimension and investigate the appearance of droplet packing and transition between one and two-row packings of monodisperse emulsion droplets. By calculating packing force applied on the droplet interface, we investigate the effect of flow rate, droplet size, and surface tension on the packing configurations of droplets and transition between different topological packings.

  14. [Research progress on the management of no packing after septoplasty].

    PubMed

    Lu, Sheng; Zhang, Longcheng; Li, Jieen

    2016-01-01

    Packing the nose after septoplasty is common practice. The use of postoperative packing has been proposed to reduce the dead space between the subperichondrial flaps and minimize postoperative complications such as hemorrhage, septal hematoma, and formation of synechiae. Additionally, postoperative packing is thought to stabilize the remaining cartilaginous septum and minimize persistence or recurrence of septal deviation. Despite these theoretic advantages, evidence to support the use of postoperative packing is lacking. Additionally, nasal packing is not an innocuous procedure. The use of nasal packing actually cause these complications such as postop- erative pain, mucosal injury, bleeding, worsening of breathing due to sleep disorders, and postoperative infections. Routine use of anterior nasal packing after septoplasty should be challenged for not presenting proven benefit. As alternatives to traditional packing, septal suturing, septal stapler and fibrin glue have been used recently. The purpose of this article is to summarize the progress of traditional packing to no packing after septoplasty.

  15. Study of the Unequal Spheres Packing Problem:

    NASA Astrophysics Data System (ADS)

    Li, S. P.; Ng, Ka-Lok

    We employ the Monte Carlo method to study a constrained optimization problem — packing hard spheres with unequal radii (r2 > r1) into a 3D bounded region and discuss its connection with the Gamma Knife radiosurgery treatment planning. Selection of the best fit solution is based on the Boltzmann factor, e-ΔE/T, which allows us to search for the global optimal solution. As an illustration we determined the least number (≤15) of packed spheres that will occupy the largest volume for three different hypothetical tumor sizes (4115, 10 000 and 36 000 voxels). For the bounded regions and the sizes of the packed spheres that we studied here, the optimal volume packing ratio ranges from 41.3 to 48.7%. From our study, using a lower r2/r1 ratio is more desirable due to the ≤15 radiation shots constraint. The optimal volume packing ratio can be obtained within a relative short CPU computing time and could provide a good starting point for the radiosurgery treatment planning.

  16. Coalescence preference in dense packing of bubbles

    NASA Astrophysics Data System (ADS)

    Kim, Yeseul; Gim, Bopil; Gim, Bopil; Weon, Byung Mook

    2015-11-01

    Coalescence preference is the tendency that a merged bubble from the contact of two original bubbles (parent) tends to be near to the bigger parent. Here, we show that the coalescence preference can be blocked by densely packing of neighbor bubbles. We use high-speed high-resolution X-ray microscopy to clearly visualize individual coalescence phenomenon which occurs in micro scale seconds and inside dense packing of microbubbles with a local packing fraction of ~40%. Previous theory and experimental evidence predict a power of -5 between the relative coalescence position and the parent size. However, our new observation for coalescence preference in densely packed microbubbles shows a different power of -2. We believe that this result may be important to understand coalescence dynamics in dense packing of soft matter. This work (NRF-2013R1A22A04008115) was supported by Mid-career Researcher Program through NRF grant funded by the MEST and also was supported by Ministry of Science, ICT and Future Planning (2009-0082580) and by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry and Education, Science and Technology (NRF-2012R1A6A3A04039257).

  17. Molecular predictors of locoregional and distant metastases in oropharyngeal squamous cell carcinoma

    PubMed Central

    2013-01-01

    Background The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing due to fundamental changes in oncogenesis related to effects of the human papilomavirus (HPV). Virally-mediated tumours behave and respond to treatment differently than their classic, carcinogenically-mediated counterparts despite similar stage and grade of disease. This difference in behaviour has lead to investigation of etiologies of OPSCC at the molecular level. Molecular biomarkers offer potential insight into the behaviour of OPSCC. Identifying a subset of patients that are more likely to have recurrence and distant metastasis is valuable for prognostication and treatment planning. There is limited information regarding the profiles of these biomarkers in locoregional and distant metastases in OPSCC. Objective This study was designed to identify biomarker profiles predictive of locoregional and distant metastases and recurrence in OPSCC. Methods Cross-sectional study of a prospectively-collected oropharyngeal tumour database was undertaken. All patients with OPSCC presenting to the University of Alberta Hospital from 2002-2009 were included in the study. Data collection from the Alberta Cancer Registry, including demographics, nodal status, distant metastases, treatment, recurrence, and survival, was undertaken. Tissue micro-arrays (TMAs) were constructed for each tumour specimen using triplicate cores (0.6mm) of formalin-fixed, paraffin-embedded (FFPE) pre-treatment tumour tissue. TMAs were processed using immunohistochemistry for p16, EGFR, Ki67, p53, and Bcl-XL. Positivity for each biomarker was determined using quantified AQUAnalysis ® scores on histoplots. Multivariate statistics were utilized to assess the relationship between each biomarker and locoregional and distant metastases, as well as recurrence-free survival (RFS). Results High expression of p16 (p=0.000) and Bcl-XL (p=0.039) independently demonstrated a significant association with nodal disease at

  18. Deterioration of organic packing materials commonly used in air biofiltration: effect of VOC-packing interactions.

    PubMed

    Lebrero, Raquel; Estrada, José M; Muñoz, Raúl; Quijano, Guillermo

    2014-05-01

    The abiotic deterioration of three conventional organic packing materials used in biofiltration (compost, wood bark and Macadamia nutshells) caused by their interaction with toluene (used as a model volatile organic compound) was here studied. The deterioration of the materials was evaluated in terms of structural damage, release of co-substrates and increase of the packing biodegradability. After 21 days of exposure to toluene, all packing materials released co-substrates able to support microbial growth, which were not released by the control materials not exposed to toluene. Likewise, the exposure to toluene increased the packing material biodegradability by 26% in wood bark, 20% in compost and 17% in Macadamia nutshells. Finally, scanning electron microscopy analysis confirmed the deterioration in the structure of the packing materials evaluated due to the exposure to toluene, Macadamia nutshells being the material with the highest resistance to volatile organic compound attack.

  19. Application of new packing material in endoscopic nasal surgery

    PubMed Central

    Yin, Haiying; Han, Fei; Cui, Zhaoyang

    2015-01-01

    Objective: To show the efficacy and comfort of pneumatic bag packing after the endoscopic nasal surgery. Pneumatic bag packing may be recommendable in terms of comfort and efficacy after endoscopic nasal surgery. Significant findings: There were statistical significant differences between the pneumatic bag packing and the expansive sponge packing regarding subjective symptoms and objective findings after surgery. Conclusions: Pneumatic bag packing may be recommendable in terms of comfort and efficacy after endoscopic nasal surgery. PMID:25785173

  20. Streptococcus pneumoniae oropharyngeal colonization in school-age children and adolescents with type 1 diabetes mellitus: Impact of the heptavalent pneumococcal conjugate vaccine.

    PubMed

    Principi, Nicola; Iughetti, Lorenzo; Cappa, Marco; Maffeis, Claudio; Chiarelli, Franco; Bona, Gianni; Gambino, Monia; Ruggiero, Luca; Patianna, Viviana; Matteoli, Maria Cristina; Marigliano, Marco; Cipriano, Paola; Parlamento, Silvia; Esposito, Susanna

    2016-01-01

    This study evaluated Streptococcus pneumoniae colonization in children and adolescents with type 1 diabetes mellitus (DM1) to investigate the theoretical risk of invasive pneumococcal disease (IPD) in these patients and the potential protective efficacy of pneumococcal conjugate vaccines (PCVs). An oropharyngeal swab was obtained from 299 patients aged 6-17 y with DM1 who were enrolled during routine clinical visits. DNA from swabs was analyzed for S. pneumoniae using real-time polymerase chain reaction. S. pneumoniae was identified in the swabs of 148 subjects (49.8%). Colonization was strictly age-related and declined significantly in the group aged ≥15 years (odds ratio [OR] 0.28; 95% confidence interval [CI], 0.14-0.57). Carriage was also significantly influenced by sex (lower in females: OR 0.56; 95% CI, 0.35-0.91), ethnicity (less common among non-Caucasians: OR 0.34; 95% CI, 0.13-0.89), parental smoking habit (more frequent among children with at least one smoker between parents: OR 1.76; 95% CI, 0.90-2.07), and the administration of antibiotic therapy in the previous 3 months (less frequent among patients who received antibiotics: OR 0.21; 95% CI, 0.07-0.62). Multivariate analyses of the entire study population showed no association between carriage and PCV7 vaccination status. Serotypes 19F, 9V, and 4 were the most frequently identified serotypes. In conclusion, school-age children and adolescents with DM1 are frequently colonized by S. pneumoniae, and protection against pneumococcal carriage following infant and toddler vaccination was not effective after several years. Together with the need to increase vaccine uptake in all the children aged <2 years, these results suggest that PCV booster doses are needed in DM1 patients to maintain the protection offered by these vaccinations.

  1. Streptococcus pneumoniae oropharyngeal colonization in school-age children and adolescents with type 1 diabetes mellitus: Impact of the heptavalent pneumococcal conjugate vaccine

    PubMed Central

    Principi, Nicola; Iughetti, Lorenzo; Cappa, Marco; Maffeis, Claudio; Chiarelli, Franco; Bona, Gianni; Gambino, Monia; Ruggiero, Luca; Patianna, Viviana; Matteoli, Maria Cristina; Marigliano, Marco; Cipriano, Paola; Parlamento, Silvia; Esposito, Susanna

    2016-01-01

    This study evaluated Streptococcus pneumoniae colonization in children and adolescents with type 1 diabetes mellitus (DM1) to investigate the theoretical risk of invasive pneumococcal disease (IPD) in these patients and the potential protective efficacy of pneumococcal conjugate vaccines (PCVs). An oropharyngeal swab was obtained from 299 patients aged 6–17 y with DM1 who were enrolled during routine clinical visits. DNA from swabs was analyzed for S. pneumoniae using real-time polymerase chain reaction. S. pneumoniae was identified in the swabs of 148 subjects (49.8%). Colonization was strictly age-related and declined significantly in the group aged ≥15 years (odds ratio [OR] 0.28; 95% confidence interval [CI], 0.14–0.57). Carriage was also significantly influenced by sex (lower in females: OR 0.56; 95% CI, 0.35–0.91), ethnicity (less common among non-Caucasians: OR 0.34; 95% CI, 0.13–0.89), parental smoking habit (more frequent among children with at least one smoker between parents: OR 1.76; 95% CI, 0.90–2.07), and the administration of antibiotic therapy in the previous 3 months (less frequent among patients who received antibiotics: OR 0.21; 95% CI, 0.07–0.62). Multivariate analyses of the entire study population showed no association between carriage and PCV7 vaccination status. Serotypes 19F, 9V, and 4 were the most frequently identified serotypes. In conclusion, school-age children and adolescents with DM1 are frequently colonized by S. pneumoniae, and protection against pneumococcal carriage following infant and toddler vaccination was not effective after several years. Together with the need to increase vaccine uptake in all the children aged <2 years, these results suggest that PCV booster doses are needed in DM1 patients to maintain the protection offered by these vaccinations. PMID:26575615

  2. Ankle and Thigh Skin Surface Temperature Changes With Repeated Ice Pack Application

    PubMed Central

    Palmer, Janice E.; Knight, Kenneth L.

    1996-01-01

    Objective: Most of the research on cold applications has been performed on nonexercising supine subjects during a single cold pack application. Most athletic injuries occur during exercise, which increases skin temperature. Exercise before ice application will also increase ankle skin temperature during the rewarming phase. The purpose of this study was to examine the effects of activity on subsequent ice pack applications and rewarming using standard immediate care procedures. Design and Setting: Three experimental conditions (20-, 30-, and 40-minute ice pack applications) were applied to 12 subjects in a repeated measures design. Subjects rode a bicycle ergometer for 15 minutes before ice application to the ankle and opposite thigh, and were active (walking with crutches, simulated showering and dressing) for 20 minutes following application. Subjects rested with the limb elevated for an additional 40 minutes. Ice packs were then reapplied for the appropriate time (20, 30, or 40 minutes) followed by 60 minutes of rest with the limb elevated. Subjects: Twelve (8 males, 4 females) college-aged volunteers. Only subjects with good-to-high fitness levels were accepted for this study. Measurements: Ankle skin, thigh skin, and atmospheric temperatures were measured every minute using an Isothermex (Columbus Instruments, Columbus, OH). Results: Thigh temperature changes during the first ice application were greater during the 30- and 40-minute conditions than the 20-minute condition. Ankle and thigh temperature changes during the first ice application and rewarming, and for the entire trial were greater during the 40-minute condition than the 20-or 30-minute conditions. Throughout the first ice application and rewarming, and the entire trial, thigh temperature changes were greater during the 30-minute condition than the 20-minute condition. Conclusions: During immediate care procedures following injury, ice packs should be reapplied immediately following showering

  3. Method for packed column separations and purifications

    DOEpatents

    Holman, David A.; Bruckner-Lea, Cynthia J.; Brockman, Fred J.; Chandler, Darrell P.

    2006-08-15

    The invention encompasses a method of packing and unpacking a column chamber. A mixture of a fluid and a matrix material are introduced through a column chamber inlet so that the matrix material is packed within a column chamber to form a packed column. The column chamber having the column chamber inlet or first port for receiving the mixture further has an outlet port and an actuator port. The outlet port is partially closed for capturing the matrix material and permitting the fluid to flow therepast by rotating relative one to the other of a rod placed in the actuator port. Further rotation relative one to the other of the rod and the column chamber opens the outlet and permits the matrix material and the fluid to flow therethrough thereby unpacking the matrix material from the column chamber.

  4. Safety considerations for fabricating lithium battery packs

    NASA Astrophysics Data System (ADS)

    Ciesla, J. J.

    1986-09-01

    Lithium cell safety is a major issue with both manufacturers and end users. Most manufacturers have taken great strides to develop the safest cells possible while still maintaining performance characteristics. The combining of lithium cells for higher voltages, currents, and capacities requires the fabricator of lithium battery packs to be knowledgable about the specific electrochemical system being used. Relatively high rate, spirally wound (large surface area) sulfur oxychloride cells systems, such as Li/Thionyl or Sulfuryl chloride are considered. Prior to the start of a design of a battery pack, a review of the characterization studies for the cells should be conducted. The approach for fabricating a battery pack might vary with cell size.

  5. Safety considerations for fabricating lithium battery packs

    NASA Technical Reports Server (NTRS)

    Ciesla, J. J.

    1986-01-01

    Lithium cell safety is a major issue with both manufacturers and end users. Most manufacturers have taken great strides to develop the safest cells possible while still maintaining performance characteristics. The combining of lithium cells for higher voltages, currents, and capacities requires the fabricator of lithium battery packs to be knowledgable about the specific electrochemical system being used. Relatively high rate, spirally wound (large surface area) sulfur oxychloride cells systems, such as Li/Thionyl or Sulfuryl chloride are considered. Prior to the start of a design of a battery pack, a review of the characterization studies for the cells should be conducted. The approach for fabricating a battery pack might vary with cell size.

  6. Method for staged placement of gravel packs

    SciTech Connect

    Davis, B.E.

    1990-04-10

    This patent describes a process for gravel packing in a wellbore annulus including a well screen and perforations extending into a producing formation. It comprises: providing an initial gravel pack carrier fluid at below formation fracturing pressure and having a gravel loading of up to about five pounds gravel per gallon of carrier fluid within the wellbore annulus, providing additional amounts of carrier fluid at below fracturing pressure and having gravel loadings which are successively higher than a preceding and the initial gravel loading to the wellbore annulus and continually increasing the gravel loading in the carrier fluid to a range of ten to twenty pounds of gravel per gallon of carrier fluid until the gravel packing of the wellbore annulus is completed.

  7. Plankton filtration with compressible crumb rubber packs.

    PubMed

    Karanikola, Vasiliki; Ngo, Anh T; Valdes, Julio R

    2011-01-01

    The experiments described provide insight into the feasibility of using compressible particulate packs to filter live plankton. The pore constriction sizes are controlled by subjecting the filter pack to isotropic confinement, thereby allowing for: (1) enhanced filtration upon confinement and (2) enhanced unclogging upon relaxation. Results show that filtration efficiency increases with increasing confinement; however, complete plankton retention is difficult to attain due to the plankton's ability to pass through pore constrictions that are smaller than the plankton size. The results are anticipated to offer potential benefits to ballast treatment and aquatic filtration operations.

  8. Method of gravel packing a subterranean well

    SciTech Connect

    Not Available

    1991-11-05

    This patent describes a method of gravel packing a well bore penetrating a subterranean formation. It comprises blocking a first group of apertures in a liner with an immobile gel; positioning the liner within the well bore thereby defining a first annulus between the liner and the well bore; transporting a slurry comprised of gravel suspended in a fluid into the first annulus, the fluid flowing through a second group of apertures in the liner while the gravel is deposited within the first annulus to form a gravel pack; and thereafter removing substantially all of the gel from the first group of apertures.

  9. Imaging of drug smuggling by body packing.

    PubMed

    Sica, Giacomo; Guida, Franco; Bocchini, Giorgio; Iaselli, Francesco; Iadevito, Isabella; Scaglione, Mariano

    2015-02-01

    Body packing, pushing, and stuffing are hazardous practices with complex medicolegal and social implications. A radiologist plays both a social and a medicolegal role in their assessment, and it should not be limited only to the identification of the packages but must also provide accurate information about their number and their exact location so as to prevent any package remains in the body packer. Radiologists must also be able to recognize the complications associated with these risky practices. Imaging assessment of body packing is performed essentially through plain abdominal X-ray and computed tomography scans. Ultrasound and magnetic resonance imaging, although with some advantages, actually have a limited use.

  10. Current Technologies and Recent Developments for Screening of HPV-Associated Cervical and Oropharyngeal Cancers

    PubMed Central

    Shah, Sunny S.; Senapati, Satyajyoti; Klacsmann, Flora; Miller, Daniel L.; Johnson, Jeff J.; Chang, Hsueh-Chia; Stack, M. Sharon

    2016-01-01

    Mucosal infection by the human papillomavirus (HPV) is responsible for a growing number of malignancies, predominantly represented by cervical cancer and oropharyngeal squamous cell carcinoma. Because of the prevalence of the virus, persistence of infection, and long latency period, novel and low-cost methods are needed for effective population level screening and monitoring. We review established methods for screening of cervical and oral cancer as well as commercially-available techniques for detection of HPV DNA. We then describe the ongoing development of microfluidic nucleic acid-based biosensors to evaluate circulating host microRNAs that are produced in response to an oncogenic HPV infection. The goal is to develop an ideal screening platform that is low-cost, portable, and easy to use, with appropriate signal stability, sensitivity and specificity. Advances in technologies for sample lysis, pre-treatment and concentration, and multiplexed nucleic acid detection are provided. Continued development of these devices provides opportunities for cancer screening in low resource settings, for point-of-care diagnostics and self-screening, and for monitoring response to vaccination or surgical treatment. PMID:27618102

  11. Coordination of oro-pharyngeal food transport during chewing and respiratory phase.

    PubMed

    Matsuo, Koichiro; Palmer, Jeffrey B

    2015-04-01

    When eating solid food, the tongue intermittently propels triturated food to the oropharynx or valleculae, where a bolus accumulates before swallowing. The tongue motion during this food transport (stage II transport, STII) is distinctly different from that during chewing, and is more similar to the oral propulsive stage of swallowing. Therefore, we tested the hypothesis that the onset of STII cycles was more likely to occur during expiration than inspiration. Videofluorography was recorded in a lateral projection while 10 healthy subjects ate solid foods. Respiration was concurrently monitored with plethysmography. Jaw motion cycles were classified as masticatory or swallowing. Masticatory cycles were further divided into chewing cycles and STII cycles. STII cycles were defined as those with bolus propulsion through the fauces by the tongue squeezing against the palate (without swallowing). Overall, 28% (62/223) of chewing cycles were initiated during inspiration, compared with only 12% (9/76) of STII cycles in this phase. The fraction of masticatory cycles occurring during inspiration was significantly smaller for STII cycles than for chewing cycles (Odds Ratio: 0.37 [95% CI: 0.17-0.78], p=0.01). All 36 swallowing cycles had onset during expiration. Our findings reveal that stage II oro-pharyngeal food transport is linked to expiration, as is the oral propulsive stage of swallowing. This suggests a similarity in the neural control of these two feeding behaviors.

  12. Genetic Mutation and Exosome Signature of Human Papilloma Virus Associated Oropharyngeal Cancer

    PubMed Central

    Kannan, Anbarasu; Hertweck, Kate L.; Philley, Julie V.; Wells, Robert B.; Dasgupta, Santanu

    2017-01-01

    Human papilloma virus-16 (HPV-16) associated oropharyngeal cancer (HPVOPC) is increasing alarmingly in the United States. We performed whole genome sequencing of a 44 year old, male HPVOPC subject diagnosed with moderately differentiated tonsillar carcinoma. We identified new somatic mutation in MUC16 (A.k.a. CA-125), MUC12, MUC4, MUC6, MUC2, SIRPA, HLA-DRB1, HLA-A and HLA-B molecules. Increased protein expression of MUC16, SIRPA and decreased expression of HLA-DRB1 was further demonstrated in this HPVOPC subject and an additional set of 15 HPVOPC cases. Copy number gain (3 copies) was also observed for MUC2, MUC4, MUC6 and SIRPA. Enhanced expression of MUC16, SIRPA and HPV-16-E7 protein was detectable in the circulating exosomes of numerous HPVOPC subjects. Treatment of non-tumorigenic mammary epithelial cells with exosomes derived from aggressive HPVOPC cells harboring MUC16, SIRPA and HPV-16-E7 proteins augmented invasion and induced epithelial to mesenchymal transition (EMT) accompanied by an increased expression ratio of the EMT markers Vimentin/E-cadherin. Exosome based screening of key HPVOPC associated molecules could be beneficial for early cancer diagnosis, monitoring and surveillance. PMID:28383029

  13. Management of the node-positive neck in the patient with HPV-associated oropharyngeal cancer

    PubMed Central

    Garden, Adam S.; Gunn, Gary B.; Hessel, Amy; Beadle, Beth M.; Ahmed, Salmaan; El-naggar, Adel; Fuller, Clifton D.; Byers, Lauren A.; Phan, Jack; Frank, Steven J.; Morrison, William H.; Kies, Merill S.; Rosenthal, David I.; Sturgis, Erich M.

    2014-01-01

    Background The goal of this study was to assess the rates of recurrence in the neck for node-positive patients with HPV-associated oropharynx cancer treated with definitive radiation (with or without chemotherapy). Methods This is a single institutional retrospective study. Methodology included database search, and statistical testing including frequency analysis, Kaplan-Meier tests, and comparative tests including chi-square, logistic regression and log-rank. Results The cohort consisted of 401 node-positive patients irradiated between 2006 – June 2012. Three hundred eighty eight patients had CT restaging, and 251 had PET and/or US as a component of their post radiation staging. Eighty patients (20%) underwent neck dissection, and 21 (26%) had a positive specimen. The rate of neck dissection increased with increasing nodal stage, and was lower in patients who had PET scans or ultrasound in addition to CT restaging. The median follow-up was 30 months. The 2-year actuarial neck recurrence rate was 7% and 5% in all patients and those with local control, respectively. Nodal recurrence rates were greater in current smokers (p=.008). There was no difference in nodal recurrences rates in patients who did or did not have a neck dissection (p = .4) Conclusions A treatment strategy of (chemo)radiation with neck dissection performed based on response resulted in high rates of regional disease control in patients with HPV-associated oropharyngeal cancer. PMID:24898672

  14. Functional outcome in acute stroke patients with oropharyngeal Dysphagia after swallowing therapy.

    PubMed

    Huang, Kun-Ling; Liu, Ting-Yuan; Huang, Yu-Chi; Leong, Chau-Peng; Lin, Wei-Che; Pong, Ya-Ping

    2014-01-01

    Dysphagia after stroke is associated with mortality and increased pulmonary complications. Swallowing therapies may decrease pulmonary complications and improve patients' quality of life after stroke. This study used clinical swallowing assessments and videofluoroscopy (VFS) to assess the functional recovery of acute stroke patients with dysphagia after different swallowing therapies. We enrolled 29 acute stroke patients with dysphagia and randomly divided them into 3 therapy groups: traditional swallowing (TS), oropharyngeal neuromuscular electrical stimulation (NMES), and combined NMES/TS. All patients were assessed using the clinical functional oral intake scale (FOIS), 8-point penetration-aspiration scale (PAS), and functional dysphagia scale (FDS) of VFS before and after treatment. There were no differences in the clinical parameters and swallowing results of the FOIS and VFS before swallowing treatment among the 3 groups (P > .05). TS therapy and combined therapy both had significant swallowing improvement after therapy according to the FOIS and 8-point PAS (P < .05). When comparing the results of the VFS among the 3 groups, we found significant improvements in patients eating cookies and thick liquid after combined NMES/TS therapy (P < .05). In acute stroke patients with dysphagia, combined NMES/TS therapy is the most effective swallowing therapy in taking solid diets and thick liquids.

  15. Candida glabrata Binding to Candida albicans Hyphae Enables Its Development in Oropharyngeal Candidiasis

    PubMed Central

    Tati, Swetha; Davidow, Peter; McCall, Andrew; Hwang-Wong, Elizabeth; Rojas, Isolde G.; Cormack, Brendan; Edgerton, Mira

    2016-01-01

    Pathogenic mechanisms of Candida glabrata in oral candidiasis, especially because of its inability to form hyphae, are understudied. Since both Candida albicans and C. glabrata are frequently co-isolated in oropharyngeal candidiasis (OPC), we examined their co-adhesion in vitro and observed adhesion of C. glabrata only to C. albicans hyphae microscopically. Mice were infected sublingually with C. albicans or C. glabrata individually, or with both species concurrently, to study their ability to cause OPC. Infection with C. glabrata alone resulted in negligible infection of tongues; however, colonization by C. glabrata was increased by co-infection or a pre-established infection with C. albicans. Furthermore, C. glabrata required C. albicans for colonization of tongues, since decreasing C. albicans burden with fluconazole also reduced C. glabrata. C. albicans hyphal wall adhesins Als1 and Als3 were important for in vitro adhesion of C. glabrata and to establish OPC. C. glabrata cell wall protein coding genes EPA8, EPA19, AWP2, AWP7, and CAGL0F00181 were implicated in mediating adhesion to C. albicans hyphae and remarkably, their expression was induced by incubation with germinated C. albicans. Thus, we found a near essential requirement for the presence of C. albicans for both initial colonization and establishment of OPC infection by C. glabrata. PMID:27029023

  16. The Aryl Hydrocarbon Receptor Governs Epithelial Cell Invasion during Oropharyngeal Candidiasis

    PubMed Central

    Solis, Norma V.; Swidergall, Marc; Bruno, Vincent M.; Gaffen, Sarah L.

    2017-01-01

    ABSTRACT Oropharyngeal candidiasis (OPC), caused predominantly by Candida albicans, is a prevalent infection in patients with advanced AIDS, defects in Th17 immunity, and head and neck cancer. A characteristic feature of OPC is fungal invasion of the oral epithelial cells. One mechanism by which C. albicans hyphae can invade oral epithelial cells is by expressing the Als3 and Ssa1 invasins that interact with the epidermal growth factor receptor (EGFR) on epithelial cells and stimulate endocytosis of the organism. However, the signaling pathways that function downstream of EGFR and mediate C. albicans endocytosis are poorly defined. Here, we report that C. albicans infection activates the aryl hydrocarbon receptor (AhR), leading to activation of Src family kinases (SFKs), which in turn phosphorylate EGFR and induce endocytosis of the fungus. Furthermore, treatment of oral epithelial cells with interferon gamma inhibits fungal endocytosis by inducing the synthesis of kynurenines, which cause prolonged activation of AhR and SFKs, thereby interfering with C. albicans-induced EGFR signaling. Treatment of both immunosuppressed and immunocompetent mice with an AhR inhibitor decreases phosphorylation of SFKs and EGFR in the oral mucosa, reduces fungal invasion, and lessens the severity of OPC. Thus, our data indicate that AhR plays a central role in governing the pathogenic interactions of C. albicans with oral epithelial cells during OPC and suggest that this receptor is a potential therapeutic target. PMID:28325761

  17. Candida glabrata Binding to Candida albicans Hyphae Enables Its Development in Oropharyngeal Candidiasis.

    PubMed

    Tati, Swetha; Davidow, Peter; McCall, Andrew; Hwang-Wong, Elizabeth; Rojas, Isolde G; Cormack, Brendan; Edgerton, Mira

    2016-03-01

    Pathogenic mechanisms of Candida glabrata in oral candidiasis, especially because of its inability to form hyphae, are understudied. Since both Candida albicans and C. glabrata are frequently co-isolated in oropharyngeal candidiasis (OPC), we examined their co-adhesion in vitro and observed adhesion of C. glabrata only to C. albicans hyphae microscopically. Mice were infected sublingually with C. albicans or C. glabrata individually, or with both species concurrently, to study their ability to cause OPC. Infection with C. glabrata alone resulted in negligible infection of tongues; however, colonization by C. glabrata was increased by co-infection or a pre-established infection with C. albicans. Furthermore, C. glabrata required C. albicans for colonization of tongues, since decreasing C. albicans burden with fluconazole also reduced C. glabrata. C. albicans hyphal wall adhesins Als1 and Als3 were important for in vitro adhesion of C. glabrata and to establish OPC. C. glabrata cell wall protein coding genes EPA8, EPA19, AWP2, AWP7, and CAGL0F00181 were implicated in mediating adhesion to C. albicans hyphae and remarkably, their expression was induced by incubation with germinated C. albicans. Thus, we found a near essential requirement for the presence of C. albicans for both initial colonization and establishment of OPC infection by C. glabrata.

  18. Clinical relevance of copy number profiling in oral and oropharyngeal squamous cell carcinoma.

    PubMed

    van Kempen, Pauline M W; Noorlag, Rob; Braunius, Weibel W; Moelans, Cathy B; Rifi, Widad; Savola, Suvi; Koole, Ronald; Grolman, Wilko; van Es, Robert J J; Willems, Stefan M

    2015-10-01

    Current conventional treatment modalities in head and neck squamous cell carcinoma (HNSCC) are nonselective and have shown to cause serious side effects. Unraveling the molecular profiles of head and neck cancer may enable promising clinical applications that pave the road for personalized cancer treatment. We examined copy number status in 36 common oncogenes and tumor suppressor genes in a cohort of 191 oropharyngeal squamous cell carcinomas (OPSCC) and 164 oral cavity squamous cell carcinomas (OSCC) using multiplex ligation probe amplification. Copy number status was correlated with human papillomavirus (HPV) status in OPSCC, with occult lymph node status in OSCC and with patient survival. The 11q13 region showed gain or amplifications in 59% of HPV-negative OPSCC, whereas this amplification was almost absent in HPV-positive OPSCC. Additionally, in clinically lymph node-negative OSCC (Stage I-II), gain of the 11q13 region was significantly correlated with occult lymph node metastases with a negative predictive value of 81%. Multivariate survival analysis revealed a significantly decreased disease-free survival in both HPV-negative and HPV-positive OPSCC with a gain of Wnt-induced secreted protein-1. Gain of CCND1 showed to be an independent predictor for worse survival in OSCC. These results show that copy number aberrations, mainly of the 11q13 region, may be important predictors and prognosticators which allow for stratifying patients for personalized treatment of HNSCC.

  19. Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

    SciTech Connect

    Gligorov, Joseph; Bastit, Laurent; Gervais, Honorine; Henni, Mehdi; Kahila, Widad; Lepille, Daniel; Luporsi, Elisabeth; Sasso, Giuseppe; Varette, Charles; Azria, David

    2011-06-01

    Purpose: The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Methods and Materials: Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Results: Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%-11.0%]in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). Conclusion: OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs.

  20. Current and future techniques for human papilloma virus (HPV) testing in oropharyngeal squamous cell carcinoma.

    PubMed

    Qureishi, Ali; Mawby, Thomas; Fraser, Lisa; Shah, Ketan A; Møller, Henrik; Winter, Stuart

    2017-03-11

    Despite a reduction in smoking and alcohol consumption, the incidence of oropharyngeal squamous cell carcinoma (OPSCC) is rising. This is attributed to human papilloma virus (HPV) infection and screening for HPV is now recommended in all cases of OPSCC. Despite a variety of clinically available tests and new non-invasive test strategies there is no consensus on which technique is best. This review reports on current techniques for HPV detection in OPSCC and the clinical applicability of emerging techniques. Literature searches of Medline, Embase and clinicaltrials.gov using the search terms 'head and neck neoplasms', 'squamous cell carcinoma' and 'HPV testing' were performed. 45 studies were identified and included. p16 immunohistochemistry (IHC), HPV DNA in situ hybridization (ISH) and HPV polymerase chain reaction (PCR) are the commonest tests to determine HPV status. p16 IHC and HPV DNA PCR are highly sensitive whilst HPV DNA ISH is more specific, these techniques conventionally utilize surgical biopsies. New tests using PCR to screen fine needle aspirates, saliva, brush cytology and serum for HPV are promising but have variable sensitivity and specificity. These non-invasive samples avoid the morbidity of surgical biopsies and need for tissue blocks; their clinical role in screening and surveillance remains largely untested. Further work is needed to validate these tests and define their role.

  1. Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia

    PubMed Central

    Santos, Karoline Weber dos; Scheeren, Betina; Maciel, Antonio Carlos; Cassol, Mauriceia

    2014-01-01

    Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter “wet voice” were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders. PMID:25992153

  2. Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia.

    PubMed

    Santos, Karoline Weber Dos; Scheeren, Betina; Maciel, Antonio Carlos; Cassol, Mauriceia

    2015-01-01

    Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter "wet voice" were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders.

  3. Oropharyngeal Aspiration of Burkholderia mallei and Burkholderia pseudomallei in BALB/c Mice

    PubMed Central

    Schully, Kevin L.; Bell, Matthew G.; Ward, Jerrold M.; Keane-Myers, Andrea M.

    2014-01-01

    Burkholderia mallei and Burkholderia pseudomallei are potentially lethal pathogens categorized as biothreat agents due, in part, to their ability to be disseminated via aerosol. There are no protective vaccines against these pathogens and treatment options are limited and cumbersome. Since disease severity is greatest when these agents are inhaled, efforts to develop pre- or post-exposure prophylaxis focus largely on inhalation models of infection. Here, we demonstrate a non-invasive and technically simple method for affecting the inhalational challenge of BALB/c mice with B. pseudomallei and B. mallei. In this model, two investigators utilized common laboratory tools such as forceps and a micropipette to conduct and characterize an effective and reproducible inhalational challenge of BALB/c mice with B. mallei and B. pseudomallei. Challenge by oropharyngeal aspiration resulted in acute disease. Additionally, 50% endpoints for B. pseudomallei K96243 and B. mallei ATCC 23344 were nearly identical to published aerosol challenge methods. Furthermore, the pathogens disseminated to all major organs typically targeted by these agents where they proliferated. The pro-inflammatory cytokine production in the proximal and peripheral fluids demonstrated a rapid and robust immune response comparable to previously described murine and human studies. These observations demonstrate that OA is a viable alternative to aerosol exposure. PMID:25503969

  4. Simple Cloud Chambers Using Gel Ice Packs

    ERIC Educational Resources Information Center

    Kamata, Masahiro; Kubota, Miki

    2012-01-01

    Although cloud chambers are highly regarded as teaching aids for radiation education, school teachers have difficulty in using cloud chambers because they have to prepare dry ice or liquid nitrogen before the experiment. We developed a very simple and inexpensive cloud chamber that uses the contents of gel ice packs which can substitute for dry…

  5. Stuffed Derivatives of Close-Packed Structures

    ERIC Educational Resources Information Center

    Douglas, Bodie E.

    2007-01-01

    Decades ago Buerger described and later Palmer reviewed stuffed silica crystal structures widely used by mineralogists. Many publications and books have discussed common crystal structures in terms of close-packing of one set of atoms or ions (P sites) with other atoms or ions in tetrahedral (T) or octahedral (O) sites. Douglas and Ho described…

  6. Porous bead packings for gas chromatography

    NASA Technical Reports Server (NTRS)

    Pollock, G. E.; Woeller, F. H.

    1979-01-01

    Porous polyaromatic packing beads have low polarity, high efficiency, short retention time, and may be synthesized in size range of 50 to 150 micrometers (100 to 270 mesh). Mechanically strong beads may be produced using various materials depending on elements and compounds to be identified.

  7. Random close packing in protein cores

    NASA Astrophysics Data System (ADS)

    Ohern, Corey

    Shortly after the determination of the first protein x-ray crystal structures, researchers analyzed their cores and reported packing fractions ϕ ~ 0 . 75 , a value that is similar to close packing equal-sized spheres. A limitation of these analyses was the use of `extended atom' models, rather than the more physically accurate `explicit hydrogen' model. The validity of using the explicit hydrogen model is proved by its ability to predict the side chain dihedral angle distributions observed in proteins. We employ the explicit hydrogen model to calculate the packing fraction of the cores of over 200 high resolution protein structures. We find that these protein cores have ϕ ~ 0 . 55 , which is comparable to random close-packing of non-spherical particles. This result provides a deeper understanding of the physical basis of protein structure that will enable predictions of the effects of amino acid mutations and design of new functional proteins. We gratefully acknowledge the support of the Raymond and Beverly Sackler Institute for Biological, Physical, and Engineering Sciences, National Library of Medicine training grant T15LM00705628 (J.C.G.), and National Science Foundation DMR-1307712 (L.R.).

  8. Monkey Baker in bio-pack

    NASA Technical Reports Server (NTRS)

    1959-01-01

    A squirrel monkey, Baker, in bio-pack couch being readied for Jupiter (AM-18 flight). Jupiter, AM-18 mission, also carried an American-born rhesus monkey, Able into suborbit. The flight was successful and both monkeys were recovered in good condition. AM-18 was launched on May 28, 1959.

  9. 7 CFR 989.9 - Packed raisins.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Packed raisins. 989.9 Section 989.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN...

  10. 7 CFR 989.9 - Packed raisins.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Packed raisins. 989.9 Section 989.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN...

  11. 7 CFR 989.9 - Packed raisins.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Packed raisins. 989.9 Section 989.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN...

  12. 7 CFR 989.9 - Packed raisins.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Packed raisins. 989.9 Section 989.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN...

  13. 7 CFR 989.9 - Packed raisins.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Packed raisins. 989.9 Section 989.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN...

  14. Close packing of rods on spherical surfaces

    NASA Astrophysics Data System (ADS)

    Smallenburg, Frank; Löwen, Hartmut

    2016-04-01

    We study the optimal packing of short, hard spherocylinders confined to lie tangential to a spherical surface, using simulated annealing and molecular dynamics simulations. For clusters of up to twelve particles, we map out the changes in the geometry of the closest-packed configuration as a function of the aspect ratio L/D, where L is the cylinder length and D the diameter of the rods. We find a rich variety of cluster structures. For larger clusters, we find that the best-packed configurations up to around 100 particles are highly dependent on the exact number of particles and aspect ratio. For even larger clusters, we find largely disordered clusters for very short rods (L/D = 0.25), while slightly longer rods (L/D = 0.5 or 1) prefer a global baseball-like geometry of smectic-like domains, similar to the behavior of large-scale nematic shells. Intriguingly, we observe that when compared to their optimal flat-plane packing, short rods adapt to the spherical geometry more efficiently than both spheres and longer rods. Our results provide predictions for experimentally realizable systems of colloidal rods trapped at the interface of emulsion droplets.

  15. Random close packing in protein cores

    NASA Astrophysics Data System (ADS)

    Gaines, Jennifer C.; Smith, W. Wendell; Regan, Lynne; O'Hern, Corey S.

    2016-03-01

    Shortly after the determination of the first protein x-ray crystal structures, researchers analyzed their cores and reported packing fractions ϕ ≈0.75 , a value that is similar to close packing of equal-sized spheres. A limitation of these analyses was the use of extended atom models, rather than the more physically accurate explicit hydrogen model. The validity of the explicit hydrogen model was proved in our previous studies by its ability to predict the side chain dihedral angle distributions observed in proteins. In contrast, the extended atom model is not able to recapitulate the side chain dihedral angle distributions, and gives rise to large atomic clashes at side chain dihedral angle combinations that are highly probable in protein crystal structures. Here, we employ the explicit hydrogen model to calculate the packing fraction of the cores of over 200 high-resolution protein structures. We find that these protein cores have ϕ ≈0.56 , which is similar to results obtained from simulations of random packings of individual amino acids. This result provides a deeper understanding of the physical basis of protein structure that will enable predictions of the effects of amino acid mutations to protein cores and interfaces of known structure.

  16. The General Heating Multi-Project Pack

    ERIC Educational Resources Information Center

    Cowking A.; And Others

    1978-01-01

    Describes a multi-project pack on central heating systems, developed into an educational game, used for teaching a variety of subjects in high school. The students examine the basic decision to install a central heating system, for a particular house, and the economics involved. (GA)

  17. Radiological and practical aspects of body packing

    PubMed Central

    Reginelli, A; Pinto, F; Sica, G; Scaglione, M; Berger, F H; Romano, L; Brunese, L

    2014-01-01

    Body packing represents the concealment of illegal substances in a person's body with the aim of smuggling. “Body packers” either swallow drug-filled packets or introduce drug-filled packets into their bodies rectally or vaginally with the purpose of concealing them. The three main smuggled drugs are cocaine, heroin and cannabis products. Body packing represents a serious risk of acute narcotic toxicity from drug exposure, intestinal obstruction owing to pellet impaction and bowel perforation with consequent abdominal sepsis. A suspected body packer is generally admitted to hospital to perform imaging investigations and confirm the presence of drugs in his/her body. Radiological imaging methods are essential to diagnose body packing and to detect potential complications. Increasing sophistication of traffickers and improvements in packaging add to the detection difficulty. Radiologists should be aware of the appearance of drug packets in a range of imaging modalities. This article informs physicians about the challenging aspects of body packing, its background and medicolegal issues, what imaging methods can be used and what criteria are necessary to perform a correct diagnosis. PMID:24472727

  18. 7 CFR 51.1311 - Packing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... size and quality of the contents of the package. (b) Pears packed in any container shall be...

  19. 7 CFR 51.1270 - Packing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... representative in size and quality of the contents of the package. (b) Pears packed in any container shall...

  20. 7 CFR 917.13 - Pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Pack. 917.13 Section 917.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE FRESH PEARS AND PEACHES GROWN IN...

  1. 7 CFR 917.13 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Pack. 917.13 Section 917.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE FRESH PEARS AND PEACHES GROWN IN...

  2. 7 CFR 917.13 - Pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Pack. 917.13 Section 917.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE FRESH PEARS AND PEACHES GROWN IN...

  3. 7 CFR 917.13 - Pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Pack. 917.13 Section 917.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE FRESH PEARS AND PEACHES GROWN IN...

  4. 7 CFR 917.13 - Pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Pack. 917.13 Section 917.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE FRESH PEARS AND PEACHES GROWN IN...

  5. 7 CFR 920.13 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Pack. 920.13 Section 920.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE KIWIFRUIT GROWN IN CALIFORNIA...

  6. 7 CFR 920.13 - Pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Pack. 920.13 Section 920.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE KIWIFRUIT GROWN IN CALIFORNIA...

  7. The benefits of using customized procedure packs.

    PubMed

    Baines, R; Colquhoun, G; Jones, N; Bateman, R

    2001-01-01

    Discrete item purchasing is the traditional approach for hospitals to obtain consumable supplies for theatre procedures. Although most items are relatively low cost, the management and co-ordination of the supply chain, raising orders, controlling stock, picking and delivering to each operating theatre can be complex and costly. Customized procedure packs provide a solution.

  8. Experimental study of bolted connections using light gauge channel sections and packing plates at the joints

    NASA Astrophysics Data System (ADS)

    Kulkarni, Ravindra B.; Vaghe, Vishal M.

    2014-12-01

    Cold-formed structural members are being used more widely in routine structural design as the world steel industry moves from the production of hot-rolled section and plate to coil and strip, often with galvanized and/or painted coatings. Steel in this form is more easily delivered from the steel mill to the manufacturing plant where it is usually cold-rolled into open and closed section members. In the present experimental study, the use of packing plate at the joints in cold-formed channel sections may increase the load carrying capacity and also reduce the buckling of unconnected cold form channel steel plate at joints. The present study focuses on examining the experimental investigation to use mild steel as a packing plate with cold-formed channel sections by bolted connection at the joints and the connection subjected to axial tension. Series of tests are carried out with increase in the thickness of packing plate and results are observed and analyzed. Total Twelve experimental tests have been carried out on cold-formed channel tension members fastened with single as well as three numbers of bolts at the connection and from the observations the strength of the joint is increased by increasing the various thicknesses of packing plates and also the buckling of unconnected leg of channel specimen is reduced. It is analyzed by plotting the entire load versus elongation path, so that the behavior of the connection is examined.

  9. Frequent and Asymptomatic Oropharyngeal Shedding of Human Herpesvirus 8 among Immunocompetent Men

    PubMed Central

    Casper, Corey; Krantz, Elizabeth; Selke, Stacy; Kuntz, Steven R.; Wang, Jie; Huang, Meei-Li; Pauk, John S.; Corey, Lawrence; Wald, Anna

    2007-01-01

    Background. Little is known about the clinical and virologic manifestations of human herpesvirus (HHV)–8 infection in immunocompetent persons in the absence of malignancy. Methods. A total of 46 human immunodeficiency virus–negative, HHV-8–seropositive men collected saliva daily, and 25 recorded 15 common symptoms daily (gastrointestinal, constitutional, and oropharyngeal) and absences from work or school. Quantitative polymerase chain reaction measured HHV-8 DNA in saliva. Results. Some 44 (96%) of 46 men reported having sex with men (MSM). Of the 44 MSM, 27 (61%) had HHV-8 detected in saliva on ≥1 day; heterosexual men also shed HHV-8. In analyses restricted to MSM, HHV-8 DNA was detected on 636 (22%) of 2897 days. Among MSM with HHV-8 detected in saliva, the median rate was 20% (range, 1%–100%), with 30% shedding on >50% of days, and the median quantity was 4.5 log10 copies/mL (range, 2.0−7.3 log10 copies/mL). The quantity of HHV-8 shed was lower in nonwhites (P < .001) and younger participants (P = .03). The frequency of HHV-8 detection and quantity were correlated (r = 0.62; p < .001). Symptoms were reported on 10 (9%) of 114 days when HHV-8 was present, compared with 78 (9%) of 830 days without (odds ratio, 0.93 [95% confidence interval, 0.30−2.88]; P = .9). Conclusions. HHV-8 is detected frequently and intermittently in the saliva of chronically infected immunocompetent MSM, but this infection is asymptomatic. PMID:17152006

  10. Review of the Complications Associated with Treatment of Oropharyngeal Cancer: A Guide to the Dental Practitioner

    PubMed Central

    Turner, Lena; Mupparapu, Muralidhar; Akintoye, Sunday O

    2013-01-01

    Objectives Oropharyngeal cancer (OPC) is the 6th most common cancer worldwide. Focus on risk factors, improved diagnostic methods and effective management strategies have made it possible to successfully treat OPC. However, the 5-year survival rate has not improved for several years due to multiple treatment complications, tissue morbidity, loss of function and diminished quality of life. Survivors are faced with complications like oral mucositis, hyposalivation, osteoradionecrosis; tissue fibrosis, morbidity from jaw resection; disfigurement and loss of function that further diminish quality of life. The aim of this review is to highlight major complications associated with treatment of OPC via a literature search and review of available options for identification and management of these complications. Data Sources Relevant publications on oral complications of OPC therapy were thoroughly reviewed from the literature published between the years 1988 and 2012. Material and Method We evaluated reported incidence, prevalence and risk factors for oral complications of chemotherapy and radiotherapy for OPC. The authors conducted electronic search using English language databases namely PubMed Plus, Medline (Pre-Medline and Medline), Cochrane Database of systematic reviews (evidence-based medicine), Dentistry & Oral sciences source, AccessScience, Embase, Evidence-Based Medicine Reviews Multifile, Google Scholar, ISI Journal Citation Reports, Ovid Multi-Database. Conclusion We identified the most common complications associated with the treatment of oral cancers. Based on the information gathered, there is evidence that survival of OPC extends beyond eradication of the diseased tissue. Understanding the potential treatment complications and utilizing available resources to prevent and minimize them are important. Caring for OPC survivors should be a multidisciplinary team approach involving the dentist, oncologist, internist and social worker to improve the currently

  11. Metastatic model of HPV+ oropharyngeal squamous cell carcinoma demonstrates heterogeneity in tumor metastasis

    PubMed Central

    Vermeer, Daniel W.; Coppock, Joseph D.; Zeng, Erliang; Lee, Kimberly M.; Spanos, William C.; Onken, Michael D.; Uppaluri, Ravindra; Lee, John H.; Vermeer, Paola D.

    2016-01-01

    Human papillomavirus induced (HPV+) cancer incidence is rapidly rising, comprising 60–80% of oropharyngeal squamous cell carcinomas (OPSCCs); while rare, recurrent/metastatic disease accounts for nearly all related deaths. An in vivo pre-clinical model for these invasive cancers is necessary for testing new therapies. We characterize an immune competent recurrent/metastatic HPV+ murine model of OPSSC which consists of four lung metastatic (MLM) cell lines isolated from an animal with HPV+ OPSCC that failed cisplatin/radiation treatment. These individual metastatic clonal cell lines were tested to verify their origin (parental transgene expression and define their physiological properties: proliferation, metastatic potential, heterogeneity and sensitivity/resistance to cisplatin and radiation. All MLMs retain expression of parental HPV16 E6 and E7 and degrade P53 yet are heterogeneous from one another and from the parental cell line as defined by Illumina expression microarray. Consistent with this, reverse phase protein array defines differences in protein expression/activation between MLMs as well as the parental line. While in vitro growth rates of MLMs are slower than the parental line, in vivo growth of MLM clones is greatly enhanced. Moreover, in vivo resistance to standard therapies is dramatically increased in 3 of the 4 MLMs. Lymphatic and/or lung metastasis occurs 100% of the time in one MLM line. This recurrent/metastatic model of HPV+ OPSCC retains the characteristics evident in refractory human disease (heterogeneity, resistance to therapy, metastasis in lymph nodes/lungs) thus serving as an ideal translational system to test novel therapeutics. Moreover, this system may provide insights into the molecular mechanisms of metastasis. PMID:27013584

  12. Variations in the Contouring of Organs at Risk: Test Case From a Patient With Oropharyngeal Cancer

    SciTech Connect

    Nelms, Benjamin E.; Tome, Wolfgang A.; Robinson, Greg; Wheeler, James

    2012-01-01

    Purpose: Anatomy contouring is critical in radiation therapy. Inaccuracy and variation in defining critical volumes will affect everything downstream: treatment planning, dose-volume histogram analysis, and contour-based visual guidance used in image-guided radiation therapy. This study quantified: (1) variation in the contouring of organs at risk (OAR) in a clinical test case and (2) corresponding effects on dosimetric metrics of highly conformal plans. Methods and Materials: A common CT data set with predefined targets from a patient with oropharyngeal cancer was provided to a population of clinics, which were asked to (1) contour OARs and (2) design an intensity-modulated radiation therapy plan. Thirty-two acceptable plans were submitted as DICOM RT data sets, each generated by a different clinical team. Using those data sets, we quantified: (1) the OAR contouring variation and (2) the impact this variation has on dosimetric metrics. New technologies were employed, including a software tool to quantify three-dimensional structure comparisons. Results: There was significant interclinician variation in OAR contouring. The degree of variation is organ-dependent. We found substantial dose differences resulting strictly from contouring variation (differences ranging from -289% to 56% for mean OAR dose; -22% to 35% for maximum dose). However, there appears to be a threshold in the OAR comparison metric beyond which the dose differences stabilize. Conclusions: The effects of interclinician variation in contouring organs-at-risk in the head and neck can be large and are organ-specific. Physicians need to be aware of the effect that variation in OAR contouring can play on the final treatment plan and not restrict their focus only to the target volumes.

  13. Management of Recurrent and Metastatic HPV-Positive Oropharyngeal Squamous Cell Carcinoma after Transoral Robotic Surgery.

    PubMed

    Sims, John R; Van Abel, Kathryn; Martin, Eliot J; Lohse, Christine M; Price, Daniel L; Olsen, Kerry D; Moore, Eric J

    2017-03-01

    Objective To describe management and oncologic outcomes for patients who develop locoregional recurrence (LRR) or distant metastasis (DM) following transoral robotic surgery for human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC). Study Design Case series with chart review. Setting Tertiary care referral center. Subjects and Methods A total of 286 patients with HPV-positive OPSCC who underwent transoral robotic surgery-based treatment from May 2007 to May 2015. Results Of 286 patients (12.2%), 35 met inclusion criteria. Of these, 19 experienced an LRR and 16 developed a DM; 2 patients with LRR subsequently developed DM. In those patients with an LRR, 79% had T1/T2 tumors, and 47% had N0/N1 nodal disease, compared with 75% and 6% in the DM group, respectively. The median time to LRR or DM was 0.6 years (interquartile range [IQR], 0.4-1.0) and 1.8 years (IQR, 1.0-2.1), respectively. Salvage treatment with intent to cure was attempted in 23 patients (16 LRR, 7 DM). The median time from LRR or DM to last follow-up for the 18 patients who were still alive after salvage was 1.9 years (IQR, 0.4-3.8; range, 7 days-6.2 years). Estimated cancer-specific survival rates at 3 years following intent-to-cure treatment were 63% (95% CI, 39-100; number still at risk, 5) in the LRR group and 100% (95% CI, 100-100; number still at risk, 2) in the DM group. Conclusion Overall, LRR and DM for HPV-positive OPSCC following transoral robotic surgery-based therapy are infrequent. In our subset of patients who underwent intent-to-cure treatment, cancer-specific survival rates were favorable. Therefore, aggressive salvage treatment for LRR and DM for HPV-positive OPSCC should be recommended for appropriate candidates.

  14. Oropharyngeal dysphagia, free water protocol and quality of life: an update from a prospective clinical trial.

    PubMed

    Karagiannis, Martha; Karagiannis, Tom C

    2014-01-01

    Oropharyngeal dysphagia, typically associated with older adults, represents a spectrum of swallowing disorders with potentially serious complications and a negative impact on quality of life. A major complication of dysphagia is caused by aspiration, predominantly of thin liquids, which may cause aspiration pneumonia. Given that thin liquids are typically aspirated, the conventional therapy involves altering the diet to one consisting of modified solid consistencies and thickened fluids. While it is well known that this approach is appropriate for aspiration, it does represent difficulties with compliancy and quality of life. We have undertaken a relatively large scale clinical trial to investigate the relationships between the effects of free access to water and the development of aspiration, aspects of hydration and issues related to quality in people with dysphagia. Along with clinical observations and findings from others we have previously stratified people with dysphagia, namely those that are immobile or who have low mobility and severe degenerative neurological dysfunction, at highest risk of developing aspiration pneumonia following intake of water. In the present study, we have extended our previous clinical results. Our findings indicate that following purposeful selection of people with dysphagia with their own mobility and relatively healthy cognitive function, free access to water did not result in aspiration pneumonia, improved measures of hydration and in particular, significantly increased quality of life when compared to a diet consisting of thickened fluids only. Overall, we conclude that in people with good mobility and cognitive ability, there is no need to deviate from the Frazier Rehabilitation Centre free water protocol, which allows for the provision of water to people with dysphagia with strict guidelines particularly in relation to good physical ability.

  15. Human papillomavirus DNA and p16 expression in Japanese patients with oropharyngeal squamous cell carcinoma

    PubMed Central

    Kawakami, Hisato; Okamoto, Isamu; Terao, Kyoichi; Sakai, Kazuko; Suzuki, Minoru; Ueda, Shinya; Tanaka, Kaoru; Kuwata, Kiyoko; Morita, Yume; Ono, Koji; Nishio, Kazuto; Nishimura, Yasumasa; Doi, Katsumi; Nakagawa, Kazuhiko

    2013-01-01

    Human papillomavirus (HPV) is a major etiologic factor for oropharyngeal squamous cell carcinoma (OPSCC). However, little is known about HPV-related OPSCC in Japan. During the study, formalin-fixed, paraffin-embedded OPSCC specimens from Japanese patients were analyzed for HPV DNA by the polymerase chain reaction (PCR) and for the surrogate marker p16 by immuno-histochemistry. For HPV DNA-positive, p16-negative specimens, the methylation status of the p16 gene promoter was examined by methylation-specific PCR. Overall survival was calculated in relation to HPV DNA and p16 status and was subjected to multivariate analysis. OPSCC cell lines were examined for sensitivity to radiation or cisplatin in vitro. The study results showed that tumor specimens from 40 (38%) of the 104 study patients contained HPV DNA, with such positivity being associated with tumors of the tonsils, lymph node metastasis, and nonsmoking. Overall survival was better for OPSCC patients with HPV DNA than for those without it (hazard ratio, 0.214; 95% confidence interval, 0.074–0.614; P = 0.002). Multivariate analysis revealed HPV DNA to be an independent prognostic factor for overall survival (P = 0.015). Expression of p16 was associated with HPV DNA positivity. However, 20% of HPV DNA-positive tumors were negative for p16, with most of these tumors manifesting DNA methylation at the p16 gene promoter. Radiation or cisplatin sensitivity did not differ between OPSCC cell lines positive or negative for HPV DNA. Thus, positivity for HPV DNA identifies a distinct clinical subset of OPSCC with a more favorable outcome in Japanese. PMID:24403267

  16. Human papillomavirus DNA and p16 expression in Japanese patients with oropharyngeal squamous cell carcinoma.

    PubMed

    Kawakami, Hisato; Okamoto, Isamu; Terao, Kyoichi; Sakai, Kazuko; Suzuki, Minoru; Ueda, Shinya; Tanaka, Kaoru; Kuwata, Kiyoko; Morita, Yume; Ono, Koji; Nishio, Kazuto; Nishimura, Yasumasa; Doi, Katsumi; Nakagawa, Kazuhiko

    2013-12-01

    Human papillomavirus (HPV) is a major etiologic factor for oropharyngeal squamous cell carcinoma (OPSCC). However, little is known about HPV-related OPSCC in Japan. During the study, formalin-fixed, paraffin-embedded OPSCC specimens from Japanese patients were analyzed for HPV DNA by the polymerase chain reaction (PCR) and for the surrogate marker p16 by immuno-histochemistry. For HPV DNA-positive, p16-negative specimens, the methylation status of the p16 gene promoter was examined by methylation-specific PCR. Overall survival was calculated in relation to HPV DNA and p16 status and was subjected to multivariate analysis. OPSCC cell lines were examined for sensitivity to radiation or cisplatin in vitro. The study results showed that tumor specimens from 40 (38%) of the 104 study patients contained HPV DNA, with such positivity being associated with tumors of the tonsils, lymph node metastasis, and nonsmoking. Overall survival was better for OPSCC patients with HPV DNA than for those without it (hazard ratio, 0.214; 95% confidence interval, 0.074-0.614; P = 0.002). Multivariate analysis revealed HPV DNA to be an independent prognostic factor for overall survival (P = 0.015). Expression of p16 was associated with HPV DNA positivity. However, 20% of HPV DNA-positive tumors were negative for p16, with most of these tumors manifesting DNA methylation at the p16 gene promoter. Radiation or cisplatin sensitivity did not differ between OPSCC cell lines positive or negative for HPV DNA. Thus, positivity for HPV DNA identifies a distinct clinical subset of OPSCC with a more favorable outcome in Japanese.

  17. Quantitation of Human Papillomavirus DNA in Plasma of Oropharyngeal Carcinoma Patients

    SciTech Connect

    Cao Hongbin; Banh, Alice; Kwok, Shirley; Shi Xiaoli; Wu, Simon; Krakow, Trevor; Khong, Brian; Bavan, Brindha; Bala, Rajeev; Pinsky, Benjamin A.; Colevas, Dimitrios; Pourmand, Nader; Koong, Albert C.; Kong, Christina S.; Le, Quynh-Thu

    2012-03-01

    Purpose: To determine whether human papillomavirus (HPV) DNA can be detected in the plasma of patients with HPV-positive oropharyngeal carcinoma (OPC) and to monitor its temporal change during radiotherapy. Methods and Materials: We used polymerase chain reaction to detect HPV DNA in the culture media of HPV-positive SCC90 and VU147T cells and the plasma of SCC90 and HeLa tumor-bearing mice, non-tumor-bearing controls, and those with HPV-negative tumors. We used real-time quantitative polymerase chain reaction to quantify the plasma HPV DNA in 40 HPV-positive OPC, 24 HPV-negative head-and-neck cancer patients and 10 non-cancer volunteers. The tumor HPV status was confirmed by p16{sup INK4a} staining and HPV16/18 polymerase chain reaction or HPV in situ hybridization. A total of 14 patients had serial plasma samples for HPV DNA quantification during radiotherapy. Results: HPV DNA was detectable in the plasma samples of SCC90- and HeLa-bearing mice but not in the controls. It was detected in 65% of the pretreatment plasma samples from HPV-positive OPC patients using E6/7 quantitative polymerase chain reaction. None of the HPV-negative head-and-neck cancer patients or non-cancer controls had detectable HPV DNA. The pretreatment plasma HPV DNA copy number correlated significantly with the nodal metabolic tumor volume (assessed using {sup 18}F-deoxyglucose positron emission tomography). The serial measurements in 14 patients showed a rapid decline in HPV DNA that had become undetectable at radiotherapy completion. In 3 patients, the HPV DNA level had increased to a discernable level at metastasis. Conclusions: Xenograft studies indicated that plasma HPV DNA is released from HPV-positive tumors. Circulating HPV DNA was detectable in most HPV-positive OPC patients. Thus, plasma HPV DNA might be a valuable tool for identifying relapse.

  18. SU-E-T-352: Why Is the Survival Rate Low in Oropharyngeal Squamous Cell Carcinoma?

    SciTech Connect

    Huang, Z; Feng, Y; Rasmussen, K; Rice, J; Stephenson, S; Ferreira, Maria C; Liu, T; Yuh, K; Wang, R; Grecula, J; Lo, S; Mayr, N; Yuh, W

    2014-06-01

    Purpose: Tumors are composed of a large number of clonogens that have the capability of indefinite reproduction. Even when there is complete clinical or radiographic regression of the gross tumor mass after treatment, tumor recurrence can occur if the clonogens are not completely eradicated by radiotherapy. This study was to investigate the colonogen number and its association with the tumor control probability (TCP) in oropharyngeal squamous cell carcinoma (OSCCA). Methods: A literature search was conducted to collect clinical information of patients with OSCCA, including the prescription dose, tumor volume and survival rate. The linear-quadratic (LQ) model was incorporated into TCP model for clinical data analysis. The total dose ranged from 60 to 70 Gy and tumor volume ranged from 10 to 50 cc. The TCP was calculated for each group according to tumor size and dose. The least χ{sup 2} method was used to fit the TCP calculation to clinical data while other LQ model parameters (α, β) were adopted from the literature, due to the limited patient data. Results: A total of 190 patients with T2–T4 OSCCA were included. The association with HPV was not available for all the patients. The 3-year survival rate was about 82% for T2 squamous cell carcinoma and 40% for advanced tumors. Fitting the TCP model to the survival data, the average clonogen number was 1.56×10{sup 12}. For the prescription dose of 70 Gy, the calculated TCP ranged from 40% to 90% when the tumor volume varied from 10 to 50 cc. Conclusion: Our data suggests variation between the clonogen number and TCP in OSCCA. Tumors with larger colonogen number tend to have lower TCP and therefore dose escalation above 70 Gy may be indicated in order to improve the TCP and survival rate. Our result will require future confirmation with a large number of patients.

  19. Candida-host interactions in HIV disease: implications for oropharyngeal candidiasis.

    PubMed

    Fidel, P L

    2011-04-01

    Oropharyngeal candidiasis (OPC), caused primarily by Candida albicans, is the most common oral infection in HIV(+) persons. Although Th1-type CD4(+) T cells are the predominant host defense mechanism against OPC, CD8(+) T cells and epithelial cells become important when blood CD4(+) T cells are reduced below a protective threshold during progression to AIDS. In an early cross-sectional study, OPC(+) tissue biopsied from HIV(+) persons had an accumulation of activated memory CD8(+) T cells at the oral epithelial-lamina propria interface, with reduced expression of the adhesion molecule E-cadherin, suggesting a protective role for CD8(+) T cells but a dysfunction in the mucosal migration of the cells. In a subsequent 1-year longitudinal study, OPC(-) patients with high oral Candida colonization (indicative of a preclinical OPC condition), had higher numbers of CD8(+) T cells distributed throughout the tissue, with normal E-cadherin expression. In OPC(+) patients, where lack of CD8(+) T cell migration was associated with reduced E-cadherin, subsequent evaluations following successful treatment of infection revealed normal E-cadherin expression and cellular distribution. Regarding epithelial cell responses, intact oral epithelial cells exhibit fungistatic activity via an acid-labile protein moiety. A proteomic analysis revealed that annexin A1 is a strong candidate for the effector moiety. The current hypothesis is that under reduced CD4(+) T cells, HIV(+) persons protected from OPC have CD8(+) T cells that migrate to the site of a preclinical infection under normal expression of E-cadherin, whereas those with OPC have a transient reduction in E-cadherin that prohibits CD8(+) T cells from migrating for effector function. Oral epithelial cells concomitantly function through annexin A1 to keep Candida in a commensal state but can easily be overwhelmed, thereby contributing to susceptibility to OPC.

  20. Prevalence of oropharyngeal dysphagia in Parkinson's disease: a meta-analysis.

    PubMed

    Kalf, J G; de Swart, B J M; Bloem, B R; Munneke, M

    2012-05-01

    Dysphagia is a potentially harmful feature, also in Parkinson's disease (PD). As published prevalence rates vary widely, we aimed to estimate the prevalence of oropharyngeal dysphagia in PD in a meta-analysis. We conducted a systematic literature search in February 2011 and two independent reviewers selected the papers. We computed the estimates of the pooled prevalence weighted by sample size. Twelve studies were suitable for calculating prevalence rates. Ten studies provided an estimate based on subjective outcomes, which proved statistically heterogeneous (p < 0.001), with a pooled prevalence estimate with random effect analysis of 35% (95% CI 28-41). Four studies provided an estimate based on objective measurements, which were statistically homogeneous (p = 0.23), with a pooled prevalence estimate of 82% (95% CI 77-87). In controls the pooled subjective prevalence was 9% (95% CI 2-17), while the pooled objective prevalence was 23% (95% CI 13-32). The pooled relative risk was 3.2 for both subjective outcomes (95% CI 2.32-4.41) and objective outcomes (95% CI 2.08-4.98). Clinical heterogeneity between studies was chiefly explained by differences in disease severity. Subjective dysphagia occurs in one third of community-dwelling PD patients. Objectively measured dysphagia rates were much higher, with 4 out of 5 patients being affected. This suggests that dysphagia is common in PD, but patients do not always report swallowing difficulties unless asked. This underreporting calls for a proactive clinical approach to dysphagia, particularly in light of the serious clinical consequences.

  1. Oropharyngeal aspiration of bleomycin: An alternative experimental model of pulmonary fibrosis developed in Swiss mice

    PubMed Central

    Bale, Swarna; Sunkoju, Manoj; Reddy, Shiva Shankar; Swamy, Veerabhadra; Godugu, Chandraiah

    2016-01-01

    Objective: Pulmonary fibrosis (PF) is a progressive and predominantly lethal form of several interstitial lung diseases with limited current therapeutics; it is, therefore, essential to develop a simple, homogeneous, and noninvasive disease model to investigate possible anti-fibrotic approaches. The present study is designed to develop oropharyngeal aspiration (OPA) model of bleomycin (BLM)-induced PF as a simple and alternative to intratracheal (IT) administration of BLM in Swiss mice strain. Materials and Methods: Mice were divided into two groups, BLM-treated and normal control. BLM via OPA (2 IU/kg) was used to induce PF. Water for injection was used as a vehicle in control animals. Body weights were measured once in a week, and the study was continued for 21 days. At the end of the study, animals were euthanized and bronchoalveolar lavage fluid was collected and subjected to lymphocytes count, estimation of albumin and protein levels. Lung tissues were collected, and various biochemical assays (malondialdehyde, glutathione, nitric oxide, hydroxyproline) and molecular techniques including ELISA and Western blot were performed to investigate the effect of OPA-BLM. Further, histopathology and Masson's trichrome staining techniques were performed in lung sections. Results: OPA administration of BLM in Swiss mice significantly induced PF, evident from lung index and morphology. Several oxidative stress parameters and hydroxyproline assay revealed the significant (P < 0.05) induction of PF. Further results obtained from histopathology, Masson's trichrome staining, ELISA, and Western blot confirmed the significant induction of PF via OPA-BLM. Conclusion: BLM administration by OPA route in Swiss mice can be used as a simple, homogeneous, and noninvasive model of inducing PF and to investigate the effect of various anti-fibrotic agents as an alternative to IT-BLM. PMID:28066100

  2. Osteoradionecrosis and Radiation Dose to the Mandible in Patients With Oropharyngeal Cancer

    SciTech Connect

    Tsai, Chiaojung Jillian; Hofstede, Theresa M.; Sturgis, Erich M.; Garden, Adam S.; Lindberg, Mary E.; Wei Qingyi; Tucker, Susan L.; Dong Lei

    2013-02-01

    Purpose: To determine the association between radiation doses delivered to the mandible and the occurrence of osteoradionecrosis (ORN). Methods and Materials: We reviewed the records of 402 oropharyngeal cancer patients with stage T1 or T2 disease treated with definitive radiation between January 2000 and October 2008 for the occurrence of ORN. Demographic and treatment variables were compared between patients with ORN and those without. To examine the dosimetric relationship further, a nested case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by age, sex, radiation type, treatment year, and cancer subsite. Detailed radiation treatment plans for the ORN cases and matched controls were reviewed. Mann-Whitney test and conditional logistic regression were used to compare relative volumes of the mandible exposed to doses ranging from 10 Gy-60 Gy in 10-Gy increments. Results: In 30 patients (7.5%), ORN developed during a median follow-up time of 31 months, including 6 patients with grade 4 ORN that required major surgery. The median time to develop ORN was 8 months (range, 0-71 months). Detailed radiation treatment plans were available for 25 of the 30 ORN patients and 40 matched ORN-free patients. In the matched case-control analysis, there was a statistically significant difference between the volumes of mandible in the 2 groups receiving doses between 50 Gy (V50) and 60 Gy (V60). The most notable difference was seen at V50, with a P value of .02 in the multivariate model after adjustment for the matching variables and dental status (dentate or with extraction). Conclusions: V50 and V60 saw the most significant differences between the ORN group and the comparison group. Minimizing the percent mandibular volume exposed to 50 Gy may reduce ORN risk.

  3. Molecular characterization of p16-immunopositive but HPV DNA-negative oropharyngeal carcinomas.

    PubMed

    Rietbergen, Michelle M; Snijders, Peter J F; Beekzada, Derakshan; Braakhuis, Boudewijn J M; Brink, Arjen; Heideman, Daniëlle A M; Hesselink, Albertus T; Witte, Birgit I; Bloemena, Elisabeth; Baatenburg-De Jong, Robert J; Leemans, C René; Brakenhoff, Ruud H

    2014-05-15

    Recent studies have reported that p16 protein overexpression qualifies as a surrogate marker identifying an oncogenic human papillomavirus (HPV) infection in oropharyngeal squamous cell carcinoma (OPSCC). However, there is still a percentage of OPSCCs that are positive for p16 immunohistochemistry (p16 IHC) but lack HPV DNA. The objective of this study was to characterize this group at the molecular level by performing sensitive HPV DNA- and RNA-based PCR methods and genetic profiling. All patients diagnosed with an OPSCC in the period 2000-2006 in two Dutch university medical centers were included (n = 841). The presence of HPV in a tumor sample was tested by p16 IHC followed by an HPV DNA GP5+/6+ PCR. p16 IHC scored positive in 195 samples, of which 161 were HPV DNA-positive and 34 (17%) HPV DNA-negative. In the latter group, a SPF10-LiPA25 assay, an HPV16 type-specific E7 PCR and an E6 mRNA RT-PCR were performed. Next, ten of these cases were further analyzed for loss of heterozygosity (LOH) of 15 microsatellite markers at chromosome arms 3p, 9p and 17p. Of the 34 p16-positive but PCR-negative OPSCCs, two samples tested positive by SPF10 assay, HPV16 E7 PCR and HPV16 E6 mRNA RT-PCR. Three samples tested positive by SPF10 assay but negative by the HPV16-specific assays. Nine of ten cases that were tested for LOH showed a genetic pattern comparable to that of HPV-negative tumors. This study categorizes p16-positive but HPV DNA-negative OPSCCs as HPV-negative tumors based on genetic profiling. This study highlights the importance of performing HPV testing in addition to p16 IHC for proper identification of HPV-associated OPSCCs.

  4. Forecasting longitudinal changes in oropharyngeal tumor morphology throughout the course of head and neck radiation therapy

    SciTech Connect

    Yock, Adam D.; Kudchadker, Rajat J.; Rao, Arvind; Dong, Lei; Beadle, Beth M.; Garden, Adam S.; Court, Laurence E.

    2014-08-15

    Purpose: To create models that forecast longitudinal trends in changing tumor morphology and to evaluate and compare their predictive potential throughout the course of radiation therapy. Methods: Two morphology feature vectors were used to describe 35 gross tumor volumes (GTVs) throughout the course of intensity-modulated radiation therapy for oropharyngeal tumors. The feature vectors comprised the coordinates of the GTV centroids and a description of GTV shape using either interlandmark distances or a spherical harmonic decomposition of these distances. The change in the morphology feature vector observed at 33 time points throughout the course of treatment was described using static, linear, and mean models. Models were adjusted at 0, 1, 2, 3, or 5 different time points (adjustment points) to improve prediction accuracy. The potential of these models to forecast GTV morphology was evaluated using leave-one-out cross-validation, and the accuracy of the models was compared using Wilcoxon signed-rank tests. Results: Adding a single adjustment point to the static model without any adjustment points decreased the median error in forecasting the position of GTV surface landmarks by the largest amount (1.2 mm). Additional adjustment points further decreased the forecast error by about 0.4 mm each. Selection of the linear model decreased the forecast error for both the distance-based and spherical harmonic morphology descriptors (0.2 mm), while the mean model decreased the forecast error for the distance-based descriptor only (0.2 mm). The magnitude and statistical significance of these improvements decreased with each additional adjustment point, and the effect from model selection was not as large as that from adding the initial points. Conclusions: The authors present models that anticipate longitudinal changes in tumor morphology using various models and model adjustment schemes. The accuracy of these models depended on their form, and the utility of these models

  5. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome

    PubMed Central

    Baijens, Laura WJ; Clavé, Pere; Cras, Patrick; Ekberg, Olle; Forster, Alexandre; Kolb, Gerald F; Leners, Jean-Claude; Masiero, Stefano; Mateos-Nozal, Jesús; Ortega, Omar; Smithard, David G; Speyer, Renée; Walshe, Margaret

    2016-01-01

    This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization’s classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies

  6. European Society for Swallowing Disorders - European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome.

    PubMed

    Baijens, Laura Wj; Clavé, Pere; Cras, Patrick; Ekberg, Olle; Forster, Alexandre; Kolb, Gerald F; Leners, Jean-Claude; Masiero, Stefano; Mateos-Nozal, Jesús; Ortega, Omar; Smithard, David G; Speyer, Renée; Walshe, Margaret

    2016-01-01

    This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization's classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies.

  7. Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma.

    PubMed

    Wong, Ling Siew; McMahon, Jeremy; Devine, John; McLellan, Douglas; Thompson, Ewen; Farrow, Adrian; Moos, Khursheed; Ayoub, Ashraf

    2012-03-01

    There is a lack of consistency among published reports in the definition of what constitutes close resection margins (1-5mm) in the surgical treatment of oral and oropharyngeal squamous cell carcinoma (SCC). Our aim was to define what would constitute close resection margins in predicting local recurrence and disease-specific survival. The study comprised 192 previously untreated patients with oral and oropharyngeal SCC who were recruited at the Southern General Hospital, Glasgow, from 2001 to 2007 with a minimum follow-up of 2 years. Resection was the primary treatment and the surgical margins were recorded for all patients. Statistical analyses were aided by the Statistical Package for the Social Sciences, version 15.0, and MedCalc software. The status of the surgical margins was evaluated using a receiver operating characteristic (ROC) curve to define the cut-off point. Cox's proportional hazard model was used to establish predictive factors for local recurrence and disease-specific survival. Of 192 patients, 23 (12%) had involved margins (<1.0mm), 107 (56%) had close margins (1.0-2.0mm (16.1%); 2.1-3.0mm (12%); 3.1-4.0mm (10.4%); 4.1-5.0mm (17.2%), and 62 (32.3%) had clear margins (>5mm). No predictive cut-off point was found that related close surgical margins to local recurrence. However, there was a significant adverse association between surgical margins ≤1.6mm and disease-specific survival. In recommending postoperative adjuvant treatment for oral and oropharyngeal SCC, we suggest that surgical margins within 2mm should be considered as the cut-off. However, other clinical and pathological prognostic factors should also be taken into consideration when recommending further treatment.

  8. Health-Related Quality-of-Life Outcomes Following IMRT Versus Conventional Radiotherapy for Oropharyngeal Squamous Cell Carcinoma

    SciTech Connect

    Yao Min Karnell, Lucy H.; Funk, Gerry F.; Lu Heming; Dornfeld, Ken; Buatti, John M.

    2007-12-01

    Purpose: To compare health-related quality-of-life (HRQOL) outcomes of patients with oropharyngeal squamous cell carcinoma treated using intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT). Patients and Methods: Patients with oropharyngeal squamous cell carcinoma were extracted from the database of an ongoing longitudinal Outcome Assessment Project. Eligible criteria included (1) treated with definitive radiation, and (2) provided 12-month posttreatment HRQOL data. Excluded were 7 patients who received IMRT before October 1, 2002, during this institution's developmental phase of the IMRT technique. The HRQOL outcomes of patients treated with IMRT were compared with those of patients who received CRT. Results: Twenty-six patients treated using IMRT and 27 patients treated using CRT were included. Patients in the IMRT group were older and had more advanced-stage diseases and more patients received concurrent chemotherapy. However, the IMRT group had higher mean Head and Neck Cancer Inventory scores (which represent better outcomes) for each of the four head-and-neck cancer-specific domains, including eating, speech, aesthetics, and social disruption, at 12 months after treatment. A significantly greater percentage of patients in the CRT group had restricted diets compared with those in the IMRT group (48.0% vs. 16.0%, p = 0.032). At 3 months after treatment, both groups had significant decreases from pretreatment eating scores. However, the IMRT group had a significant improvement during the first year, but the CRT group had only small improvement. Conclusions: Proper delivery of IMRT can improve HRQOL for patients with oropharyngeal cancer compared with CRT.

  9. VIEW NORTHEAST, WEST FRONT OF PACKING SHED (BUILDING 20) AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW NORTHEAST, WEST FRONT OF PACKING SHED (BUILDING 20) AND BAMBOO STAND ALONG SOUTH FRONT - U.S. Plant Introduction Station, Packing Shed, 11601 Old Pond Road, Glenn Dale, Prince George's County, MD

  10. Most Americans Favor Larger Health Warnings on Cigarette Packs

    MedlinePlus

    ... html Most Americans Favor Larger Health Warnings on Cigarette Packs Even many smokers think these warnings should ... 31, 2017 FRIDAY, March 31, 2017 (HealthDay News) -- Cigarette packs carry health warnings, but many Americans think ...

  11. Routine nasal packing follwoing nasal surgery-Is it necessary?

    PubMed

    Basha, S I; Gupta, D; Kaluskar, S K

    2005-01-01

    The practice of routine nasal packing after nasal surgery is usually customary and not evidence based. Post operative complications, while uncoumon, are sometimes pack related. A retrospective analysis of 110 patients who underwent a variety of nasal operations was performed to determine the incidence of complications when nasal packs were not routinely inserted 9 cases (8.2%) [6 out of these were revision surgeries] needed nasal packing for haemostasis at the end of surgery. 4 cases (3.6%) required to be packed in the immediate post operative period. One patient who required nasal packing developed a unilateral adhesion. No patient developed septal hematoma. The need for routine nasal packing is not supported. Packing should be indicated where there continuous bleeding at.

  12. Sorption-capacity limited retardation of radionuclides transport in water-saturated packing materials

    SciTech Connect

    Pescatore, C.; Sullivan, T.

    1984-01-01

    Radionuclides breakthrough times as calculated through constant retardation factors obtained in dilute solutions are non-conservative. The constant retardation approach regards the solid as having infinite sorption capacity throughout the solid. However, as the solid becomes locally saturated, such as in the proximity of the waste form-packing materials interface, it will exhibit no retardation properties, and transport will take place as if the radionuclides were locally non-reactive. The magnitude of the effect of finite sorption capacity of the packing materials on radionuclide transport is discussed with reference to high-level waste package performance. An example based on literature sorption data indicates that the breakthrough time may be overpredicted by orders of magnitude using a constant retardation factor as compared to using the entire sorption isotherm to obtain a concentration-dependent retardation factor. 8 references, 3 figures, 3 tables.

  13. Evolution of the local packing density in a sheared granular material

    NASA Astrophysics Data System (ADS)

    Umbanhowar, Paul; van Hecke, Martin; Sakaie, Ken

    2005-11-01

    The local particle packing density, η, in a bed of poppy seeds sheared in a vertical, split-bottom cylindrical container is measured using magnetic resonance imaging. Wide shear zones away from the wall are generated when a thin concentric disk at the bottom of the cylinder, and with radius less than the cylinder radius, is rotated slowly. Experiments reveal that, initially, a shear band forms at the outer edge of the disk which decreases in radius with decreasing depth. Material near the shear zone dilates with a corresponding decrease in η of about 15%. The radial extent of the dilated region increases approximately logarithmically with increasing rotation in shallow layers. In relatively deep layers, the shear zone is at first entirely below the free surface, but with further rotation grows vertically creating a low η core. We discuss the relation between the previously reported universal velocity profiles across the shear zone and the spatial and temporal evolution of the packing density.

  14. Morphology and distribution of taste papillae and oral denticles in the developing oropharyngeal cavity of the bamboo shark, Chiloscyllium punctatum

    PubMed Central

    Atkinson, Carla J. L.; Martin, Kyle J.; Fraser, Gareth J.

    2016-01-01

    ABSTRACT Gustation in sharks is not well understood, especially within species that ingest food items using suction. This study examines the morphological and immunohistochemical characterisation of taste papillae and oral denticles in the oropharynx of the brown-banded bamboo shark Chiloscyllium punctatum and compares their distribution during development. Taste papillae of C. punctatum are located throughout the oropharyngeal region and are most concentrated on the oral valves (2125-3483 per cm2 in embryos; 89-111 per cm2 in mature adults) close to the tooth territories. Papillae appearance is comparable at all stages of development, with the exception of the embryos (unhatched specimens), where no microvilli are present. Oral valve papillae are comparable in structure to Type I taste buds of teleost fishes, whereas those of the rest of the oropharyngeal region are comparable to Type II. Both types of papillae show immunofluorescence for a number of markers of taste buds, including β-Catenin and Sox2. Taste papillae densities are highest in embryos with 420-941 per cm2 compared to 8-29 per cm2 in mature adults. The total number of papillae remains around 1900 for all stages of development. However, the papillae increase in diameter from 72±1 μm (mean±s.e.m.) in embryos to 310±7 μm in mature individuals. Microvilli protrude in multiple patches at the apical tip of the papilla covering ∼0.5% of the papillar surface area. We further document the relationship between taste papillae and the closely associated oral denticles within the shark orophayngeal cavity. Oral denticles first break through the epithelium in the antero-central region of the dorsal oral cavity, shortly after the emergence of teeth, around time of hatching. Denticles are located throughout the oropharyngeal epithelium of both immature and mature stages, with the highest concentrations in the antero-dorsal oral cavity and the central regions of the pharynx. These denticle-rich areas of

  15. Changing prevalence and treatment outcomes of patients with p16 human papillomavirus related oropharyngeal squamous cell carcinoma in New Zealand.

    PubMed

    Kwon, H J; Brasch, H D; Benison, S; Marsh, R W; Itinteang, T; Titchener, G W; Evans, J; Tan, S T

    2016-10-01

    There has, to our knowledge, been no previous report of changes in the prevalence and outcomes of treatment of HPV-positive (+) oropharyngeal squamous cell carcinoma (SCC) in New Zealand. We identified all affected patients in the greater Wellington region between 1 January 1994 and 30 November 2014 from the New Zealand Cancer Registry. Their personal details, characteristics of their tumours, treatment, complications, and outcomes were collected retrospectively from their casenotes and the New Zealand Death Registry, followed by p16 immunohistochemical staining. Of the 161 patients included, 131 (81%) were men. p16 immunohistochemical staining was done routinely in 13 patients during investigations, and retrospectively for 135 patients. The proportion of p16+ oropharyngeal SCC increased from 24% during 1994-1999, to 76% during 2009-2014 (p<0.001). Oropharyngeal SCC among Europeans was more likely to be p16+ than in non-Europeans (67% compared with 44%, p=0.036). Patients with p16+ disease were younger (mean (SD) 56 (10) compared with 66 (9) years, p<0.01) with fewer coexisting conditions (mean (SD) Charlson Comorbidity Index: 2.45 (0.82) compared with 2.92 (1.16), p=0.01), and less likely to have smoked (57/81(70%) compared with 38/42 (91%) p=0.035), or misused alcohol (12/81 (15%) compared with 14/42 (31%), p=0.042), or both. They were also more likely to have poorly differentiated tumours (30/52 (58%) compared with 9/34 (26%), p=0.019) with nodal metastases (74/85 (87%) compared with 17/30 (57%), p=0.001). Overall 5-year all-cause survival was more favourable for patients with p16+ disease (65/86 (76%) compared with 15/49 (31%), p=0.000). Interestingly, all-cause age at death was younger in p16+ patients (62 (11.1) compared with 71 (11.2) years, p=0.001). The prevalence of p16+ oropharyngeal SCC had tripled in this population between 1994 and 2014, and affected patients have distinct characteristics and outcomes of treatment.

  16. Mineral scale in gravel packed wells

    SciTech Connect

    Schmidt, T.; Soereide, F.

    1994-12-31

    Mineral scales of barium, strontium and calcium sulphate are well known to the oil industry. The most common scale is calcium carbonate. However carbonate, unlike the three other scales mentioned, is acid soluble and it is perhaps the sulphate scales which gives the greatest problems. One additional feature of the sulphate scales is that they very often coprecipitate radium sulphate which is radioactive and difficult to dispose of and troublesome to work with from a health and safety aspect. This paper presents the production history of gravel packed wells which have experienced the deposition and removal of mainly strontium sulphate (SrSO{sub 4}) scale. A scale prediction program is used to analyze the scale tendencies under both equilibrium and kinetic controlled conditions. The flow and scale characteristics of gravel packed and naturally completed wells are compared.

  17. Body Packing: From Seizures to Laparotomy

    PubMed Central

    Janczak, Joanna M.; Beutner, Ulrich; Hasler, Karin

    2015-01-01

    Body packing is a common method for illegal drug trafficking. Complications associated with body packing can be severe and even lead to rapid death. Thus, a timely diagnosis is warranted. As most body packers initially do not show any symptoms, making a correct diagnosis can be rather challenging. We describe a case of a 41-year-old male, who was admitted with an epileptic seizure and who turned out to be a cocaine intoxicated body packer. Due to neurological and cardiovascular deterioration an emergency surgery was performed. Four bags of cocaine could be removed. We discuss the current management regimen in symptomatic and asymptomatic body packers and highlight pearls and pitfalls with diagnosis and treatment. PMID:25883813

  18. Is incest common in gray wolf packs?

    USGS Publications Warehouse

    Smith, D.; Meier, T.; Geffen, E.; Mech, L.D.; Burch, J.W.; Adams, L.G.; Wayne, R.K.

    1997-01-01

    Wolf packs generally consist of a breeding pair and their maturing offspring that help provision and protect pack young. Because the reproductive tenure in wolves often is short, reproductively mature offspring might replace their parents, resulting in sibling or parent-offspring matings. To determine the extent of incestuous pairings, we measure relatedness based on variability in 20 microsatellite loci of mated pairs, parent-offspring pairs and siblings in two populations of gray wolves. Our 16 sampled mated pairs had values of relatedness not overlapping those of known parent-offspring or sibling dyads, which is consistent with their being unrelated or distantly related. These results suggest that full siblings or a parent and their offspring rarely mate and that incest avoidance is an important constraint on gray wolf behavioral ecology.

  19. 29 CFR 784.135 - “Packing.”

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... packing of the various named marine products at sea as an incident to, or in conjunction with, the fishing..., sizing, and placing layers of crushed ice in the containers are deemed a part of packing when performed... to no more than the simple operation, of packing the product in chipped or crushed ice in...

  20. 29 CFR 784.135 - “Packing.”

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... packing of the various named marine products at sea as an incident to, or in conjunction with, the fishing..., sizing, and placing layers of crushed ice in the containers are deemed a part of packing when performed... to no more than the simple operation, of packing the product in chipped or crushed ice in...

  1. 29 CFR 784.135 - “Packing.”

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... packing of the various named marine products at sea as an incident to, or in conjunction with, the fishing..., sizing, and placing layers of crushed ice in the containers are deemed a part of packing when performed... to no more than the simple operation, of packing the product in chipped or crushed ice in...

  2. 29 CFR 784.135 - “Packing.”

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... packing of the various named marine products at sea as an incident to, or in conjunction with, the fishing..., sizing, and placing layers of crushed ice in the containers are deemed a part of packing when performed... to no more than the simple operation, of packing the product in chipped or crushed ice in...

  3. 29 CFR 784.135 - “Packing.”

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... packing of the various named marine products at sea as an incident to, or in conjunction with, the fishing..., sizing, and placing layers of crushed ice in the containers are deemed a part of packing when performed... to no more than the simple operation, of packing the product in chipped or crushed ice in...

  4. 48 CFR 211.272 - Alternate preservation, packaging, and packing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., packaging, and packing. 211.272 Section 211.272 Federal Acquisition Regulations System DEFENSE ACQUISITION... Requirements Documents 211.272 Alternate preservation, packaging, and packing. Use the provision at 252.211-7004, Alternate Preservation, Packaging, and Packing, in solicitations which include...

  5. 48 CFR 452.247-72 - Packing for Domestic Shipment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Packing for Domestic Shipment. 452.247-72 Section 452.247-72 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE... Packing for Domestic Shipment. As prescribed in 447.305-10(b), insert the following clause: Packing...

  6. 48 CFR 452.247-73 - Packing for Overseas Shipment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Packing for Overseas Shipment. 452.247-73 Section 452.247-73 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE... Packing for Overseas Shipment. As prescribed in 447.305-10(c), insert the following clause: Packing...

  7. 48 CFR 552.211-77 - Packing List.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Packing List. 552.211-77... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.211-77 Packing List. As prescribed in 511.204(c), insert the following clause: Packing List (FEB 1996) (a) A...

  8. 7 CFR 51.1312 - Tolerances for standard pack.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Tolerances for standard pack. 51.1312 Section 51.1312... STANDARDS) United States Standards for Winter Pears 1 Standard Pack § 51.1312 Tolerances for standard pack... are both stated, an additional 10 percent tolerance shall be allowed for pears which are larger...

  9. Steam injection well gravel pack material of sintered bauxite

    SciTech Connect

    Elson, T. D.; Millhone, R. S.

    1985-08-27

    A packing material useful in a gravel pack for open or cased wells or in a prepack for use in steam or hot fluid injection and production wells. The packing material is a material which is insoluble in high temperature caustic fluids and subsurface formation fluids. Sintered bauxite is a claimed material.

  10. 27 CFR 24.255 - Bottling or packing wine.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Bottling or packing wine..., DEPARTMENT OF THE TREASURY ALCOHOL WINE Storage, Treatment and Finishing of Wine Bottling, Packing, and Labeling of Wine § 24.255 Bottling or packing wine. (a) General. Proprietors of a bonded wine premises...

  11. 27 CFR 24.255 - Bottling or packing wine.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Bottling or packing wine..., DEPARTMENT OF THE TREASURY LIQUORS WINE Storage, Treatment and Finishing of Wine Bottling, Packing, and Labeling of Wine § 24.255 Bottling or packing wine. (a) General. Proprietors of a bonded wine premises...

  12. 27 CFR 24.255 - Bottling or packing wine.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Bottling or packing wine..., DEPARTMENT OF THE TREASURY LIQUORS WINE Storage, Treatment and Finishing of Wine Bottling, Packing, and Labeling of Wine § 24.255 Bottling or packing wine. (a) General. Proprietors of a bonded wine premises...

  13. 27 CFR 24.255 - Bottling or packing wine.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Bottling or packing wine..., DEPARTMENT OF THE TREASURY LIQUORS WINE Storage, Treatment and Finishing of Wine Bottling, Packing, and Labeling of Wine § 24.255 Bottling or packing wine. (a) General. Proprietors of a bonded wine premises...

  14. 27 CFR 24.255 - Bottling or packing wine.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Bottling or packing wine..., DEPARTMENT OF THE TREASURY ALCOHOL WINE Storage, Treatment and Finishing of Wine Bottling, Packing, and Labeling of Wine § 24.255 Bottling or packing wine. (a) General. Proprietors of a bonded wine premises...

  15. 7 CFR 51.2840 - Export packing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Export packing requirements. 51.2840 Section 51.2840 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards...) Export Packing Requirements § 51.2840 Export packing requirements. Onions specified as meeting...

  16. 48 CFR 552.211-87 - Export packing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Export packing. 552.211-87... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.211-87 Export packing. As prescribed in 511.204(b)(7), insert the following clause: Export Packing (JAN 2010)...

  17. 1. Contextual view looking west, showing packing house and Union ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Contextual view looking west, showing packing house and Union Ice building, which is located to the north of Packing House (right hand side in photo) - College Heights Lemon Packing House, 519-532 West First Street, Claremont, Los Angeles County, CA

  18. 36 CFR 34.10 - Saddle and pack animals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Saddle and pack animals. 34... INTERIOR EL PORTAL ADMINISTRATIVE SITE REGULATIONS § 34.10 Saddle and pack animals. The use of saddle and pack animals is prohibited without a permit from the Superintendent....

  19. 36 CFR 2.16 - Horses and pack animals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Horses and pack animals. 2.16... RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of...

  20. 36 CFR 2.16 - Horses and pack animals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Horses and pack animals. 2.16... RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of...

  1. 36 CFR 34.10 - Saddle and pack animals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Saddle and pack animals. 34... INTERIOR EL PORTAL ADMINISTRATIVE SITE REGULATIONS § 34.10 Saddle and pack animals. The use of saddle and pack animals is prohibited without a permit from the Superintendent....

  2. 36 CFR 1002.16 - Horses and pack animals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Horses and pack animals. 1002... AND RECREATION § 1002.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of transporting equipment. (b) The use...

  3. 36 CFR 1002.16 - Horses and pack animals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Horses and pack animals. 1002... AND RECREATION § 1002.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of transporting equipment. (b) The use...

  4. 36 CFR 2.16 - Horses and pack animals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Horses and pack animals. 2.16... RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of...

  5. 36 CFR 34.10 - Saddle and pack animals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Saddle and pack animals. 34... INTERIOR EL PORTAL ADMINISTRATIVE SITE REGULATIONS § 34.10 Saddle and pack animals. The use of saddle and pack animals is prohibited without a permit from the Superintendent....

  6. 36 CFR 34.10 - Saddle and pack animals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Saddle and pack animals. 34... INTERIOR EL PORTAL ADMINISTRATIVE SITE REGULATIONS § 34.10 Saddle and pack animals. The use of saddle and pack animals is prohibited without a permit from the Superintendent....

  7. 36 CFR 2.16 - Horses and pack animals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Horses and pack animals. 2.16... RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of...

  8. 36 CFR 1002.16 - Horses and pack animals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Horses and pack animals. 1002... AND RECREATION § 1002.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of transporting equipment. (b) The use...

  9. 36 CFR 2.16 - Horses and pack animals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Horses and pack animals. 2.16... RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of...

  10. 36 CFR 1002.16 - Horses and pack animals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Horses and pack animals. 1002... AND RECREATION § 1002.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of transporting equipment. (b) The use...

  11. 36 CFR 34.10 - Saddle and pack animals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Saddle and pack animals. 34... INTERIOR EL PORTAL ADMINISTRATIVE SITE REGULATIONS § 34.10 Saddle and pack animals. The use of saddle and pack animals is prohibited without a permit from the Superintendent....

  12. 36 CFR 1002.16 - Horses and pack animals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Horses and pack animals. 1002... AND RECREATION § 1002.16 Horses and pack animals. The following are prohibited: (a) The use of animals other than those designated as “pack animals” for purposes of transporting equipment. (b) The use...

  13. Protection of gravel pack well completions during steam injection

    SciTech Connect

    Burrows, D.N.; Northrop, P.S.

    1993-08-31

    A method is described for protecting a gravel pack completion in a well through which steam is injected into a subterranean formation wherein gravel used to form said gravel pack completion contains silica; said method comprising: passing said steam through a silica-containing particulate material at the surface prior to injecting said steam through said gravel pack well completion.

  14. Partitioning And Packing Equations For Parallel Processing

    NASA Technical Reports Server (NTRS)

    Arpasi, Dale J.; Milner, Edward J.

    1989-01-01

    Algorithm developed to identify parallelism in set of coupled ordinary differential equations that describe physical system and to divide set into parallel computational paths, along with parts of solution proceeds independently of others during at least part of time. Path-identifying algorithm creates number of paths consisting of equations that must be computed serially and table that gives dependent and independent arguments and "can start," "can end," and "must end" times of each equation. "Must end" time used subsequently by packing algorithm.

  15. Sensory Analysis of Stored Tray Pack Foods

    DTIC Science & Technology

    1989-12-01

    Milk chocolate brown. ODOR: Sweet, typical of heat processed milk cocoa . FLAVOR: Sweet, full milk cocoa flavor. TEXTURE: Smooth, medium thick...7B DEGREES 100 DEGREES 6. DESSERTS Chocolate Pudding There was no significant finding with this Tray Pack item. Marble Cake At 70°F, the effect...and 6 months. The main effect of temperature on acceptability of this item was not significant. Chocolate Cake At 70°F, there was a significant

  16. Influence of fiber packing structure on permeability

    NASA Technical Reports Server (NTRS)

    Cai, Zhong; Berdichevsky, Alexander L.

    1993-01-01

    The study on the permeability of an aligned fiber bundle is the key building block in modeling the permeability of advanced woven and braided preforms. Available results on the permeability of fiber bundles in the literature show that a substantial difference exists between numerical and analytical calculations on idealized fiber packing structures, such as square and hexagonal packing, and experimental measurements on practical fiber bundles. The present study focuses on the variation of the permeability of a fiber bundle under practical process conditions. Fiber bundles are considered as containing openings and fiber clusters within the bundle. Numerical simulations on the influence of various openings on the permeability were conducted. Idealized packing structures are used, but with introduced openings distributed in different patterns. Both longitudinal and transverse flow are considered. The results show that openings within the fiber bundle have substantial effect on the permeability. In the longitudinal flow case, the openings become the dominant flow path. In the transverse flow case, the fiber clusters reduce the gap sizes among fibers. Therefore the permeability is greatly influenced by these openings and clusters, respectively. In addition to the porosity or fiber volume fraction, which is commonly used in the permeability expression, another fiber bundle status parameter, the ultimate fiber volume fraction, is introduced to capture the disturbance within a fiber bundle.

  17. Probe with integrated heater and thermocouple pack

    DOEpatents

    McCulloch, Reginald W.; Dial, Ralph E.; Finnell, Wilber K. R.

    1988-01-01

    A probe for measuring heat includes an elongate rod fitted within a sheath, and a plurality of annular recesses are formed on the surface of the rod in a spaced-apart relationship to form annular chambers that are resistant to heat flow. A longitudinal bore extends axially into the rod and within the cylinders defined by the annular chambers, and an integrated heater and thermocouple pack is dimensioned to fit within the bore. In construction, the integrated pack includes a plurality of wires disposed in electrical insulation within a sheath and a heater cable. These wires include one common wire and a plurality of thermocouple wires. The common wire is constructed of one type of conductive material while the thermocouple wires are each constructed of two types of materials so that at least one thermocouple junction is formed therein. All of the wires extend the length of the integrated pack and are connected together at their ends. The thermocouple wires are constructed to form thermocouple junctions proximate to each annular chamber for producing electromotive forces corresponding to the temperature of the rod within the annular chambers relative to outside the chambers. In the preferred embodiment, each thermocouple wire forms two thermocouple junctions, one junction being disposed within an annular chamber and the second junction being disposed outside of, but proximate to, the same annular chamber. In one embodiment two thermocouple wires are configured to double the sensitivity of the probe in one region.

  18. Probe with integrated heater and thermocouple pack

    DOEpatents

    McCulloch, Reg W.; Dial, Ralph E.; Finnell, Wilber K. R.

    1990-01-01

    A probe for measuring heat includes an elongate rod fitted within a sheath, and a plurality of annular recesses are formed on the surface of the rod in a spaced-apart relationship to form annular chambers that are resistant to heat flow. A longitudinal bore extends axially into the rod and within the cylinders defined by the annular chambers, and an integrated heater and thermocouple pack is dimensioned to fit within the bore. In construction, the integrated pack includes a plurality of wires disposed in electrical insulation within a sheath and a heater cable. These wires include one common wire and a plurality of thermocuple wires. The common wire is constructed of one type of conductive material while the thermocouple wires are each constructed of two types of materials so that at least one thermocouple junction is formed therein. All of the wires extend the length of the integrated pack and are connected together at their ends. The thermocouple wires are constructed to form thermocouple junctions proximate to each annular chamber for producing electromotive forces corresponding to the temperature of the rod within the annular chambers relative to outside the chambers. In the preferred embodiment, each thermocouple wire forms two thermocouple junctions, one junction being disposed within an annular chamber and the second junction being disposed outside of, but proximate to, the same annular chamber. In one embodiment two thermocouple wires are configured to double the sensitivity of the probe in one region.

  19. 27 CFR 31.66 - Retail dealer selling entire stock in liquidation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... entire stock in liquidation. 31.66 Section 31.66 Alcohol, Tobacco Products and Firearms ALCOHOL AND... Exceptions Persons Who Are Not Dealers in Liquors Or Beer § 31.66 Retail dealer selling entire stock in... liquors or a wholesale dealer in beer by virtue of selling in liquidation that dealer's entire stock...

  20. Eating less from bigger packs: Preventing the pack size effect with diet primes.

    PubMed

    Versluis, Iris; Papies, Esther K

    2016-05-01

    An increase in the package size of food has been shown to lead to an increase in energy intake from this food, the so-called pack size effect. Previous research has shown that providing diet-concerned individuals with a reminder, or prime, of their dieting goal can help them control their consumption. Here, we investigated if providing such a prime is also effective for reducing the magnitude of the pack size effect. We conducted two experiments in which the cover of a dieting magazine (Experiment 1) and diet-related commercials (Experiment 2) served as diet goal primes. Both experiments had a 2 (pack size: small vs. large) × 2 (prime: diet vs. control) × 2 (dietary restraint: high vs. low) between participants design. We measured expected consumption of four snack foods in Experiment 1 (N = 477), and actual consumption of M&M's in Experiment 2 (N = 224). Results showed that the diet prime reduced the pack size effect for both restrained and unrestrained eaters in Experiment 1 and for restrained eaters only in Experiment 2. Although effect sizes were small, these findings suggest that a diet prime motivates restrained eaters to limit their consumption, and as a result the pack size has less influence on the amount consumed. We discuss limitations of this research as well as potential avenues for further research and theoretical and practical implications.

  1. Volatile species in halide-activated-diffusion coating packs

    NASA Technical Reports Server (NTRS)

    Bianco, Robert; Rapp, Robert A.; Jacobson, Nathan S.

    1992-01-01

    An atmospheric pressure sampling mass spectrometer was used to identify the vapor species generated in a halide-activated cementation pack. Pack powder mixtures containing a Cr-Al binary masteralloy powder, an NH4Cl activator salt, and either ZrO2 or Y2O3 (or neither) were analyzed at 1000 C. Both the equilibrium calculations for the pack and mass spectrometer results indicated that volatile AlCl(x) and CrCl(y) species were generated by the pack powder mixture; in packs containing the reactive element oxide, volatile ZrCl(z) and YCl(w) species were formed by the conversion of their oxide sources.

  2. The usefulness of toluidine staining as a diagnostic tool for precancerous and cancerous oropharyngeal and oral cavity lesions

    PubMed Central

    Allegra, E; Lombardo, N; L. Puzzo; Garozzo, A

    2009-01-01

    Summary Toluidine blue stain is used as a marker to differentiate lesions at high risk of progression in order to improve early diagnosis of oropharyngeal carcinomas. This study focused on 45 oral mucosal lesions in 32 patients (13 female, 19 male). In 9 cases, multiple biopsies were collected. Of the 45 lesions examined, 26 (57.0%) were defined clinically benign, while 19 (42.3%) were defined as suspected lesions (premalignant or malignant). According to the clinical examination, the sensitivity was 53% (16/30) and for toluidine blue staining 96.2% (26/27) (p = 0.0007). The specificity was 80% (12/15) for clinical examination and 77.7% (14/15) for toluidine blue staining (p = 0.79). In conclusion toluidine blue stain has been shown to be a reliable aid when clinical examination is unable to differentiate lesions at high risk of progression and then it improves early diagnosis for oral cavity and oropharyngeal cancer. PMID:20161875

  3. Multidrug Resistance Protein 1 Protects the Oropharyngeal Mucosal Layer and the Testicular Tubules against Drug-induced Damage

    PubMed Central

    Wijnholds, Jan; Scheffer, George L.; van der  Valk, Martin; van der  Valk, Paul; Beijnen, Jos H.; Scheper, Rik J.; Borst, Piet

    1998-01-01

    The multidrug resistance protein 1 (MRP1) gene encodes a transporter protein that helps to protect cells against xenobiotics. Elevated levels of MRP1 in tumor cells can result in active extrusion of a wide range of (anticancer) drugs with different cellular targets, a phenomenon called multidrug resistance (MDR). To explore the protective function of the mouse mrp1 protein during drug treatment, we investigated the toxicity caused by the anticancer drug etoposide-phosphate (ETOPOPHOS) in mice lacking the mrp1 gene (mrp1−/− mice). We show here that the lack of mrp1 protein results in increased etoposide-induced damage to the mucosa of the oropharyngeal cavity and to the seminiferous tubules of the testis. The high concentrations of mrp1 that we find in the basal layers of the oropharyngeal mucosa and in the basal membrane of the Sertoli cells in the testis apparently protect wild-type mice against this tissue damage. We also find drug-induced polyuria in mrp1−/− mice, which correlates with the presence of mrp1 protein in the urinary collecting tubules, the major site of kidney water reabsorption. Our results indicate that specific inhibitors of MRP1 used to reverse MDR, in combination with carcinostatic drugs transported by MRP1, might lead to drug-induced mucositis, (temporary) infertility, and diabetes insipidus. PMID:9730882

  4. Concurrent Chemoradiation With Carboplatin-5-Fluorouracil Versus Cisplatin in Locally Advanced Oropharyngeal Cancers: Is More Always Better?

    SciTech Connect

    Barkati, Maroie; Fortin, Bernard; Soulieres, Denis; Clavel, Sebastien; Despres, Phillipe; Charpentier, Danielle; Tabet, Jean-Claude; Guertin, Louis; Olivier, Marie-Jo; Coulombe, Genevieve; Donath, David; Nguyen-Tan, Phuc Felix

    2010-02-01

    Purpose: The optimal chemotherapy regimen remains undefined in the treatment of locally advanced oropharyngeal cancer by concomitant chemoradiation. This article compares two platinum-based chemotherapy regimens. Methods and Materials: In this retrospective study, we reviewed all consecutive patients treated for Stage III or IVA-B oropharyngeal cancer using either a combination of carboplatin and 5-fluorouracil (5FU) every 3 weeks or high-dose cisplatin every 3 weeks concomitant with definitive radiation therapy. Results: A total of 200 patients were treated with carboplatin-5FU and 53 patients with cisplatin. Median potential follow-up was 43 months. The 3-year overall survival rates for carboplatin-5FU and cisplatin respectively were 79.1% and 74.9% (p = 0.628), the 3-year disease-free survival rates were 76.0% and 71.3% (p = 0.799), and the 3-year locoregional control rates were 88.4% and 94.2% (p = 0.244). Conclusions: We could not demonstrate differences between these two regimens, which both proved efficacious. Polychemotherapy and monochemotherapy therefore seem comparable in this retrospective analysis.

  5. Dense packings of the Platonic and Archimedean solids.

    PubMed

    Torquato, S; Jiao, Y

    2009-08-13

    Dense particle packings have served as useful models of the structures of liquid, glassy and crystalline states of matter, granular media, heterogeneous materials and biological systems. Probing the symmetries and other mathematical properties of the densest packings is a problem of interest in discrete geometry and number theory. Previous work has focused mainly on spherical particles-very little is known about dense polyhedral packings. Here we formulate the generation of dense packings of polyhedra as an optimization problem, using an adaptive fundamental cell subject to periodic boundary conditions (we term this the 'adaptive shrinking cell' scheme). Using a variety of multi-particle initial configurations, we find the densest known packings of the four non-tiling Platonic solids (the tetrahedron, octahedron, dodecahedron and icosahedron) in three-dimensional Euclidean space. The densities are 0.782..., 0.947..., 0.904... and 0.836..., respectively. Unlike the densest tetrahedral packing, which must not be a Bravais lattice packing, the densest packings of the other non-tiling Platonic solids that we obtain are their previously known optimal (Bravais) lattice packings. Combining our simulation results with derived rigorous upper bounds and theoretical arguments leads us to the conjecture that the densest packings of the Platonic and Archimedean solids with central symmetry are given by their corresponding densest lattice packings. This is the analogue of Kepler's sphere conjecture for these solids.

  6. Structural characterization of the packings of granular regular polygons

    NASA Astrophysics Data System (ADS)

    Wang, Chuncheng; Dong, Kejun; Yu, Aibing

    2015-12-01

    By using a recently developed method for discrete modeling of nonspherical particles, we simulate the random packings of granular regular polygons with three to 11 edges under gravity. The effects of shape and friction on the packing structures are investigated by various structural parameters, including packing fraction, the radial distribution function, coordination number, Voronoi tessellation, and bond-orientational order. We find that packing fraction is generally higher for geometrically nonfrustrated regular polygons, and can be increased by the increase of edge number and decrease of friction. The changes of packing fraction are linked with those of the microstructures, such as the variations of the translational and orientational orders and local configurations. In particular, the free areas of Voronoi tessellations (which are related to local packing fractions) can be described by log-normal distributions for all polygons. The quantitative analyses establish a clearer picture for the packings of regular polygons.

  7. Larynx-sparing techniques using intensity-modulated radiation therapy for oropharyngeal cancer

    SciTech Connect

    Bar Ad, Voichita; Lin, Haibo; Hwang, Wei-Ting; Deville, Curtiland; Dutta, Pinaki R.; Tochner, Zelig; Both, Stefan

    2012-01-01

    The purpose of the current study was to explore whether the laryngeal dose can be reduced by using 2 intensity-modulated radiation therapy (IMRT) techniques: whole-neck field IMRT technique (WF-IMRT) vs. junctioned IMRT (J-IMRT). The effect on planning target volumes (PTVs) coverage and laryngeal sparing was evaluated. WF-IMRT technique consisted of a single IMRT plan, including the primary tumor and the superior and inferior neck to the level of the clavicular heads. The larynx was defined as an organ at risk extending superiorly to cover the arytenoid cartilages and inferiorly to include the cricoid cartilage. The J-IMRT technique consisted of an IMRT plan for the primary tumor and the superior neck, matched to conventional antero-posterior opposing lower neck fields at the level of the thyroid notch. A central block was used for the anterior lower neck field at the level of the larynx to restrict the dose to the larynx. Ten oropharyngeal cancer cases were analyzed. Both the primary site and bilateral regional lymphatics were included in the radiotherapy targets. The averaged V95 for the PTV57.6 was 99.2% for the WF-IMRT technique compared with 97.4% (p = 0.02) for J-IMRT. The averaged V95 for the PTV64 was 99.9% for the WF-IMRT technique compared with 98.9% (p = 0.02) for J-IMRT and the averaged V95 for the PT70 was 100.0% for WF-IMRT technique compared with 99.5% (p = 0.04) for J-IMRT. The averaged mean laryngeal dose was 18 Gy with both techniques. The averaged mean doses within the matchline volumes were 69.3 Gy for WF-MRT and 66.2 Gy for J-IMRT (p = 0.03). The WF-IMRT technique appears to offer an optimal coverage of the target volumes and a mean dose to the larynx similar with J-IMRT and should be further evaluated in clinical trials.

  8. Larynx-sparing techniques using intensity-modulated radiation therapy for oropharyngeal cancer.

    PubMed

    Bar Ad, Voichita; Lin, Haibo; Hwang, Wei-Ting; Deville, Curtiland; Dutta, Pinaki R; Tochner, Zelig; Both, Stefan

    2012-01-01

    The purpose of the current study was to explore whether the laryngeal dose can be reduced by using 2 intensity-modulated radiation therapy (IMRT) techniques: whole-neck field IMRT technique (WF-IMRT) vs. junctioned IMRT (J-IMRT). The effect on planning target volumes (PTVs) coverage and laryngeal sparing was evaluated. WF-IMRT technique consisted of a single IMRT plan, including the primary tumor and the superior and inferior neck to the level of the clavicular heads. The larynx was defined as an organ at risk extending superiorly to cover the arytenoid cartilages and inferiorly to include the cricoid cartilage. The J-IMRT technique consisted of an IMRT plan for the primary tumor and the superior neck, matched to conventional antero-posterior opposing lower neck fields at the level of the thyroid notch. A central block was used for the anterior lower neck field at the level of the larynx to restrict the dose to the larynx. Ten oropharyngeal cancer cases were analyzed. Both the primary site and bilateral regional lymphatics were included in the radiotherapy targets. The averaged V95 for the PTV57.6 was 99.2% for the WF-IMRT technique compared with 97.4% (p = 0.02) for J-IMRT. The averaged V95 for the PTV64 was 99.9% for the WF-IMRT technique compared with 98.9% (p = 0.02) for J-IMRT and the averaged V95 for the PT70 was 100.0% for WF-IMRT technique compared with 99.5% (p = 0.04) for J-IMRT. The averaged mean laryngeal dose was 18 Gy with both techniques. The averaged mean doses within the matchline volumes were 69.3 Gy for WF-MRT and 66.2 Gy for J-IMRT (p = 0.03). The WF-IMRT technique appears to offer an optimal coverage of the target volumes and a mean dose to the larynx similar with J-IMRT and should be further evaluated in clinical trials.

  9. Cost analysis in oral cavity and oropharyngeal reconstructions with microvascular and pedicled flaps.

    PubMed

    Deganello, A; Gitti, G; Parrinello, G; Muratori, E; Larotonda, G; Gallo, O

    2013-12-01

    Reconstructive surgery of the head and neck region has undergone tremendous advancement over the past three decades, and the success rate of free tissue transfers has risen to greater than 95%. It must always be considered that not all patients are ideal candidates for free flap reconstruction, and also that not every defect strictly requires a free flap transfer to achieve good functional results. At our institution, free flap reconstruction is first choice, although we use pedicled alternative flaps for most weak patients suffering from severe comorbidities, and for pretreated patients presenting a second primary or a recurrent cancer. From July 2006 to May 2010, 54 consecutive patients underwent soft tissue reconstruction of oral cavity and oropharyngeal defects. We divided the cohort in three groups: Group 1 (G1): 16 patients in good general conditions that received free radial forearm flap reconstruction; Group 2 (G2): 18 high-risk patients that received a reconstruction with infrahyoid flap; Group 3 (G3): 20 patients that received temporal flap (10 cases) or pectoral flap (10 cases) reconstruction. We must highlight that pedicled alternative flaps were used in elderly, unfavourable and weak patients, where usually the medical costs tend to rise rather than decrease. We compared the healthcare costs of the three groups, calculating real costs in each group from review of medical records and operating room registers, and calculating the corresponding DRG system reimbursement. For real costs, we found a statistically significant difference among groups: in G1 the average total cost per patient was € 22,924, in G2 it was € 18,037 and in G3 was € 19,872 (p = 0.043). The amount of the refund, based on the DRG system, was € 7,650 per patient, independently of the type of surgery. Our analysis shows that the use of alternative non-microvascular techniques, in high-risk patients, is functionally and oncologically sound, and can even produce a cost savings. In

  10. Origin of Tumor Recurrence After Intensity Modulated Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma

    SciTech Connect

    Raktoe, Sawan A.S.; Dehnad, Homan; Raaijmakers, Cornelis P.J.; Braunius, Weibel; Terhaard, Chris H.J.

    2013-01-01

    Purpose: To model locoregional recurrences of oropharyngeal squamous cell carcinomas (OSCC) treated with primary intensity modulated radiation therapy (IMRT) in order to find the origins from which recurrences grow and relate their location to original target volume borders. Methods and Materials: This was a retrospective analysis of OSCC treated with primary IMRT between January 2002 and December 2009. Locoregional recurrence volumes were delineated on diagnostic scans and coregistered rigidly with treatment planning computed tomography scans. Each recurrence was analyzed with two methods. First, overlapping volumes of a recurrence and original target were measured ('volumetric approach') and assessed as 'in-field', 'marginal', or 'out-field'. Then, the center of mass (COM) of a recurrence volume was assumed as the origin from where a recurrence expanded, the COM location was compared with original target volume borders and assessed as 'in-field', 'marginal', or 'out-field'. Results: One hundred thirty-one OSCC were assessed. For all patients alive at the end of follow-up, the mean follow-up time was 40 months (range, 12-83 months); 2 patients were lost to follow-up. The locoregional recurrence rate was 27%. Of all recurrences, 51% were local, 23% were regional, and 26% had both local and regional recurrences. Of all recurrences, 74% had imaging available for assessment. Regarding volumetric analysis of local recurrences, 15% were in-field gross tumor volume (GTV), and 65% were in-field clinical tumor volume (CTV). Using the COM approach, we found that 70% of local recurrences were in-field GTV and 90% were in-field CTV. Of the regional recurrences, 25% were volumetrically in-field GTV, and using the COM approach, we found 54% were in-field GTV. The COM of local out-field CTV recurrences were maximally 16 mm outside CTV borders, whereas for regional recurrences, this was 17 mm. Conclusions: The COM model is practical and specific for recurrence assessment. Most

  11. Gastrostomy in oropharyngeal cancer patients with ERCC4 (XPF) germline variants

    SciTech Connect

    Kornguth, David G.; Garden, Adam S.; Zheng Yuxin; Dahlstrom, Kristina R.; Wei Qingyi; Sturgis, Erich M. . E-mail: esturgis@mdanderson.org

    2005-07-01

    Purpose: ERCC4 (XPF) plays a role in both recombinant DNA repair and nucleotide excision repair, which involve repairing radiation-induced genetic damage. We hypothesized that two ERCC4 single-nucleotide polymorphisms are associated with normal-tissue toxicity in patients treated with radiotherapy for oropharyngeal squamous cell carcinoma (OPSCC). Methods and Materials: A retrospective review of the medical records of 130 patients with OPSCC who were prospectively recruited into a molecular epidemiologic study was performed to determine whether a long-term percutaneous feeding gastrostomy (LPFG) tube (a tube required for more than 180 days) had been used during and after definitive radiotherapy. We determined the genotype of the ERCC4 G1244A and T2505C polymorphisms using standard polymerase chain reaction-restriction fragment-length polymorphism techniques on DNA extracted from peripheral blood lymphocytes. Results: Of 130 patients, 100 (77%) were evaluable for the ERCC4 G1244A polymorphism in exon 8, and 122 (94%) were evaluable for the ERCC4 T2505C polymorphism in exon 11. The ERCC4 G1244A polymorphism was associated with a decreased need for LPFG, but this was not statistically significant (adjusted odds ratio = 0.53; 95% confidence interval, 0.10-2.78). Sixteen (32%), 9 (14%), and 1 (10%) of patients with the wild-type homozygous TT genotype of ERCC4 T2505C, the heterozygous TC genotype, and the homozygous CC polymorphic genotype, respectively, required LPFG. These results suggest that the ERCC4 2505C allele was associated with a reduced need for LPFG (adjusted odds ratio = 0.20; 95% confidence interval, 0.06-0.67). Furthermore, the need for LPFG was reduced by having more than 1 ERCC4 2505C allele and further for having both the ERCC4 1244A and 2505C polymorphic alleles, but this was not statistically significant. In addition, the actual time of gastrostomy dependence was associated with the T2505C polymorphism based on the Kaplan-Meier method (p = 0

  12. Clinicopathological and immunohistochemical evaluation of oral and oropharyngeal squamous cell carcinoma in Chilean population.

    PubMed

    Rivera, César; González-Arriagada, Wilfredo A; Loyola-Brambilla, Marco; de Almeida, Oslei Paes; Coletta, Ricardo Della; Venegas, Bernardo

    2014-01-01

    In oral and oropharyngeal squamous cell carcinoma (OCSCC and OPSCC) exist an association between clinical and histopathological parameters with cell proliferation, basal lamina, connective tissue degradation and surrounding stroma markers. We evaluated these associations in Chilean patients. A convenience sample of 37 cases of OCSCC (n=16) and OPSCC (n=21) was analyzed clinically (TNM, clinical stage) and histologically (WHO grade of differentiation, pattern of tumor invasion). We assessed the expression of p53, Ki67, HOXA1, HOXB7, type IV collagen (ColIV) and carcinoma-associated fibroblast (α-SMA-positive cells). Additionally we conducted a univariate/bivariate analysis to assess the relationship of these variables with survival rates. Males were mostly affected (56.2% OCSCC, 76.2% OPSCC). Patients were mainly diagnosed at III/IV clinical stages (68.8% OCSCC, 90.5% OPSCC) with a predominantly infiltrative pattern invasion (62.9% OCSCC, 57.1% OPSCC). Significant association between regional lymph nodes (N) and clinical stage with OCSCC-HOXB7 expression (Chi-Square test P < 0.05) was observed. In OPSCC a statistically significant association exists between p53, Ki67 with gender (Chi-Square test P < 0.05). In OCSCC and OPSCC was statistically significant association between ki67 with HOXA1, HOXB7, and between these last two antigens (Pearson's Correlation test P < 0.05). Furthermore OPSCC-p53 showed significant correlation when it was compared with α-SMA (Kendall's Tau-c test P < 0.05). Only OCSCC-pattern invasion and OPSCC-primary tumor (T) pattern resulted associated with survival at the end of the follow up period (Chi-Square Likelihood Ratio, P < 0.05). Clinical, histological and immunohistochemical features are similar to seen in other countries. Cancer proliferation markers were associated strongly from each other. Our sample highlights prognostic value of T and pattern of invasion, but the conclusions may be limited and should be considered with caution

  13. Ecological Effect of Solithromycin on Normal Human Oropharyngeal and Intestinal Microbiota

    PubMed Central

    Rashid, Mamun-Ur; Rosenborg, Staffan; Panagiotidis, Georgios; Holm, Johan; Söderberg Löfdal, Karin; Nord, Carl Erik

    2016-01-01

    Solithromycin is a new fluoroketolide. The purpose of the present study was to investigate the effect of orally administered solithromycin on the human oropharyngeal and intestinal microbiota. Thirteen healthy volunteers (median age, 27.3 years) received oral solithromycin at 800 mg on day 1 followed by 400 mg daily on days 2 to 7. Fecal and saliva samples were collected at baseline and on days 2, 5, 7, 9, 14, and 21 for pharmacokinetic and microbiological analyses. Plasma samples were collected predose on days 2, 5, and 7 as proof of exposure, and solithromycin concentration ranges were 21.9 to 258 ng/ml, 18.0 to 386 ng/ml, and 16.9 to 417 ng/ml, respectively. The solithromycin concentrations in feces were 15.8 to 65.4 mg/kg, 24.5 to 82.7 mg/kg, 21.4 to 82.7 mg/kg, 12.1 to 72.4 mg/kg, 0.2 to 25.6 mg/kg, and 0 to 0.5 mg/kg on days 2, 5, 7, 9, 14, and 21, respectively. The numbers of enterobacteria and enterococci decreased and were normalized on day 14. The numbers of lactobacilli and bifidobacteria decreased from day 2 to day 14 and were normalized on day 21. The clostridia decreased on days 2, 7, and 14 and were normalized on day 21. No Clostridium difficile strains or toxins were detected during the study period. The number of Bacteroides strains was not significantly changed. The solithromycin concentrations in saliva were 0 to 1.2 mg/liter, 0 to 0.5 mg/liter, 0 to 0.5 mg/liter, and 0 to 0.1 mg/liter on days 2, 5, 7, and 9, respectively. The numbers of streptococci decreased on day 2 and were normalized on day 5. The numbers of lactobacilli, prevotellae, fusobacteria, and leptotrichiae decreased from day 2 and were normalized on day 21. PMID:27139483

  14. Comparison of cloacal and oropharyngeal samples for the detection of avian influenza virus in wild birds.

    PubMed

    Jindal, Naresh; de Abin, Martha; Primus, Alexander E; Raju, Subathra; Chander, Yogesh; Redig, Patrick T; Goyal, Sagar M

    2010-03-01

    This study was conducted to compare oropharyngeal (OP) and cloacal samples of wild birds (n = 137) for the detection and isolation of avian influenza virus (AIV). A total of 39 (28.5%) cloacal and 85 (62.0%) OP samples were positive for AIV by real-time reverse transcription-PCR (RRT-PCR). The AIV nucleic acid was detected in both cloacal and OP samples from 27 (19.7%) birds, in cloacal samples only from 12 (8.8%) birds, and in OP samples only from 58 (42.3%) birds. Thus, a total of 97 (70.8%) birds were AIV positive by RRT-PCR. The cycle threshold values for the cloacal samples ranged from 16.6 to 36.9 (mean 31.5), and those for OP samples ranged from 18 to 38.9 (mean 34.9). Of the cloacal samples, 12 were positive for H5 subtype influenza virus by RRT-PCR, with one being low pathogenic H5N1. In contrast, five of the OP samples were H5 positive, but none was H5N1. None of the cloacal or OP samples was H7 positive. Eight cloacal samples yielded AIV on inoculation in embryonated chicken eggs, while only one isolate was obtained from OP samples. Thus, from testing of 137 birds, only nine (6.6%) AIV isolates were obtained. The isolates from cloacal samples were subtyped as H6N1 (n = 5), H3N8 (n = 2), and H4N8 (n = 1), and the isolate from OP sample was subtyped as H6N1. No virus was isolated from the corresponding cloacal sample of the bird whose OP sample yielded AIV on virus isolation. These results suggest that surveillance programs for detection of AIV by RRT-PCR may include both sample types (cloacal and OP) to obtain a better picture of AIV prevalence, and OP samples may yield additional isolates of AIV when tested in conjunction with cloacal samples.

  15. Target Volume Delineation in Oropharyngeal Cancer: Impact of PET, MRI, and Physical Examination

    SciTech Connect

    Thiagarajan, Anuradha; Caria, Nicola; Schoeder, Heiko; Iyer, N. Gopalakrishna; Wolden, Suzanne; Wong, Richard J.; Sherman, Eric; Fury, Matthew G.; Lee, Nancy

    2012-05-01

    Introduction: Sole utilization of computed tomography (CT) scans in gross tumor volume (GTV) delineation for head-and-neck cancers is subject to inaccuracies. This study aims to evaluate contributions of magnetic resonance imaging (MRI), positron emission tomography (PET), and physical examination (PE) to GTV delineation in oropharyngeal cancer (OPC). Methods: Forty-one patients with OPC were studied. All underwent contrast-enhanced CT simulation scans (CECTs) that were registered with pretreatment PETs and MRIs. For each patient, three sets of primary and nodal GTV were contoured. First, reference GTVs (GTVref) were contoured by the treating radiation oncologist (RO) using CT, MRI, PET, and PE findings. Additional GTVs were created using fused CT/PET scans (GTVctpet) and CT/MRI scans (GTVctmr) by two other ROs blinded to GTVref. To compare GTVs, concordance indices (CI) were calculated by dividing the respective overlap volumes by overall volumes. To evaluate the contribution of PE, composite GTVs derived from CT, MRI, and PET (GTVctpetmr) were compared with GTVref. Results: For primary tumors, GTVref was significantly larger than GTVctpet and GTVctmr (p < 0.001). Although no significant difference in size was noted between GTVctpet and GTVctmr (p = 0.39), there was poor concordance between them (CI = 0.62). In addition, although CI (ctpetmr vs. ref) was low, it was significantly higher than CI (ctpet vs. ref) and CI (ctmr vs. ref) (p < 0.001), suggesting that neither modality should be used alone. Qualitative analyses to explain the low CI (ctpetmr vs. ref) revealed underestimation of mucosal disease when GTV was contoured without knowledge of PE findings. Similar trends were observed for nodal GTVs. However, CI (ctpet vs. ref), CI (ctmr vs. ref), and CI (ctpetmr vs. ref) were high (>0.75), indicating that although the modalities were complementary, the added benefit was small in the context of CECTs. In addition, PE did not aid greatly in nodal GTV delineation

  16. Summary of Calculations Performed to Evaluate the Structural Integrity of the 6-Pack Container Pallet

    SciTech Connect

    Hrousis, C.A.

    1999-10-01

    The 6-Pack Container Pallet is a space-frame structure, designed by Mason & Hanger Corp. to hold six AL-R8 containers together in a convenient bundle. The AL-R8 containers hold nuclear weapon components that require special care and consideration. The primary purpose of the 6-pack assembly is storage, but there is some manipulation as the 6-pack is loaded, moved and stacked. Recently, there has been an upgrade to a new AL-R8-SI container that is heavier than its predecessor was. The analysis discussed herein was conducted to ensure that the increased stresses due to the heavier containers are within design safety limits. At this time, however, there is disagreement as to what the strength requirements for the 6-pack pallet are. Depending on which classification applies to the structure, a factor of safety (yield stress over design stress) of 3.0 or more may need to be satisfied. This report documents strength analyses of loaded 6-packs performed at Lawrence Livermore National Laboratory (LLNL). The entire 6-pack assembly was discretized into a mesh with a total of 38682 first-order finite elements. The stresses were found for four characteristic load cases using the implicit code NIKE3D. This was a static strength analysis only. Dynamic loading was not considered. Stability, also, was not addressed. There are two 6-pack pallet designs under consideration: one that uses 1/2 inch diameter bolts and one with 3/8 inch bolts. In both cases, the maximum torque applied to the bolts is 55 in-lbf. This analysis finds the minimum factor of safety based on yield to be less than 3.0 in the main load path of both the 1/2 inch and 3/8 inch diameter bolt designs. In general, the peak stresses found in the 1/2 inch bolt design are less than those of the 3/8 inch bolt design. At the welded ends of the main tube section that spans the length of the pallet, the minimum safety factor is 2.14 when 1/2 inch bolts are used and 1.77 when 3/8 inch bolts are used. Minimum safety factors of

  17. Base-Bleed Effect on X-33 Aerospike Plume Induced Base-Heating Environment During Power-Pack Out

    NASA Technical Reports Server (NTRS)

    Wang, Tee-See; Droege, Alan; D'Agostino, Mark; Lee, Young-Ching; Williams, Robert

    2003-01-01

    A computational heat transfer methodology was developed to study the dual-engine linear aerospike plume induced base-heating environment during one power-pack out, in ascent flight. One power-pack out results in reduction of power levels for both engines. That, in turn, reduces the amount of base-bleed and changes the distribution of base-bleed on the two pillows. Hence, the concern of increased base-heating during power-pack out. The thermo-flowfield of the entire vehicle was computed. The computational methodology for the convective heating is based on a three-dimensional, finite-volume, viscous, chemically reacting, and pressure-based computational fluid dynamics formulation. The computational methodology for the radiative heating is based on a three-dimensional, finite-volume, and spectral-line-based weighted-sum-of-gray-gases absorption computational radiation heat transfer formulation. A separate radiation model was used for diagnostic purposes. The computational methodology was systematically benchmarked. In this study, near-base radiative heat fluxes were computed and they compared well with those measured from an installed linear aerospike engine tests. The base-heating environment of 18 trajectory points selected from three power-pack out ascent scenarios was computed and is presented here. The power-pack out condition has the most impact on convective base-heating when it happens early in flight. The some of its impact comes from the asymmetric and reduced base-bleed.

  18. Development and application of a hybrid inert/organic packing material for the biofiltration of composting off-gases mimics.

    PubMed

    Hernández, Jerónimo; Prado, Oscar J; Almarcha, Manuel; Lafuente, Javier; Gabriel, David

    2010-06-15

    The performance of three biofilters (BF1-BF3) packed with a new hybrid (inert/organic) packing material that consists of spherical argyle pellets covered with compost was examined in different operational scenarios and compared with a biofilter packed with pine bark (BF4). BF1, BF2 and BF4 were inoculated with an enriched microbial population, while BF3 was inoculated with sludge from a wastewater treatment plant. A gas mixture containing ammonia and six VOCs was fed to the reactors with N-NH(3) loads ranging from 0 to 10 g N/m(3)h and a VOCs load of around 10 g C/m(3)h. A profound analysis of the fate of nitrogen was performed in all four reactors. Results show that the biofilters packed with the hybrid packing material and inoculated with the microbial pre-adapted population (BF1 and BF2) achieved the highest nitrification rates and VOCs removal efficiencies. In BF3, nitratation was inhibited during most of the study, while only slight evidence of nitrification could be observed in BF4. All four reactors were able to treat the VOCs mixture with efficiencies greater than 80% during the entire experimental period, regardless of the inlet ammonia load.

  19. An innovative technique for damage by-pass in gravel packed completions using tip screen-out fracture prepacks

    SciTech Connect

    Montagna, J.N.; Saucier, R.J.; Kelly, P.

    1995-12-31

    An innovative completion technique is being used in wells that require sand control to help eliminate high skins and increase pay, or effective kh, and thus improve well productivity. The success of this technique lies in concentrating high conductivity proppants in the near-wellbore region. This is accomplished by creating and propping a properly designed, length limited, hydraulically-induced fracture in conjunction with an annular water gravel pack. The result is a highly conductive flow path from virgin formation, through the near-wellbore damaged zone, and into the wellbore that also controls formation sand. The limited fracture is designed with the intent of preserving the integrity of the near well gravel pack since this aspect is critical to realizing the full benefits of the fracture. Industry data indicates that optimum gravel packing is achieved with a brine proppant carrier. In some cases, the entire operation (limited fracture and gravel pack) may be completed with brine. However, in other cases, as discussed here, the high leak-off associated with brine is reduced by a product developed to overcome the excessive fluid leak-off. Brine following this material provides the carrier medium for proppant placement in the fracture and for the gravel pack. The process is described and examples of field applications and results will be presented.

  20. Packed fluidized bed blanket for fusion reactor

    DOEpatents

    Chi, John W. H.

    1984-01-01

    A packed fluidized bed blanket for a fusion reactor providing for efficient radiation absorption for energy recovery, efficient neutron absorption for nuclear transformations, ease of blanket removal, processing and replacement, and on-line fueling/refueling. The blanket of the reactor contains a bed of stationary particles during reactor operation, cooled by a radial flow of coolant. During fueling/refueling, an axial flow is introduced into the bed in stages at various axial locations to fluidize the bed. When desired, the fluidization flow can be used to remove particles from the blanket.

  1. Techdrill`s Drill Soft Pack One

    SciTech Connect

    Prieur, J.M.

    1993-12-01

    This article presents the main features of Drill Soft Pack One (DSP-One) version 1.4 developed by Techdrill (Paris, France). DSP-One is an integrated drilling engineering package that covers most aspects of drilling engineering. The package has been used for 6 months to prepare drilling programs and monitor wells. DSP-One is a PC-based, fully menu-driven program that runs on any IBM PC compatible. The program requires 550 KB of memory and 6 MB of hard-disk space. The software manufacture recommends a math coprocessor for speed and a VGA color monitor to achieve full benefit from the color graphic displays.

  2. Optimizing materials for better gravel packs

    SciTech Connect

    Cocales, B. )

    1992-12-01

    This paper reports on the permeability of crystalline silica (commercial) gravel used for gravel packs. Many gravel properties are tested and monitored frequently, but an industry permeability standard has not been established. To standardize permeability numbers, experiments were conducted on crystalline silica and aluminum silicate (Carbo-Prop) using a constant-head permeameter. Equations developed from lab results show permeability as a function of porosity. These equations were developed for each material size and type, and can be used to determine permeability for any porosity.

  3. The effect of nanoparticle packing on capacitive electrode performance.

    PubMed

    Lee, Younghee; Noh, Seonmyeong; Kim, Min-Sik; Kong, Hye Jeong; Im, Kyungun; Kwon, Oh Seok; Kim, Sungmin; Yoon, Hyeonseok

    2016-06-09

    Nanoparticles pack together to form macro-scale electrodes in various types of devices, and thus, optimization of the nanoparticle packing is a prerequisite for the realization of a desirable device performance. In this work, we provide in-depth insight into the effect of nanoparticle packing on the performance of nanoparticle-based electrodes by combining experimental and computational findings. As a model system, polypyrrole nanospheres of three different diameters were used to construct pseudocapacitive electrodes, and the performance of the electrodes was examined at various nanosphere diameter ratios and mixed weight fractions. Two numerical algorithms are proposed to simulate the random packing of the nanospheres on the electrode. The binary nanospheres exhibited diverse, complicated packing behaviors compared with the monophasic packing of each nanosphere species. The packing of the two nanosphere species with lower diameter ratios at an optimized composition could lead to more dense packing of the nanospheres, which in turn could contribute to better device performance. The dense packing of the nanospheres would provide more efficient transport pathways for ions because of the reduced inter-nanosphere pore size and enlarged surface area for charge storage. Ultimately, it is anticipated that our approach can be widely used to define the concept of "the best nanoparticle packing" for desirable device performance.

  4. Testing of high temperature coal slurry pump packings

    SciTech Connect

    Hao, B.R.

    1982-12-01

    This report presents the results of a test program of packing designs and materials for high temperature coal slurry plunger pump services. The work was conducted to support the investigations and development of reliable and cost-effective reciprocating coal slurry pumps for future coal liquefaction process application. The short-term objectives were to screen, test and evaluate the state-of-the-art, commercially available packing designs and materials for the coal slurry feed pumps at the coal liquefaction pilot plants. Four major tasks were completed: failure analysis of slurry feed pumps packing components; selection of commercial packing designs and materials for testing; laboratory testing of high temperature coal slurry pump packings; and field testing of selected coalslurry pump packings. The results are presented. The primary root causes of the packing failures experienced at the pilot plants were identified as: insufficient packing lubrication, ineffective plunger flushing, unstable plunger alignment conditions of the pump, packing material incompatible to slurry and solvent, and undesirable packing installation, start-up, standby, and maintenance.

  5. Microstructural characterization of random packings of cubic particles

    PubMed Central

    Malmir, Hessam; Sahimi, Muhammad; Tabar, M. Reza Rahimi

    2016-01-01

    Understanding the properties of random packings of solid objects is of critical importance to a wide variety of fundamental scientific and practical problems. The great majority of the previous works focused, however, on packings of spherical and sphere-like particles. We report the first detailed simulation and characterization of packings of non-overlapping cubic particles. Such packings arise in a variety of problems, ranging from biological materials, to colloids and fabrication of porous scaffolds using salt powders. In addition, packing of cubic salt crystals arise in various problems involving preservation of pavements, paintings, and historical monuments, mineral-fluid interactions, CO2 sequestration in rock, and intrusion of groundwater aquifers by saline water. Not much is known, however, about the structure and statistical descriptors of such packings. We have developed a version of the random sequential addition algorithm to generate such packings, and have computed a variety of microstructural descriptors, including the radial distribution function, two-point probability function, orientational correlation function, specific surface, and mean chord length, and have studied the effect of finite system size and porosity on such characteristics. The results indicate the existence of both spatial and orientational long-range order in the packing, which is more distinctive for higher packing densities. The maximum packing fraction is about 0.57. PMID:27725736

  6. Subsite, T Class, and N Class Cannot be Used to Exclude the Retropharyngeal Nodes From Treatment De-Intensification in Advanced Oropharyngeal Squamous Cell Carcinoma

    PubMed Central

    Spector, Matthew E.; Chinn, Steven B.; Bellile, Emily; Gallagher, K. Kelly; Kang, Stephen Y.; Moyer, Jeffrey S.; Prince, Mark E.; Wolf, Gregory T.; Bradford, Carol R.; McHugh, Jonathan B.; Carey, Thomas E.; Worden, Francis P.; Eisbruch, Avraham; Ibrahim, Mohannad; Chepeha, Douglas B.

    2016-01-01

    Importance Understanding the drainage patterns to the retropharyngeal nodes is an important consideration in oropharyngeal squamous cell carcinoma (OPSCC) because treatment of these nodes is related to increased morbidity. Prediction of these drainage patterns could not only help minimize treatment morbidity, but could also prevent failures in at-risk patients, as de-escalation trials are underway for this disease. Objective To evaluate the prevalence of pathologic retropharyngeal adenopathy (RPA) in OPSCC relative to involvement of the oropharyngeal subsite, number of neck nodes, T classification and N classification. Design Retrospective review from 2003–2010 Setting Academic Referral Center Participants 205 previously untreated, advanced stage (III, IV), pathologically confirmed patients with OPSCC Exposure: Concurrent chemoradiation Main Outcome Measures Radiologic evidence of pathologic RPA was tabulated and related to involvement of the oropharyngeal subsite, number of neck nodes, T classification and N classification. Results Pathologic RPA was identified in 18% of patients. There were pathologic retropharyngeal lymph nodes in 12/89 (13%) base of tongue cancers, 24/109 (22%) tonsil cancers, and 1/7 (14%) other oropharyngeal subsite cancers. Increasing prevalence of RPA was positively correlated with closer proximity to the posterior tonsillar pillar. A multivariate predictive regression model using the oropharyngeal subsite, involvement of the posterior tonsillar pillar, number of metastatic nodes, T classification, and N classification, showed that the number of metastatic nodes was statistically significant with an odds ratio of 1.436 (p=0.0001, 95% confidence interval: 1.203 – 1.714). Conclusions and Relevance The prevalence of pathologic RPA in this cohort was 18% and patients with multiple nodes had the highest risk for pathologic RPA, followed by involvement of the posterior tonsillar pillar. However, this data suggests that there is no clear

  7. Understanding shape entropy through local dense packing

    PubMed Central

    van Anders, Greg; Klotsa, Daphne; Ahmed, N. Khalid; Engel, Michael; Glotzer, Sharon C.

    2014-01-01

    Entropy drives the phase behavior of colloids ranging from dense suspensions of hard spheres or rods to dilute suspensions of hard spheres and depletants. Entropic ordering of anisotropic shapes into complex crystals, liquid crystals, and even quasicrystals was demonstrated recently in computer simulations and experiments. The ordering of shapes appears to arise from the emergence of directional entropic forces (DEFs) that align neighboring particles, but these forces have been neither rigorously defined nor quantified in generic systems. Here, we show quantitatively that shape drives the phase behavior of systems of anisotropic particles upon crowding through DEFs. We define DEFs in generic systems and compute them for several hard particle systems. We show they are on the order of a few times the thermal energy (kBT) at the onset of ordering, placing DEFs on par with traditional depletion, van der Waals, and other intrinsic interactions. In experimental systems with these other interactions, we provide direct quantitative evidence that entropic effects of shape also contribute to self-assembly. We use DEFs to draw a distinction between self-assembly and packing behavior. We show that the mechanism that generates directional entropic forces is the maximization of entropy by optimizing local particle packing. We show that this mechanism occurs in a wide class of systems and we treat, in a unified way, the entropy-driven phase behavior of arbitrary shapes, incorporating the well-known works of Kirkwood, Onsager, and Asakura and Oosawa. PMID:25344532

  8. Ferromagnetic model on the Apollonian packing

    NASA Astrophysics Data System (ADS)

    Oliveira, Rafael S.; Andrade, Roberto F. S.

    2017-01-01

    This work investigates the influence of geometrical features of the Apollonian packing (AP) on the behavior of magnetic models. The proposed model differs from previous investigations on the Apollonian network (AN), where the magnetic coupling constants depend only on the properties of the network structure defined by the packing, but not on quantitative aspects of its geometry. In opposition to the exact scale invariance observed in the AN, the circle's sizes in the AP are scaled by different factors when one goes from one generation to the next, requiring a different approach for the evaluation of the model's properties. If the nearest-neighbors coupling constants are defined by Ji ,j˜1 /(ri+rj) α , where ri indicates the radius of the circle i containing the node i , the results for the correlation length ξ indicate that the model's behavior depend on α . In the thermodynamic limit, the uniform model (α =0 ) is characterized by ξ →∞ for all T >0 . Our results indicate that, on increasing α , the system changes to an uncorrelated pattern, with finite ξ at all T >0 , at a value αc≃0.743 . For any fixed value of α , no finite temperature singularity in the specific heat is observed, indicating that changes in the magnetic ordering occur only when α is changed. This is corroborated by the results for the magnetization and magnetic susceptibility.

  9. Structural characterization of submerged granular packings.

    PubMed

    Jakšić, Z M; Šćepanović, J R; Lončarević, I; Budinski-Petković, Lj; Vrhovac, S B; Belić, A

    2014-12-01

    We consider the impact of the effective gravitational acceleration on microstructural properties of granular packings through experimental studies of spherical granular materials saturated within fluids of varying density. We characterize the local organization of spheres in terms of contact connectivity, distribution of the Delaunay free volumes, and the shape factor (parameter of nonsphericity) of the Voronoï polygons. The shape factor gives a clear physical picture of the competition between less and more ordered domains of particles in experimentally obtained packings. As the effective gravity increases, the probability distribution of the shape factor becomes narrower and more localized around the lowest values of the shape factor corresponding to regular hexagon. It is found that curves of the pore distributions are asymmetric with a long tail on the right-hand side, which progressively reduces while the effective gravity gets stronger for lower densities of interstitial fluid. We show that the distribution of local areas (Voronoï cells) broadens with decreasing value of the effective gravity due to the formation of lose structures such as large pores and chainlike structures (arches or bridges). Our results should be particularly helpful in testing the newly developed simulation techniques involving liquid-related forces associated with immersed granular particles.

  10. Structural characterization of submerged granular packings

    NASA Astrophysics Data System (ADS)

    Jakšić, Z. M.; Šćepanović, J. R.; Lončarević, I.; Budinski-Petković, Lj.; Vrhovac, S. B.; Belić, A.

    2014-12-01

    We consider the impact of the effective gravitational acceleration on microstructural properties of granular packings through experimental studies of spherical granular materials saturated within fluids of varying density. We characterize the local organization of spheres in terms of contact connectivity, distribution of the Delaunay free volumes, and the shape factor (parameter of nonsphericity) of the Voronoï polygons. The shape factor gives a clear physical picture of the competition between less and more ordered domains of particles in experimentally obtained packings. As the effective gravity increases, the probability distribution of the shape factor becomes narrower and more localized around the lowest values of the shape factor corresponding to regular hexagon. It is found that curves of the pore distributions are asymmetric with a long tail on the right-hand side, which progressively reduces while the effective gravity gets stronger for lower densities of interstitial fluid. We show that the distribution of local areas (Voronoï cells) broadens with decreasing value of the effective gravity due to the formation of lose structures such as large pores and chainlike structures (arches or bridges). Our results should be particularly helpful in testing the newly developed simulation techniques involving liquid-related forces associated with immersed granular particles.

  11. Drag coefficients for winter Antarctic pack ice

    NASA Technical Reports Server (NTRS)

    Wamser, Christian; Martinson, Douglas G.

    1993-01-01

    Air-ice and ice-water drag coefficients referenced to 10-m-height winds for winter Antarctic pack ice based on measurements made from R/V Polarstern during the Winter Weddell Sea Project, 1986 (WWSP-86), and from R/V Akademik Fedorov during the Winter Weddell Gyre Study, 1989 (WWGS-89), are presented. The optimal values of the air-ice drag coefficients, made from turbulent flux measurements, are (1.79 +/- 0.06) x 10 exp -3 for WWSP-86 and (1.45 +/- 0.09) x 10 exp -3 for WWGS-89. A single ice-water drag coefficient for both WWSP-86 and WWGS-89, estimated from periods of ice drift throught to represent free-drift conditions, is (1.13 +/- 0.26) x 10 exp -3, and the ice-water turning angle is 18 +/- 18 deg. It is suggested that for a typical Antarctic winter pack ice cover, the ice cover reduces the momentum flux from the atmosphere to the ocean by about 33 percent.

  12. Understanding shape entropy through local dense packing

    DOE PAGES

    van Anders, Greg; Klotsa, Daphne; Ahmed, N. Khalid; ...

    2014-10-24

    Entropy drives the phase behavior of colloids ranging from dense suspensions of hard spheres or rods to dilute suspensions of hard spheres and depletants. Entropic ordering of anisotropic shapes into complex crystals, liquid crystals, and even quasicrystals was demonstrated recently in computer simulations and experiments. The ordering of shapes appears to arise from the emergence of directional entropic forces (DEFs) that align neighboring particles, but these forces have been neither rigorously defined nor quantified in generic systems. In this paper, we show quantitatively that shape drives the phase behavior of systems of anisotropic particles upon crowding through DEFs. We definemore » DEFs in generic systems and compute them for several hard particle systems. We show they are on the order of a few times the thermal energy (kBT) at the onset of ordering, placing DEFs on par with traditional depletion, van der Waals, and other intrinsic interactions. In experimental systems with these other interactions, we provide direct quantitative evidence that entropic effects of shape also contribute to self-assembly. We use DEFs to draw a distinction between self-assembly and packing behavior. We show that the mechanism that generates directional entropic forces is the maximization of entropy by optimizing local particle packing. Finally, we show that this mechanism occurs in a wide class of systems and we treat, in a unified way, the entropy-driven phase behavior of arbitrary shapes, incorporating the well-known works of Kirkwood, Onsager, and Asakura and Oosawa.« less

  13. Protein packing defects "heat up" interfacial water.

    PubMed

    Sierra, María Belén; Accordino, Sebastián R; Rodriguez-Fris, J Ariel; Morini, Marcela A; Appignanesi, Gustavo A; Fernández Stigliano, Ariel

    2013-06-01

    Ligands must displace water molecules from their corresponding protein surface binding site during association. Thus, protein binding sites are expected to be surrounded by non-tightly-bound, easily removable water molecules. In turn, the existence of packing defects at protein binding sites has been also established. At such structural motifs, named dehydrons, the protein backbone is exposed to the solvent since the intramolecular interactions are incompletely wrapped by non-polar groups. Hence, dehydrons are sticky since they depend on additional intermolecular wrapping in order to properly protect the structure from water attack. Thus, a picture of protein binding is emerging wherein binding sites should be both dehydrons rich and surrounded by easily removable water. In this work we shall indeed confirm such a link between structure and dynamics by showing the existence of a firm correlation between the degree of underwrapping of the protein chain and the mobility of the corresponding hydration water molecules. In other words, we shall show that protein packing defects promote their local dehydration, thus producing a region of "hot" interfacial water which might be easily removed by a ligand upon association.

  14. Understanding shape entropy through local dense packing

    SciTech Connect

    van Anders, Greg; Klotsa, Daphne; Ahmed, N. Khalid; Engel, Michael; Glotzer, Sharon C.

    2014-10-24

    Entropy drives the phase behavior of colloids ranging from dense suspensions of hard spheres or rods to dilute suspensions of hard spheres and depletants. Entropic ordering of anisotropic shapes into complex crystals, liquid crystals, and even quasicrystals was demonstrated recently in computer simulations and experiments. The ordering of shapes appears to arise from the emergence of directional entropic forces (DEFs) that align neighboring particles, but these forces have been neither rigorously defined nor quantified in generic systems. In this paper, we show quantitatively that shape drives the phase behavior of systems of anisotropic particles upon crowding through DEFs. We define DEFs in generic systems and compute them for several hard particle systems. We show they are on the order of a few times the thermal energy (kBT) at the onset of ordering, placing DEFs on par with traditional depletion, van der Waals, and other intrinsic interactions. In experimental systems with these other interactions, we provide direct quantitative evidence that entropic effects of shape also contribute to self-assembly. We use DEFs to draw a distinction between self-assembly and packing behavior. We show that the mechanism that generates directional entropic forces is the maximization of entropy by optimizing local particle packing. Finally, we show that this mechanism occurs in a wide class of systems and we treat, in a unified way, the entropy-driven phase behavior of arbitrary shapes, incorporating the well-known works of Kirkwood, Onsager, and Asakura and Oosawa.

  15. 2-d Packing of Prolate Granular Materials

    NASA Astrophysics Data System (ADS)

    Franklin, Scott

    2002-11-01

    Piles of extremely prolate (aspect ratio α=L/D>10) granular materials are qualitatively different than lower aspect-ratio particles. One can run a hand through sand, for example, but not through nails. In three dimensions this transition occurs at α ˜ 35. We investigate the two-dimensional packing of particles with aspect ratios ranging from 10-44, comparing experiments with Monte-Carlo simulations. Particle alignment can quantified by an orientational order correlation function and related to the packing fraction. In both simulation and experiment the correlation between particle orientation decays after a distance of two particle lengths. We also quantify the distribution of voids in the pile, finding it to follow a power law with exponent -β=-2.370.05. Dynamic experiments involve rotating the pile. Particles with aspect ratio as low as 10 do not appear to have a well defined angle of repose, suggesting that the transition to rigidity occurs at a far lower aspect ratio in two dimensions. Preliminary results from this experiment will be presented.

  16. Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures

    PubMed Central

    Patkar, Geeta A.; Ourasang, Anil Kumar; Tendolkar, Bharati A.

    2017-01-01

    Introduction A sustained and effective oropharyngeal sealing with supraglottic airway is required to maintain the ventilation during laparoscopic surgery. Previous studies have observed the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal Mask Airway (PLMA) after pneumoperitoneum in supine and trendelenburg position, where PLMA was found to be an effective airway device. This study was conducted with ProSeal LMA, for laparoscopic Urologic procedures done in lateral position. Aim To measure OSP in supine and lateral position and to observe the effect of pneumoperitoneum in lateral position on OSP. Secondary objectives were to assess adequacy of ventilation and incidence of adverse events. Materials and Methods A total number of 25 patients of American Society of Anaesthesiologists (ASA) physical status II and I were enrolled. After induction of anaesthesia using a standardized protocol, PLMA was inserted. Ryle’s tube was inserted through drain tube. The position of PLMA was confirmed with ease of insertion of Ryle’s tube and fibreoptic grading of vocal cords. Patients were then put in lateral position. The OSP was measured in supine position. This value was baseline comparison for OSP in lateral position and that after pneumoperitoneum. We assessed the efficacy of PLMA for ventilation, after carboperitoneum in lateral position (peak airway pressure, End Tidal Carbon dioxide (EtCO2), SPO2). Incidence of adverse effects (displacement of device, gastric insufflation, regurgitation, coughing, sore throat, blood on device, trauma) was also noted. Results The OSP was above Peak Airway Pressure (PAP) in supine (22.1±5.4 and 15.4±4.49cm of H2O) and lateral position (22.6±5.3 and 16.1±4.6). After pneumoperitoneum, which was in lateral position, there was statistically significant (p-value <0.05) increase in both PAP (19.96±4.015) and OSP (24.32±4.98, p-value 0.03). There was no intraoperative displacement of PLMA. There was no event of suboptimal oxygenation

  17. Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives

    PubMed Central

    Ruangsri, Supanigar; Jorns, Teekayu Plangkoon; Puasiri, Subin; Luecha, Thitisan; Chaithap, Chariya; Sawanyawisuth, Kittisak

    2016-01-01

    Objective Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Untreated OSA may lead to a number of cardiovascular complications. Dentists may play an important role in OSA detection by conducting careful oral examinations. This study focused on the correlation of oral anatomical features in Thai patients who presented with OSA. Methods We conducted a prospective comparative study at a sleep/hypertension clinic and a dental clinic at Khon Kaen University in Thailand. Patients with OSA were enrolled in the study, along with age-matched patients with non-OSA (controls). Baseline characteristics, clinical data, and oropharyngeal data of all patients were compared between the two groups. Oropharyngeal measurements included tongue size, torus mandibularis, Mallampati classification, palatal space, and lateral pharyngeal wall area. Multivariate logistic regression analysis was used to identify the factors associated with OSA. Results During the study period, there were 156 patients who met the study criteria; 78 were patients with OSA and the other 78 were healthy control subjects. In the OSA group, there were 43 males with a mean age of 53 (standard deviation 12.29) years and a mean BMI of 30.86 kg/mm2. There were 37 males in the control group with a mean age of 50 (standard deviation 12.04) years and a mean BMI of 24.03 kg/mm2. According to multivariate logistic analysis, three factors were perfectly associated with OSA, including torus mandibularis class 6, narrow lateral pharyngeal wall, and Mallampati class 4. There were two other significant factors associated with having OSA, namely, BMI and Mallampati classification. The adjusted odds ratios (95% confidence interval) of these two factors were 1.445 (1.017, 2.052) and 5.040 (1.655, 15.358), respectively. Conclusion Dentists may play an important role in the detection of OSA in patients with high BMI through careful oropharyngeal examination in routine dental treatment. A large torus mandibularis

  18. The Powder-Pack Nitriding Process: Growth Kinetics of Nitride Layers on Pure Iron

    NASA Astrophysics Data System (ADS)

    Campos-Silva, I.; Ortiz-Dominguez, M.; Elias-Espinosa, M.; Vega-Morón, R. C.; Bravo-Bárcenas, D.; Figueroa-López, U.

    2015-09-01

    In this study, the growth kinetics of nitride layers that develop during the powder-pack nitriding process on the surface of ARMCO pure iron was estimated. The powder-pack nitriding of pure iron was performed according to the Pulnieren© (H.E.F. Durferrit) method using a "Pulnier" powder and an activator, at 798-848 K with different exposure times (2-12 h) for each temperature. In addition, for the entire set of nitriding conditions, three different activator/"Pulnier" powder ratios (0.20, 0.25, and 0.35) were used to evaluate the activation level during the growth of nitride layers. The kinetics of the nitride layers over the surface of ARMCO pure iron were estimated by two mathematical approaches, that consider the mass balance equations at the growth interphases. The resulting expressions for the effective diffusion coefficients in the nitride layers were evaluated as a function of nitriding temperatures and activator/"Pulnier" powder ratio. Finally, based on the experimental parameters ascribed to the powder-pack nitriding process, two expressions were proposed to estimate the nitride layer thicknesses at 798 and 823 K after 9 h of exposure for each temperature, to validate the diffusion models used in this work.

  19. A Paley-Wiener theorem for generalized entire functions on infinite-dimensional spaces

    NASA Astrophysics Data System (ADS)

    Khrennikov, A. Yu; Petersson, H.

    2001-04-01

    We study entire functions on infinite-dimensional spaces. The basis is the study of spaces of Gateaux holomorphic functions that are bounded on certain subsets (bounded entire functions). The main goal is to characterize the Fourier image of the corresponding spaces of generalized entire functions (ultra-distributions) by an infinite-dimensional Paley-Wiener theorem. We introduce entire functions of exponential type and prove a generalization of the classical Paley-Wiener theorem. The crucial point of our theory is the dimension-invariant estimate given by Lemma 4.12.

  20. Infective endocarditis of native valve after anterior nasal packing.

    PubMed

    Jayawardena, Suriya; Eisdorfer, Jacob; Indulkar, Shalaka; Zarkaria, Muhammad

    2006-01-01

    We present a case report of a patient who was previously treated for spontaneous epistaxis with a petroleum jelly gauze (0.5 in x 72 in) anterior nasal packing filled with an antibiotic ointment, along with prophylactic oral clindamycin. The patient presented with fever and hypotension 3 days after the nasal packing. Her blood cultures grew methicillin-resistant Staphylococcus aureus and the transesophageal echocardiography showed vegetation on the atrial surface of the posterior mitral valve leaflet, confirming the diagnosis of bacterial endocarditis attributable to nasal packing. Several case reports discuss toxic shock syndrome after nasal packing, but none describe endocarditis of the native heart valves subsequent to anterior nasal packing. Current guidelines on endocarditis prophylaxis produced by the American Heart Association, European Cardiac Society, and British Cardiac Society together with published evidence do not recommend endocarditis prophylaxis for patients with native heart valves undergoing anterior nasal packing.