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. Entire Sky

    NASA Image and Video Library

    1999-12-01

    Aitoff projection of the three-color composite JHKs source count map of the entire sky, based on 95,851,173 stars with Ks 13.5. What appears most prominently are the Galactic plane and the Galactic bulge.

  6. [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.

  7. 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

  8. Robotic Surgery for Oropharyngeal Cancer

    PubMed Central

    Shah, Shivani; Goldenberg, David

    2014-01-01

    Oropharyngeal cancer represents a growing proportion of head and neck malignancies. This has been associated with the increase in infection of the oropharynx by oncogenic strains of human papillomavirus (HPV). Transoral robotic surgery (TORS) has opened the door for minimally invasive surgery for HPV-related and non-HPV-related oropharyngeal cancer. Compared to traditional open surgical approaches, TORS has been shown to improve functional outcomes in speech and swallowing, while maintaining good oncologic outcomes. PMID:24808952

  9. 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

  10. 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…

  11. 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…

  12. Neurogenic [corrected] and oropharyngeal dysphagia.

    PubMed

    Rofes, Laia; Clavé, Pere; Ouyang, Ann; Scharitzer, Martina; Pokieser, Peter; Vilardell, Natalia; Ortega, Omar

    2013-10-01

    Oropharyngeal dysphagia (OD) is a swallowing disorder caused by congenital abnormalities and structural damage and disease-associated damage of the oral cavity, pharynx, and upper esophageal sphincter. Patients with OD lack the protective mechanisms necessary for effective swallowing, exhibiting difficulty controlling food in the mouth and initiating a swallow, leading to choking, coughing, and nasal regurgitation. OD is a major risk factor for malnutrition, dehydration, and aspiration pneumonia. The following on OD includes commentaries on the application of simulation of oropharyngeal transient receptor potential vanilloid 1 (TRPV1) and maneuvers like the Shaker exercise to improve the safety and efficacy of swallow in OD patients; the prevalence of esophageal pathologies in OD patients and the need to evaluate the esophagus, esophagogastric junction, and stomach; and strategies for clinical screening to detect OD and aspiration among high-risk patients and to improve oral health care, maintain nutrition and hydration, and prevent aspiration pneumonia. © 2013 New York Academy of Sciences.

  13. 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.

  14. 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

  15. Entire Island of Crete

    NASA Image and Video Library

    1973-06-22

    SL2-05-364 (22 June 1973) --- Lying in the eastern Mediterranean Sea, the entire Island of Crete (35.0N, 25.0E) can be seen in great detail in this cloud free view. The volcanic origins of this island can also be observed in the many sharp and angular ridgelines and rugged coastal features. Photo credit: NASA

  16. HPV-associated oropharyngeal squamous cell carcinoma.

    PubMed

    Smith, Timothy J; Mendez, Anthony; Donald, Carrlene; Nagel, Thomas Harold

    2017-01-01

    Human papillomavirus (HPV) can infect the tonsillar tissues of the oropharynx and is associated with oropharyngeal squamous cell carcinoma. This article provides an overview to guide primary care providers in screening patients for oropharyngeal cancer and making appropriate referrals. The article also reviews available HPV vaccines and immunization adherence rates.

  17. 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....

  18. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 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. (a...

  19. 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

  20. 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

  1. 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.

  2. [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.

  3. 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.

  4. [Efficacy of rehabilitation in oropharyngeal dysphagia].

    PubMed

    Silva, Roberta Gonçalves da

    2007-01-01

    efficacy of rehabilitation in oropharyngeal dysphagia. In our country the practice of speech-language pathology in oropharyngeal dysphagia has increased significantly and, at this moment, deserves attention since practice needs to be based on scientific evidence. Therapeutic techniques and the outcome of rehabilitation in oropharyngeal dysphagia have been studied since the 70s, reaching its high point during the 80s and 90s. Few studies have investigated the efficacy of therapy in the rehabilitation of oropharyngeal dysphagia, the vast majority have tried to prove the effects of therapy on the dynamics of swallowing. In Brazil, the studies about oropharyngeal dysphagia have, in great part, investigated assessment procedures, and only a few have worried about rehabilitation. to present a critical analysis about the efficacy of rehabilitation in oropharyngeal dysphagia. this review of the literature indicates that non-randomized studies have compromised the results, once the casuistic of the researches are very heterogeneous--they include neurogenic and mechanical oropharyngeal dyshagia caused by different etiologies. Besides that, therapeutic programs which are used are not sufficiently described, compromising the reproduction of the methodology by other researchers. These results suggest the need for more randomized studies, which can be initially developed as case studies in order to exclude the control variables of therapy efficacy. Another suggestion is, as proposed by present researches, to use scales that can measure the impact of swallowing training in the nutritional and pulmonary condition of dysphagic patients. An important research area, related to the control of therapeutic efficacy and efficiency, are the studies that aim to establish the decrease in hospital and home care costs as a consequence of speech-language intervention with patients with oropharyngeal dyspahgia.

  5. Epidemiology of HPV-associated oropharyngeal cancer

    PubMed Central

    Pytynia, Kristen B.; Dahlstrom, Kristina R.; Sturgis, Erich M.

    2015-01-01

    Squamous cell carcinoma of the oropharynx is increasing in incidence in epidemic proportion. This site specific increase in incidence is due to an increase in human papillomavirus (HPV)-related squamous cell carcinoma, while the incidence of tobacco related squamous cell carcinoma is decreasing. In particular, the incidence of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) is increased among middle aged white men, and sexual behavior is a risk factor. HPV-related oropharyngeal squamous cell carcinoma represents a growing etiologically distinct subset of head and neck cancers with unique epidemiological, clinical, and molecular characteristics that differ from those of HPV-unassociated cancers. In this review, we discuss the epidemiology of HPV-related OPSCC, the prevalence of oral/oropharyngeal HPV infection, and efforts aimed at reducing the incidence of HPV-related OPSCC. PMID:24461628

  6. Impact of HPV in Oropharyngeal Cancer

    PubMed Central

    Marklund, Linda; Hammarstedt, Lalle

    2011-01-01

    The incidence of oropharyngeal cancers has increased in the western world and Human Papilloma Virus (HPV) has been recognised as a risk factor in the last decades. During the same period the prevalence of HPV in oropharyngeal tumours has increased and HPV has been suggested responsible for the increase. The HPV-positive tumours are today recognized as a distinct subset of head and neck cancers with its own clinopathological and risk profile and have a significantly improved prognosis regardless of treatment strategy. This review summarizes current knowledge regarding human papillomavirus biology, oncogenic mechanisms, risk factors, and impact of treatment. PMID:21234307

  7. [Treatment of oropharyngeal dysphagia with neuromuscular electrostimulaiton].

    PubMed

    Terré, Rosa; Martinell, Montse; González, Beatriz; Ejarque, Judith; Mearin, Fermín

    2013-02-16

    Oropharyngeal dysphagia is highly prevalent in stroke patients, with a high mortality and morbidity. Neuromuscular electrostimulation (NMES) is a new and potentially useful therapy. We assessed the therapeutic effectiveness and safety of NMES in the treatment of oropharyngeal dysphagia in patients with stroke. Prospective study of stroke patients, with tracheal aspiration revealed by videofluoroscopy (VDF), who underwent conventional therapy of oropharyngeal dysphagia as well as NMES. We did a follow-up at the end of the treatment and 3 months later. Patients underwent 18 courses of treatment (15-20) with a mean stimulation intensity of 12.45mA (range: 6.6-16.7mA). Before starting therapy, 8 patients were fed exclusively by means of a gastrostomy tube; after the treatment, only one patient needed it. No patient had complications. VDF parameters before treatment: oral transition time, swallowing reflex shooting (SRS) and pharyngeal transition time were longer and the hyoid elevation was reduced. After the treatment, the number of patients with tracheal aspiration decreased to 6, but only in 6 it persisted for the three analyzed viscosities (liquid, nectar and pudding), with an overall improvement of the VDF parameters. The only predictive factor of therapeutic effectiveness was the delay in the SRS. NMES is an effective and safe treatment for stroke patients with oropharyngeal dysphagia. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Cuffed oropharyngeal airway for difficult airway management.

    PubMed

    Takaishi, Kazumi; Kawahito, Shinji; Tomioka, Shigemasa; Eguchi, Satoru; Kitahata, Hiroshi

    2014-01-01

    Difficulties with airway management are often caused by anatomic abnormalities due to previous oral surgery. We performed general anesthesia for a patient who had undergone several operations such as hemisection of the mandible and reconstructive surgery with a deltopectoralis flap, resulting in severe maxillofacial deformation. This made it impossible to ventilate with a face mask and to intubate in the normal way. An attempt at oral awake intubation using fiberoptic bronchoscopy was unsuccessful because of severe anatomical abnormality of the neck. We therefore decided to perform retrograde intubation and selected the cuffed oropharyngeal airway (COPA) for airway management. We inserted the COPA, not through the patient's mouth but through the abnormal oropharyngeal space. Retrograde nasal intubation was accomplished with controlled ventilation through the COPA, which proved to be very useful for this difficult airway management during tracheal intubation even though the method was unusual.

  15. 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.

  16. Human Papillomavirus-Related Oropharyngeal Cancer in Women.

    PubMed

    Scaffidi, Rose M; Gerhardt, Jill; Eisele, Cheryle

    2016-05-01

    The number of women diagnosed with oropharyngeal cancer related to the human papillomavirus (HPV) is increasing in the United States. Educating health care providers and women about the link between HPV and oropharyngeal cancers can aid in earlier diagnosis and treatment. This article discusses the etiology and clinical presentation of HPV-positive and HPV-negative oropharyngeal cancer, noting distinctions between the 2 types. Recommendations for screening and prevention are provided. © 2016 by the American College of Nurse-Midwives.

  17. Packed Bed Reactor Experiment

    NASA Image and Video Library

    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 ...

  18. Oropharyngeal perinatal colonization by human papillomavirus.

    PubMed

    Sánchez-Torices, María Soledad; Corrales-Millan, Rocío; Hijona-Elosegui, Jesús J

    2016-01-01

    Human papillomavirus (HPV) infection is the most common human sexually transmitted disease. It is clinically relevant because this condition is necessary for the development of epithelial cervical cancer, and it is also a factor closely associated with the occurrence of diverse tumours and various benign and malignant lesions of the head and neck area. The infective mechanism in most of these cases is associated with sexual intercourse, but there is recent scientific evidence suggesting that HPV infection may also be acquired by other routes of infection not necessarily linked to sexual contact. One of them is vertical transmission from mother to child, either during pregnancy or at the time of delivery. The aim of our research was to study maternal-foetal HPV transmission during childbirth in detail, establishing the rate of oropharyngeal neonatal HPV in vaginal deliveries. The presence and type of HPV viral DNA at the time of delivery in samples of maternal cervical secretions, amniotic fluid, venous cord blood samples and neonatal oropharynx in pregnant women (and their babies) were determined. The rate of oropharyngeal neonatal HPV colonization in vaginal deliveries was 58.24%. The maternal and neonatal HPV colonization mechanism is essentially, but not exclusively, transvaginal. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  19. Oropharyngeal Dysphagia: neurogenic etiology and manifestation.

    PubMed

    Sebastian, Swapna; Nair, Prem G; Thomas, Philip; Tyagi, Amit Kumar

    2015-03-01

    To determine the type, severity and manifestation of dysphagia in patients with neurogenic etiology. Clinical documentation was done on the different etiologies, its manifestation, assessment findings and management strategies taken for patients with neurogenic oropharyngeal dysphagia who were referred for assessment and management of dysphagia over a period of three months in a tertiary care teaching hospital. Flexible endoscopic examination was done in all the patients. The severity of dysphagia in these patients were graded based on Gugging Swallowing Screen (GUSS). A total of 53 patients with neurogenic oropharyngeal dysphagia were evaluated by an otolaryngologist and a speech language pathologist over a period of three months. The grading of severity based on GUSS for these patients were done. There were 30 patients with recurrent laryngeal nerve injury due to various etiologies, one patient with Neurofibroma-vestibular schwanoma who underwent surgical excision, 16 patients with stroke, two patients with traumatic brain injury, two patients with Parkinsonism and two patients with myasthenia gravis. The manifestation of dysphagia was mainly in the form of prolonged masticatory time, oral transit time, and increased number of swallows required for each bolus, cricopharyngeal spasms and aspiration. Among the dysphagia patients with neurogenic etiology, dysphagia is manifested with a gradual onset and is found to have a progressive course in degenerative disorders. Morbidity and mortality may be reduced with early identification and management of neurogenic dysphagia.

  20. Pediatric transoral robotic surgery for oropharyngeal malignancy: a case report.

    PubMed

    Wine, Todd M; Duvvuri, Umamaheswar; Maurer, Scott H; Mehta, Deepak K

    2013-07-01

    The treatment of oropharyngeal malignancy is associated with numerous functional morbidities. Transoral robotic surgery has been used with increased frequency in adult oropharyngeal malignancy. The benefits include decreased surgical morbidity and improved functional outcomes. Use of transoral robotic has been limited in children. This case represents our experience with a 17-month old child who was diagnosed with a high-grade undifferentiated sarcoma of the soft palate. She was able to be successfully treated with transoral robotic surgery as a part of her multimodal therapy, representing the first case of transoral robotic surgery for an oropharyngeal malignancy in a young child. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Management of oropharyngeal neurogenic dysphagia in adults.

    PubMed

    Miles, Anna; Allen, Jacqui E

    2015-12-01

    This article reviews recent literature in the management of neurogenic oropharyngeal dysphagia (OPD) including assessment processes and treatments, with a specific focus on OPD as a result of stroke and Parkinson's disease. A large number of high-quality systematic reviews were published that provide an excellent summary of current evidence across assessment and treatment of swallowing disorders. There is building interest and knowledge in technology in both the understanding and treatment of OPD including functional MRI, manometry, and noninvasive brain stimulation. Neurologic disorders demonstrate a high prevalence of OPD resulting in significant decrement to health and healthcare costs. Novel technologies were reported in assessment and tracking of dysphagia as well as emerging innovative therapeutic options.

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

    MedlinePlus

    ... Is Doing Related Links Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All ... Cancer Home HPV-Associated Oropharyngeal Cancer Rates by Race and Ethnicity Language: English (US) Español (Spanish) ...

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Oropharyngeal Candidiasis in the Era of Antiretroviral Therapy

    PubMed Central

    Thompson, George R.; Patel, Payal K.; Kirkpatrick, William R.; Westbrook, Steven D.; Berg, Deborah; Erlandsen, Josh; Redding, Spencer W.; Patterson, Thomas F.

    2009-01-01

    Oropharyngeal candidiasis (OPC) remains a common problem in the HIV-infected population despite the availability of antiretroviral therapy (ART). Although Candida albicans is the most frequently implicated pathogen, other Candida spp. may also cause infection. The emergence of antifungal resistance within these causative yeasts, especially in patients with recurrent oropharyngeal infection or with long-term use of antifungal therapies, requires a working knowledge of alternative antifungal agents. Identification of the infecting organism and antifungal susceptibility testing enhances the ability of clinicians to prescribe appropriate antifungal therapy. Characterization of the responsible mechanisms has improved our understanding of the development of antifungal resistance and could enhance the management of these infections. Immune reconstitution has been shown to reduce rates of oropharyngeal candidiasis but few studies have evaluated the current impact of ART on the epidemiology of oropharyngeal candidiasis and antifungal resistance in these patients. Preliminary results from an ongoing clinical study showed that in patients with advanced AIDS oral yeast colonization was extensive, occurring in 81.1% of the 122 patients studied and symptomatic infection occurred in a third. In addition, resistant yeasts were still common occurring in 25.3% of patients colonized with yeasts or with symptomatic infection. Thus, oropharyngeal candidasis remains a significant infection in advanced AIDS even with ART. Current knowledge of the epidemiology, pathogenesis, clinical presentation, treatment, and mechanisms of antifungal resistance observed in oropharyngeal candidiasis are important in managing patients with this infection and are the focus of this review. PMID:20156694

  8. Prevalence of human papillomavirus in oropharyngeal cancer: a systematic review

    PubMed Central

    Stein, Andrew P.; Saha, Sandeep; Kraninger, Jennifer L.; Swick, Adam D.; Yu, Menggang; Lambertg, Paul F.; Kimple, Randall

    2015-01-01

    Purpose The global incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been increasing, and it has been proposed that a rising rate of human papillomavirus (HPV) associated cancers is driving the observed changes in OPSCC incidence. We carried out this systematic review to further examine the prevalence of HPV in OPSCC over time worldwide. Methods A systematic literature search was performed to identify all articles through January 31, 2014 that reported on the prevalence of HPV in OPSCC. Articles that met inclusion criteria were divided into four time frames (pre-1995, 1995—1999, 2000—2004, and 2005—present) based on the median year of the study's sample collection period. Employing a weighted analysis of variance (ANOVA) model, we examined the trends of HPV-positivity over time worldwide, in North America, and in Europe. Results Our literature search identified 699 unique articles. 175 underwent review of the entire study and 105 met inclusion criteria. These 105 articles reported on the HPV prevalence in 9541 OPSCC specimens across 23 nations. We demonstrated significant increases in the percentage change of HPV-positive OPSCCs from pre-1995 to present: 20.6% worldwide (p-value for trend: p<0.001), 21.6% in North America (p=0.013) and 21.5% in Europe (p=0.033). Discussion Interestingly, while in Europe there was a steady increase in HPV prevalence across all time frames, reaching nearly 50% most recently, in North America HPV prevalence appears to have plateaued over the past decade at about 65%. These findings may have important implications regarding predictions for the future incidence of OPSCC. PMID:26049691

  9. Packed Planetary Systems

    NASA Astrophysics Data System (ADS)

    Barnes, R.; Greenberg, R.

    2005-08-01

    Planetary systems display a wide range of appearances, with apparently arbitrary values of semi-major axis, eccentricity, etc. We reduce the complexity of orbital configurations to a single value, δ , which is a measure of how close, over secular timescales ( ˜10,000 orbits), two consecutive planets come to each other. We measure this distance relative to the sum of the radii of their Hill spheres, sometimes referred to as mutual Hill radii (MHR). We determine the closest approach distance by numerically integrating the entire system on coplanar orbits, using minimum masses. For non-resonant systems, close approach occurs during apsidal alignment, either parallel or anti-parallel. For resonant pairs the distance at conjunction determines the closest approach distance. Previous analytic work found that planets on circular orbits were assuredly unstable if they came within 3.5 MHR (i.e. Gladman 1993; Chambers, Wetherill & Boss 1996). We find that most known pairs of jovian planets (including those in our solar system) come within 3.5 -- 7 MHR of each other. We also find that several systems are unstable (their closest approach distance is less than 3.5 MHR). These systems, if they are real, probably exist in an observationally permitted location somewhat different from the current best fit. In these cases, the planets' closest approach distance will most likely also be slightly larger than 3.5 MHR. Most pairs beyond 7 MHR probably experienced post-formation migration (i.e. tidal circularization, inward scattering of small bodies) which moved them further apart. This result is even more remarkable since we have used the minimum masses; most likely the systems are inclined to the line of sight, making the Hill spheres larger, and shrinking δ . This dense packing may reflect a tendency for planets to form as close together as they can without being dynamically unstable. This result further implies there may be a large number of smaller, currently undetectable

  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. Copyright © 2014. Published by Elsevier GmbH.

  11. 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.

  12. 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.

  13. 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 ...

  14. Cryostimulation improves recovery from oropharyngeal dysphagia after stroke.

    PubMed

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

    2013-01-01

     Stroke is considered one of the most frequent neurological causes of oropharyngeal dysphagia.  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.  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.  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.  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.

  15. 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

  16. 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.

  17. 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…

  18. 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,…

  19. 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

  20. Theory of random packings

    NASA Astrophysics Data System (ADS)

    Makse, Hernan; Song, Chaoming; Wang, Ping

    2009-03-01

    We present a theory of random packings to describe the statistical mechanics of jammed matter with the aim of shedding light to the long-standing problem of characterizing the random close packing (RCP) and random loose packing (RLP) of particles. We describe the jammed system with equations of state relating observables such as entropy, coordination number, volume fraction, and compactivity as well as the probability distributions of volume and contacts. We follow a systematic route to classify packings into a phase diagram of jamming, from frictionless to frictional particles, from hard to deformable particles, from monodisperse to polydisperse systems, from spherical particles to nonspherical convex particles, in an attempt to understand the packing problem from a unifying perspective. The studies of RCP and RLP includes 2d, nd, and the mean field limit of infinite dimension.

  1. Exploring the Impact of Human Papillomavirus Status, Comorbidity, Polypharmacy, and Treatment Intensity on Outcome of Elderly Oropharyngeal Cancer Patients Treated With Radiation Therapy With or Without Chemotherapy.

    PubMed

    Caparrotti, Francesca; O'Sullivan, Brian; Bratman, Scott V; Ringash, Jolie; Lu, Lin; Bayley, Andrew; Cho, John; Giuliani, Meredith; Hope, Andrew; Kim, John; Waldron, John; Hansen, Aaron; Goldstein, David; Perez-Ordonez, Bayardo; Weinreb, Ilan; Tong, Li; Song, Yuyao; Xu, Wei; Huang, Shao Hui

    2017-07-15

    To explore the impact of tumor human papillomavirus (HPV) status, comorbidity, polypharmacy, and treatment intensity on overall survival (OS) of elderly oropharyngeal cancer (OPC) patients. All elderly (>70 years) OPC patients receiving definitive (chemo-) radiation therapy in 2000 to 2013 were reviewed. Charlson comorbidity index (CCI, comorbidity alone) and the comorbidity-polypharmacy score (CPS, comorbidity and medication) were calculated. Overall survival was compared between HPV-positive (HPV+) and HPV-negative (HPV-) cohorts. Multivariable analyses (MVA) incorporating either the CCI (MVA-CCI) or the CPS (MVA-CPS) identified survival predictors. Among 231 of 287 patients (80%) with p16 staining, 117 were HPV+ and 114 HPV-. Systemic treatments were administered in 48 patients (21%) (chemotherapy 17; epidermal growth factor receptor inhibitor 31). The distribution of CCI (P=.59), CPS (P=.23), and age (P=.50) were similar between HPV+ versus HPV- cohorts. Median follow-up was 4.3 years. The HPV+ patients had better 5-year OS (57% vs 32%, P<.001) versus HPV- patients. Multivariable analysis adjusted for T-/N-category confirmed that HPV+ status (MVA-CCI: hazard ratio [HR] 0.58, P=.01; MVA-CPS: HR 0.60, P=.02), Zubrod scale score (0-1) (MVA-CCI: HR 0.44, P<.001; MVA-CPS: HR 0.43, P<.001), and higher radiation therapy dose (MVA-CCI: HR 0.97, P=.001; MVA-CPS: HR 0.96, P<.001) were correlated with higher OS. A marginal inverse correlation between CPS and OS was observed in the entire cohort (HR 1.05, P=.05) and was stronger for the HPV+ cohort (HR 1.11, P=.02). Nonsignificant higher OS was also found with ≤20 pack-years of smoking (MVA-CCI: P=.10; MVA-CPS: P=.15) and with systemic treatments (MVA-CCI: P=.13; MVA-CPS: P=.19). No association with OS was found for CCI (P=.46). Elderly HPV+ OPC patients have longer survival than their HPV- counterparts. Lower Zubrod scale score and higher radiation therapy dose are associated with longer OS, whereas fewer smoking

  2. High-Resolution Manometry Evaluation of Pressures at the Pharyngo-upper Esophageal Area in Patients with Oropharyngeal Dysphagia Due to Vagal Paralysis.

    PubMed

    Pinna, Bruno Rezende; Herbella, Fernando A M; de Biase, Noemi; Vaiano, Thays C G; Patti, Marco G

    2017-05-20

    The motility of the pharynx, upper esophageal sphincter (UES), and proximal esophagus in patients with oropharyngeal dysphagia is still not entirely understood. High-resolution manometry (HRM) was recently added to the armamentarium for the study of this area. This study aims to describe HRM findings in patients with vagal paralysis. Sixteen patients (mean age 54 years, 69% females) with oropharyngeal dysphagia due to unilateral vagal paralysis were prospectively studied. All patients underwent HRM. Motility of the UES and at the topography of the velopharynx and epiglottis were recorded. (1) UES relaxation is compromised in a minority of patients, (2) epiglottis pressure does not follow a specific pattern, (3) vellum is hypotonic in half of the patients, (4) dysphagia is related to a low pharyngeal pressure, not to a flow obstruction at the level of the UES, and (5) aspiration is related to low pressures at the level of the UES and epiglottis and higher pressures at the level of the vellum. Pharyngeal motility is significantly impaired in patients with oropharyngeal dysphagia and unilateral vagal paralysis. In half of the cases, UES resting pressure is preserved due to unilateral innervation and relaxation is normal in most patients. Dysphagia therapy in these patients must be directed toward improvement in the oropharyngeal motility not at the UES.

  3. Focus Issue: Neck Dissection for Oropharyngeal Squamous Cell Carcinoma

    PubMed Central

    Van Abel, Kathryn M.; Moore, Eric J.

    2012-01-01

    The staging and prognosis of oropharyngeal squamous cell carcinoma is intimately tied to the status of the cervical lymph nodes. Due to the high risk for occult nodal disease, most clinicians recommend treating the neck for these primary tumors. While there are many modalities available, surgical resection of nodal disease offers both a therapeutic and a diagnostic intervention. We review the relevant anatomy, nodal drainage patterns, clinical workup, surgical management and common complications associated with neck dissection for oropharyngeal squamous cell carcinoma. PMID:22586518

  4. 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

  5. Packing in protein cores

    NASA Astrophysics Data System (ADS)

    Gaines, J. C.; Clark, A. H.; Regan, L.; O'Hern, C. S.

    2017-07-01

    Proteins are biological polymers that underlie all cellular functions. The first high-resolution protein structures were determined by x-ray crystallography in the 1960s. Since then, there has been continued interest in understanding and predicting protein structure and stability. It is well-established that a large contribution to protein stability originates from the sequestration from solvent of hydrophobic residues in the protein core. How are such hydrophobic residues arranged in the core; how can one best model the packing of these residues, and are residues loosely packed with multiple allowed side chain conformations or densely packed with a single allowed side chain conformation? Here we show that to properly model the packing of residues in protein cores it is essential that amino acids are represented by appropriately calibrated atom sizes, and that hydrogen atoms are explicitly included. We show that protein cores possess a packing fraction of φ ≈ 0.56 , which is significantly less than the typically quoted value of 0.74 obtained using the extended atom representation. We also compare the results for the packing of amino acids in protein cores to results obtained for jammed packings from discrete element simulations of spheres, elongated particles, and composite particles with bumpy surfaces. We show that amino acids in protein cores pack as densely as disordered jammed packings of particles with similar values for the aspect ratio and bumpiness as found for amino acids. Knowing the structural properties of protein cores is of both fundamental and practical importance. Practically, it enables the assessment of changes in the structure and stability of proteins arising from amino acid mutations (such as those identified as a result of the massive human genome sequencing efforts) and the design of new folded, stable proteins and protein-protein interactions with tunable specificity and affinity.

  6. Graphitic packing removal tool

    SciTech Connect

    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.

  7. 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.

  8. 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.

  9. 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.

  10. 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…

  11. [Health-related Quality of Life After Oropharyngeal Cancer Treatment].

    PubMed

    Volkenstein, S; Willers, J; Noack, V; Dazert, S; Minovi, A

    2015-08-01

    Oropharyngeal cancer is a diagnosis which means a change in life and even after successful treatment a tremendous reduction in the quality of life. Aim of this study is to analyse the health-related quality of life in patients with oropharyngeal cancer dependent on different treatment options. Charts of 256 patients treated for oropharyngeal cancer between 1997 and 2007 were analysed in a retrospective study. Inclusion criteria for this study has been fulfilled by 98 patients, 82 of these completed the study. Therefore, standardised questionnaires (EORTC QLQ-C30 und EORTC QLQ-H&N35) have been used and 2 groups were compared: patients with primary radiochemotherapy (pRCT) vs. patients treated by an operation and adjuvant radiation. Most of the health-related quality of life domains in our patients were significantly reduced compared to the general population. There have been just very few significant differences in the quality of life domains in between the 2 groups. Health-related quality of life after treatment of oropharyngeal cancer is significantly compromised for these patients compared to the general population, but there have been no obvious differences depending on the compared treatment options. Only regarding the items "physical and cognitive functioning" patients after primary radiochemotherapy showed significantly better results and thus a better quality of life, despite the fact, that this group has a significantly advanced cancer stadium. © Georg Thieme Verlag KG Stuttgart · New York.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Morphologic and topographic radiologic features of human papillomavirus-related and -unrelated oropharyngeal carcinoma.

    PubMed

    Chan, Michael W; Yu, Eugene; Bartlett, Eric; O'Sullivan, Brian; Su, Jie; Waldron, John; Ringash, Jolie; Bratman, Scott V; Chen, Yingming Amy; Irish, Jonathan; Kim, John; Gullane, Patrick; Gilbert, Ralph; Chepeha, Douglas; Perez-Ordonez, Bayardo; Weinreb, Ilan; Hansen, Aaron; Tong, Li; Xu, Wei; Huang, Shao Hui

    2017-08-01

    The purpose of this study was to compare the clinicoradiologic characteristics of human papillomavirus (HPV)-related (HPV-positive) and HPV-unrelated (HPV-negative) oropharyngeal carcinoma (OPC). Primary tumor and lymph node features of HPV-positive and HPV-negative OPCs from 2008 to 2013 were compared on pretreatment CT/MRI. Intrarater/interrater concordance was assessed. Multivariable analyses identified factors associated with HPV-positivity to be used in nomogram construction. Compared to HPV-negative (n = 194), HPV-positive (n = 488) tumors were more exophytic (73% vs 63%; p = .02) with well-defined border (58% vs 47%; p = .033) and smaller axial dimensions; lymph node involvement predominated (89% vs 69%; p < .001) with cystic appearance (45% vs 32%; p = .009) but similar topography. Intrarater/interrater concordance varied (fair to excellent). Nomograms combining clinical (age, sex, smoking pack-years, subsite, T/N classification) and/or radiologic (nonnecrotic tumor and cystic lymph node) features were used to weigh the likelihood of HPV-driven tumors (area under the curve [AUC] = 0.84). HPV-positive OPC has different radiologic tumor (exophytic/well-defined border/smaller axial dimension) and lymph node (cystic) features but similar lymph node topography. © 2017 Wiley Periodicals, Inc.

  18. 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

  19. [Update oropharyngeal dysphagia part 1: Physiology, pathology and diagnosis].

    PubMed

    Reiter, R; Brosch, S

    2012-04-01

    Swallowing is a complex mechanism with many muscles and nerves needed. If this is disturbed, oropharyngeal dysphagia may be caused, especially in the elderly. There is a wide range of causes. Where oral feeding is sufficiently impaired then this route may have to be bypassed by percutaneous enteral gastostomy. Evaluation of swallowing is usually done with a fiberoptic or 90-degree optic. Individual needs must be addressed, usually, and best, by a multidisciplinary team. © Georg Thieme Verlag KG Stuttgart · New York.

  20. 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

  1. Oropharyngeal dysphagia in dermatomyosites: case report and literature review.

    PubMed

    Lemos, Elza Maria; Santoro, Patricia Paula; Tavares, Raquel Aguiar; Garcia, Roberta Ismael Dias; Furia, Cristina Lemos Barbosa

    2008-01-01

    We present a rare case of dermatomyosites associated with severe oropharyngeal dysphagia. A 13 year old female patient, being followed at the Rheumatologic Department, was referred to the Otolaryngology Department of the University of São Paulo School of Medicine Hospital. She complained of swallowing problems, especially with solids. Following our dysphagia study protocol, we employed a speech pathologist and otolaryngology evaluation, mainly for clinical history, examination of anatomical structures involved with swallowing events, cranium nerves integrity and videoendoscopic swallowing study. We diagnosed severe oropharyngeal dysphagia, with aspiration of saliva and food of all consistencies. We advised against oral feeding and recommended a diet through a gastric tube. She started with therapy and xerostomia medication, together with the treatment of the base disease. The patient showed a significant improvement, noticed by the clinical evaluation and the control videoendoscopic swallowing study, with the possibility of returning to oral feeding. The authors stress the incidence of oropharyngeal dysphagia in dermatomyosites and suggest the videoendoscopic swallowing study as a good exam for diagnosis and follow-up of these patients.

  2. Clinical evaluation of oropharyngeal dysphagia in Machado-Joseph disease.

    PubMed

    Corrêa, Sabrina Mello Alves; Felix, Valter Nilton; Gurgel, Jonas Lírio; Sallum, Rubens A A; Cecconello, Ivan

    2010-01-01

    In Machado-Joseph disease, poor posture, dystonia and peripheral neuropathy are extremely predisposing to oropharyngeal dysphagia, which is more commonly associated with muscular dystrophy. To evaluate the clinical characteristics of oropharyngeal dysphagia in Machado-Joseph disease patients. Forty individuals participated in this study, including 20 with no clinical complaints and 20 dysphagic patients with Machado-Joseph disease of clinical type 1, who were all similar in terms of gender distribution, average age, and cognitive function. The medical history of each patient was reviewed and each subject underwent a clinical evaluation of deglutition. At the end, the profile of dysphagia in patients with Machado-Joseph disease was classified according to the Severity Scale of Dysphagia, as described by O'Neil and collaborators. Comparison between dysphagic patients and controls did not reveal many significant differences with respect to the clinical evaluation of the oral phase of deglutition, since afflicted patients only demonstrated deficits related to the protrusion, retraction and tonus of the tongue. However, several significant differences were observed with respect to the pharyngeal phase. Dysphagic patients presented pharyngeal stasis during deglutition of liquids and solids, accompanied by coughing and/or choking as well as penetration and/or aspiration; these signs were absent in the controls. Oropharyngeal dysphagia is part of the Machado-Joseph disease since the first neurological manifestations. There is greater involvement of the pharyngeal phase, in relation to oral phase of the deglutition. The dysphagia of these patients is classified between mild and moderate.

  3. [Oropharyngeal reconstruction with radial forearm free flap: functional results].

    PubMed

    Bozec, A; Poissonnet, G; Converset, S; Lattes, L; Chamorey, E; Vallicionni, J; Demard, F; Dassonville, O

    2007-01-01

    The aim of this retrospective study is to evaluate functional results of oral and oropharyngeal reconstructions with radial forearm free flap. We present our experience with radial forearm free flap for reconstructing oral and oropharyngeal defect between 2000 and 2004. A total of 96 patients were included in this study. We analysed functional results (alimentation, elocution, mouth opening and cosmetic appearance) and researched the potentialy predictive factors of these results (age, comorbidity, preoperative irradiation...; Chi 2 test). The rate of free flap success was 97.9%. Good functional results (normal or quasi normal function) were obtained for alimentation, elocution, mouth opening and cosmetic appearance in respectively 92.6%, 64.9%, 81.9% and 84.1% of cases. Age (p = 0.05), preoperative irradiation (p = 0.005) and T stage (p = 0,02) had a negative effect on elocution, free flap failure on mouth opening (p = 0.03), preoperative irradiation (p = 0.05) and free flap failure (p = 0,02) on cosmetic appearance. Radial forearm free flap is considered as the flap of choice for oral and oropharyngeal reconstructions and allows excellent functional results.

  4. 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…

  5. 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)

  6. 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,…

  7. 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…

  8. Sun Packs Double Punch

    NASA Image and Video Library

    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 ...

  9. 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)

  10. 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,…

  11. [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

  12. 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.

  13. Effect of packing method on the randomness of disc packings

    NASA Astrophysics Data System (ADS)

    Zhang, Z. P.; Yu, A. B.; Oakeshott, R. B. S.

    1996-06-01

    The randomness of disc packings, generated by random sequential adsorption (RSA), random packing under gravity (RPG) and Mason packing (MP) which gives a packing density close to that of the RSA packing, has been analysed, based on the Delaunay tessellation, and is evaluated at two levels, i.e. the randomness at individual subunit level which relates to the construction of a triangle from a given edge length distribution and the randomness at network level which relates to the connection between triangles from a given triangle frequency distribution. The Delaunay tessellation itself is also analysed and its almost perfect randomness at the two levels is demonstrated, which verifies the proposed approach and provides a random reference system for the present analysis. It is found that (i) the construction of a triangle subunit is not random for the RSA, MP and RPG packings, with the degree of randomness decreasing from the RSA to MP and then to RPG packing; (ii) the connection of triangular subunits in the network is almost perfectly random for the RSA packing, acceptable for the MP packing and not good for the RPG packing. Packing method is an important factor governing the randomness of disc packings.

  14. 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.

  15. 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.

  16. Failures to Ignore Entirely Irrelevant Distractors

    PubMed Central

    Forster, Sophie; Lavie, Nilli

    2008-01-01

    In daily life (e.g., in the work environment) people are often distracted by stimuli that are clearly irrelevant to the current task and should be ignored. In contrast, much applied distraction research has focused on task interruptions by information that requires a response and therefore cannot be ignored. Moreover, the most commonly used laboratory measures of distractibility (e.g., in the response-competition and attentional-capture paradigms), typically involve distractors that are task relevant (e.g., through response associations or location). A series of experiments assessed interference effects from stimuli that are entirely unrelated to the current task, comparing the effects of perceptual load on task-irrelevant and task-relevant (response competing) distractors. The results showed that an entirely irrelevant distractor can interfere with task performance to the same extent as a response-competing distractor and that, as with other types of distractors, the interfering effects of the irrelevant distractors can be eliminated with high perceptual load in the relevant task. These findings establish a new laboratory measure of a form of distractibility common to everyday life and highlight load as an important determinant of such distractibility. PMID:18377168

  17. Avoidance of Cigarette Pack Health Warnings among Regular Cigarette Smokers

    PubMed Central

    Maynard, Olivia M.; Attwood, Angela; O’Brien, Laura; Brooks, Sabrina; Hedge, Craig; Leonards, Ute; Munafò, Marcus R.

    2016-01-01

    Background Previous research with adults and adolescents indicates that plain cigarette packs increase visual attention to health warnings among non-smokers and non-regular smokers, but not among regular smokers. This may be because regular smokers: 1) are familiar with the health warnings, 2) preferentially attend to branding, or 3) actively avoid health warnings. We sought to distinguish between these explanations using eye-tracking technology. Method A convenience sample of 30 adult dependant smokers were recruited to participate in an eye-tracking study. Participants viewed branded, plain and blank packs of cigarettes with familiar and unfamiliar health warnings. The number of fixations to health warnings and branding on the different pack types were recorded. Results Analysis of variance indicated that regular smokers were biased towards fixating the branding location rather than the health warning location on all three pack types (p < 0.002). This bias was smaller, but still evident, for blank packs, where smokers preferentially attended the blank region over the health warnings. Time-course analysis showed that for branded and plain packs, attention was preferentially directed to the branding location for the entire 10 seconds of the stimulus presentation, while for blank packs this occurred for the last 8 seconds of the stimulus presentation. Familiarity with health warnings had no effect on eye gaze location. Conclusion Smokers actively avoid cigarette pack health warnings, and this remains the case even in the absence of salient branding information. Smokers may have learned to divert their attention away from cigarette pack health warnings. These findings have policy implications for the design of health warning on cigarette packs. PMID:24485554

  18. Radiomics biomarkers for accurate tumor progression prediction of oropharyngeal cancer

    NASA Astrophysics Data System (ADS)

    Hadjiiski, Lubomir; Chan, Heang-Ping; Cha, Kenny H.; Srinivasan, Ashok; Wei, Jun; Zhou, Chuan; Prince, Mark; Papagerakis, Silvana

    2017-03-01

    Accurate tumor progression prediction for oropharyngeal cancers is crucial for identifying patients who would best be treated with optimized treatment and therefore minimize the risk of under- or over-treatment. An objective decision support system that can merge the available radiomics, histopathologic and molecular biomarkers in a predictive model based on statistical outcomes of previous cases and machine learning may assist clinicians in making more accurate assessment of oropharyngeal tumor progression. In this study, we evaluated the feasibility of developing individual and combined predictive models based on quantitative image analysis from radiomics, histopathology and molecular biomarkers for oropharyngeal tumor progression prediction. With IRB approval, 31, 84, and 127 patients with head and neck CT (CT-HN), tumor tissue microarrays (TMAs) and molecular biomarker expressions, respectively, were collected. For 8 of the patients all 3 types of biomarkers were available and they were sequestered in a test set. The CT-HN lesions were automatically segmented using our level sets based method. Morphological, texture and molecular based features were extracted from CT-HN and TMA images, and selected features were merged by a neural network. The classification accuracy was quantified using the area under the ROC curve (AUC). Test AUCs of 0.87, 0.74, and 0.71 were obtained with the individual predictive models based on radiomics, histopathologic, and molecular features, respectively. Combining the radiomics and molecular models increased the test AUC to 0.90. Combining all 3 models increased the test AUC further to 0.94. This preliminary study demonstrates that the individual domains of biomarkers are useful and the integrated multi-domain approach is most promising for tumor progression prediction.

  19. Recent trends in oropharyngeal cancer funding and public interest.

    PubMed

    Blasco, Michael A; Svider, Peter F; Tenbrunsel, Troy; Vellaichamy, Gautham; Yoo, George H; Fribley, Andrew M; Raza, S Naweed

    2017-06-01

    The incidence of oropharyngeal cancer (OPC) has increased in the United States. This has been driven by an increase in human papillomavirus (HPV)-positive OPC. Our objective is to determine trends in National Institutes (NIH)-supported research funding and public interest in OPC. The NIH Research Portfolio Online Reporting Tools database was evaluated for projects related to OPC between 2004 and 2015. Projects were evaluated for total funding, relation to HPV, principal investigator departmental affiliation and degree, and NIH agency or center responsible for grant. The Google Trends database was evaluated for relative Internet search popularity of oropharyngeal cancer and related search terms between 2004 and 2015. In terms of NIH funding, 100 OPC-related projects representing 242 grant years and $108.5 million were funded between 2004 and 2015. Total NIH funding for OPC projects increased from $167,406 in 2004 to $16.2 million in 2015. Funding for HPV-related OPC increased from less than $2 million yearly between 2004 and 2010 up to $12.7 million in 2015. Principal investigators related to radiation oncology ($41.8 million) and with doctor of medicine degrees ($52.8 million) received the largest share of total funding. Relative Internet search popularity for oropharyngeal cancer has increased from 2004 to 2015 compared to control cancer search terms. Increased public interest and NIH funding has paralleled the rising incidence of OPC. NIH funding has been driven by projects related to the role of HPV in OPC. 2c. Laryngoscope, 127:1345-1350, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  20. [Outcomes following transoral resection of oropharyngeal squamous cell carcinoma].

    PubMed

    López, Fernando; Llorente, José L; Álvarez-Marcos, César; Morato, Marta; Suárez, Carlos; Rodrigo, Juan P

    2015-01-01

    The aim of our study was to evaluate outcomes of a minimally invasive approach, using transoral surgery (TOS) as the primary treatment for oropharyngeal carcinoma. We reviewed 43 previously untreated patients with oropharyngeal carcinoma, who were treated with TOS. Distribution of the primary tumor site was: tonsil (52%), soft palate (23%), base of the tongue (21%) and posterior wall (4%). Eight patients had a stage I disease, 9 had a stage II disease, 7 had a stage III disease, 16 had a stage IVA, and 3 had stage IVB disease. Eighteen patients underwent postoperative radiotherapy. Records of these patients were reviewed to obtain measures such as local and regional control, overall and disease-specific survival, and speech and swallowing function. The overall recurrence rate was 44%, and the local recurrence rate was 18%. The 5-year overall survival and disease-specific survival rates were 55% and 66%, respectively. Five-year disease-specific survival rates by site were as follows: 100%, 85%, 44%, and 30% for posterior wall, tonsil, soft palate and base of the tongue, respectively. Five-year estimates for local control were 100%, 90%, and 0% for palate, tonsil and for base of the tongue tumors, respectively. All of the patients preserved the larynx and live without tracheotomy and oral alimentation was successfully without feeding tube. TOS as the primary treatment approach offers a surgical alternative for treatment of the primary oropharyngeal tumor, in the era of chemoradiation therapy. This approach confers a good local control and functional outcomes. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  1. 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.

  2. Oral sex and oropharyngeal cancer: The role of the primary care physicians.

    PubMed

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

    2016-07-01

    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. 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. 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. Family physicians will play a key role in prevention and educating the public about the risk of oral sex.

  3. 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

  4. 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

  5. [Results of palliative treatment of advanced regional oropharyngeal cancer].

    PubMed

    Laskus, Z; Szutkowski, Z

    1998-01-01

    We present results of palliative radiotherapy in 76 oropharyngeal advanced cancer patients. We recommend, according to appreciated results of palliative treatment, the two high fractionation dose courses (so called split course) if the first application of high fractionation dose had resulted in partial remission. Conventional fractionation dose in the second part of split course of radiotherapy did not result in better effect in regression, better subjective feeling after radiotherapy and longer survival time in our material. Patients with poor presentation status (Zubrod 3) should be excluded from palliative radiotherapy.

  6. 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.

  7. A sphere packing slideshow

    NASA Astrophysics Data System (ADS)

    Holmes-Cerfon, Miranda; Gortler, Steven; Brenner, Michael

    2014-03-01

    We have enumerated all the ways to arrange n <= 13+ spheres as a cluster that is nonlinearly rigid. We have discovered many packings that are hypostatic, namely they have fewer than the 3n-6 contacts required to be linearly rigid. Simple scaling arguments explain why these are thermodynamically important when the spheres are colloids interacting with a short-range potential. We discuss these clusters, as well as other surprises that came up along the way. (''+'' means we have enumerated only a particular kind of cluster for n=14, 15, and beyond.)

  8. Effects of different types of pharyngeal packing in patients undergoing nasal surgery: A comparative study

    PubMed Central

    Rizvi, Mohd Meesam; Singh, Raj Bahadur; Rasheed, Mohd Asim; Sarkar, Arindam

    2015-01-01

    Context: Postoperative throat complaints such as postoperative sore throat (POST), dysphagia, and hoarseness frequently arises after tracheal intubation and throat packing for patient undergoing general anesthesia. This condition is very disturbing to patient. Avoiding POST is a major priority for these patients because preventing postoperative complications contributes to patient satisfaction. Aims: To describe and analyze the postoperative throat effects of nasopharyngeal packing and oropharyngeal packing in patients undergoing nasal surgery. Settings and Design: A randomized comparative study. Subjects and Methods: After obtaining approval of Ethical Committee 40 patients were included in study. After this patient were randomly allocated into two groups of 20 each. Group A - in which the oropharynx was packed and Group B - inwhich the nasopharynx was packed. General anesthesia were given and throat packing was done and patients were interviewed postoperatively for any throat complications such as sore throat, difficulty in swallowing (dysphagia), hoarseness of voice, throat irritation, and any other symptom pertaining to the study were noted and data were analyzed. Statistical Analysis Used: T-test to compare the age, while Chi-square test and Fisher's exact test were used to compare sex distribution, sore throat, dysphagia, hoarseness, and throat irritation. Results: Results showed statistically significant difference in incidence and severity of POST in Group A patients when compared to Group B patients to be more. Patients in Group A had a higher incidence of dysphagia when compared to their Group B counterparts. With respect to the incidence of hoarseness and throat irritation, there was no statistical significance between the groups. Conclusion: We concluded that the site of pharyngeal packing influences the incidence and severity of POST and as well as the incidence of dysphagia after general anesthesia. The use of nasopharyngeal packing in the patients

  9. 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.

  10. 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.

  11. Tobacco Smoking and Increased Risk of Death and Progression for Patients With p16-Positive and p16-Negative Oropharyngeal Cancer

    PubMed Central

    Gillison, Maura L.; Zhang, Qiang; Jordan, Richard; Xiao, Weihong; Westra, William H.; Trotti, Andy; Spencer, Sharon; Harris, Jonathan; Chung, Christine H.; Ang, K. Kian

    2012-01-01

    Purpose Tobacco smoking is associated with oropharynx cancer survival, but to what extent cancer progression or death increases with increasing tobacco exposure is unknown. Patients and Methods Patients with oropharynx cancer enrolled onto a phase III trial of radiotherapy from 1991 to 1997 (Radiation Therapy Oncology Group [RTOG] 9003) or of chemoradiotherapy from 2002 to 2005 (RTOG 0129) were evaluated for tumor human papillomavirus status by a surrogate, p16 immunohistochemistry, and for tobacco exposure by a standardized questionnaire. Associations between tobacco exposure and overall survival (OS) and progression-free survival (PFS) were estimated by Cox proportional hazards models. Results Prevalence of p16-positive cancer was 39.5% among patients in RTOG 9003 and 68.0% in RTOG 0129. Median pack-years of tobacco smoking were lower among p16-positive than p16-negative patients in both trials (RTOG 9003: 29 v 45.9 pack-years; P = .02; RTOG 0129: 10 v 40 pack-years; P < .001). After adjustment for p16 and other factors, risk of progression (PFS) or death (OS) increased by 1% per pack-year (for both, hazard ratio [HR], 1.01; 95% CI, 1.00 to 1.01; P = .002) or 2% per year of smoking (for both, HR, 1.02; 95% CI, 1.01 to 1.03; P < .001) in both trials. In RTOG 9003, risk of death doubled (HR, 2.19; 95% CI, 1.46 to 3.28) among those who smoked during radiotherapy after accounting for pack-years and other factors, and risk of second primary tumors increased by 1.5% per pack-year (HR, 1.015; 95% CI, 1.005 to 1.026). Conclusion Risk of oropharyngeal cancer progression and death increases directly as a function of tobacco exposure at diagnosis and during therapy and is independent of tumor p16 status and treatment. PMID:22565003

  12. Oropharyngeal Dermoid Cyst in an Infant with Intermittent Airway Obstruction

    PubMed Central

    Wagner, Matthias W.; Haileselassie, Bereketeab; Kannan, Sujatha; Chen, Cynthia; Poretti, Andrea; Tunkel, David E.; Huisman, Thierry A.G.M.

    2014-01-01

    Summary Dermoid cysts are benign epithelial inclusions and cystic lesions that may occur in several locations including the oropharynx. We describe the case of a two-month-old baby girl who presented with progressive respiratory distress, hypoxemia, and feeding difficulties because of an oropharyngeal dermoid cyst. The child had an airway work-up that included laryngoscopy. However, the mass remained undetected. This is most likely explained by the mobile nature of the lesion, prolapsing into the high nasopharynx in supine position. In our patient, magnetic resonance imaging (MRI), initially performed to rule out brainstem pathology, revealed an oropharyngeal dermoid cyst. This case shows the potential role of neuroimaging in the diagnostic work-up of a young child presenting with respiratory distress by excluding a central nervous system lesion and diagnosing an “unexpected” nasopharyngeal mass lesion. In addition, MRI allowed exclusion of skull base lesions of neural origin such as an anterior meningoencephalocele or heterotopic neuroglial tissue which would be managed differently from pharyngeal masses. PMID:25260210

  13. Interventions for oropharyngeal dysphagia in children with neurological impairment.

    PubMed

    Morgan, Angela T; Dodrill, Pamela; Ward, Elizabeth C

    2012-10-17

    Oropharyngeal dysphagia encompasses problems with the oral preparatory phase of swallowing (chewing and preparing the food), oral phase (moving the food or fluid posteriorly through the oral cavity with the tongue into the back of the throat) and pharyngeal phase (swallowing the food or fluid and moving it through the pharynx to the oesophagus). Populations of children with neurological impairment who commonly experience dysphagia include, but are not limited to, those with acquired brain impairment (for example, cerebral palsy, traumatic brain injury, stroke), genetic syndromes (for example, Down syndrome, Rett syndrome) and degenerative conditions (for example, myotonic dystrophy). To examine the effectiveness of interventions for oropharyngeal dysphagia in children with neurological impairment. We searched the following electronic databases in October 2011: CENTRAL 2011(3), MEDLINE (1948 to September Week 4 2011), EMBASE (1980 to 2011 Week 40)
, CINAHL (1937 to current)
, ERIC (1966 to current), PsycINFO (1806 to October Week 1 2011), Science Citation Index (1970 to 7 October 2011), Social Science Citation Index (1970 to 7 October 2011), Cochrane Database of Systematic Reviews, 2011(3), DARE 2011(3), Current Controlled Trials (ISRCTN Register) (15 October 2011), ClinicalTrials.gov (15 October 2011) and WHO ICTRP (15 October 2011). We searched for dissertations and theses using Networked Digital Library of Theses and Dissertations, Australasian Digital Theses Program and DART-Europe E-theses Portal (11 October 2011). Finally, additional references were also obtained from reference lists from articles. The review included randomised controlled trials and quasi-randomised controlled trials for children with oropharyngeal dysphagia and neurological impairment. All three review authors (AM, PD and EW) independently screened titles and abstracts for inclusion and discussed results. In cases of uncertainty over whether an abstract met inclusion criterion, review

  14. Oropharyngeal dysphagia and aspiration in patients with ataxia-telangiectasia.

    PubMed

    Lefton-Greif, M A; Crawford, T O; Winkelstein, J A; Loughlin, G M; Koerner, C B; Zahurak, M; Lederman, H M

    2000-02-01

    To determine whether patients with ataxia-telangiectasia exhibit oropharyngeal dysphagia with concomitant aspiration and to examine the relationships among swallowing function, age, and nutritional status. Seventy patients (mean age, 10.7 years; range, 1.8 to 30 years) had feeding/swallowing and nutritional evaluations. Fifty-one patients, in whom there were concerns about swallowing safety, were examined with a standardized videofluoroscopic swallow study. Fourteen of the 51 patients (27%) with histories suggestive of dysphagia demonstrated aspiration. Of these, silent aspiration (aspiration without a cough) occurred in 10 (71%) patients. Aspirators were significantly older than non-aspirators (mean age, 16.9 vs 10.8 years; P =.002). Advancing age was the strongest factor associated with aspiration during continuous drinking (P =.01). In patients with ataxia-telangiectasia, weight and weight/height were abnormally low at all ages and most compromised in older patients. Patients who aspirated had significantly lower mean weight (P <.002) and weight/height z scores (P <.001) than did patients who did not aspirate. Oropharyngeal dysphagia is common and appears to be progressive in patients with ataxia-telangiectasia. Older patients also have a higher incidence of poorer nutritional status. The relationship between dysphagia and nutritional status deserves further investigation.

  15. Acoustic analysis of oropharyngeal swallowing using Sonar Doppler.

    PubMed

    Soria, Franciele Savaris; Silva, Roberta Gonçalves da; Furkim, Ana Maria

    2016-01-01

    During the aging process, one of the functions that changes is swallowing. These alterations in oropharyngeal swallowing may be diagnosed by methods that allow both the diagnosis and biofeedback monitoring by the patient. One of the methods recently described in the literature for the evaluation of swallowing is the Sonar Doppler. To compare the acoustic parameters of oropharyngeal swallowing between different age groups. This was a field, quantitative, study. Examination with Sonar Doppler was performed in 75 elderly and 72 non-elderly adult subjects. The following acoustic parameters were established: initial frequency, first peak frequency, second peak frequency; initial intensity, final intensity; and time for the swallowing of saliva, liquid, nectar, honey, and pudding, with 5- and 10-mL free drinks. Objective, measurable data were obtained; most acoustic parameters studied between adult and elderly groups with respect to consistency and volume were significant. When comparing elderly with non-elderly adult subjects, there is a modification of the acoustic pattern of swallowing, regarding both consistency and food bolus volume. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. 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

  17. Electrostatic Properties of an Entirely Hydrophilic Polyelectrolyte.

    NASA Astrophysics Data System (ADS)

    Hoagland, David; Popov, Alexei

    2007-03-01

    A new of class of polyelectrolyte ionenes is described, one with an entirely hydrophilic backbone of quaternized nitrogens connected by polyoxyethylene spacers of controlled length. The chemistry of these pegylated ionenes yields solubility at constant charge density in solvents of varying dielectric constant; it also allows for controlled variation of polyelectrolyte charge density through choice of monomers. Such features make the new ionenes ideal model polyelectrolytes on which to test theories for electrostatic properties of polyelectrolytes. In particular, we report on the use of electrophoresis to measure effective charge density for different charge spacings and dielectric constants. In conformance with previous results for aliphatic ionenes, we find counterion condensation for pegylated ionenes at conditions different than classical predictions. Counterion condensation -- a constant effective charge density - is encountered in univalent electrolyte by the lowering of dielectric constant even when the dimensionless charge density is less than unity; conditions for the condensation depend on counterion identity (size). Additional studies on various anionic polyelectrolytes dissolved in nonaqueous solvents reproduce the same trends, suggesting their universality.

  18. Dentofacial Composition: An Entire Aesthetic Concept.

    PubMed

    Stiller, Michael; Peleska, Barbara; Hmaidouch, Rim; Mehrhof, Jürgen; Weigel, Dana

    2015-10-01

    The aesthetic appearance of the mouth region, in addition to the eye and nose area, is the impressive element for facial aesthetics. Therefore, the reconstruction of the intraoral region is very important for the facial aesthetics in the case of genetic dysplasia, trauma, or even in cases for rejuvenating purposes only. The entire region is complex so that in many patient cases only the team work of restorative dentists, surgeons, and orthodontists will be effective. A key role is played here by the dental technician. Besides the frequent necessity of osseous augmentation, the mucogingival complex needs to be, in most cases, harmonized and reconstructed, respectively. There is often a lack of keratinized gingiva and disturbing cicatrice tracks. Quite frequently the mucogingival appearance is also unsatisfactory due to preceding operations and attempted plastic coverages. The aim of this report is to describe the successful surgical and prosthetic treatment of aesthetically and functionally impaired intraoral hard and soft tissue. For surgeons who are interested in aesthetics, it is advisable to learn from experiences of a specialized restorative dentist, oral surgeon, and orthodontist. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. 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.

  20. Avoidance of cigarette pack health warnings among regular cigarette smokers.

    PubMed

    Maynard, Olivia M; Attwood, Angela; O'Brien, Laura; Brooks, Sabrina; Hedge, Craig; Leonards, Ute; Munafò, Marcus R

    2014-03-01

    Previous research with adults and adolescents indicates that plain cigarette packs increase visual attention to health warnings among non-smokers and non-regular smokers, but not among regular smokers. This may be because regular smokers: (1) are familiar with the health warnings, (2) preferentially attend to branding, or (3) actively avoid health warnings. We sought to distinguish between these explanations using eye-tracking technology. A convenience sample of 30 adult dependent smokers participated in an eye-tracking study. Participants viewed branded, plain and blank packs of cigarettes with familiar and unfamiliar health warnings. The number of fixations to health warnings and branding on the different pack types were recorded. Analysis of variance indicated that regular smokers were biased towards fixating the branding rather than the health warning on all three pack types. This bias was smaller, but still evident, for blank packs, where smokers preferentially attended the blank region over the health warnings. Time-course analysis showed that for branded and plain packs, attention was preferentially directed to the branding location for the entire 10s of the stimulus presentation, while for blank packs this occurred for the last 8s of the stimulus presentation. Familiarity with health warnings had no effect on eye gaze location. Smokers actively avoid cigarette pack health warnings, and this remains the case even in the absence of salient branding information. Smokers may have learned to divert their attention away from cigarette pack health warnings. These findings have implications for cigarette packaging and health warning policy. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  1. Comparing function and structure between entire proteomes

    PubMed Central

    Liu, Jinfeng; Rost, Burkhard

    2001-01-01

    More than 30 organisms have been sequenced entirely. Here, we applied a variety of simple bioinformatics tools to analyze 29 proteomes for representatives from all three kingdoms: eukaryotes, prokaryotes, and archaebacteria. We confirmed that eukaryotes have relatively more long proteins than prokaryotes and archaes, and that the overall amino acid composition is similar among the three. We predicted that ∼15%–30% of all proteins contained transmembrane helices. We could not find a correlation between the content of membrane proteins and the complexity of the organism. In particular, we did not find significantly higher percentages of helical membrane proteins in eukaryotes than in prokaryotes or archae. However, we found more proteins with seven transmembrane helices in eukaryotes and more with six and 12 transmembrane helices in prokaryotes. We found twice as many coiled-coil proteins in eukaryotes (10%) as in prokaryotes and archaes (4%–5%), and we predicted ∼15%–25% of all proteins to be secreted by most eukaryotes and prokaryotes. Every tenth protein had no known homolog in current databases, and 30%–40% of the proteins fell into structural families with >100 members. A classification by cellular function verified that eukaryotes have a higher proportion of proteins for communication with the environment. Finally, we found at least one homolog of experimentally known structure for ∼20%–45% of all proteins; the regions with structural homology covered 20%–30% of all residues. These numbers may or may not suggest that there are 1200–2600 folds in the universe of protein structures. All predictions are available at http://cubic.bioc.columbia.edu/genomes. PMID:11567088

  2. 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.

  3. 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.

  4. 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.

  5. Knowledge and risk perception of oral cavity and oropharyngeal cancer among non-medical university students.

    PubMed

    Osazuwa-Peters, Nosayaba; Tutlam, Nhial T

    2016-01-28

    To assess non-medical university students' knowledge and perceived risk of developing oral cavity and oropharyngeal cancer. A cross-sectional survey was conducted among non-medical students of a private Midwestern university in the United States in May 2012. Questionnaire assessed demographic information and contained 21 previously validated questions regarding knowledge and perceived risk of developing oral cavity and oropharyngeal cancer. Knowledge scale was categorized into low and high. Risk level was estimated based on smoking, drinking, and sexual habits. Bivariate associations between continuous and categorical variables were assessed using Pearson correlation and Chi-square tests, respectively. The response rate was 87% (100 out of 115 students approached). Eighty-one percent (81%) had low oral cavity and oropharyngeal cancer knowledge; and only 2% perceived that their oral cavity and oropharyngeal cancer risk was high. Risk perception was negatively correlated with age at sexual debut, r (64) = -0.26, p = 0.037; one-way ANOVA showed a marginally significant association between risk perception and number of sexual partners, F(4, 60) = 2.48, p = 0.05. There was no significant association between knowledge and perception of risk; however, oral cavity and oropharyngeal cancer knowledge was significantly associated with frequency of prevention of STDs (p < 0.05). Although 86% had heard about oral cavity and oropharyngeal cancer, only 18% had heard of oral mouth examination, and 7% of these reported ever having an oral cavity and oropharyngeal cancer exam. Oral cavity and oropharyngeal cancer knowledge and risk perception is low among this student population. Since oral cavity and oropharyngeal cancer incidence is increasingly shifting towards younger adults, interventions must be tailored to this group in order to improve prevention and control.

  6. Polarizable protein packing.

    PubMed

    Ng, Albert H; Snow, Christopher D

    2011-05-01

    To incorporate protein polarization effects within a protein combinatorial optimization framework, we decompose the polarizable force field AMOEBA into low order terms. Including terms up to the third-order provides a fair approximation to the full energy while maintaining tractability. We represent the polarizable packing problem for protein G as a hypergraph and solve for optimal rotamers with the FASTER combinatorial optimization algorithm. These approximate energy models can be improved to high accuracy [root mean square deviation (rmsd) < 1 kJ mol(-1)] via ridge regression. The resulting trained approximations are used to efficiently identify new, low-energy solutions. The approach is general and should allow combinatorial optimization of other many-body problems. Copyright © 2011 Wiley Periodicals, Inc.

  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. 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. © 2012

  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. 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…

  12. Human papillomavirus-mediated carcinogenesis and HPV-associated oral and oropharyngeal squamous cell carcinoma. Part 2: Human papillomavirus associated oral and oropharyngeal squamous cell carcinoma.

    PubMed

    Feller, Liviu; Wood, Neil H; Khammissa, Razia A G; Lemmer, Johan

    2010-07-15

    Human papillomavirus (HPV) infection of the mouth and oropharynx can be acquired by a variety of sexual and social forms of transmission. HPV-16 genotype is present in many oral and oropharyngeal squamous cell carcinomata. It has an essential aetiologic role in the development of oropharyngeal squamous cell carcinoma in a subset of subjects who are typically younger, are more engaged with high-risk sexual behaviour, have higher HPV-16 serum antibody titer, use less tobacco and have better survival rates than in subjects with HPV-cytonegative oropharyngeal squamous cell carcinoma. In this subset of subjects the HPV-cytopositive carcinomatous cells have a distinct molecular profile. In contrast to HPV-cytopositive oropharyngeal squamous cell carcinoma, the causal association between HPV-16 and other high-risk HPV genotypes and squamous cell carcinoma of the oral mucosa is weak, and the nature of the association is unclear. It is likely that routine administration of HPV vaccination against high-risk HPV genotypes before the start of sexual activity will bring about a reduction in the incidence of HPV-mediated oral and oropharyngeal squamous cell carcinoma. This article focuses on aspects of HPV infection of the mouth and the oropharynx with emphasis on the link between HPV and squamous cell carcinoma, and on the limitations of the available diagnostic tests in identifying a cause-and-effect relationship of HPV with squamous cell carcinoma of the mouth and oropharynx.

  13. Simulation of lithium ion battery replacement in a battery pack for application in electric vehicles

    NASA Astrophysics Data System (ADS)

    Mathew, M.; Kong, Q. H.; McGrory, J.; Fowler, M.

    2017-05-01

    The design and optimization of the battery pack in an electric vehicle (EV) is essential for continued integration of EVs into the global market. Reconfigurable battery packs are of significant interest lately as they allow for damaged cells to be removed from the circuit, limiting their impact on the entire pack. This paper provides a simulation framework that models a battery pack and examines the effect of replacing damaged cells with new ones. The cells within the battery pack vary stochastically and the performance of the entire pack is evaluated under different conditions. The results show that by changing out cells in the battery pack, the state of health of the pack can be consistently maintained above a certain threshold value selected by the user. In situations where the cells are checked for replacement at discrete intervals, referred to as maintenance event intervals, it is found that the length of the interval is dependent on the mean time to failure of the individual cells. The simulation framework as well as the results from this paper can be utilized to better optimize lithium ion battery pack design in EVs and make long term deployment of EVs more economically feasible.

  14. 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.

  15. 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.

  16. Oropharyngeal trauma mimicking a first branchial cleft anomaly.

    PubMed

    Larem, Aisha; Sheikh, Rashid; Al Qahtani, Abdulsalam; Khais, Frat; Ganesan, Shanmugam; Haidar, Hassan

    2016-06-01

    We present a unique and challenging case of a remnant foreign body that presented to us in a child disguised as a strongly suspected congenital branchial cleft anomaly. This case entailed oropharyngeal trauma, with a delayed presentation as a retroauricular cyst accompanied by otorrhea that mimicked the classic presentation of an infected first branchial cleft anomaly. During surgical excision of the presumed branchial anomaly, a large wooden stick was found in the tract. The diagnostic and therapeutic obstacles in the management of such cases are highlighted. In addition to exploring the existing literature, we retrospectively analyzed a plausible explanation of the findings of this case. Laryngoscope, 126:E224-E226, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  17. 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 that...

  18. 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 that...

  19. 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 that...

  20. Ultracision Harmonic Scalpel in oral and oropharyngeal cancer resection.

    PubMed

    Tirelli, Giancarlo; Del Piero, Giulia Carolina; Perrino, Fiorella

    2014-07-01

    The aim of this prospective study was to evaluate the benefits and risks when using an Ultracision Harmonic Scalpel in the surgical treatment of oral and oropharyngeal carcinomas. Prospective non-randomized. Clinica Otorinolaringoiatrica, Azienda Ospedaliero-Universitaria. Trieste, Italy. In this study, conducted from April 2008 to August 2010, 36 consecutive patients underwent resection of oral or oropharyngeal carcinoma and lateral lymphadenectomy using the Ultracision Harmonic Scalpel. Evaluation criteria included length of the surgical procedure, intraoperative blood loss, quantity of neck drainage on the first, second and third postoperative days, postoperative complications, and a subjective assessment of postoperative pain and lymphatic oedema of the neck. Results were compared with previous surgical procedures carried out between May 2006 and March 2008 using cold knife and bipolar haemostasis (n = 36) when the Harmonic Scalpel was not available. In patients treated with the Harmonic Scalpel, operating time was significantly reduced, both for resection of the carcinoma and the lateral lymphadenectomy. Intraoperative blood loss and neck drainage on the first and second postoperative days were significantly less and pain scores were significantly lower than in the cold knife group. No postoperative complications were noted in the Harmonic Scalpel group. The only disadvantage noted in the Harmonic Scalpel group was the high incidence of lymphatic oedema of the neck. Use of the Harmonic Scalpel during resection of oral cancer and lateral lymphadenectomy is safe and confers some advantages over conventional methods. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. 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.

  2. Use of Oropharyngeal Washes to Diagnose and Genotype Pneumocystis jirovecii

    PubMed Central

    Juliano, Jonathan J.; Barnett, Eric; Parobek, Christian M.; Taylor, Steve M.; Meshnick, Steven R.; Stone, Stephen; Chang, Emily; Fong, Serena; Huang, Laurence

    2015-01-01

    Pneumocystis jirovecii is a symbiotic respiratory fungus that presents in 2 clinical forms: pneumonia in immunocompromised patients or colonization, defined by the presence of the organism without associated clinical symptoms. Currently, diagnosis requires invasive bronchoscopy, which may not be available in some settings and is inappropriate for detecting colonization in healthy individuals. Noninvasive diagnostic techniques and molecular strain typing tools that can be used on these samples are critical for conducting studies to better understand transmission. We evaluated 2 real-time polymerase chain reaction (PCR) assays targeting dihydropteroate synthase and the major surface glycoprotein for detection in 77 oropharyngeal washes (OPWs) from 43 symptomatic human immunodeficiency virus-infected patients who underwent bronchoscopy. We also evaluated the ability of a new microsatellite (MS) genotyping panel to strain type infections from these samples. Each PCR used individually provided a high sensitivity (>80%) for detection of pneumonia but a modest specificity (<70%). When used in combination, specificity was increased to 100% with a drop in sensitivity (74%). Concentration of organisms by PCR in the OPW tended to be lower in colonized individuals compared with those with pneumonia, but differences in concentration could not clearly define colonization in symptomatic individuals. Oropharyngeal wash samples were genotyped using 6 MSs with ≥4 alleles successfully genotyped in the majority of colonized patients and ≥5 alleles in patients with pneumonia. The MS profile was consistent over time within patients with serial OPWs analyzed. Microsatellite genotyping on noninvasive samples may aid in studying the molecular epidemiology of this pathogen without requiring invasive diagnostic techniques. PMID:26180832

  3. 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.

  4. [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.

  5. 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

  6. 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.

  7. 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

  8. Oropharyngeal airway appliance for infant with upper airway obstruction: report of a case.

    PubMed

    Shimoyama, T; Kato, T; Horie, Norio; Nasu, D; Kaneko, T

    2002-01-01

    A palatal appliance with oropharyngeal tube that reduces the upper airway obstructions of an eleven-month-old male infant with severe cerebral palsy is presented. The palatal appliance was composed of the base plate, the outer guide tube that held the oropharyngeal tube inside it, and the extra outer guide tube for the suction catheter. After the setting of the appliance, respiratory distress was improved without side effects.

  9. Oropharyngeal oxygen and volatile anesthetic agent concentration during the use of laryngeal mask airway in children.

    PubMed

    Hakim, Mumin; Krishna, Senthil G; Syed, Ahsan; Lind, Meredith; Elmaraghy, Charles; Tobias, Joseph D

    2016-01-01

    The laryngeal mask airway is increasingly used as an airway adjunct during general anesthesia. Although placement is generally simpler than an endotracheal tube, complete sealing of the airway may not occur, resulting in contamination of the oropharynx with anesthetic gases. Oropharyngeal oxygen enrichment may be one of the contributing factors predisposing to an airway fire during adenotonsillectomy. The current study prospectively assesses the oropharyngeal oxygen and volatile anesthetic agent concentration during laryngeal mask airway use in infants and children. Following the induction of general anesthesia and placement of a laryngeal mask airway, the oropharyngeal gas sample was obtained by placing a 14-gauge catheter attached to the gas sampling tube into the oropharynx above the laryngeal mask airway. The oropharyngeal concentration of the oxygen and the anesthetic agent were recorded for five breaths during both spontaneous ventilation (SV) and positive pressure ventilation (PPV). The study included 238 patients. The oropharyngeal concentration of sevoflurane was >50% of the inspired sevoflurane concentration during SV in 10 of 238 (4.2%) patients and during PPV in 135 of 238 (56.7%) patients. Similarly, during SV and PPV, the oropharyngeal oxygen concentration was >21% in 30 of 238 (12.6%) patients and in 188 of 238 (79%) patients, respectively. Significantly, we also noticed that the oropharyngeal oxygen concentration exceeded 50% in 5 of 238 (2.1%) patients during SV and in 139 of 238 patients (58.4%) patients during PPV. With the use of a laryngeal mask airway and the administration of 100% oxygen, there was significant contamination of the oropharynx during both PPV and SV. The oropharyngeal concentration of oxygen was high enough to support combustion in a significant number of patients. The use of a laryngeal mask airway does not ensure sealing of the airway and may be one risk factor for an airway fire during adenotonsillectomy. © 2015 John Wiley

  10. High-risk human papillomavirus and cervical lymph node metastasis in patients with oropharyngeal cancer.

    PubMed

    Joo, Young-Hoon; Jung, Chan-Kwon; Sun, Dong-Il; Park, Jun-Ook; Cho, Kwang-Jae; Kim, Min-Sik

    2012-01-01

    The purpose of this study was to determine the role of high-risk human papillomavirus (HPV) in lymph node metastasis and the depth of invasion in oropharyngeal cancer. The study included patients with 90 oral carcinomas and 66 oropharyngeal carcinomas. High-risk HPV in situ hybridization was performed to detect HPV infection. The positive rate of high-risk HPV in situ hybridization was 15.4% (24 of 156). There was a significant difference in the fraction of positive high-risk HPV between oral (6.7%) and oropharyngeal (27.3%) cancers (p < .000). Significant correlations were found between positive high-risk HPV and cervical lymph node metastasis, tumor depth of invasion in patients with oropharyngeal cancer (p = .002, p = .016, respectively). There was a statistically significant association between high-risk HPV positivity and the disease-specific survival in patients with oropharyngeal cancer (p = .035). High-risk HPV infection was significantly related to cervical lymph node metastasis and depth of invasion in patients with oropharyngeal cancer. © 2011 Wiley Periodicals, Inc. Head Neck, 2012. Copyright © 2011 Wiley Periodicals, Inc.

  11. 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.

  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. 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.

  14. 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.

  15. 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.

  16. Aspiration of Nasopore nasal packing.

    PubMed

    Smith, Jonathan; Reddy, Ekambar

    2017-10-04

    We present a case of postoperative Nasopore aspiration in an otherwise fit and well 11-year-old. An endoscopic adenoidectomy had been performed without incident and Nasopore packing placed into each nasal cavity. Immediately after extubation, there was marked hypoxia, tachypnoea and high clinical suspicion of pack aspiration. The patient returned to theatre for emergency rigid bronchoscopy and retrieval of nasal packing. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Response of Jammed Ellipsoid Packings

    NASA Astrophysics Data System (ADS)

    Zeravcic, Zorana; Liu, Andrea; Nagel, Sidney

    2011-03-01

    We investigate the nature of the jamming transition for packings of spheroids by examining the elastic moduli as a function of the aspect ratio of the particles ɛ and the compression. Irrespective of the particle aspect ratio, both shear modulus G and bulk modulus B show the same scaling as a function of compression as is found for packings of spheres. Moreover, for any value of ɛ , G is proportional to the excess of the coordination number above that found at the jamming threshold; this recovers the result for frictionless spheres at ɛ = 1 . Our results imply a new diverging length scale associated with the loss of rigidity of these spheroid packings. The critical behavior of ellipsoid packings is an extension of that found for spheres.

  18. 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.

  19. Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: Clinical Outcomes and Patterns of Failure

    SciTech Connect

    Daly, Megan E.; Le, Quynh-Thu; Maxim, Peter G.; Loo, Billy W.; Kaplan, Michael J.; Fischbein, Nancy J.; Pinto, Harlan; Chang, Daniel T.

    2010-04-15

    Purpose: To report outcomes, failures, and toxicities in patients treated with intensity-modulated radiotherapy (IMRT) for squamous cell carcinoma of the oropharynx. Methods And Materials: Between Aug 2001 and Oct 2007, 107 patients were treated with IMRT with curative intent at Stanford University. Twenty-two patients were treated postoperatively, and 85 were treated definitively. Concurrent platinum-based chemotherapy was administered to 86 patients (80%) and cetuximab to 8 patients (7%). The prescribed dose was 66 Gy at 2.2 Gy/fraction for definitively treated cases and 60 Gy at 2 Gy/fraction for postoperative cases. Median follow-up was 29 months among surviving patients (range, 4-105 months). Results: Eight patients had persistent disease or local-regional failure at a median of 6.5 months (range, 0-9.9 months). Six local failures occurred entirely within the high-risk clinical target volume (CTV) (one with simultaneous distant metastasis). One patient relapsed within the high- and intermediate-risk CTV. One patient had a recurrence at the junction between the IMRT and low-neck fields. Seven patients developed distant metastasis as the first site of failure. The 3-year local-regional control (LRC), freedom from distant metastasis, overall survival, and disease-free survival rates were 92%, 92%, 83%, and 81%, respectively. T stage (T4 vs. T1-T3) was predictive of poorer LRC (p = 0.001), overall survival (p = 0.001), and disease-free survival (p < 0.001) rates. Acute toxicity consisted of 58% grade 3 mucosal and 5% grade 3 skin reactions. Six patients (6%) developed grade >=3 late complications. Conclusions: IMRT provides excellent LRC for oropharyngeal squamous cell carcinoma. Distant metastases are a major failure pattern. No marginal failures were observed.

  20. 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.

  1. Oral and oropharyngeal cancer in a Venezuelan population.

    PubMed

    Rivera, Helen; Nikitakis, Nikolaos G; Correnti, María; Maissi, Sara; Ponce, José G

    2008-01-01

    The aim of this work was to analyze diagnosed cases of Oral Cancer (OC) and Oropharyngeal Cancer (OPC) in a Venezuelan population. We clinically evaluated 130 patients with OC and OPC and a histopathologic diagnosis of squamous cell carcinoma. The patients were analyzed according to gender age, and use of alcohol and tobacco and the tumors were classIfied based on anatomic location, staging parameters, and degree of difFerentiation. Ninety one patients (70%) were male and 39 (30%) were female. Patients' age ranged from 26 to 86 years old. Use of smoking tobacco, alcohol or both was reported by 84.3%, 49.1% and 45.4% of patients, respectively, and was more frequent in males. The most common oropharyngeal anatomic location was the base of the tongue (22.3%), followed by the tonsils (13.9%), while the most frequently affected oral location was the oral tongue (19.2%) followed by the gingiva and alveolar mucosa (10.8%), and the floor of mouth (7.7%). The majority of tumors (77.7%) were diagnosed at an advanced stage (Stage III or IV); metastasis to the regional lymph nodes occurred in 53.1% of cases. According to degree of diferentiation, well, moderately and poorly difFerentiated tumors accounted for 45.4%, 46.1% and 8.5% of cases, respectively. Well differentiated tumors accounted for 56.7% of OC cases, while the majority of OPC cases were classified as moderately or poorly differentiated (72.3%) (p < or = 0.002). Also, non-metastatic cases (NO) showed a predominance of well-diferentiated tumors (61.2%), while metastatic tumors (N+) were classified as moderately or poorly differentiated in 89.8% of cases (p < or = 0.0001). Our study population was characterized by a predominance of smokers and/or drinkers and a predilection for male patients. Most tumors were diagnosed at an advanced stage with a high incidence of metastatic spread to the regional lymph nodes, indicating possible delays in diagnosis. Less differentiated tumors were more frequently encountered among

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

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

    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.

  3. 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

  4. 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…

  5. 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…

  6. Prognostic value of p16 expression irrespective of human papillomavirus status in patients with oropharyngeal carcinoma.

    PubMed

    Saito, Yuki; Yoshida, Masafumi; Omura, Go; Kobayashi, Kenya; Fujimoto, Chisato; Ando, Mizuo; Sakamoto, Takashi; Asakage, Takahiro; Yamasoba, Tatsuya

    2015-09-01

    In a previous study, we reported the value of p16 expression and alcohol consumption in oropharyngeal carcinoma in Japan. We now report the clinical significance of human papillomavirus status and p16 expression in oropharyngeal carcinoma in Japan. Over a 9-year period, a retrospective case comparison study of the pathology database was conducted at the University of Tokyo to identify tumor samples of oropharyngeal carcinoma. We performed immunohistochemistry for the p16 protein, in situ hybridization for human papillomavirus-deoxyribonucleic acid and polymerase chain reaction for the human papillomavirus-deoxyribonucleic acid oncogene E6 in oropharyngeal carcinoma in Japanese patients. We evaluated the human papillomavirus status in patients with oropharyngeal carcinoma to determine its prevalence and association with prognosis. We defined human papillomavirus(+) and human papillomavirus(-) oropharyngeal carcinoma cohorts as those with and without polymerase chain reaction for the human papillomavirus-deoxyribonucleic acid oncogene E6 or in situ hybridization-human papillomavirus. In oropharyngeal carcinoma, the prevalences of p16(+)human papillomavirus(+), p16(+)human papillomavirus(-), p16(-)human papillomavirus(+) and p16(-)human papillomavirus(-) were 32% (48/150), 7% (10/150), 2% (3/150) and 59% (89/150), respectively. Low tobacco and alcohol consumption, tonsil or base of tongue localization, but not age, were associated with p16(+)human papillomavirus(+). Low alcohol consumption was associated with p16(+)human papillomavirus(-). There was a significant difference in overall survival between p16(+)human papillomavirus(-) and p16(-)human papillomavirus(-) (P = 0.03). In multivariate Cox regression models, p16 was the independent prognostic factor, regardless of human papillomavirus status. p16 expression was a reliable prognostic biomarker regardless of human papillomavirus status. © The Author 2015. Published by Oxford University Press. All rights reserved

  7. Human papillomavirus-induced oropharyngeal cancer in Hispanics in the United States.

    PubMed

    Thomas, Giovana R; Lo, Kaming; Nwojo, Raphael

    2017-05-01

    Determine disparities in survival outcome and clinical presentation between Hispanic and non-Hispanic white patients with human papillomavirus-positive oropharyngeal squamous cell carcinoma. Retrospective clinical research. Clinical data on Hispanics and non-Hispanic white patients with diagnosis of human papillomavirus/p16-positive oropharyngeal squamous cell carcinoma were drawn from a tumor registry from the University of Miami Hospitals and Clinics from 2008 to 2014. Of 436 patients with oropharyngeal squamous cell carcinoma, 237 patents met inclusion criteria. Patient's age, gender, smoking history, alcohol history, race/ethnicity, tumor T stage, nodal N stage, and composite TNM stage were included in the analysis. Associations between race and other categorical variables were explored with χ(2) test or Fisher exact test where appropriate. Survival curves were generated using the Kaplan-Meier method. Significant differences in clinical presentation was detected between Hispanic (N = 70) and non-Hispanic white (N = 167) patients. Hispanic human papillomavirus-positive oropharyngeal squamous cell carcinoma patients showed a higher proportion of women with disease, a higher proportion of patients presenting with tonsil rather than tongue base primary subsite cancer, and a higher proportion of patients who do not consume alcohol compared to non-Hispanic white human papillomavirus-positive oropharyngeal squamous cell carcinoma patients. A statistically significant survival difference between these two ethnic groups was not detected in the current dataset. Unique differences in clinical presentations between Hispanic patients and non-Hispanic whites with human papillomavirus-positive oropharyngeal squamous cell carcinoma were detected. This may be the first study to report novel clinical presentation in Hispanic human papillomavirus-positive patients with oropharyngeal squamous cell carcinoma living in the United States. 4. Laryngoscope, 127:1097-1101, 2017.

  8. Comparative analysis of HPV16 gene expression profiles in cervical and in oropharyngeal squamous cell carcinoma

    PubMed Central

    Cerasuolo, Andrea; Annunziata, Clorinda; Tortora, Marianna; Starita, Noemy; Stellato, Giovanni; Greggi, Stefano; Maglione, Maria Grazia; Ionna, Franco; Losito, Simona; Botti, Gerardo; Buonaguro, Luigi; Buonaguro, Franco M.; Tornesello, Maria Lina

    2017-01-01

    Human papillomavirus type 16 (HPV16) is the major cause of cervical cancer and of a fraction of oropharyngeal carcinoma. Few studies compared the viral expression profiles in the two types of tumor. We analyzed HPV genotypes and viral load as well as early (E2/E4, E5, E6, E6*I, E6*II, E7) and late (L1 and L2) gene expression of HPV16 in cervical and oropharyngeal cancer biopsies. The study included 28 cervical squamous cell carcinoma (SCC) and ten oropharyngeal SCC, along with pair-matched non-tumor tissues, as well as four oropharynx dysplastic tissues and 112 cervical intraepithelial neoplasia biopsies. Viral load was found higher in cervical SCC (<1 to 694 copies/cell) and CIN (<1 to 43 copies/cell) compared to oropharyngeal SCC (<1 to 4 copies/cell). HPV16 E2/E4 and E5 as well as L1 and L2 mRNA levels were low in cervical SCC and CIN and undetectable in oropharynx cases. The HPV16 E6 and E7 mRNAs were consistently high in cervical SCC and low in oropharyngeal SCC. The analysis of HPV16 E6 mRNA expression pattern showed statistically significant higher levels of E6*I versus E6*II isoform in cervical SCC (p = 0.002) and a slightly higher expression of E6*I versus E6*II in oropharyngeal cases. In conclusion, the HPV16 E5, E6, E6*I, E6*II and E7 mRNA levels were more abundant in cervical SCC compared to oropharyngeal SCC suggesting different carcinogenic mechanisms in the two types of HPV-related cancers. PMID:28423662

  9. Comparative analysis of HPV16 gene expression profiles in cervical and in oropharyngeal squamous cell carcinoma.

    PubMed

    Cerasuolo, Andrea; Annunziata, Clorinda; Tortora, Marianna; Starita, Noemy; Stellato, Giovanni; Greggi, Stefano; Maglione, Maria Grazia; Ionna, Franco; Losito, Simona; Botti, Gerardo; Buonaguro, Luigi; Buonaguro, Franco M; Tornesello, Maria Lina

    2017-05-23

    Human papillomavirus type 16 (HPV16) is the major cause of cervical cancer and of a fraction of oropharyngeal carcinoma. Few studies compared the viral expression profiles in the two types of tumor. We analyzed HPV genotypes and viral load as well as early (E2/E4, E5, E6, E6*I, E6*II, E7) and late (L1 and L2) gene expression of HPV16 in cervical and oropharyngeal cancer biopsies. The study included 28 cervical squamous cell carcinoma (SCC) and ten oropharyngeal SCC, along with pair-matched non-tumor tissues, as well as four oropharynx dysplastic tissues and 112 cervical intraepithelial neoplasia biopsies. Viral load was found higher in cervical SCC (<1 to 694 copies/cell) and CIN (<1 to 43 copies/cell) compared to oropharyngeal SCC (<1 to 4 copies/cell). HPV16 E2/E4 and E5 as well as L1 and L2 mRNA levels were low in cervical SCC and CIN and undetectable in oropharynx cases. The HPV16 E6 and E7 mRNAs were consistently high in cervical SCC and low in oropharyngeal SCC. The analysis of HPV16 E6 mRNA expression pattern showed statistically significant higher levels of E6*I versus E6*II isoform in cervical SCC (p = 0.002) and a slightly higher expression of E6*I versus E6*II in oropharyngeal cases. In conclusion, the HPV16 E5, E6, E6*I, E6*II and E7 mRNA levels were more abundant in cervical SCC compared to oropharyngeal SCC suggesting different carcinogenic mechanisms in the two types of HPV-related cancers.

  10. 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.

  11. Random close packing revisited: ways to pack frictionless disks.

    PubMed

    Xu, Ning; Blawzdziewicz, Jerzy; O'Hern, Corey S

    2005-06-01

    We create collectively jammed (CJ) packings of 50-50 bidisperse mixtures of smooth disks in two dimensions (2D) using an algorithm in which we successively compress or expand soft particles and minimize the total energy at each step until the particles are just at contact. We focus on small systems in 2D and thus are able to find nearly all of the collectively jammed states at each system size. We decompose the probability P(phi) for obtaining a collectively jammed state at a particular packing fraction phi into two composite functions: (1) the density of CJ packing fractions rho(phi), which only depends on geometry, and (2) the frequency distribution beta(phi), which depends on the particular algorithm used to create them. We find that the function rho(phi) is sharply peaked and that beta(phi) depends exponentially on phi. We predict that in the infinite-system-size limit the behavior of P(phi) in these systems is controlled by the density of CJ packing fractions--not the frequency distribution. These results suggest that the location of the peak in P(phi) when N --> infinity can be used as a protocol-independent definition of random close packing.

  12. 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.

  13. Management of Oropharyngeal Dysphagia in Laryngeal and Hypopharyngeal Cancer

    PubMed Central

    Granell, Jose; Garrido, Laura; Millas, Teresa; Gutierrez-Fonseca, Raimundo

    2012-01-01

    On considering a function-preserving treatment for laryngeal and hypopharyngeal cancer, swallowing is a capital issue. For most of the patients, achieving an effective and safe deglutition will mark the difference between a functional and a dysfunctional outcome. We present an overview of the management of dysphagia in head and neck cancer patients. A brief review on the normal physiology of swallowing is mandatory to analyze next the impact of head and neck cancer and its treatment on the anatomic and functional foundations of deglutition. The approach proposed underlines two leading principles: a transversal one, that is, the multidisciplinary approach, as clinical aspects to be managed in the oncologic patient with oropharyngeal dysphagia are diverse, and a longitudinal one; that is, the concern for preserving a functional swallow permeates the whole process of the diagnosis and treatment, with interventions required at multiple levels. We further discuss the clinical reports of two patients who underwent a supracricoid laryngectomy, a function-preserving surgical technique that particularly disturbs the laryngeal mechanics, and in which swallowing rehabilitation dramatically conditions the functional results. PMID:23346112

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?

    PubMed

    Özbal Koç, Ayça E; Türkoğlu Babakurban, Seda; Kibar, Sermin Sayan; Büyüklü, Fuat

    2016-01-01

    This study aims to compare pain, bleeding, nasal obstruction, crust and synechia formation, and anesthesia-related morbidity in patients with and without use of nasal packs after septoplasty. A total of 66 patients (32 women, 34 men; mean age 24 years; range 18 to 48 years) who underwent Cottle's septoplasty under general anesthesia were randomly allocated to three groups in this prospective cohort. Telfa nasal packs were used in sutures + telfa group (n=22) and Merocell nasal packs in merocel alone group (n=22). No packs were administered in sutures alone group (n=22). Three groups were compared in terms of nasal obstruction, bleeding, pain, crust and synechia formation, as well as the amount of secretion, the need for oropharyngeal airway, the presence of laryngospasm, and effort for nasal breathing after anesthesia. The amount of bleeding was higher with lower degree of nasal obstruction in sutures alone group. Pain and secretion were more remarkable in merocel alone group. After the first week, these differences were unable to be differentiated among the groups. There were no differences between three groups with respect to crust and synechia formation two weeks after septal surgery. Nasal packs can be more useful in patients who suffer from bleeding-related morbidity, while septoplasty applied without nasal packs can be more suitable in patients with obstructive sleep apnea. The use of nasal packs in septoplasty should be determined on an individualized basis with respect to the characteristics of each patient.

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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. Standard...

  4. 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, shall...

  5. 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, shall...

  6. 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. Standard...

  7. 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...

  8. 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...

  9. 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 which...

  10. 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 which...

  11. Nature of packs used in propellant modeling.

    PubMed

    Maggi, F; Stafford, S; Jackson, T L; Buckmaster, J

    2008-04-01

    In recent years we have constructed closely packed spheres using the Lubachevsky-Stillinger algorithm to generate morphological models of heterogeneous solid propellants. Improvements to the algorithm now allow us to create large polydisperse packs on a laptop computer, and to create monodisperse packs with packing fractions greater than 70% which display significant crystal order. The use of these models in the physical context motivates efforts to examine in some detail the nature of the packs, including certain statistical properties. We compare packing fractions for binary packs with long-known experimental data. Also, we discuss the near-neighbor number and the radial distribution function (RDF) for monodisperse packs and make comparisons with experimental data. We also briefly discuss the RDF for bidisperse packs. We also consider bounded monodisperse packs, and pay particular attention to the near-wall structure where we identify significant order.

  12. 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.

  13. Packing loops into annular cavities

    NASA Astrophysics Data System (ADS)

    Sobral, T. A.; Gomes, M. A. F.

    2017-02-01

    The continuous packing of a flexible rod in two-dimensional cavities yields a countable set of interacting domains that resembles nonequilibrium cellular systems and belongs to a new class of lightweight material. However, the link between the length of the rod and the number of domains requires investigation, especially in the case of non-simply connected cavities, where the number of avoided regions emulates an effective topological temperature. In the present article we report the results of an experiment of injection of a single flexible rod into annular cavities in order to find the total length needed to insert a given number of loops (domains of one vertex). Using an exponential model to describe the experimental data we quite minutely analyze the initial conditions, the intermediary behavior, and the tight packing limit. This method allows the observation of a new fluctuation phenomenon associated with instabilities in the dynamic evolution of the packing process. Furthermore, the fractal dimension of the global pattern enters the discussion under a novel point of view. A comparison with the classical problems of the random close packing of disks and jammed disk packings is made.

  14. Pack structure and genetic relatedness among wolf packs in a naturally-regulated population

    USGS Publications Warehouse

    Meier, Thomas J.; Burch, John W.; Mech, L. David; Adams, Layne G.; Carbyn, Ludwig N.; Fritts, Steven H.; Seip, Dale R.

    1995-01-01

    Observations of wolf pack dynamics over a six-year period in Denali National Park and Preserve, Alaska, found high rates of intraspecific strife, wolf pack dissolution and new pack formation, and the acceptance of new wolves into established packs. These observations corroborate genetic studies that found more genetic links between packs, and more genetic diversity within packs, than would be expected if most packs were composed of an unrelated breeding pair and their offspring. Longevity of packs, stability of pack territories, and the incidence of inbreeding all appear to be less than previously suggested, even in the absence of significant human disturbance. The formation of new packs by two or more local dispersers, the acceptance of unrelated wolves into existing packs, and the presence of multiple breeding females within packs would tend to blur genetic distinctions between the packs in a population.

  15. Current trends in initial management of oropharyngeal cancer: the declining use of open surgery.

    PubMed

    Haigentz, Missak; Silver, Carl E; Corry, June; Genden, Eric M; Takes, Robert P; Rinaldo, Alessandra; Ferlito, Alfio

    2009-12-01

    The widespread availability of novel primary treatment approaches against oropharyngeal cancers has provided several potentially curative surgical and nonsurgical treatment options for patients, generating both hope and controversy. As treatment is usually curative in intent, management considerations must include consideration of primary tumor and nodal disease control as well as long-term toxicities and functional outcomes. Anatomical and functional organ preservation (speech and deglutition) remains of paramount importance to patients with oropharyngeal cancer and the physicians involved in their care, accounting for the growing popularity of chemoradiotherapy and transoral surgical techniques for this indication. These novel approaches have greatly diminished the role of open surgery as initial therapy for oropharyngeal cancers. Open surgery which is often reserved for salvage on relapse, may still be an appropriate therapy for certain early stage primary lesions. The growing treatment armamentarium requires careful consideration for optimal individualized care. The identification of oncogenic human papillomavirus as a predictive and prognostic marker in patients with oropharyngeal cancer has great potential to further optimize the choice of treatment. In this review, novel primary therapies against oropharyngeal squamous cell carcinoma are presented in the context of anatomical, quality of life, and emerging biological considerations.

  16. Role of human papillomavirus in oropharyngeal squamous cell carcinoma: A review

    PubMed Central

    Woods, Robbie SR; O’Regan, Esther M; Kennedy, Susan; Martin, Cara; O’Leary, John J; Timon, Conrad

    2014-01-01

    Human papillomavirus (HPV) has been implicated in the pathogenesis of a subset of oropharyngeal squamous cell carcinoma. As a result, traditional paradigms in relation to the management of head and neck squamous cell carcinoma have been changing. Research into HPV-related oropharyngeal squamous cell carcinoma is rapidly expanding, however many molecular pathological and clinical aspects of the role of HPV remain uncertain and are the subject of ongoing investigation. A detailed search of the literature pertaining to HPV-related oropharyngeal squamous cell carcinoma was performed and information on the topic was gathered. In this article, we present an extensive review of the current literature on the role of HPV in oropharyngeal squamous cell carcinoma, particularly in relation to epidemiology, risk factors, carcinogenesis, biomarkers and clinical implications. HPV has been established as a causative agent in oropharyngeal squamous cell carcinoma and biologically active HPV can act as a prognosticator with better overall survival than HPV-negative tumours. A distinct group of younger patients with limited tobacco and alcohol exposure have emerged as characteristic of this HPV-related subset of squamous cell carcinoma of the head and neck. However, the exact molecular mechanisms of carcinogenesis are not completely understood and further studies are needed to assist development of optimal prevention and treatment modalities. PMID:24945004

  17. Investigation of the presence of HPV related oropharyngeal and oral tongue squamous cell carcinoma in Mozambique.

    PubMed

    Blumberg, Jeffrey; Monjane, Leonel; Prasad, Manju; Carrilho, Carla; Judson, Benjamin L

    2015-12-01

    Cervical cancer caused by the human papillomavirus (HPV) is endemic in East Africa. Recent, dramatic, increases in the incidence of oropharyngeal cancer in the United States and Europe are linked to the same high risk HPV genotypes responsible for cervical cancer. Currently, there is extremely limited data regarding the role of HPV in head and neck cancers in Africa. Evidence of HPV as an etiologic agent in head and neck cancers in Africa would have important prevention and treatment implications. A retrospective single institution review of oral tongue and oropharyngeal squamous cell carcinomas diagnosed between 2005 and 2013 was performed. Individual case data for 51 patients with biopsy proven squamous cell carcinoma (SCC) from the oropharynx (n=22) and oral tongue (n=29) were identified. Formalin fixed, paraffin embedded biopsy samples were obtained and evaluated for p16 by immunohistochemistry and HPV genotype 16 specific oncogenes, E6 and E7, by PCR. All of the positive controls, but none of the oropharyngeal samples stained positively for p16. Two of the oral tongue samples stained positive for p16. None of the oropharyngeal or oral tongue cases demonstrated PCR products for HPV-16 E6 or E7. Though Mozambique has extremely high levels of HPV positive cervical cancer this study demonstrates an absence of HPV positive oropharyngeal or oral tongue squamous cell carcinoma within biopsy samples from a single referral hospital in Maputo, the capital of Mozambique. Copyright © 2015. Published by Elsevier Ltd.

  18. 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.

  19. 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.

  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. 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.

  3. Confronting human papilloma virus/oropharyngeal cancer: a model for interprofessional collaboration.

    PubMed

    Fried, Jacquelyn L

    2014-06-01

    A collaborative practice model related to Human Papilloma Virus (HPV) associated oropharyngeal cancer highlights the role of the dental hygienist in addressing this condition. The incidence of HPV associated head and neck cancer is rising. Multiple professionals including the dental hygienist can work collaboratively to confront this growing public health concern. A critical review applies the growth and utilization of interprofessional education (IPE) and interprofessional collaboration (IPC) to multi-disciplinary models addressing the human papilloma virus and oropharyngeal cancers. A model related to HPV associated oropharyngeal cancer addresses an oral systemic condition that supports the inclusion of a dental hygienist on collaborative teams addressing prevention, detection, treatment and cure of OPC. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. 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.

  5. Oropharyngeal squamous cell carcinomas differentially express granzyme inhibitors.

    PubMed

    van Kempen, Pauline M W; Noorlag, Rob; Swartz, Justin E; Bovenschen, Niels; Braunius, Weibel W; Vermeulen, Jeroen F; Van Cann, Ellen M; Grolman, Wilko; Willems, Stefan M

    2016-05-01

    Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCCs) have an improved prognosis compared to HPV-negative OPSCCs. Several theories have been proposed to explain this relatively good prognosis. One hypothesis is a difference in immune response. In this study, we compared tumor-infiltrating CD3+, CD4+, CD8+ T-cells, and granzyme inhibitors (SERPINB1, SERPINB4, and SERPINB9) between HPV-positive and HPV-negative tumors and the relation with survival. Protein expression of tumor-infiltrating lymphocytes (TILs) (CD3, CD4, and CD8) and granzyme inhibitors was analyzed in 262 OPSCCs by immunohistochemistry (IHC). Most patients (67%) received primary radiotherapy with or without chemotherapy. Cox regression analysis was carried out to compare overall survival (OS) of patients with low and high TIL infiltration and expression of granzyme inhibitors. HPV-positive OPSCCs were significantly more heavily infiltrated by TILs (p < 0.001) compared to HPV-negative OPSCCs. A high level of CD3+ TILs was correlated with a favorable outcome in the total cohort and in HPV-positive OPSCCs, while it reached no significance in HPV-negative OPSCCs. There was expression of all three granzyme inhibitors in OPSCCs. No differences in expression were found between HPV-positive and HPV-negative OPSCCs. Within the group of HPV-positive tumors, a high expression of SERPINB1 was associated with a significantly worse overall survival. HPV-positive OPSCCs with a low count of CD3+ TILs or high expression of SERPINB1 have a worse OS, comparable with HPV-negative OPSCCs. This suggests that the immune system plays an important role in the carcinogenesis of the virally induced oropharynx tumors.

  6. 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

  7. 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

  8. 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

  9. 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.

  10. Transoral oropharyngeal resection classification: Proposal of the SCORL working group.

    PubMed

    Virós Porcuna, David; Avilés Jurado, Francisco; Pollán Guisasola, Carlos; Ramírez Ruiz, Rosa Delia; García Lorenzo, Jacinto; Tobed Secall, Marc; Vilaseca González, Isabel; Costa González, José Miguel; Soteras Olle, Josep; Casamitjana Claramunt, Francesc; Sumarroca Trouboul, Anna; Hijano Esqué, Rafael; Viscasillas Pallàs, Guillem; Mañós Pujol, Manel; Quer Agustí, Miquel

    There has been a very significant increase in the use of minimally invasive surgery has in the last decade. In order to provide a common language after transoral surgery of the oropharynx, a system for classifying resections has been created in this area, regardless of the instrumentation used. From the Oncology Working Group of the Catalan Society of Otorhinolaryngology, a proposal for classification based on a topographical division of the different areas of the oropharynx is presented, as also based on the invasion of the related structures according to the anatomical routes of extension of these tumours. The classification starts using the letter D or I according to laterality either right (D) or left (I). The number of the resected area is then placed. This numbering defines the zones beginning at the cranial level where area I would be the soft palate, lateral area II in the tonsillar area, area III in the tongue base, area IV in the glossoepiglottic folds, epiglottis and pharyngoepiglottic folds, area V posterior oropharyngeal wall and VI the retromolar trigone. The suffix p is added if the resection deeply affects the submucosal plane of the compromised area. The different proposed areas would, in theory, have different functional implications. Proposal for a system of classification by area to definedifferent types of transoral surgery of the oropharynx, and enable as sharing of results and helps in teaching this type of technique. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  11. Treatment failure of gentamicin in pediatric patients with oropharyngeal tularemia

    PubMed Central

    Kaya, Ali; Uysal, İsmail Önder; Güven, Ahmet Sami; Engin, Aynur; Gültürk, Abdulaziz; İçağasıoğlu, Füsun Dilara; Cevit, Ömer

    2011-01-01

    Summary Background Tularemia is a zoonotic infection, and the causative agent is Francisella tularensis. A first-line therapy for treating tularemia is aminoglycosides (streptomycin or, more commonly, gentamicin), and treatment duration is typically 7 to 10 days, with longer courses for more severe cases. Material/Methods We evaluated 11 patients retrospectively. Failure of the therapy was defined by persistent or recurrent fever, increased size or appearance of new lymphadenopathies and persistence of the constitutional syndrome with elevation of the levels of the proteins associated with the acute phase of infection. Results We observed fluctuating size of lymph nodes of 4 patients who were on the 7th day of empirical therapy. The therapy was switched to streptomycin alone and continued for 14 days. The other 7 patients, who had no complications, were on cefazolin and gentamycin therapy until the serologic diagnosis. Then we evaluated them again and observed that none of their lymph nodes regressed. We also switched their therapy to 14 days of streptomycin. After the 14 days on streptomycin therapy, we observed all the lymph nodes had recovered or regressed. During a follow-up 3 weeks later, we observed that all their lymph nodes had regressed to the clinically non-significant dimensions (<1 cm). Conclusions All patients were first treated with gentamicin, but were than given streptomycin after failure of gentamicin. This treatment was successful in all patients. The results of our study suggest that streptomycin is an effective choice of first-line treatment for pediatric oropharyngeal tularemia patients. PMID:21709631

  12. Packing hyperspheres in high-dimensional Euclidean spaces.

    PubMed

    Skoge, Monica; Donev, Aleksandar; Stillinger, Frank H; Torquato, Salvatore

    2006-10-01

    We present a study of disordered jammed hard-sphere packings in four-, five-, and six-dimensional Euclidean spaces. Using a collision-driven packing generation algorithm, we obtain the first estimates for the packing fractions of the maximally random jammed (MRJ) states for space dimensions d=4, 5, and 6 to be phi(MRJ) approximately 0.46, 0.31, and 0.20, respectively. To a good approximation, the MRJ density obeys the scaling form phi(MRJ)=c1/2(d)+(c2d)/2d, where c1=-2.72 and c2=2.56, which appears to be consistent with the high-dimensional asymptotic limit, albeit with different coefficients. Calculations of the pair correlation function g2(r) and structure factor S(k) for these states show that short-range ordering appreciably decreases with increasing dimension, consistent with a recently proposed "decorrelation principle," which, among other things, states that unconstrained correlations diminish as the dimension increases and vanish entirely in the limit d-->infinity. As in three dimensions (where phi(MRJ) approximately 0.64), the packings show no signs of crystallization, are isostatic, and have a power-law divergence in g2(r) at contact with power-law exponent approximately 0.4. Across dimensions, the cumulative number of neighbors equals the kissing number of the conjectured densest packing close to where g2(r) has its first minimum. Additionally, we obtain estimates for the freezing and melting packing fractions for the equilibrium hard-sphere fluid-solid transition, phi(F) approximately 0.32 and phi(M) approximately 0.39, respectively, for d=4, and phi(F) approximately 0.20 and phi(M) approximately 0.25, respectively, for d=5. Although our results indicate the stable phase at high density is a crystalline solid, nucleation appears to be strongly suppressed with increasing dimension.

  13. 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

  14. Association of marijuana smoking with oropharyngeal and oral tongue cancers: pooled analysis from the INHANCE consortium.

    PubMed

    Marks, Morgan A; Chaturvedi, Anil K; Kelsey, Karl; Straif, Kurt; Berthiller, Julien; Schwartz, Stephen M; Smith, Elaine; Wyss, Annah; Brennan, Paul; Olshan, Andrew F; Wei, Qingyi; Sturgis, Erich M; Zhang, Zuo-Feng; Morgenstern, Hal; Muscat, Joshua; Lazarus, Philip; McClean, Michael; Chen, Chu; Vaughan, Thomas L; Wunsch-Filho, Victor; Curado, Maria Paula; Koifman, Sergio; Matos, Elena; Menezes, Ana; Daudt, Alexander W; Fernandez, Leticia; Posner, Marshall; Boffetta, Paolo; Lee, Yuan-Chin Amy; Hashibe, Mia; D'Souza, Gypsyamber

    2014-01-01

    The incidence of oropharyngeal and oral tongue cancers has increased over the last 20 years which parallels increased use of marijuana among individuals born after 1950. A pooled analysis was conducted comprising individual-level data from nine case-control studies from the United States and Latin America in the INHANCE consortium. Self-reported information on marijuana smoking, demographic, and behavioral factors was obtained from 1,921 oropharyngeal cases, 356 oral tongue cases, and 7,639 controls. Compared with never marijuana smokers, ever marijuana smokers had an elevated risk of oropharyngeal [adjusted OR (aOR), 1.24; 95% confidence interval (CI): 1.06-1.47] and a reduced risk of oral tongue cancer (aOR, 0.47; 95% CI, 0.29, 0.75). The risk of oropharyngeal cancer remained elevated among never tobacco and alcohol users. The risk of oral tongue cancer was reduced among never users of tobacco and alcohol. Sensitivity analysis adjusting for potential confounding by HPV exposure attenuated the association of marijuana use with oropharyngeal cancer (aOR, 0.99; 95% CI, 0.71-1.25), but had no effect on the oral tongue cancer association. These results suggest that the association of marijuana use with head and neck carcinoma may differ by tumor site. The associations of marijuana use with oropharyngeal and oral tongue cancer are consistent with both possible pro- and anticarcinogenic effects of cannabinoids. Additional work is needed to rule out various sources of bias, including residual confounding by HPV infection and misclassification of marijuana exposure.

  15. Microfabricated packed gas chromatographic column

    DOEpatents

    Kottenstette, Richard; Matzke, Carolyn M.; Frye-Mason, Gregory C.

    2003-12-16

    A new class of miniaturized gas chromatographic columns has been invented. These chromatographic columns are formed using conventional micromachining techniques, and allow packed columns having lengths on the order of a meter to be fabricated with a footprint on the order of a square centimeter.

  16. 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…

  17. 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…

  18. 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.

  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. 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.

  1. 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.

  2. 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.)

  3. 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.

  4. Efficient algorithms for orthogonal packing problems

    NASA Astrophysics Data System (ADS)

    Chekanin, A. V.; Chekanin, V. A.

    2013-10-01

    The NP complete problem of the orthogonal packing of objects of arbitrary dimension is considered in the general form. A new model for representing objects in containers is proposed that ensures the fast design of an orthogonal packing. New heuristics for the placement of orthogonal packing are proposed. A single-pass heuristic algorithm and a multimethod genetic algorithm are developed that optimize an orthogonal packing solution by increasing the packing density. Numerical experiments for two- and three-dimensional orthogonal packing problems are performed.

  5. 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...

  6. 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...

  7. 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...

  8. Lab on a chip packing of submicron particles for high performance EOF pumping.

    PubMed

    Lu, Qin; Collins, Greg E

    2010-11-05

    The packing of submicrometer sized silica beads inside a microchannel was enabled by a novel method which avoids the complication and limitations of generating a frit using conventional approaches and the restriction of flow using a submicrometer sized weir. A micrometer sized weir and two short columns of 5 μm and 800 nm silica beads packed in succession behind the weir together functioned as a high pressure frit to allow the construction of a primary packed bed of 390 nm silica beads. This packed bed microchannel was tested as an EOF pump, wherein it exhibited superior performance with regards to pressure tolerance, i.e., sustaining good flow rate under extremely high back pressure, and maximal pressure generation. Under a modest applied electric field strength of 150 V/cm, the flow rate against a back pressure of 1200 psi (∼8.3 MPa) was 40 nL/min, and the maximal pressure reached 1470 psi (∼10 MPa). This work has demonstrated that it is possible to create a high performance packed bed microchannel EOF pump using nanometer sized silica beads, as long as proper care is taken during the packing process to minimize the undesirable mixing of two different sized particles at the boundaries between particle segments and to maximize the packing density throughout the entire packed bed. Published by Elsevier B.V.

  9. Videofluoroscopic assessment of the pathophysiology of chronic poststroke oropharyngeal dysphagia.

    PubMed

    Vilardell, N; Rofes, L; Arreola, V; Martin, A; Muriana, D; Palomeras, E; Ortega, O; Clavé, P

    2017-10-01

    Oropharyngeal dysphagia (OD) is a major complaint following stroke, associated with poor clinical outcome and high mortality rates. We aimed at characterizing the kinematics of swallow response associated with unsafe swallowing in chronic poststroke patients with OD. Consecutive poststroke patients with a positive volume-viscosity swallow test for OD 3 months following stroke were studied by videofluoroscopy (VFS). Demographical and clinical factors and kinematics of swallow response were compared between those poststroke patients with safe swallow (penetration-aspiration scale, PAS≤2) and those with unsafe swallow (PAS≥3). Receiver operating characteristic (ROC) curves were drawn for laryngeal vestibule closure (LVC) time which predicts unsafe swallow. We studied 73 poststroke patients (76.7±9.3 years, 53.4% male) by VFS (60.4% with impaired safety, PAS=4.47±1.44, and 95.9% with impaired efficacy of swallow). Poststroke patients with unsafe swallow presented a poorer functional (Rankin 2.2±1.6 vs 1.2±1.0, P<.012) and nutritional status (MNA-sf≤11, 34.2% vs 7.4%, P<.05) than poststroke patients with safe swallow. Poststroke patients with unsafe swallow presented a significant delay in LVC time (406.4±99.5 ms vs 318.9±80.4 ms; P<.05) and weaker tongue bolus propulsion forces (0.771±0.450 mJ vs 1.638±3.212 mJ; P=.043). LVC time ≥340 ms predicts unsafe swallow in chronic poststroke patients with a diagnostic accuracy of 0.78. Impaired safety of swallow in chronic poststroke patients is caused by specific impairments in swallow response including delayed timing of airway protection mechanisms and weak tongue propulsion forces. Treatments aiming to restore swallowing function in poststroke patients with OD should be targeted to improve these critical biomechanical events. © 2017 John Wiley & Sons Ltd.

  10. The value of scintigraphy in the evaluation of oropharyngeal dysphagia.

    PubMed

    Argon, Murat; Secil, Yaprak; Duygun, Ulkem; Aydogdu, Ibrahim; Kocacelebi, Kenan; Ozkilic, Hayal; Ertekin, Cumhur

    2004-01-01

    scintigraphic evaluations of piecemeal deglutition and dysphagia limit could be of value especially in centres which do not have electrophysiological test facilities. The technique should be added to the list of standard scintigraphic methods for the evaluation of patients with oropharyngeal dysphagia.

  11. 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....

  12. 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....

  13. 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....

  14. 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....

  15. 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....

  16. An overview of gravel-packed completions

    SciTech Connect

    Heng, H.B.

    1987-05-01

    Sarawak Shell Bhd./Sabah Shell Petroleum Co. (SSB/SSPC) experience with gravel-packed completions covers some 12 years. During that period, some 290 gravel-packed zones have been completed, and about 400X10/sup 6/ bbl (64X10/sup 6/ m/sup 3/) of oil have been produced through gravel packs in 13 offshore fields. This paper presents an overview of the development of gravel-packing methods, with special reference to the new gravel-packing technique developed in early 1984 for the Bayan field gravel-packed completions. Productivity reduction resulting from gravel packing and the long-term performance of the packs are discussed briefly.

  17. 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.

  18. 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.

  19. Packing nanomechanics of viral genomes

    NASA Astrophysics Data System (ADS)

    Iber, A. Å.; Dragar, M.; Parsegian, V. A.; Podgornik, R.

    2008-07-01

    We investigate the osmotic equilibrium between a bulk polyethylene glycol (PEG) solution and DNA tightly packed in a spherical capsid. We base our analysis on the equations of thermodynamic equilibrium in terms of osmotic pressure. The equality between external osmotic pressure of PEG and osmotic pressure of tightly packed DNA gives us the DNA encapsidation curves. In this way we directly connect the wealth of existing osmotic pressure data for DNA in the bulk with the DNA encapsidation curves within small viral capsids. Specific calculations are made for a monovalent salt, Na+ -DNA and a divalent salt, Mn2+ -DNA that have quite different DNA encapsidation behaviors. The main conclusion of our work is that bending energy of DNA is of minor importance regarding the encapsidated DNA length, but has a non-negligible influence on the density distribution of DNA within the capsid.

  20. Ammonium nitrate cold pack ingestion.

    PubMed

    Challoner, K R; McCarron, M M

    1988-01-01

    Disposable ammonium nitrate cold packs are widely used in emergency departments instead of ice bags. Five confused or suicidal patients who tore open a pack and ingested from 64 to 234 grams of ammonium nitrate in a single dose, and another patient who attempted to do so, are reported. It is known that chronic ingestion of 6 to 12 grams/day of ammonium nitrate may cause gastritis, acidosis, isosmotic diuresis, and nitrite toxicity manifesting as methemoglobinemia or vasodilatation. None of these patients developed severe toxicity, although three had symptoms of gastritis, three had slight methemoglobinemia, and two had mild hypotension. The product was removed from the stomach promptly in three of the five patients. None had pre-existing renal or intestinal dysfunction, which are known to enhance ammonium nitrate toxicity.

  1. Prevalence and predictive role of p16 and epidermal growth factor receptor in surgically treated oropharyngeal and oral cavity cancer.

    PubMed

    Chandarana, Shamir P; Lee, Julia S; Chanowski, Eric J P; Sacco, Assuntina G; Bradford, Carol R; Wolf, Gregory T; Prince, Mark E; Moyer, Jeffrey S; Eisbruch, Avraham; Worden, Francis P; Giordano, Thomas J; Kumar, Bhavna; Cordell, Katrina G; Carey, Thomas E; Chepeha, Douglas B

    2013-08-01

    The purpose of this study was to describe the relationship of p16 and epidermal growth factor receptor (EGFR) expression with survival in surgically treated patients who had oropharyngeal or oral cavity squamous cell carcinoma (SCC). Tissue from 36 patients with oropharyngeal SCC and 49 patients with oral cavity SCC treated between 1997 and 2001 was imbedded and immunostained using a tissue microarray. The p16 was positive in 57% and 13% of patients with oropharyngeal SCC and oral cavity SCC, respectively. EGFR was positive in 60% and 63% of patients with oropharyngeal SCC and oral cavity SCC, respectively. In patients with oropharyngeal SCC, p16 expression was associated with improved disease-specific survival (DSS), overall survival (OS), and time to recurrence (TTR) (p < .01, < .01, and <.01, respectively). EGFR expression was associated with poorer DSS, OS, and TTR (p < .01, = .01, and < .01, respectively). For oropharyngeal SCC, when examining both p16 and EGFR expression as combined biomarkers, high p16 expression coupled with low EGFR expression was associated with improved DSS (p p16 = .01; p EGFR = .01). Patients with oral cavity SCC showed no association between biomarker and outcome. For patients with oropharyngeal SCC, high p16 and low EGFR were associated with improved outcome, suggesting a predictive role in surgically treated patients. Copyright © 2012 Wiley Periodicals, Inc.

  2. HPV-Positive Oropharyngeal Cancer Via p16 Immunohistochemistry in Japan.

    PubMed

    Toman, Julia; Von Larson, Scott; Umeno, Hirohito; Kurita, Takashi; Furusaka, Tohru; Hasegawa, Hisashi; Prasad, Manju L; Sasaki, Clarence T

    2017-02-01

    Human papillomavirus (HPV) has emerged as a driving cause of head and neck cancer, but investigations outside the West are limited. A p16 immunohistochemistry is a commonly used biomarker for HPV cancers. We sought to investigate the pathology and rates of HPV head and neck oropharyngeal cancer in Japan via p16 immunohistochemistry at 2 institutions in Japan. Fifty-nine oropharyngeal specimens from 2 university hospitals in Japan were examined for morphology and p16 immunohistochemistry. The rate of p16 positivity was then determined, and the 2 groups were compared for differences in age, smoking history, gender, and stage of presentation and mortality. The rate of p16 positivity among the oropharyngeal specimens was 29.5%. There were important differences in the pathology compared to morphology usually seen in the US. The patients with p16+ cancer tended to be younger. There was no significant difference in smoking status. Patients with p16+ cancers trended toward better survival. There appears to be a geographical difference in HPV rates of oropharyngeal cancers with persistently lower rates in Asian countries when compared to Western Europe and the US. Conclusions about HPV head and neck squamous cell carcinoma (HNSCC) in Western countries may not be generalizable across the globe at this time.

  3. 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

  4. 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

  5. Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance.

    PubMed

    Rizk, Susan; Kulbersh, Valmy Pangrazio; Al-Qawasmi, Riyad

    2016-11-01

     To evaluate the effects of functional appliance treatment on the oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position of growing Class II patients.  Twenty Class II white patients (mean age, 11.7 ± 1.75 years) treated with the MARA followed by fixed appliances were matched to an untreated control sample by cervical vertebrae maturation stage at pretreatment (T1) and posttreatment (T2) time points. Cone beam computed tomography scans were taken at T1 and T2. Dolphin3D imaging software was used to determine oropharyngeal airway volume, dimensions, and anteroposterior hyoid bone position.  Multivariate ANOVA was used to evaluate changes between T1 and T2. Oropharyngeal airway volume, airway dimensions, and A-P position of the hyoid bone increased significantly with functional appliance treatment. SNA and ANB decreased significantly in the experimental group (P ≤ .05). Changes in SNB and Sn-GoGn failed to reach statistical significance.  Functional appliance therapy increases oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position in growing patients.

  6. 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.

  7. 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.

  8. Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function.

    PubMed

    Cabib, Christopher; Ortega, Omar; Kumru, Hatice; Palomeras, Ernest; Vilardell, Natalia; Alvarez-Berdugo, Daniel; Muriana, Desirée; Rofes, Laia; Terré, Rosa; Mearin, Fermín; Clavé, Pere

    2016-09-01

    Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction. © 2016 New York Academy of Sciences.

  9. 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

  10. 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.

  11. 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.

  12. 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…

  13. 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…

  14. Evaluation of speech outcomes following treatment of oral and oropharyngeal cancers.

    PubMed

    Dwivedi, Raghav C; Kazi, Rehan A; Agrawal, Nishant; Nutting, Christopher M; Clarke, Peter M; Kerawala, Cyrus J; Rhys-Evans, Peter H; Harrington, Kevin J

    2009-08-01

    Oral and oropharyngeal cancers are amongst the commonest cancers worldwide and present a major health problem. Owing to their critical anatomical location and complex physiologic functions, the treatment of oral and oropharyngeal cancers often affects important functions, including speech. The importance of speech in a patient's life can not be overemphasized, as its loss is often associated with severe functional and psychosocial problems and a poor quality of life. A thorough understanding of the speech problems that are faced by these patients and their timely management is the key to providing a better functional quality of life, which must be one of the major goals of modern oncologic practice. This review summarises key methods of evaluation and outcome of speech functions in the literature on oral and oropharyngeal cancer published between January 2000 and December 2008. Speech has been generally overlooked and poorly investigated in this group of patients. This review is an attempt to fill this gap by conducting the first speech-specific review for oral and oropharyngeal cancer patients. We have proposed guidelines for better understanding and management of speech problems faced by these patients in their day-to-day life.

  15. Treatment of oral and oropharyngeal epidermoid carcinomas by means of CO2 laser.

    PubMed

    Villarreal Renedo, Pedro M; Monje Gil, Florencio; Junquera Gutiérrez, Luis M; De Vicente Rodríguez, Juan C; Morillo Sánchez, Antonio J

    2004-01-01

    The effect of the wide long-wave CO2 laser is the thermal vaporization of the tissues, getting a maximum energy concentration with a minimum of tissue penetration. In oral surgery, it is generally used for the treatment of oral and oropharyngeal small mucous tumors, due to the scarce morbidity that takes place and the absence of reconstructive necessity. To analyze the postoperative evolution, in the patients treated by oral and oropharyngeal epidermoid carcinomas, after CO2 laser resection. To compare it with that of the patients treated by means of conventional surgical methods, achieving the reconstruction through direct suture or the employment of local, regional or distance flaps. A prospective study was designed including 70 patients treated by oral and oropharyngeal epidermoid carcinomas. Thirty-five patients were treated by means of CO2 laser, in 10 cases direct wound-closure was realized, and in the remaining 25 patients some local, regional or distance flap were used. There were analysed the presence of postoperative pain, the degree of cicatricial retraction, and the speech and swallowing functional results. We obtained a smaller painful degree and postoperative cicatricial retraction by the employment of CO2 laser. It permits minimizing the functional speech sequels (better words articulation) and swallowing (effective and precocious functional recovery). CO2 laser resection has become the elective treatment for small oral and oropharyngeal epidermoid carcinomas. The reasons are the absence of reconstructive surgery necessity, the scarce cicatricial retraction, and the excellent postoperative evolution.

  16. Oral and oropharyngeal impalement injury in pediatric patients--focus on rural environment.

    PubMed

    Syebele, Kabunda; Van Straten, Cornelia; Chidinyane, Lebaka

    2012-08-01

    This article describes a case series of oral and oropharyngeal impalement injuries in pediatric patients and highlights the peculiar etiological role of the rural environment. The records of nine pediatric patients who presented with oropharyngeal impalement injuries were reviewed. The patients were all from various rural areas of South Africa. The article focuses on the challenges and risk of post-impalement injury infection in the context of a rural environment. There were eight boys and one girl. The ages of the study participants ranged from 2 to 10 years. Object-to-head injury was the predominant etiopathogenic mechanism (six cases) compared with head-to-object injury (three cases). Six out of nine lesions were shallow. The hard palate was the single most commonly affected site. Two cases (2/9) of post-impalement injury infection were recorded. Although the risk of infection post-oropharyngeal impalement injury is reported to be low, it remains, however, a legitimate concern in cases occurring in the rural environment. The specific challenges in terms of health infrastructures in the rural environment, especially in developing countries, may have an impact on the ways oropharyngeal impalement injuries are managed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Oropharyngeal Tularemia Outbreak Associated with Drinking Contaminated Tap Water, Turkey, July-September 2013.

    PubMed

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

    2015-12-01

    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.

  18. 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

  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. 7 CFR 51.3055 - Standard pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... FRESH FRUITS, VEGETABLES AND OTHER PRODUCTS 1,2 (INSPECTION, CERTIFICATION, AND STANDARDS) United States Standards for Florida Avocados Standard Pack § 51.3055 Standard pack. (a) The avocados shall be packed in... smallest fruit in any container shall be not less than 75 percent of the weight of the largest fruit in the...

  1. 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 of...

  2. 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 of...

  3. 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.

  4. Significance and technology of coal mine packing

    NASA Astrophysics Data System (ADS)

    Wang, Yunliang

    2017-08-01

    Packing is a kind of mining method which is used to fill the goaf with filling material to control the movement of overlying strata and reduce the deformation of the surface. This paper mainly discusses the significance of coal mine packing, and introduces the current method of filling and mining. Finally, the future of coal mine packing is forecasted.

  5. 7 CFR 906.10 - Pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... GRANDE VALLEY IN TEXAS Order Regulating Handling Definitions § 906.10 Pack. Pack means the specific grade... 7 Agriculture 8 2012-01-01 2012-01-01 false Pack. 906.10 Section 906.10 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and...

  6. 7 CFR 906.10 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... GRANDE VALLEY IN TEXAS Order Regulating Handling Definitions § 906.10 Pack. Pack means the specific grade... 7 Agriculture 8 2011-01-01 2011-01-01 false Pack. 906.10 Section 906.10 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and...

  7. 7 CFR 906.10 - Pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... GRANDE VALLEY IN TEXAS Order Regulating Handling Definitions § 906.10 Pack. Pack means the specific grade... 7 Agriculture 8 2014-01-01 2014-01-01 false Pack. 906.10 Section 906.10 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND...

  8. 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 (§§ 51...

  9. 7 CFR 966.11 - Pack.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 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 (§§ 51...

  10. 7 CFR 966.11 - Pack.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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 (§§ 51...

  11. 7 CFR 966.11 - Pack.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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 (§§ 51...

  12. 7 CFR 966.11 - Pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 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 (§§ 51...

  13. Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States

    PubMed Central

    Chaturvedi, Anil K.; Engels, Eric A.; Pfeiffer, Ruth M.; Hernandez, Brenda Y.; Xiao, Weihong; Kim, Esther; Jiang, Bo; Goodman, Marc T.; Sibug-Saber, Maria; Cozen, Wendy; Liu, Lihua; Lynch, Charles F.; Wentzensen, Nicolas; Jordan, Richard C.; Altekruse, Sean; Anderson, William F.; Rosenberg, Philip S.; Gillison, Maura L.

    2011-01-01

    Purpose Recent increases in incidence and survival of oropharyngeal cancers in the United States have been attributed to human papillomavirus (HPV) infection, but empirical evidence is lacking. Patients and Methods HPV status was determined for all 271 oropharyngeal cancers (1984-2004) collected by the three population-based cancer registries in the Surveillance, Epidemiology, and End Results (SEER) Residual Tissue Repositories Program by using polymerase chain reaction and genotyping (Inno-LiPA), HPV16 viral load, and HPV16 mRNA expression. Trends in HPV prevalence across four calendar periods were estimated by using logistic regression. Observed HPV prevalence was reweighted to all oropharyngeal cancers within the cancer registries to account for nonrandom selection and to calculate incidence trends. Survival of HPV-positive and HPV-negative patients was compared by using Kaplan-Meier and multivariable Cox regression analyses. Results HPV prevalence in oropharyngeal cancers significantly increased over calendar time regardless of HPV detection assay (P trend < .05). For example, HPV prevalence by Inno-LiPA increased from 16.3% during 1984 to 1989 to 71.7% during 2000 to 2004. Median survival was significantly longer for HPV-positive than for HPV-negative patients (131 v 20 months; log-rank P < .001; adjusted hazard ratio, 0.31; 95% CI, 0.21 to 0.46). Survival significantly increased across calendar periods for HPV-positive (P = .003) but not for HPV-negative patients (P = .18). Population-level incidence of HPV-positive oropharyngeal cancers increased by 225% (95% CI, 208% to 242%) from 1988 to 2004 (from 0.8 per 100,000 to 2.6 per 100,000), and incidence for HPV-negative cancers declined by 50% (95% CI, 47% to 53%; from 2.0 per 100,000 to 1.0 per 100,000). If recent incidence trends continue, the annual number of HPV-positive oropharyngeal cancers is expected to surpass the annual number of cervical cancers by the year 2020. Conclusion Increases in the

  14. 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).

  15. 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.

  16. 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...

  17. 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...

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 3. GENERAL ELEVATION, FROM THE NORTH, SHOWING ENTIRE BASCULE SPAN ...

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

    3. GENERAL ELEVATION, FROM THE NORTH, SHOWING ENTIRE BASCULE SPAN AND FOCUSING ON FIXED SPAN IN FOREGROUND - Seddon Island Scherzer Rolling Lift Bridge, Spanning Garrison Channel from Tampa to Seddon Island, Tampa, Hillsborough County, FL

  7. 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

  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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. 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.

  10. Disordered spherical bead packs are anisotropic

    NASA Astrophysics Data System (ADS)

    Schröder-Turk, G. E.; Mickel, W.; Schröter, M.; Delaney, G. W.; Saadatfar, M.; Senden, T. J.; Mecke, K.; Aste, T.

    2010-05-01

    Investigating how tightly objects pack space is a long-standing problem, with relevance for many disciplines from discrete mathematics to the theory of glasses. Here we report on the fundamental yet so far overlooked geometric property that disordered mono-disperse spherical bead packs have significant local structural anisotropy manifest in the shape of the free space associated with each bead. Jammed disordered packings from several types of experiments and simulations reveal very similar values of the cell anisotropy, showing a linear decrease with packing fraction. Strong deviations from this trend are observed for unjammed configurations and for partially crystalline packings above 64%. These findings suggest an inherent geometrical reason why, in disordered packings, anisotropic shapes can fill space more efficiently than spheres, and have implications for packing effects in non-spherical liquid crystals, foams and structural glasses.

  11. 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.

  12. Detection of endogenous boldenone in the entire male horses.

    PubMed

    Ho, Emmie N M; Yiu, Kenneth C H; Tang, Francis P W; Dehennin, Louis; Plou, Philippe; Bonnaire, Yves; Wan, Terence S M

    2004-09-05

    Boldenone (1,2-dehydrotestosterone) is a common veterinary anabolic agent. Its structure is very similar to testosterone. Testosterone is endogenous in the horse, whereas there has been no report concerning the detection of endogenous boldenone. This paper reports the direct observation of sulphate conjugate of boldenone in equine urine from entires. The detection procedures involved solid-phase extraction, immunoaffinity column (IAC) purification, and then LC-MS-MS analysis on a Q-ToF instrument. The identification of boldenone sulphate has provided direct evidence for the endogenous nature of boldenone in entire male horses. Quantification data for the normal level of boldenone in Hong Kong racehorses will also be discussed.

  13. 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.

  14. Functional Outcomes and Complications of Robot-Assisted Free Flap Oropharyngeal Reconstruction.

    PubMed

    Tsai, Yueh-Chi; Liu, Shih-An; Lai, Chih-Sheng; Chen, Yen-Wei; Lu, Chen-Te; Yen, Jung-Hsing; Chen, I-Chen

    2017-03-01

    Robotic surgical systems provide a clear, magnified 3-dimensional visualization as well as precise, stable instrumental movement, thereby minimizing technical difficulties that may be encountered in the surgical treatment of oropharyngeal tumors. This study assessed the outcomes of robotic-assisted free flap oropharyngeal reconstruction compared with those of conventional free flap reconstruction. A retrospective review of 47 patients who underwent reconstructive operations using a free radial forearm fasciocutaneous flap for oropharyngeal defects was conducted over a 20-month period (May 2013-December 2014). Complications were evaluated for a robot-assisted reconstruction group and a conventional reconstruction group; postoperative complication rates and revision rates were further evaluated. The Functional Intraoral Glasgow Scale (FIGS) was adopted for functional outcome assessment. This study recruited 47 people who underwent reconstructive operations using a free radial forearm fasciocutaneous flap for oropharyngeal defects (14 robot-assisted and 33 conventional reconstructions). The mean postoperative FIGS score was 10.29 ± 2.02 in the robot-assisted group (P = 0.010) and 8.42 ± 2.29 in the conventional group at 1 month postoperatively. The mean postoperative FIGS score was 12.57 ± 1.91 in the robot-assisted group (P = 0.005) and 9.91 ± 3.09 in the conventional group at 3 months postoperatively. Complication rates between the robot-assisted and conventional groups were similar for flap failure (P = 0.531), partial necrosis, wound infection, hematoma or seroma formation (P = 0.893), wound dehiscence, and fistula formation (P = 0.515). The number of flap revision operations requiring additional surgery (P = 0.627) was comparable between the cohorts. There is no significant difference in complications or revision rates between the robot-assisted and conventional oropharyngeal reconstructions. The functional postoperative outcomes of robot

  15. 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.

  16. Proof-of-principle pilot study of oropharyngeal air-pulse application in individuals with dysphagia after hemispheric stroke.

    PubMed

    Theurer, Julie A; Johnston, Jennifer L; Fisher, James; Darling, Sherry; Stevens, Rebecca C; Taves, Donald; Teasell, Robert; Hachinski, Vladimir; Martin, Ruth E

    2013-06-01

    To test the hypothesis that oropharyngeal air-pulse application is associated with increased swallowing rates in individuals with dysphagia secondary to stroke. Case control. Stroke rehabilitation hospital or home setting. Convenience sample of individuals (N=8) with new-onset dysphagia after stroke. Air-pulse trains were applied to the oropharynx of 8 subjects who presented with dysphagia after hemispheric stroke. Resting swallowing rates were determined for 5 experimental conditions: baseline without air-pulse mouthpiece, baseline with mouthpiece in situ, unilateral right oropharyngeal air-pulse, unilateral left oropharyngeal air-pulse, and bilateral oropharyngeal air-pulse application. Individual swallowing responses were analyzed using a 2-SD band method. Swallowing rate (swallows/min). Swallowing rates associated with bilateral air-pulse application were greater than baseline in 4 of the 8 subjects. The 4 subjects who demonstrated this response to air-pulse application had greater baseline swallowing rates than did subjects whose swallowing rates were not altered in association with air-pulse application. Oropharyngeal air-pulse trains can be applied in individuals with swallowing impairment. Air-pulse application is associated with increased resting swallowing rates in some individuals with dysphagia secondary to hemispheric stroke. Further research should extend this proof-of-principle study by examining the efficacy of oropharyngeal air-pulse application in terms of improved swallowing and related outcomes in dysphagic stroke through a large randomized trial. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Human papillomavirus-related oropharyngeal cancer: HPV and p16 status in the recurrent versus parent tumor.

    PubMed

    Vainshtein, Jeffrey; McHugh, Jonathan B; Spector, Matthew E; Walline, Heather M; Komarck, Christine M; Stenmark, Matthew H; Prince, Mark E; Worden, Francis P; Wolf, Gregory T; Bradford, Carol R; Chepeha, Douglas B; Carey, Thomas; Eisbruch, Avraham

    2015-01-01

    Although typically associated with a favorable prognosis, a minority of human papillomavirus (HPV)-related (+) oropharyngeal cancers recur after chemoradiation. We postulated that a minor HPV-negative tumor subfraction may be responsible for recurrences of HPV+ oropharyngeal cancer. Paired untreated primary and recurrent tumor specimens were identified for 37 patients with oropharyngeal cancer who received definitive chemoradiotherapy at our institution. Concordance in HPV/p16 expression between primary and recurrent tumors was assessed. Among 31 patients with HPV+/p16+ primary tumors, 30 (97%) retained evidence of both HPV and p16 expression at recurrence (27 HPV+/p16+; 3 HPV+/p16-partial). One (3%) initially HPV+/p16+ patient developed an HPV-negative/p16-negative lung squamous cell carcinoma (SCC), representing either a discordant oropharyngeal cancer metastasis or second primary tumor. HPV-related oropharyngeal cancers retain HPV+/p16+ expression at recurrence. Our results fail to provide evidence that a minor HPV-negative tumor subfraction is responsible for biologically aggressive behavior of HPV+ oropharyngeal cancer that recurs after chemoradiation. © 2014 Wiley Periodicals, Inc.

  18. Human Papillomavirus and Epidermal Growth Factor Receptor in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma: Correlation With Dynamic Contrast-Enhanced MRI Parameters.

    PubMed

    Choi, Yoon Seong; Park, Mina; Kwon, Hyeong Ju; Koh, Yoon Woo; Lee, Seung-Koo; Kim, Jinna

    2016-02-01

    The objective of this study was to investigate differences in dynamic contrast-enhanced MRI (DCE-MRI) parameters on the basis of the status of human papillomavirus (HPV) and epidermal growth factor receptor (EGFR) biomarkers in patients with squamous cell carcinoma (SCC) of the oral cavity and oropharynx by use of histogram analysis. A total of 22 consecutive patients with oral cavity and oropharyngeal SCC underwent DCE-MRI before receiving treatment. DCE parameter maps of the volume transfer constant (K(trans)), the flux rate constant (kep), and the extravascular extracellular volume fraction (ve) were obtained. The histogram parameters were calculated using the entire enhancing tumor volume and were compared between the patient subgroups on the basis of HPV and EGFR biomarker statuses. The cumulative histogram parameters of K(trans) and kep showed lower values in the HPV-negative and EFGR-overexpression group than in the HPV-positive EGFR-negative group. These differences were statistically significant for the mean (p = 0.009), 25th, 50th, and 75th percentile values of K(trans) and for the 25th percentile value of kep when correlated with HPV status in addition to the mean K(trans) value (p = 0.047) and kep value (p = 0.004) when correlated with EGFR status. No statistically significant difference in ve was found on the basis of HPV and EGFR status. DCE-MRI is useful for the assessment of the tumor microenvironment associated with HPV and EGFR biomarkers before treatment of patients with oral cavity and oropharyngeal SCC.

  19. 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

  20. 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

  1. 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

  2. Overview to northwest of entire project area, from the communications ...

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

    Overview to northwest of entire project area, from the communications tower. At farthest left is warehouse A-141. Warehouse A-199 and magazine A-210 are just left of center, and the fresh water tanks are in the right distance. - Mare Island Naval Shipyard, Magazine, Corbett Road, southwest end of Kieper Road, Vallejo, Solano County, CA

  3. 3. Elevation view of entire midsection using ultrawide angle lens. ...

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

    3. Elevation view of entire midsection using ultrawide angle lens. Note opened south doors and closed north doors. The following photo WA-203-C-4 is similar except the camera position was moved right to include the slope of the south end. - Puget Sound Naval Shipyard, Munitions Storage Bunker, Naval Ammunitions Depot, South of Campbell Trail, Bremerton, Kitsap County, WA

  4. 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

  5. 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

  6. 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.

  7. 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.

  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. 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…

  10. 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.

  11. The packing of granular polymer chains.

    PubMed

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

    2009-10-16

    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. The Packing of Granular Polymer Chains

    SciTech Connect

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

    2009-12-01

    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.

  13. 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.

  14. 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.

  15. 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.

  16. Metallurgical Analysis of Leaking Tray Packs

    DTIC Science & Technology

    1990-05-01

    i j L Copyi MTL TR 90-30 JAD AD-A223 157 METALLURGICAL ANALYSIS OF LEAKING TRAY PACKS KUAN S. LEI GEO-CENTERS, INC. NEWTON, MA FRANK C. CHANG and...RECIPIENTS CATALOG NUMBER 4. TITLE (and Subute) 5. TYPE OF REPORT & PERIOD COVERED Final Report METALLURGICAL ANALYSIS OF LEAKING TRAY PACKS 6...CLASSIFICATION OF THIS PAGE (Wihn Daa Entend) Block No. 20 ABSTRACT A metallurgical analysis was performed to determine the cause of leaking tray packs and the

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Random packing of spheres in Menger sponge.

    PubMed

    Cieśla, Michał; Barbasz, Jakub

    2013-06-07

    Random packing of spheres inside fractal collectors of dimension 2 < d < 3 is studied numerically using Random Sequential Adsorption (RSA) algorithm. The paper focuses mainly on the measurement of random packing saturation limit. Additionally, scaling properties of density autocorrelations in the obtained packing are analyzed. The RSA kinetics coefficients are also measured. Obtained results allow to test phenomenological relation between random packing saturation density and collector dimension. Additionally, performed simulations together with previously obtained results confirm that, in general, the known dimensional relations are obeyed by systems having non-integer dimension, at least for d < 3.

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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.

  10. The Oropharyngeal Morphology in the Semiaquatic Giant Asian Pond Turtle, Heosemys grandis, and Its Evolutionary Implications

    PubMed Central

    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. PMID:23029486

  11. [Consumption of animal-derived foods and mouth and oropharyngeal cancer].

    PubMed

    Toporcov, Tatiana Natasha; Biazevic, Maria Gabriela Haye; Rotundo, Lígia Drovandi Braga; de Andrade, Fabiana Paula; de Carvalho, Marcos Brasilino; Brasileiro, Rosana Sarmento; Kowalski, Luiz Paulo; Antunes, Jose Leopoldo Ferreira

    2012-09-01

    Evaluate the relationship between animal-derived foods and mouth and oropharyngeal cancer. Hospital-based case-control study matched by sex and age (± 5 years) with data collected between July of 2006 and June of 2008. The sample contained 296 patients with mouth and oropharyngeal cancer and 296 patients without a cancer history who were treated in four hospitals in the City of São Paulo, State of São Paulo, Brazil. A semistructured questionnaire was administered to collect data regarding socioeconomic condition and harmful habits (tobacco and alcoholic beverage consumption). To assess eating habits, a qualitative questionnaire that asked about the frequency of food consumption was used. The analysis was rendered by means of multivariate logistic regression models that considered the existing hierarchy among the characteristics studied. Among foods of animal origin, frequent consumption of beef (OR = 2.73; CI95% = 1.27-5.87; P < 0.001), bacon (OR = 2.48; CI95% = 1.30-4.74; P < 0.001) and eggs (OR = 3.04; CI95% = 1.51-6.15; P < 0.001) was linked to an increased risk of mouth and oropharyngeal cancer, in both the univariate and multivariate analyses. Among dairy products, milk showed a protective effect against the disease (OR = 0.41; CI95% = 0.21-0.82; P < 0.001). This study affirms the hypothesis that animal-derived foods can be etiologically linked to mouth and oropharyngeal cancer. This information can guide policies to prevent these diseases, generating public health benefits.

  12. Randomized trial of itraconazole oral solution for oropharyngeal candidiasis in HIV/AIDS patients.

    PubMed

    Graybill, J R; Vazquez, J; Darouiche, R O; Morhart, R; Greenspan, D; Tuazon, C; Wheat, L J; Carey, J; Leviton, I; Hewitt, R G; MacGregor, R R; Valenti, W; Restrepo, M; Moskovitz, B L

    1998-01-01

    Oropharyngeal candidasis (thrush) is the most common opportunistic infection in individuals who are positive for the human immunodeficiency virus (HIV) and those who have progressed to AIDS. Itraconazole has a broad in vitro spectrum of activity, including a wide variety of Candida species. Our study determined the relative efficacy of a new oral solution formulation of itraconazole and fluconazole tablets in the treatment of oropharyngeal candidiasis. This was a prospective randomized, third-party-blind, multicenter trial conducted at 12 centers in the United States. One hundred seventy-nine HIV-positive patients with mycologically documented oropharyngeal candidiasis were treated with itraconazole oral solution 200 mg/ day for 7 or 14 days, or fluconazole tablets 100 mg/day for 14 days. Severity of disease was scored clinically before treatment and at clinical evaluations on days 3, 7, 14, 21, 35, and 42. Semi-quantitative cultures of mouth washings were also obtained on these days. Both 14-day and 7-day regimens of itraconazole oral solution were equivalent to fluconazole for most efficacy parameters. The clinical response rate was 97% after 14 days of itraconazole and 87% after 14 days of fluconazole. Itraconazole oral solution given for 7 days was also equivalent to fluconazole treatment for 14 days. Approximately one half of patients in all three groups relapsed by 1 month after completion of treatment. There were few adverse reactions to either drug. Itraconazole oral solution is well tolerated and offers an alternative at least as effective as fluconazole in the treatment of oropharyngeal candidiasis.

  13. 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.

  14. 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.

  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. Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review.

    PubMed

    Speyer, Renée; Baijens, Laura; Heijnen, Mariëlle; Zwijnenberg, Iris

    2010-03-01

    Medical and paramedical treatments should be evaluated according to current standards of evidence-based medicine. Evaluation of therapy in oropharyngeal dysphagia fits into this growing interest. A systematic review is given of the literature on the effects of therapy in oropharyngeal dysphagia carried out by speech therapists. Thus, the review excludes reports of surgical or pharmacological treatments. The literature search was performed using the electronic databases PubMed and Embase. All available inclusion dates up to November 2008 were used. The search was limited to English, German, French, Spanish, and Dutch publications. MESH terms were supplemented by using free-text words (for the period after January 2005). Fifty-nine studies were included. In general, statistically significant positive therapy effects were found. However, the number of papers was rather small. Moreover, diverse methodological problems were found in many of these studies. For most studies, the conclusions could not be generalized; comparison was hindered by the range of diagnoses, types of therapies, and evaluation techniques. Many questions remain about the effects of therapy in oropharyngeal dysphagia as performed by speech and language therapists. Although some positive significant outcome studies have been published, further research based on randomized controlled trials is needed.

  17. Feasibility and relevance of level I substation node counts in oropharyngeal carcinoma.

    PubMed

    Rassekh, Christopher H; O'Malley, Bert W; Bewley, Arnaud F; Montone, Kathleen T; Livolsi, Virginia A; Weinstein, Gregory S

    2016-08-01

    The inclusion of level I in neck dissections for oropharyngeal carcinoma remains controversial. Our objectives were to evaluate the feasibility and relevance of substation node counts in level I of the neck dissection and to determine the specific substation location of metastases in level I in oropharyngeal carcinoma. Sixty specimens were retrospectively analyzed after an orientation using a new paradigm of demarcating level I specimens into 8 substations. Three of the specimens (5%) in this study showed nodal metastasis in level I, one each in 3 different substations. All positive nodes in level I were associated with N+ disease in level II with 2 being radiographically occult (3.3%). Average total node count for level I was 8.1 (range, 2-19). In oropharyngeal carcinoma, substation level I node quantification is feasible and relevant. This study shows a 5% risk to level I with metastasis in 3 different substations. © 2016 Wiley Periodicals, Inc. Head Neck 38:1194-1200, 2016. © 2016 Wiley Periodicals, Inc.

  18. Retrospective cohort study of prognostic factors in patients with oral cavity and oropharyngeal squamous cell carcinoma.

    PubMed

    Carrillo, José F; Carrillo, Liliana C; Cano, Ana; Ramirez-Ortega, Margarita C; Chanona, Jorge G; Avilés, Alejandro; Herrera-Goepfert, Roberto; Corona-Rivera, Jaime; Ochoa-Carrillo, Francisco J; Oñate-Ocaña, Luis F

    2016-04-01

    Prognostic factors in oral cavity and oropharyngeal squamous cell carcinoma (SCC) are debated. The purpose of this study was to investigate the association of prognostic factors with oncologic outcomes. Patients with oral cavity and oropharyngeal SCC treated from 1997 to 2012 were included in this retrospective cohort study. Associations of prognostic factors with locoregional recurrence (LRR) or overall survival (OS) were analyzed using the logistic regression and the Cox models. Six hundred thirty-four patients were included in this study; tumor size, surgical margins, and N classification were associated with LRR (p < .0001); considering histopathology: perineural invasion, lymphocytic infiltration, infiltrative borders, and N classification were significant determinants of LRR. Tumor size, N classification, alcoholism, and surgical margins were associated with OS (p < .0001); considering pathologic prognostic factors, perivascular invasion, islands borders, and surgical margins were independently associated with OS (p < .0001). Surgical margins, perineural and perivascular invasion, lymphocytic infiltration, and infiltrative patterns of tumor invasion are significant prognostic factors in oral cavity and oropharyngeal SCC. © 2015 Wiley Periodicals, Inc.

  19. 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

  20. 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.

  1. Malnutrition and quality of life in patients treated for oral or oropharyngeal cancer.

    PubMed

    Jager-Wittenaar, Harriët; Dijkstra, Pieter U; Vissink, Arjan; van der Laan, Bernard F A M; van Oort, Rob P; Roodenburg, Jan L N

    2011-04-01

    This study assessed whether malnourished patients score lower on quality of life after treatment for oral/oropharyngeal cancer. Malnutrition (weight loss ≥ 10% in 6 months/ ≥ 5% in 1 month) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 questionnaire) were assessed cross-sectionally in patients treated for oral/oropharyngeal cancer. The interval after treatment varied from 1 day to 3 years. The relationship between malnutrition and quality of life was analyzed univariately (Mann-Whitney U test) and multivariately (linear regression analyses). Statistical significance was set at p < .05. Prevalence of posttreatment malnutrition was 16% (18/115, 95% confidence interval [CI]: 9% to 23%). Analyzed univariately, malnourished patients scored significantly worse on physical functioning (p = .007) and fatigue (p = .034) than well-nourished patients. Multivariate analysis revealed that malnutrition was significantly related to physical functioning (p = .015). Malnourished patients treated for oral/oropharyngeal cancer score lower on quality of life scales related to physical fitness. Copyright © 2010 Wiley Periodicals, Inc.

  2. Effects of wearing and removing dentures on oropharyngeal motility during swallowing.

    PubMed

    Onodera, S; Furuya, J; Yamamoto, H; Tamada, Y; Kondo, H

    2016-11-01

    Wearing dentures and dysphagia are common in older individuals; however, it is still unknown how dentures affect oral and pharyngeal swallowing. The purpose of this study was to reveal the effects of wearing and removing dentures on oropharyngeal movements during pharyngeal swallowing in the feeding sequence of solid food. Participants were 25 edentulous volunteers (nine men, 16 women; mean age 76·2 years) who wore complete dentures. The test food was minced agar jelly containing barium sulphate. Subjects were instructed to feed and swallow the test food with or without dentures during observation using videofluorography. We quantitatively evaluated the range, distance and duration of oropharyngeal movements during pharyngeal swallowing. When dentures were absent, the range of mandible and hyoid movements were significantly expanded in the anterosuperior direction, and the range of laryngeal movement was significantly expanded in the anterior direction. Additionally, the posterior pharyngeal wall contraction and upper oesophageal sphincter opening significantly increased. In addition, the distances of the mandible, hyoid and laryngeal movements and the mandibular duration were significantly extended when dentures were absent. No significant differences were observed in the duration of movements of other organs between wearing and removing dentures. The hyoid bone, larynx, posterior pharyngeal wall and upper oesophageal sphincter do not change their duration of movements when dentures were removed but, rather, expand their range of movement. This might be a spatial change of oropharyngeal movement to avoid temporal changes in pharyngeal swallowing when dentures were absent in edentulous older individuals. © 2016 John Wiley & Sons Ltd.

  3. Submental sensitive transcutaneous electrical stimulation (SSTES) at home in neurogenic oropharyngeal dysphagia: a pilot study.

    PubMed

    Verin, E; Maltete, D; Ouahchi, Y; Marie, J-P; Hannequin, D; Massardier, E Guegan; Leroi, A-M

    2011-09-01

    Oropharyngeal dysphagia is frequent in chronic neurological disorders and increases mortality, mainly due to pulmonary complications. Our aim was to show that submental sensitive transcutaneous electrical stimulation (SSTES) applied during swallowing at home can improve swallowing function in patients with chronic neurological disorders. Thirteen patients were recruited for the study (4 f, 68 ± 12 years). They all suffered from neurogenic oropharyngeal dysphagia. We first compared the swallowing of paste and liquid with and without SSTES. Thereafter, the patients were asked to perform SSTES at home with each meal. Swallowing was evaluated before and after six weeks of SSTES using the SWAL-QoL questionnaire. With the stimulator switch turned on, swallowing coordination improved, with a decrease in swallow reaction time for the liquid (P<0.05) and paste boluses (P<0.01). Aspiration scores also decreased significantly with the electrical stimulations (P<0.05), with no change in stasis. At-home compliance was excellent and most patients tolerated the electrical stimulations with no discomfort. A comparison of the SWAL-QoL questionnaires after 6 weeks revealed an improvement in the burden (P=0.001), fatigue (P<0.05), and pharyngeal symptom (P<0.001) scales. The present study demonstrated that SSTES is easy to use at home and improves oropharyngeal dysphagia quality of life. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  4. Impact of positive margins on outcomes of oropharyngeal squamous cell carcinoma according to p16 status.

    PubMed

    Molony, Peter; Kharytaniuk, Natallia; Boyle, Seamus; Woods, Robbie S R; O'Leary, Gerard; Werner, Reiltin; Heffron, Cynthia; Feeley, Linda; Sheahan, Patrick

    2017-08-01

    Currently, positive surgical margins in head and neck cancer are considered to be an indicator for postoperative chemoradiotherapy (CRT) over radiotherapy (RT) alone. However, there are less data regarding the impact of margin status on human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC). We performed a retrospective review of 55 patients with oropharyngeal SCC undergoing primary surgical treatment. The impact of margin status on disease-specific survival (DSS) was studied according to p16 status. Twenty-one patients had positive margins. Adjuvant treatment in these cases was CRT (n = 6), RT alone (n = 14), and none (n = 1). Among p16-negative patients, positive margins and dysplasia at margins predicted significantly worse DSS. Among patients with p16-positive disease, margin status had no impact on DSS. Patients with p16-positive oropharyngeal SCC and positive margins after excision maintain a low risk of recurrence despite most receiving RT alone as adjuvant treatment. These findings raise questions regarding the additional benefit of postoperative CRT in this group. © 2017 Wiley Periodicals, Inc.

  5. Oral symptoms and functional outcome related to oral and oropharyngeal cancer.

    PubMed

    Kamstra, Jolanda I; Jager-Wittenaar, Harriet; Dijkstra, Pieter U; Huisman, Paulien M; van Oort, Rob P; van der Laan, Bernard F A M; Roodenburg, Jan L N

    2011-09-01

    This study aimed to assess: (1) oral symptoms of patients treated for oral or oropharyngeal cancer; (2) how patients rank the burden of oral symptoms; (3) the impact of the tumor, the treatment, and oral symptoms on functional outcome. Eighty-nine patients treated for oral or oropharyngeal cancer were asked about their oral symptoms related to mouth opening, dental status, oral sensory function, tongue mobility, salivary function, and pain. They were asked to rank these oral symptoms according to the degree of burden experienced. The Mandibular Function Impairment Questionnaire (MFIQ) was used to assess functional outcome. In a multivariate linear regression analyses, variables related to MFIQ scores (p≤0.10) were entered as predictors with MFIQ score as the outcome. Lack of saliva (52%), restricted mouth opening (48%), and restricted tongue mobility (46%) were the most frequently reported oral symptoms. Lack of saliva was most frequently (32%) ranked as the most burdensome oral symptom. For radiated patients, an inability to wear a dental prosthesis, a T3 or T4 stage, and a higher age were predictive of MFIQ scores. For non-radiated patients, a restricted mouth opening, an inability to wear a dental prosthesis, restricted tongue mobility, and surgery of the mandible were predictive of MFIQ scores. Lack of saliva was not only the most frequently reported oral symptom after treatment for oral or oropharyngeal cancer, but also the most burdensome. Functional outcome is strongly influenced by an inability to wear a dental prosthesis in both radiated and non-radiated patients.

  6. Participation of Canadian Oral and Maxillofacial Surgeons in Oral, Lip, and Oropharyngeal Cancer Care.

    PubMed

    Cuddy, Karl K; Mascarenhas, Wendall; Cobb, Graham

    2015-12-01

    The purpose of this study was to assess the participation of Canadian oral and maxillofacial surgeons (OMSs) in the various phases of oral, lip, and oropharyngeal cancer care. A survey was conducted to quantify participation in oral, lip, and oropharyngeal cancer care and assess participation ranging from screening for malignancy to active treatment and rehabilitation of those with late-stage disease. Three hundred ninety-one surgeons were contacted and 206 (52.7%) responded to the online survey. The survey showed 98.1% of respondents were involved with cancer screening and 97.1% were involved in prevention and early intervention (monitoring and treatment) of premalignant lesions. In addition, 95.1% of respondents participated in diagnosis and staging of tumors. Early-stage cancer was managed surgically by 49.5% of respondents, whereas 11.2% of respondents managed late-stage disease. Management of oral rehabilitation was performed by 79.0% of respondents. OMSs are an integral part of all phases of oral and oropharyngeal cancer care, including primary surgical oncology, in Canada. Although OMSs in Canada participate widely in integral prevention and survivor rehabilitation programs, few members participate in late-stage disease management and regional multidisciplinary care teams. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. Virology and Molecular Pathogenesis of Human Papillomavirus (HPV)-Associated Oropharyngeal Squamous Cell Carcinoma

    PubMed Central

    Miller, Daniel L.; Puricelli, Michael D.; Stack, M. Sharon

    2012-01-01

    Current literature fully supports HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) as a unique clinical entity. It affects an unambiguous patient population with defined risk factors, has a genetic expression pattern more similar to cervical squamous cell carcinoma than non-HPV-associated head and neck squamous cell carcinoma (HNSCC), and may warrant divergent clinical management compared to HNSCC associated with traditional risk factors. However, a detailed understanding of the molecular mechanisms driving these differences and the ability to exploit this knowledge to improve clinical management of OPSCC has not yet come to fruition. This review summarizes the etiology of HPV positive (HPV+) OPSCC and provides a detailed overview of HPV virology and molecular pathogenesis relevant to infection of oropharyngeal tissues. Methods of detection and differential gene expression analyses are also summarized. Future research into mechanisms that mediate tropism of HPV to oropharyngeal tissues, improved detection strategies, and the pathophysiologic significance of altered gene and microRNA expression profiles is warranted. PMID:22452816

  9. Virology and molecular pathogenesis of HPV (human papillomavirus)-associated oropharyngeal squamous cell carcinoma.

    PubMed

    Miller, Daniel L; Puricelli, Michael D; Stack, M Sharon

    2012-04-15

    The current literature fully supports HPV (human papillomavirus)-associated OPSCC (oropharyngeal squamous cell carcinoma) as a unique clinical entity. It affects an unambiguous patient population with defined risk factors, has a genetic expression pattern more similar to cervical squamous cell carcinoma than non-HPV-associated HNSCC (head and neck squamous cell carcinoma), and may warrant divergent clinical management compared with HNSCC associated with traditional risk factors. However, a detailed understanding of the molecular mechanisms driving these differences and the ability to exploit this knowledge to improve clinical management of OPSCC has not yet come to fruition. The present review summarizes the aetiology of HPV-positive (HPV+) OPSCC and provides a detailed overview of HPV virology and molecular pathogenesis relevant to infection of oropharyngeal tissues. Methods of detection and differential gene expression analyses are also summarized. Future research into mechanisms that mediate tropism of HPV to oropharyngeal tissues, improved detection strategies and the pathophysiological significance of altered gene and microRNA expression profiles is warranted.

  10. The importance of the reproducibility of oropharyngeal swallowing in amyotrophic lateral sclerosis. An electrophysiological study.

    PubMed

    Cosentino, G; Alfonsi, E; Mainardi, L; Alvisi, E; Brighina, F; Valentino, F; Fierro, B; Sandrini, G; Bertino, G; Berlangieri, M; De Icco, R; Fresia, M; Moglia, A

    2017-05-01

    To investigate electrophysiologically the reproducibility of oropharyngeal swallowing in patients with ALS. We enrolled 26 ALS patients, both with and without clinical signs of dysphagia, and 30 age-matched controls. The reproducibility of the electrophysiological signals related to the oral phase (electromyographic activity of the submental/suprahyoid muscles) and the pharyngeal phase (laryngeal-pharyngeal mechanogram) of swallowing across repeated swallows was assessed. To do this we computed two similarity indexes (SI) by using previously described mathematical algorithms. The reproducibility of oropharyngeal swallowing was significantly reduced both in patients with and in those without clinical signs of dysphagia, with more marked alterations being detected in the dysphagic group. The SI of both phases of swallowing, oral and pharyngeal, correlated significantly with dysphagia severity and disease severity. In ALS different pathophysiological mechanisms can alter the stereotyped motor behaviors underlying normal swallowing, thus reducing the reproducibility of the swallowing act. A decrease in swallowing reproducibility could be a preclinical sign of dysphagia and, beyond a certain threshold, a pathological hallmark of oropharyngeal dysphagia. Electrophysiological assessment is a simple and useful tool for the early detection of swallowing abnormalities, and for the management of overt dysphagia in ALS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  11. Analysis of oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with Parkinson's disease.

    PubMed

    Correa-Flores, Melissa; Arch-Tirado, Emilio; Villeda-Miranda, Alicia; Rocha-Cacho, Karina Elizabeth; Verduzco-Mendoza, Antonio; Hernández-López, Xochiquetzal

    2012-01-01

    Parkinson's disease (PD) has a high incidence in Mexico and is estimated at approximately 500,000 patients. One of the main clinical manifestations of PD is dysphagia, which is the difficult passage of food from the mouth to the stomach. The aim of this study was to assess oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with PD. We conducted a census sample of patients with PD: 17 males and 10 females, aged >49 years. Clinical history, physical examination and neurological evaluation of swallowing fibroendoscopy were carried out. Of the symptomatic patients, 16 patients (59.25%) reported dysphagia. Fibroendoscopic evaluation demonstrated swallowing disorders in 25 patients (92.59%). The main findings were poor bolus control in 19 patients (70.37%), deficits in bolus propulsion in 25 patients (92.59%), impaired swallowing in 14 patients (51.85%), fractional swallowing in 11 patients (40.74%), reduced epiglottic tilting in 11 patients (48.14%), food residue in vallecula in 24 patients (88.88%) and piriform sinus in 19 patients (70.37%). There was no correlation between duration of PD and degree of involvement of oropharyngeal dysphagia. Oropharyngeal dysphagia in patients with PD is a common symptom and can range from the oral cavity to the upper esophageal sphincter. Early onset of severe dysphagia is exceptional in this disease and should alert the clinician to the diagnostic possibility of parkinsonism.

  12. Sensory outcomes of the anterior tongue after lingual nerve repair in oropharyngeal cancer.

    PubMed

    Elfring, T T; Boliek, C A; Seikaly, H; Harris, J; Rieger, J M

    2012-03-01

    Primary treatment of oropharyngeal cancer often involves surgical resection and reconstruction of the affected area. However, during base of tongue reconstruction the lingual nerve is often severed on one or both sides, affecting sensation in the preserved tissue of the anterior tongue. The loss of specific tongue sensations could negatively affect a person's oral function and quality of life. The aim of this study was to explore the effects of different types of lingual nerve intervention on sensory function for patients with base of tongue cancer as compared to healthy, age-matched adults. Subjects included 30 patients who had undergone primary oropharyngeal reconstruction with a radial forearm free-flap and 30 matched controls. Sensations tested were temperature, two-point discrimination, light touch, taste, oral stereognosis and texture on the anterior two-thirds of the tongue. Results indicated that type of surgical nerve repair may not have a significant impact on overall sensory outcomes, providing mixed results for either nerve repair technique. Sensations for the nonoperated tongue side and operated side with lingual nerve intact were comparable to matched controls, with mixed outcomes for nerve repair. The poorest sensory outcomes were observed in patients with the lingual nerve severed, while all patients with lingual nerve intervention exhibited deteriorated taste sensation on the affected tongue side. Overall, patients in this study who had undergone oropharyngeal reconstruction with lingual nerve intervention exhibited decreased levels of sensation on the operated tongue side, with minimal differences between types of lingual nerve repair. © 2011 Blackwell Publishing Ltd.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. Complications in the treatment of oropharyngeal carcinoma in patients with systemic sclerosis: A case report.

    PubMed

    Coček, Ales; Hahn, Ales; Ambruš, Miloslav; Valešová, Marie

    2015-01-01

    Systemic sclerosis is a chronic, progressive disease with an extremely poor prognosis. The incidence of malignant tumors in patients with systemic sclerosis is increased when compared with that of the general population. In certain malignancies, systemic sclerosis presents as a paraneoplastic process. The symptoms of sclerosis in the organs of the head and neck often overlap with symptoms of malignant diseases, which may increase the difficulty of a differential diagnosis. Additionally, the presence of sclerosis may complicate standard examination procedures, due to poor access to the oral cavity and oropharynx. When considering treatment options, it is important to evaluate the surgical and oncological risks to soft tissues of the head and neck with regard to both diseases, as well as the relatively poor prognosis for systemic sclerosis and oropharyngeal cancer. The low incidence of patients with systemic sclerosis and oropharyngeal carcinoma together presents a clear case for a casuistic approach. Based upon our own experience, we can attest to the difficulty of treating such patients. However, we have no evidence to indicate that these patients have reduced tolerance to surgical treatments. The current study presents the case of a 47-year-old female with systemic sclerosis, who was diagnosed with oropharyngeal carcinoma. The patient initially tolerated radiotherapy treatment well, however post-radiotherapy complications occurred. Despite many enigmatic indications to the contrary, it appears that the complications in this instance may be due to late toxicity from radiotherapy.

  18. 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

  19. Micrognathia and Oropharyngeal Space in Patients With Robin Sequence: Prenatal MRI Measurements.

    PubMed

    Kooiman, Tessa D; Calabrese, Carly E; Didier, Ryne; Estroff, Judy A; Padwa, Bonnie L; Koudstaal, Maarten J; Resnick, Cory M

    2017-07-26

    Micrognathia is the initiating feature of Robin sequence (RS) and leads to airway obstruction. Prenatal identification of micrognathia is currently qualitative and has not correlated with postnatal findings in previous studies. Oropharyngeal airway space has not been evaluated prenatally. The purposes of this study were to 1) quantitate mandibular characteristics and oropharyngeal size at prenatal magnetic resonance imaging (MRI) and 2) identify differences in fetuses with postnatal RS compared with those with micrognathia (without RS) and normal controls. This is a retrospective case-control study of fetuses with prenatal MRIs performed from 2002 through 2017 who were live born and evaluated postnatally for craniofacial findings. Postnatal findings were used to divide patients into 3 groups: 1) RS (micrognathia, glossoptosis, and airway obstruction), 2) micrognathia without RS ("micrognathia"), and 3) a gestational-age matched control group with normal craniofacial morphology ("control"). Inferior facial angle (IFA), jaw index, and oropharyngeal space (OPS) were calculated and compared among groups. Of 116 patients in this study, 27 had RS (23%), 35 had micrognathia (30%), and 54 were control subjects (47%). IFA, jaw index, and OPS were statistically significantly smaller in the RS group compared with the comparison groups (P < .0001). Prenatal MRI measurements of micrognathia and OPS are considerably different in patients with RS compared with other groups, including those with micrognathia alone. These measurements might serve as reliable prenatal predictors of RS. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  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. Entirely screen printed CdS/CdTe solar cell

    NASA Astrophysics Data System (ADS)

    Ikegami, S.; Matsumoto, H.; Uda, H.; Komatsu, Y.; Nakano, A.; Kuribayashi, K.

    An entirely screen printed CdS/CdTe solar cell has been manufactured on a borosilicate glass substrate by successively repeating screen printing and heating in a belt furnace of each paste of CdS, Cd+Te, C, Ag+In and Ag. In a small cell with 0.78 sq cm area, the intrinsic conversion efficiency of 12.8 percent has been obtained; this value is the highest in the thin film type solar cells. On a large glass substrate of 30 x 30 sq cm, 28 unit solar cells connected in series have been constructed by this printing technique, their intrinsic efficiency being 8.5 percent. Under the roof top condition, no change in output power is observed in the present solar cells encapsulated over 206 days. Thus, the entirely screen printed CdS/CdTe solar cells can be expected as low cost, highly efficient, and stable solar cells.

  2. 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.

  3. Entire Western Hemisphere visible from Apollo 8 spacecraft

    NASA Technical Reports Server (NTRS)

    1968-01-01

    A striking view from the Apollo 8 spacecraft showing nearly the entire Western Hemisphere, from the mouth of the St. Lawrence River, including nearby Newfoundland, extending to Tierra del Fuego at the southern tip of South America. Central America is clearly outlined. Nearly all of South America is covered by clouds, except the high Andes Mountain chain along the west coast. A small portion of the bulge of west Africa shows along the sunset terminator.

  4. 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

  5. Confined disordered strictly jammed binary sphere packings.

    PubMed

    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)] 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 σ(τ)(2)(R) to characterize confined packings and find that these packings possess essentially the

  6. Expression of an entire bacterial operon in plants.

    PubMed

    Mozes-Koch, Rita; Gover, Ofer; Tanne, Edna; Peretz, Yuval; Maori, Eyal; Chernin, Leonid; Sela, Ilan

    2012-04-01

    Multigene expression is required for metabolic engineering, i.e. coregulated expression of all genes in a metabolic pathway for the production of a desired secondary metabolite. To that end, several transgenic approaches have been attempted with limited success. Better success has been achieved by transforming plastids with operons. IL-60 is a platform of constructs driven from the geminivirus Tomato yellow leaf curl virus. We demonstrate that IL-60 enables nontransgenic expression of an entire bacterial operon in tomato (Solanum lycopersicum) plants without the need for plastid (or any other) transformation. Delivery to the plant is simple, and the rate of expressing plants is close to 100%, eliminating the need for selectable markers. Using this platform, we show the expression of an entire metabolic pathway in plants and delivery of the end product secondary metabolite (pyrrolnitrin). Expression of this unique secondary metabolite resulted in the appearance of a unique plant phenotype disease resistance. Pyrrolnitrin production was already evident 2 d after application of the operon to plants and persisted throughout the plant's life span. Expression of entire metabolic pathways in plants is potentially beneficial for plant improvement, disease resistance, and biotechnological advances, such as commercial production of desired metabolites.

  7. MBL, P2X7, and SLC11A1 gene polymorphisms in patients with oropharyngeal tularemia.

    PubMed

    Somuk, Battal Tahsin; Koc, Sema; Ates, Omer; Göktas, Göksel; Soyalic, Harun; Uysal, Ismail Onder; Gurbuzler, Levent; Sapmaz, Emrah; Sezer, Saime; Eyibilen, Ahmet

    2016-11-01

    A significant association was found of oropharyngeal tularemia with SLC11A1 allele polymorphism (INT4 G/C) and MBL2 C + 4T (P/Q). These results indicate C allele and Q allele might be a risk factor for the development of oropharyngeal tularemia. This study aimed to investigate the relationship of SLC11A1, MBL, and P2X7 gene polymorphism with oropharyngeal tularemia. The study included totally 120 patients who were diagnosed with oropharyngeal tularemia. Frequencies of polymorphisms in the following genes were analyzed both in the patient and control groups in the study: SLC11A1 (5'(GT)n Allele 2/3, Int4 G/C, 3' UTR, D543N G/A), MBL (MBL2 C + 4T (P/Q), and P2X7 (-762 C/T and 1513 A/C). Among all polymorphisms that were investigated in this study, SLC11A1 gene showed a significance in the distriburtion of polymorphism allelle frequency at the INT4 region. Frequency of C allele was 54 (28%) in patients with oropharyngeal tularemia, and 31 (13%) in the control group (p = 0.006 and OR = 1.96 (1.21-3.20)). An association was detected between MBL2 C + 4T (P/Q) gene polymorphism and oropharyngeal tularemia (p < 0.005 and OR = 0.30 (0.19-0.48)). No significant relation was found between P2X7 (-762 C/T and 1513 A/C) gene polymorphism and oropharyngeal tularemia in this study (p > 0.05).

  8. 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.

  9. 7 CFR 51.3055 - Standard pack.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of the weight of the largest fruit in the container. Size of the avocados may be specified by count... AND THE EGG PRODUCTS INSPECTION ACT FRESH FRUITS, VEGETABLES AND OTHER PRODUCTS 1,2 (INSPECTION, CERTIFICATION, AND STANDARDS) United States Standards for Florida Avocados Standard Pack § 51.3055 Standard pack...

  10. 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 variations...

  11. 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 order...

  12. 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 order...

  13. 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 sizing...

  14. 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 variations...

  15. 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 sizing...

  16. 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 sizing...

  17. 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.

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

    USDA-ARS?s Scientific Manuscript database

    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-...

  19. 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.

  20. 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....

  1. Kid's PACK: Population Awareness Campaign Kit.

    ERIC Educational Resources Information Center

    Zero Population Growth, Inc., Washington, DC.

    This fun and educational kit is designed specifically for elementary students. The "Kid's PACK" (Population Awareness Campaign Kit) entertains and informs children on the environment and human population growth through stories, games, and concrete ideas for making a difference. In three booklets, the "Kid's PACK" offers…

  2. 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.

  3. 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...

  4. 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....

  5. 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....

  6. 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.

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. Contiguity and Entire Separability of States on von Neumann Algebras

    NASA Astrophysics Data System (ADS)

    Haliullin, Samigulla

    2017-04-01

    We introduce the notions of the contiguity and entirely separability for two sequences of states on von Neumann algebras. The ultraproducts technique allows us to reduce the study of the contiguity to investigation of the equivalence for two states. Here we apply the Ocneanu ultraproduct and the Groh-Raynaud ultraproduct (see Ocneanu (1985), Groh (J. Operator Theory, 11, 2, 395-404 1984), Raynaud (J. Operator Theory, 48, 1, 41-68, 2002), Ando and Haagerup (J. Funct. Anal., 266, 12, 6842-6913, 2014)), as well as the technique developed in Mushtari and Haliullin (Lobachevskii J. Math., 35, 2, 138-146, 2014).

  19. Xylochemistry--Making Natural Products Entirely from Wood.

    PubMed

    Stubba, Daniel; Lahm, Günther; Geffe, Mario; Runyon, Jason W; Arduengo, Anthony J; Opatz, Till

    2015-11-16

    The first total synthesis of the dimeric berberine alkaloid ilicifoline (ilicifoline B) is reported. Its carbon skeleton is constructed from ferulic acid, veratrole, and methanol. The synthesis reported herein employs starting materials solely derived from wood. The natural product is thus constructed entirely from renewable resources. The same strategy is applied to a formal total synthesis of morphinan alkaloids. The use of wood-derived building blocks (xylochemicals) instead of the conventional petrochemicals represents a sustainable alternative to classical synthetic approaches. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Entire Western Hemisphere visible from Apollo 8 spacecraft

    NASA Image and Video Library

    1968-12-22

    AS08-16-2593 (21-27 Dec. 1968) --- A striking view from the Apollo 8 spacecraft showing nearly the entire Western Hemisphere, from the mouth of the St. Lawrence River, including nearby Newfoundland, extending to Tierra del Fuego at the southern tip of South America. Central America is clearly outlined. Nearly all of South America is covered by clouds, except the high Andes Mountain chain along the west coast. A small portion of the bulge of West Africa shows along the sunset terminator.

  1. 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

  2. No packing versus packing after endoscopic sinus surgery: pursuit of patients' comfort after surgery.

    PubMed

    Mo, Ji-Hun; Han, Doo Hee; Shin, Hyun-Woo; Cha, Wonjae; Chang, Mun-young; Jin, Hong-Ryul

    2008-01-01

    This study was designed to evaluate the necessity of postoperative nasal packing and to find factors relevant in determining if nasal packing was required after endoscopic sinus surgery (ESS). From January 2007 through June 2007, 64 consecutive patients who underwent ESS were evaluated. The decision whether or not to perform nasal packing depended on the surgeon's judgment of the bleeding after surgery. Demographic characteristics, medical history, disease extent, surgical procedures, and subjective and objective amount of intraoperative bleeding were analyzed. Postoperative symptoms and endoscopic findings were evaluated also. Forty-eight (75%) of the 64 patients included in this study did not have nasal packing after ESS. One patient from the no-packing group needed nasal packing postoperatively because of persistent nasal bleeding. Symptom scores of nasal obstruction and postnasal drip on the 1st postoperative day were lower in the no-packing group. In unilateral ESS cases, subjectively estimated blood loss and mucosal inflammation scores were lower in the no-packing group. It was observed that preoperative steroid use was more frequent in the packing group. All other parameters did not show significant differences between the two groups. Nasal packing can be safely used less frequently to help the patients experience less discomfort after ESS. The need for nasal packing after ESS can be decided by judicious estimation of bleeding during and after the surgery.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. The Infundibular Recess Passes through the Entire Pituitary Stalk.

    PubMed

    Tsutsumi, S; Hori, M; Ono, H; Tabuchi, T; Aoki, S; Yasumoto, Y

    2016-12-01

    The infundibular recess (IR), commonly illustrated as a V-shaped hollow in the sagittal view, is recognized as a small extension of the third ventricle into the pituitary stalk. The precise morphology of the human IR is unknown. The present study sought to delineate the morphology of the IR using magnetic resonance imaging. Subjects included 100 patients without acute cerebral infarcts, intracranial hemorrhage, intrasellar or suprasellar cysts, hydrocephalus, inflammatory disease, or brain tumors. Patients with symptoms of increased intracranial pressure, intracranial hypotension, or pituitary dysfunction were excluded. Thin-sliced, seamless T2-weighted sequences involving the optic chiasm, entire pituitary stalk, and pituitary gland were performed in axial and sagittal planes for each patient. The numbers of slices delineating the pituitary stalk and IR were recorded from the axial images and quantified as ratios. The pituitary stalk consistently appeared as a styloid- or cone-shaped structure with variable inclinations toward the third ventricle floor. The IR was delineated as a smoothly tapering, tubular extension of the third ventricle located in the central portion of the pituitary stalk. In 81 % of patients, the IR passed through the entire length of the pituitary stalk and reached the upper surface of the pituitary gland, which was identified in 40 % of the midsagittal images. The IR is a cerebrospinal fluid-filled canal passing through the center of the pituitary stalk and connects the third ventricle to the pituitary gland. It may function in conjunction with the pituitary gland.

  8. 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.

  9. 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

  10. Modular vaccine packaging increases packing efficiency.

    PubMed

    Norman, Bryan A; Rajgopal, Jayant; Lim, Jung; Gorham, Katrin; Haidari, Leila; Brown, Shawn T; Lee, Bruce Y

    2015-06-17

    Within a typical vaccine supply chain, vaccines are packaged into individual cylindrical vials (each containing one or more doses) that are bundled together in rectangular "inner packs" for transport via even larger groupings such as cold boxes and vaccine carriers. The variability of vaccine inner pack and vial size may hinder efficient vaccine distribution because it constrains packing of cold boxes and vaccine carriers to quantities that are often inappropriate or suboptimal in the context of country-specific vaccination guidelines. We developed in Microsoft Excel (Microsoft Corp., Redmond, WA) a spreadsheet model that evaluated the impact of different packing schemes for the Benin routine regimen plus the introduction of the Rotarix vaccine. Specifically, we used the model to compare the current packing scheme to that of a proposed modular packing scheme. Conventional packing of a Dometic RCW25 that aims to maximize fully-immunized children (FICs) results in 123 FICs and a packing efficiency of 81.93% compared to a maximum of 155 FICs and 94.1% efficiency for an alternative modular packaging system. Our analysis suggests that modular packaging systems could offer significant advantages over conventional vaccine packaging systems with respect to space efficiency and potential FICs, when they are stored in standard vaccine carrying devices. This allows for more vaccines to be stored within the same volume while also simplifying the procedures used by field workers to pack storage devices. Ultimately, modular packaging systems could be a simple way to help increase vaccine coverage worldwide. Copyright © 2015. Published by Elsevier Ltd.

  11. 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.

  12. Redesigned of T-38 Displacement Gyroscope Pack.

    DTIC Science & Technology

    1984-01-01

    0D-Ai38 847 REDESIGNED OF T-38 DISPLACEMENT GYROSCOPE PACK(U) AIR i/i. - FORCE PflCKAGING EVALUATION AGENCY WRIGHT-PATTERSON AFB OH MATERIALS...Branchv HQ AFLC/DSTZT AUTOVON 787-4519 COMMERCIAL (513) 257-4519 Ci. REDESIGNED OF T-38 DISPLACEMENT GYROSCOPE PACK D T 1 e’ 211984 HQ AFLC/DSTZ AIR FORCE... Air Force Packaging Evaluation Agency redesigned the T-38, 19005 gyroscope displacement pack (TPO-00-077-3218) reducing its cubage by 48% and tare

  13. 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.

  14. Coconut Atrium: Transmural Calcification of the Entire Left Atrium

    PubMed Central

    Campo, Carlos Del; Weinstein, Paul; Kunnelis, Constantine; DiStefano, Peter; Ebers, Gloria M.

    2000-01-01

    Massive calcification of the left atrium usually spares the interatrial septum, which provides a cleavage plane for surgical access to the mitral valve. Endoatriectomy with mitral valve replacement is the currently accepted corrective procedure because it affords maximum exposure while decreasing the risk of embolization and intraoperative hemorrhage. We describe a case in which the entire left atrium, including the septum, was thickly calcified and resembled a coconut shell. This condition prevented surgical correction of severe mitral stenosis. To our knowledge, this is the most severe case of left atrial calcification yet reported in the literature. Although it is not possible to establish preoperatively that the atrium is completely calcified and impossible to incise, when predisposing factors and evidence of complete transmural calcification are present, the surgeon should be aware of this possibility and should weigh carefully the decision to operate. PMID:10830629

  15. 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.

  16. 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.

  17. Dose Uncertainties in IMPT for Oropharyngeal Cancer in the Presence of Anatomical, Range, and Setup Errors

    SciTech Connect

    Kraan, Aafke C.; Water, Steven van de; Teguh, David N.; Al-Mamgani, Abrahim; Madden, Tom; Kooy, Hanne M.; Heijmen, Ben J.M.; Hoogeman, Mischa S.

    2013-12-01

    Purpose: Setup, range, and anatomical uncertainties influence the dose delivered with intensity modulated proton therapy (IMPT), but clinical quantification of these errors for oropharyngeal cancer is lacking. We quantified these factors and investigated treatment fidelity, that is, robustness, as influenced by adaptive planning and by applying more beam directions. Methods and Materials: We used an in-house treatment planning system with multicriteria optimization of pencil beam energies, directions, and weights to create treatment plans for 3-, 5-, and 7-beam directions for 10 oropharyngeal cancer patients. The dose prescription was a simultaneously integrated boost scheme, prescribing 66 Gy to primary tumor and positive neck levels (clinical target volume-66 Gy; CTV-66 Gy) and 54 Gy to elective neck levels (CTV-54 Gy). Doses were recalculated in 3700 simulations of setup, range, and anatomical uncertainties. Repeat computed tomography (CT) scans were used to evaluate an adaptive planning strategy using nonrigid registration for dose accumulation. Results: For the recalculated 3-beam plans including all treatment uncertainty sources, only 69% (CTV-66 Gy) and 88% (CTV-54 Gy) of the simulations had a dose received by 98% of the target volume (D98%) >95% of the prescription dose. Doses to organs at risk (OARs) showed considerable spread around planned values. Causes for major deviations were mixed. Adaptive planning based on repeat imaging positively affected dose delivery accuracy: in the presence of the other errors, percentages of treatments with D98% >95% increased to 96% (CTV-66 Gy) and 100% (CTV-54 Gy). Plans with more beam directions were not more robust. Conclusions: For oropharyngeal cancer patients, treatment uncertainties can result in significant differences between planned and delivered IMPT doses. Given the mixed causes for major deviations, we advise repeat diagnostic CT scans during treatment, recalculation of the dose, and if required, adaptive

  18. Evaluation of nasal and oropharyngeal flora in patients with acne vulgaris according to treatment options.

    PubMed

    Ozuguz, Pınar; Callioglu, Elif E; Tulaci, Kamil G; Kacar, Seval D; Balta, Ilknur; Asik, Gulsah; Karatas, Serap; Karaca, Semsettin

    2014-11-01

    The aim of this study was to evaluate changes in nasal and oropharyngeal flora in patients with acne during treatments with tetracycline and isotretinoin. Swab specimens were taken from the right and left nasal cavities and oropharynx of 55 patients with acne and 20 healthy volunteers who were admitted to the dermatology department (Etlik Educational and Research Hospital, Ankara, Turkey) before the administration of treatment and in the third month of treatment. Study participants were divided into four groups as follows: patients with acne on topical treatment only, systemic isotretinoin, and systemic tetracycline, and the control group. Of 55 patients with acne, 18 were male and 37 were female. The mean age of the patients and the control group was 22.21 ± 4.22 and 21.95 ± 7.64, respectively. Staphylococcus aureus was isolated from the nasal flora of five patients, normal flora was suppressed in the oropharyngeal cultures of seven patients, and normal flora grew in the cultures of the other 20 patients who were on tetracycline treatment. On the other hand, normal flora grew in the nasal and oropharyngeal cultures of all the patients who were on isotretinoin treatment. Treatment options and follow-up procedures for acne vulgaris may lead to the development of bacterial resistance and damage to flora. In particular, systemic tetracycline treatment leads to changes in flora of the nose and throat in patients with acne with an increased carriage of S. aureus. Therefore, careful attention should be paid to the duration of tetracycline treatment in order to not increase the risk of disturbance of microbial flora. © 2014 The International Society of Dermatology.

  19. Intensity-modulated radiation therapy for oropharyngeal cancer: radiation dosage constraint at the anterior mandible.

    PubMed

    Verdonck, Henk W D; de Jong, Jos M A; Granzier, Marlies E P G; Nieman, Fred H; de Baat, Cees; Stoelinga, Paul J W

    2009-06-01

    Because the survival of endosseous implants in irradiated bone is lower than in non-irradiated bone, particularly if the irradiation dose exceeds 50Gy, a study was carried out to assess the irradiation dose in the anterior mandible, when intensity modulated radiation therapy (IMRT) is used. The hypothesis was that adequate IMRT planning in oropharyngeal cancer patients is allowing sufficiently low anterior mandibular bone radiation dosages to safely insert endosseous implants. Ten randomly selected patients with oropharyngeal cancer, primarily treated by intensity-modulated radiotherapy (IMRT), were included in this study. First, at five determined positions distributed over the anterior mandible, the appropriate radiation dosages were calculated according to the originally arranged fractionated radiation schedule. Second, for each patient an adjusted fractionated radiation schedule was established with an extra dose constraint which allowed a lower dose in the mandible taking into account that the anterior mandible needs protection against radiation-induced osteoradionecrosis. The goal for the adjusted fractionated radiation schedule was similar as that of the original fractionated radiation schedule, including a desired tumour target dosage of 70Gy and maximum mean local dosages for organs at risk. The data revealed a considerable and statistically significant, irradiation dose reduction in the anterior mandible without compromising the other constraints. As a result of this study it is strongly advised to maximize dose constraint to the anterior mandible when planning irradiation for oropharyngeal cancer patients, using IMRT. This would greatly facilitate successful implant treatment for this group of patients. The fractionated radiation schedules used, should also be used for the planning of the best implant positions by integrating them in the implant planning software.

  20. 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.

  1. Persistence, Discordance and Diversity of Staphylococcus aureus Nasal and Oropharyngeal Colonization in School-aged Children.

    PubMed

    Williamson, Deborah A; Ritchie, Stephen; Keren, Benjamin; Harrington, Michael; Thomas, Mark G; Upton, Arlo; Lennon, Diana; Leversha, Alison

    2016-07-01

    The anterior nares are regarded as the primary site for Staphylococcus aureus colonization, although studies have highlighted the potential importance of colonization at extra-nasal sites, including the oropharynx. Accordingly, the aims of this study were to assess the prevalence, persistence and molecular epidemiology of S. aureus colonization in the nares and oropharynx of Māori and Pacific children, a population with strikingly high rates of S. aureus infection. A cross-sectional study of predominantly Māori and Pacific school-aged children in Auckland, New Zealand was performed in October 2013, and swabs were taken from the nares and oropharynx. Sampling was repeated from the same schools in October 2014. All S. aureus isolates underwent antimicrobial susceptibility testing and spa typing. Overall, 506/893 (56.7%) children were colonized with S. aureus, and the colonization prevalence was significantly higher in the oropharynx than nares (41.1% vs. 31.5%; P < 0.001). Longitudinal colonization was significantly higher in the oropharynx than the nares, and children with longitudinal oropharyngeal colonization were more likely to be colonized with the same spa type than those colonized in the nares (67.6% vs. 37.0%; P = 0.01). Approximately 40% of children had discordant spa types at the nares and oropharynx. Oropharyngeal S. aureus colonization represents a significant reservoir of S. aureus and it is possible that the oropharynx may represent a protected anatomical niche, enabling persistent colonization with the same S. aureus strain. Future study should attempt to better understand the determinants of oropharyngeal carriage.

  2. Nutritional status of older patients with oropharyngeal dysphagia in a chronic versus an acute clinical situation.

    PubMed

    Carrión, Silvia; Roca, Maria; Costa, Alicia; Arreola, Viridiana; Ortega, Omar; Palomera, Elisabet; Serra-Prat, Mateu; Cabré, Mateu; Clavé, Pere

    2017-08-01

    Oropharyngeal dysphagia (OD) is a prevalent risk factor for malnutrition (MN) in older patients and both conditions are related to poor outcome. To explore the nutritional status in older patients with OD in a chronic and an acute clinical situation. We examined 95 older (≥70 years) patients with OD associated to chronic neurological diseases or aging, and 23 older patients with OD and acute community-acquired pneumonia (CAP) with videofluoroscopy; and 15 older people without OD. We collected nutritional status, measured with the Mini Nutritional Assessment (MNA(®)), anthropometric measurements, and biochemistry and bioimpedance for body composition. Functional status was assessed with the Barthel index. 1) Taking into consideration patients with OD with chronic conditions, 51.1% presented a MNA(®) ≤23.5; 16.7%, sarcopenia and a) reduced visceral and muscular protein compartments and fat compartment; b) muscular weakness c) intracellular water depletion, and d) reduced body weight. Patients with OD and MNA(®) ≤23 needed higher levels of nectar viscosity for a safe swallow and had increased oropharyngeal residue at spoon-thick viscosity. 2) Patients with OD and CAP, 69.5%, presented an MNA(®) ≤23.5 and 29.4% sarcopenia, the inflammatory response of the pneumonia adding to the more severe depletion in visceral protein and muscular mass. Prevalence of impaired nutritional status (malnutrition risk, and sarcopenia) among older patients with OD associated with either chronic or acute conditions is very high. In patients with OD and chronic diseases, poor nutritional status further impairs OD with an increase in oropharyngeal residue at spoon-thick viscosity. In the acute setting there is inflammation and an additional protein deficiency. These findings will help develop specific products both for OD and nutritional status in each specific clinical situation. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights

  3. Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5 comprehensive cancer centres using multiple imputation.

    PubMed

    Habbous, Steven; Chu, Karen P; Lau, Harold; Schorr, Melissa; Belayneh, Mathieos; Ha, Michael N; Murray, Scott; O'Sullivan, Brian; Huang, Shao Hui; Snow, Stephanie; Parliament, Matthew; Hao, Desiree; Cheung, Winson Y; Xu, Wei; Liu, Geoffrey

    2017-08-14

    The incidence of oropharyngeal cancer has risen over the past 2 decades. This rise has been attributed to human papillomavirus (HPV), but information on temporal trends in incidence of HPV-associated cancers across Canada is limited. We collected social, clinical and demographic characteristics and p16 protein status (p16-positive or p16-negative, using this immunohistochemistry variable as a surrogate marker of HPV status) for 3643 patients with oropharyngeal cancer diagnosed between 2000 and 2012 at comprehensive cancer centres in British Columbia (6 centres), Edmonton, Calgary, Toronto and Halifax. We used receiver operating characteristic curves and multiple imputation to estimate the p16 status for missing values. We chose a best-imputation probability cut point on the basis of accuracy in samples with known p16 status and through an independent relation between p16 status and overall survival. We used logistic and Cox proportional hazard regression. We found no temporal changes in p16-positive status initially, but there was significant selection bias, with p16 testing significantly more likely to be performed in males, lifetime never-smokers, patients with tonsillar or base-of-tongue tumours and those with nodal involvement (p < 0.05 for each variable). We used the following variables associated with p16-positive status for multiple imputation: male sex, tonsillar or base-of-tongue tumours, smaller tumours, nodal involvement, less smoking and lower alcohol consumption (p < 0.05 for each variable). Using sensitivity analyses, we showed that different imputation probability cut points for p16-positive status each identified a rise from 2000 to 2012, with the best-probability cut point identifying an increase from 47.3% in 2000 to 73.7% in 2012 (p < 0.001). Across multiple centres in Canada, there was a steady rise in the proportion of oropharyngeal cancers attributable to HPV from 2000 to 2012. © 2017 Canadian Medical Association or its licensors.

  4. Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5 comprehensive cancer centres using multiple imputation

    PubMed Central

    Habbous, Steven; Chu, Karen P.; Lau, Harold; Schorr, Melissa; Belayneh, Mathieos; Ha, Michael N.; Murray, Scott; O’Sullivan, Brian; Huang, Shao Hui; Snow, Stephanie; Parliament, Matthew; Hao, Desiree; Cheung, Winson Y.; Xu, Wei; Liu, Geoffrey

    2017-01-01

    BACKGROUND: The incidence of oropharyngeal cancer has risen over the past 2 decades. This rise has been attributed to human papillomavirus (HPV), but information on temporal trends in incidence of HPV-associated cancers across Canada is limited. METHODS: We collected social, clinical and demographic characteristics and p16 protein status (p16-positive or p16-negative, using this immunohistochemistry variable as a surrogate marker of HPV status) for 3643 patients with oropharyngeal cancer diagnosed between 2000 and 2012 at comprehensive cancer centres in British Columbia (6 centres), Edmonton, Calgary, Toronto and Halifax. We used receiver operating characteristic curves and multiple imputation to estimate the p16 status for missing values. We chose a best-imputation probability cut point on the basis of accuracy in samples with known p16 status and through an independent relation between p16 status and overall survival. We used logistic and Cox proportional hazard regression. RESULTS: We found no temporal changes in p16-positive status initially, but there was significant selection bias, with p16 testing significantly more likely to be performed in males, lifetime never-smokers, patients with tonsillar or base-of-tongue tumours and those with nodal involvement (p < 0.05 for each variable). We used the following variables associated with p16-positive status for multiple imputation: male sex, tonsillar or base-of-tongue tumours, smaller tumours, nodal involvement, less smoking and lower alcohol consumption (p < 0.05 for each variable). Using sensitivity analyses, we showed that different imputation probability cut points for p16-positive status each identified a rise from 2000 to 2012, with the best-probability cut point identifying an increase from 47.3% in 2000 to 73.7% in 2012 (p < 0.001). INTERPRETATION: Across multiple centres in Canada, there was a steady rise in the proportion of oropharyngeal cancers attributable to HPV from 2000 to 2012. PMID:28808115

  5. [Candida dubliniensis studies and isolation of Candida types in oropharyngeal specimens from oncologic patients].

    PubMed

    Tekeli, Alper; Dolapçi, Iştar; Cesur, Salih; Tekeli, Emin; Içli, Fikri

    2002-01-01

    Fungal opportunistic infections, and in particular those caused by the various Candida species, have gained considerable significance as a cause of morbidity and, often, mortality. Although Candida albicans remains to be the most frequently isolated fungal species as an opportunistic oral pathogen, other yeast species are often identified in immunocompromised patients. C. dubliniensis, the recently described species, has been recovered primarily from oropharyngeal candidasis in Human Immunodeficiency Virus (HIV)-infected patients. C. dubliniensis shares many phenotypic characteristics with, and is phylogenetically closely related to, C. albicans. The aim of the present study was to investigate the colonization rates of fungal species, and especially C. dubliniensis, in the oropharyngeal samples from cancer patients. The oropharyngeal swabs of 543 patients were collected during their visits to oncology clinic in 9 months period, and a total of 209 Candida species have been isolated. Of them, 147 isolates were found to be positive for germ tube and chlamydospore formation, and they were tested for the growth inability at 42 degrees C and 45 degrees C, colony morphology in Staib agar and the intracellular beta-glucosidase activity, in order to identify C. dubliniensis. The results of these tests and carbohydrate assimilation tests by API 20C AUX yeast identification system, yielded that all these 147 (70.3%) isolates were C. albicans. The other isolates were identified as follows; 16 C. parapsilosis (7.6%), 13 C. tropicalis (6.2%), 10 C. glabrata (4.7%), 5 C. guilliermondii (2.3%), 4 C. krusei (1.9%), 3 C. keyfr (1.4%), 3 C. famata (1.4%), 2 S. cerevisiae (0.9%), 2 C. pelliculosa (0.9%), 1 C. utiles (0.4%), 1 C. neoformans (0.4%) and 1 Hansenula polymorpha (0.4%), while no C. dubliniensis was isolated.

  6. 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.

  7. 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

  8. Functional outcomes after primary oropharyngeal cancer resection and reconstruction with the radial forearm free flap.

    PubMed

    Seikaly, Hadi; Rieger, Jana; Wolfaardt, John; Moysa, Gerald; Harris, Jeffery; Jha, Naresh

    2003-05-01

    To report prospectively collected aeromechanical, acoustical, and perceptual speech outcomes, as well as preliminary swallowing data, in patients having reconstruction with radial forearm free flaps after primary resection for oropharyngeal cancer. Prospective cohort study. Acoustical, aeromechanical, and perceptual speech data and swallowing data were gathered at three evaluation times (preoperatively and before and after radiation therapy) for patients treated for oropharyngeal cancer by means of primary resection and reconstruction with a radial forearm free flap. Degree of involvement of the soft palate and base of tongue, along with reconstructive techniques, were entered as between-group factors in the analysis. There were no significant differences in speech intelligibility between the patient groups based on the degree of palate and tongue resected. However, patients with resections of half or more than half of the soft palate had significantly higher nasalance values and larger velopharyngeal orifice areas than individuals who had less than half of the soft palate resected. Significant within-subject differences were revealed across evaluation times for the dependent variables nasalance, velopharyngeal orifice area, and word intelligibility. Ninety-four percent of the patients were able to resume a normal or soft diet. There was a 6% incidence of aspiration in 128 swallows that were analyzed. The amount of base of tongue resected did not significantly affect any of the speech or swallowing parameters. Radial forearm free flaps are a good reconstructive option after oropharyngeal cancer extirpation. Our acoustic and aeromechanical results indicated that issues related to quality of the speech signal require further study for resections of half or more than half of the soft palate.

  9. Genetic Classification of Oral and Oropharyngeal Carcinomas Identifies Subgroups with a Different Prognosis

    PubMed Central

    Smeets, Serge J.; Brakenhoff, Ruud H.; Ylstrab, Bauke; van Wieringen, Wessel N.; van de Wiel, Mark A.; Leemans, C. René; Braakhuis, Boudewijn J. M.

    2009-01-01

    The common risk factors for oral and oropharyngeal cancer are tobacco smoking and alcohol consumption, and recently the human papillomavirus (HPV) was shown to be involved in a subgroup. HPV-positive and -negative carcinomas can be distinguished on basis of their genetic profiles. Aim of this study was to investigate patterns of chromosomal aberrations of HPV-negative oral and oropharyngeal squamous cell carcinomas (OOSCC) in order to improve stratification of patients regarding outcome. Thirty-nine OOSCCs were classified on basis of their genetic pattern determined by array comparative genomic hybridization (aCGH). Resulting groups were related to patient and tumor characteristics using the Fisher’s exact test and in addition to survival with the Kaplan–Meier and log rank tests. Classification distinguished three groups, one characterized by hardly any chromosomal aberration (N = 8) and another by a relatively high level (N = 26), and one with a very high level (N = 5) of chromosomal aberrations. This classification was significantly (p = 0.003) associated with survival, with the best survival in the genetically ‘silent’ group and the worst survival in the most aberrant group. The silent profile was significantly (p < 0.05) associated with wild-type TP53, an absence of alcohol consumption and a female gender. These carcinomas were negative for microsatellite instability. This classification of OOSCC was confirmed in an independent set of 89 oral carcinomas. In conclusion, the discovery of these new classes of oral and oropharyngeal cancer with unique genetic and clinical characteristics has important consequences for future basic and clinical studies. PMID:19633365

  10. 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.

  11. [Low rate of oropharyngeal human papillomavirus infection among women with cervical lesion. Preliminary results from the South-Eastern Hungarian population].

    PubMed

    Vanya, Melinda; Jakó, Mária; Terhes, Gabriella; Szakács, László; Kaiser, László; Deák, Judit; Bártfai, György

    2016-01-10

    Although the natural history of cervical and oral human papillomavirus infection has been intensively investigated in the past years, the ability of this virus to infect oral and genital mucosae in the same individual and its potential to co-infect both cervical and oral mucosa are still unclear. The aim of the authors was to assess the presence of oropharyngeal human papillomavirus infection in women with cervical lesions in the South-Eastern Hungarian population. The total of 103 women have been included in the study between March 1, 2013 and January 1, 2015. Brushing was used to collect cells from the oropharyngeal mucosa. Human papillomavirus DNA was detected using polymerase chain reaction, and Amplicor line blot test was used for genotyping. Oropharyngeal human papillomavirus infection was detected in 2 cases (3%). The detected genotypes were 31, 40/61 and 73 in the oropharyngeal region. The results indicate that in women with cervical lesions oropharyngeal human papillomavirus infection rarely occurs.

  12. Paraneoplastic encephalomyelitis: Is it an oropharyngeal or a lung cancer complication?

    PubMed Central

    MOYANO, MARÍA SERENO; GUTIÉRREZ-GUTIÉRREZ, GERARDO; GÓMEZ-RAPOSO, CÉSAR; GÓMEZ, MIRIAM LÓPEZ; OJEDA, JOAQUÍN; MIRALLES, AMBROSIO; CASADO-SÁENZ, ENRIQUE

    2011-01-01

    This case report describes a patient with a locally advanced oropharyngeal cancer with a simultaneous paraneoplastic encephalomyelitis. To the best of our knowledge, a paraneoplastic neurological syndrome is a rare complication in head and neck cancer, and has previously not been reported in the literature. One year later, following initial treatment, a small cell lung cancer developed, a tumor frequently associated with this type of paraneoplastic syndrome. The dilemma, therefore, is whether this paraneoplastic symdrome was a secondary complication of the tonsilar concurrent cancer or a metachronous paraneoplastic syndrome prior to small cell lung cancer. PMID:22870148

  13. [A rare cause of oropharyngeal mass: bilateral aberrant internal carotid artery].

    PubMed

    Yılmazer, Rasim; Yılmazer, Ayça Başkadem; Orhan, Kadir Serkan; Damar, Murat; Değer, Kemal

    2013-01-01

    Bilateral pharyngeal internal carotid artery aberration is a rarely seen variation which poses a risk during the surgical interventions of this area. A 74-year-old male patient was admitted to our clinic with the complaints of a sensation of fullness in his throat and dysphagia. Oropharyngeal examination revealed bilateral smooth-surfaced masses in the posterior pharyngeal wall. Magnetic resonance imaging showed an aberrant internal carotid artery. The patient was followed up with necessary warnings. The pulsation on the pharyngeal masses should be definitely evaluated and aberrant internal carotid artery should be kept in mind, if present.

  14. 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.

  15. [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.

  16. 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

  17. [Oropharyngeal vocal tract space during singing--comparison of tactile-kinesthetic and auditory perception with objective endoscopic findings].

    PubMed

    Schade, G; Adelmann, W; Müller, F; Mantay, C; Fleischer, S; Leuwer, R; Bubenheim, M; Berger, J; Hess, M

    2003-08-01

    In this study we compared the perceived diameter of the vocal tract's oropharyngeal part with the diameter that was determined endoscopically. 28 singers (13 male, 15 female) were examined with transnasal fiberscopic pharyngoscopy while singing the vowels /a/, /i/ and /u/ in 4 different timbres (normal, opened, covered, dumpled) and 3 different pitches (chest/modal register, subjective comfortable pitch for singing, head/falsetto register). The tactile-kinesthetic and auditive rating of the singers, the auditive rating of a singing teacher and the visual-endoscopic analysis of three laryngologists were compared. The tactile-kinesthetic and auditory self-perception of the singers was quite different from the auditive perception of a singing teacher and visual endoscopic findings of the laryngologists. The singers had the impression that the different singing timbres (normal, opened, covered, dumpled) influence oropharyngeal vocal tract space during singing. They judged the vowel itself and the pitch as having very little influence. Based on his auditory perception, the singing teacher also rated that the timbre plays an important role for the oropharyngeal vocal tract space but he found vowels to be the parameter with the greatest impact. Via visual endoscopic examination we found that, among the three parameters (vowel, timbre, pitch), the different vowels are most influential on the oropharyngeal vocal tract space. Analysis of video sequences revealed that pitch and timbre are less important. Subjective tactile-kinesthetic and auditory perception of the singers differs from auditory perception of the singing teacher as well as from endoscopic findings. The endoscopically determined oropharyngeal vocal tract space during singing the vowels /i/ or /u/ tends to be larger compared to the oropharyngeal vocal tract space while singing the vowel /a/.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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)

  3. Crystal packing effects on protein loops.

    PubMed

    Rapp, Chaya S; Pollack, Rena M

    2005-07-01

    The effects of crystal packing on protein loop structures are examined by (1) a comparison of loops in proteins that have been crystallized in alternate packing arrangements, and (2) theoretical prediction of loops both with and without the inclusion of the crystal environment. Results show that in a minority of cases, loop geometries are dependent on crystal packing effects. Explicit representation of the crystal environment in a loop prediction algorithm can be used to model these effects and to reconstruct the structures, and relative energies, of a loop in alternative packing environments. By comparing prediction results with and without the inclusion of the crystal environment, the loop prediction algorithm can further be used to identify cases in which a crystal structure does not represent the most stable state of a loop in solution. We anticipate that this capability has implications for structural biology.

  4. 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)

  5. 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.

  6. 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.

  7. 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.

  8. Ice pack test for myasthenia gravis.

    PubMed

    Sethi, K D; Rivner, M H; Swift, T R

    1987-08-01

    A common symptom of myasthenia gravis is eyelid ptosis. Often, the edrophonium test is negative, particularly in ocular myasthenia gravis. Myasthenic weakness is often improved by cold. We applied ice packs to the eye in 10 myasthenic patients and 7 disease controls. Eight of 10 patients with myasthenia gravis improved, whereas none of the controls improved. The ice pack test is useful in the diagnosis of myasthenia gravis.

  9. Ideal Clutters That Do Not Pack

    DTIC Science & Technology

    2016-09-18

    Ideal clutters that do not pack Ahmad Abdi Gérard Cornuéjols Kanstantsin Pashkovich September 18, 2016 Abstract For a clutter C over ground set E...impelled by the lack of a qualitative characterization for ideal minimally non-packing (mnp) clutters, we reduce ideal mnp clutters even further by taking...their identifications. In doing so, we reveal chains of ideal mnp clutters, demonstrate the centrality of mnp clutters with covering number two, as

  10. 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.

  11. 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.

  12. 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.

  13. Modular vaccine packaging increases packing efficiency

    PubMed Central

    Norman, Bryan A.; Rajgopal, Jayant; Lim, Jung; Gorham, Katrin; Haidari, Leila; Brown, Shawn T.; Lee, Bruce Y.

    2015-01-01

    Background Within a typical vaccine supply chain, vaccines are packaged into individual cylindrical vials (each containing one or more doses) that are bundled together in rectangular “inner packs” for transport via even larger groupings such as cold boxes and vaccine carriers. The variability of vaccine inner pack and vial size may hinder efficient vaccine distribution because it constrains packing of cold boxes and vaccine carriers to quantities that are often inappropriate or suboptimal in the context of country-specific vaccination guidelines. Methods We developed in Microsoft Excel (Microsoft Corp., Redmond, WA) a spreadsheet model that evaluated the impact of different packing schemes for the Benin routine regimen plus the introduction of the Rotarix vaccine. Specifically, we used the model to compare the current packing scheme to that of a proposed modular packing scheme. Results Conventional packing of a Dometic RCW25 that aims to maximize fully-immunized children (FICs) results in 123 FICs and a packing efficiency of 81.93% compared to a maximum of 155 FICs and 94.1% efficiency for an alternative modular packaging system. Conclusions Our analysis suggests that modular packaging systems could offer significant advantages over conventional vaccine packaging systems with respect to space efficiency and potential FICs, when they are stored in standard vaccine carrying devices. This allows for more vaccines to be stored within the same volume while also simplifying the procedures used by field workers to pack storage devices. Ultimately, modular packaging systems could be a simple way to help increase vaccine coverage worldwide. PMID:25957666

  14. JOINT DISEASE MAPPING OF CERVICAL AND MALE OROPHARYNGEAL CANCER INCIDENCE IN BLACKS AND WHITES IN SOUTH CAROLINA

    PubMed Central

    Onicescu, Georgiana; Hill, Elizabeth G.; Lawson, Andrew B.; Korte, Jeffrey E.; Gillespie, M. Boyd

    2010-01-01

    Human papillomavirus (HPV) infection is an established causal agent for cervical cancer and a subset of oropharyngeal cancers. It is hypothesized that orogenital transmission results in oral cavity infection. In this paper we explore the geographical association between cervical and male oropharyngeal cancer incidence in blacks and whites in South Carolina using Bayesian joint disease mapping models fit to publicly available data. Our results suggest weak evidence for county-level association between the diseases, and different patterns of joint disease behavior for blacks and whites. PMID:20563237

  15. 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.

  16. Geometrical families of mechanically stable granular packings

    NASA Astrophysics Data System (ADS)

    Gao, Guo-Jie; Blawzdziewicz, Jerzy; O'Hern, Corey S.

    2009-12-01

    We enumerate and classify nearly all of the possible mechanically stable (MS) packings of bidipserse mixtures of frictionless disks in small sheared systems. We find that MS packings form continuous geometrical families, where each family is defined by its particular network of particle contacts. We also monitor the dynamics of MS packings along geometrical families by applying quasistatic simple shear strain at zero pressure. For small numbers of particles (N<16) , we find that the dynamics is deterministic and highly contracting. That is, if the system is initialized in a MS packing at a given shear strain, it will quickly lock into a periodic orbit at subsequent shear strain, and therefore sample only a very small fraction of the possible MS packings in steady state. In studies with N>16 , we observe an increase in the period and random splittings of the trajectories caused by bifurcations in configuration space. We argue that the ratio of the splitting and contraction rates in large systems will determine the distribution of MS-packing geometrical families visited in steady state. This work is part of our long-term research program to develop a master-equation formalism to describe macroscopic slowly driven granular systems in terms of collections of small subsystems.

  17. Voronoia: analyzing packing in protein structures.

    PubMed

    Rother, Kristian; Hildebrand, Peter Werner; Goede, Andrean; Gruening, Bjoern; Preissner, Robert

    2009-01-01

    The packing of protein atoms is an indicator for their stability and functionality, and applied in determining thermostability, in protein design, ligand binding and to identify flexible regions in proteins. Here, we present Voronoia, a database of atomic-scale packing data for protein 3D structures. It is based on an improved Voronoi Cell algorithm using hyperboloid interfaces to construct atomic volumes, and to resolve solvent-accessible and -inaccessible regions of atoms. The database contains atomic volumes, local packing densities and interior cavities calculated for 61 318 biological units from the PDB. A report for each structure summarizes the packing by residue and atom types, and lists the environment of interior cavities. The packing data are compared to a nonredundant set of structures from SCOP superfamilies. Both packing densities and cavities can be visualized in the 3D structures by the Jmol plugin. Additionally, PDB files can be submitted to the Voronoia server for calculation. This service performs calculations for most full-atomic protein structures within a few minutes. For batch jobs, a standalone version of the program with an optional PyMOL plugin is available for download. The database can be freely accessed at: http://bioinformatics.charite.de/voronoia.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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

  5. Developing noise control strategies for entire railway networks

    NASA Astrophysics Data System (ADS)

    Oertli, Jakob

    2006-06-01

    The EU Environmental Noise Directive (2002/49) requires member states to deliver noise maps to the commission by 2007 and action plans by 2008 both for agglomerations as well as for major roads, railways and airports. Noise mitigation projects resulting from action plans are usually very expensive and therefore may threaten the economic viability of the railways in the current harsh competitive transport market, thus hindering sustainable transport policies. It is therefore of vital interest that the action plans and the resulting projects are designed in the most cost-effective way possible. The EU and Union of Railways (UIC) sponsored project Strategies and Tools to Assess and Implement noise Reducing measures for Railway Systems (STAIRRS) recognized this need and developed a tool, with which such optimal solutions can be obtained for entire railway networks. Since data collection is the most expensive part of the analysis, noise mapping data is ideally collected in such a way that it can be used for the calculation of the different scenarios, from which the most cost-effective action plans are chosen. The paper shows how the STAIRRS tool is used for this purpose and how cost-effectiveness considerations have led to optimal railway noise mitigation strategies in Switzerland and have given a basis for noise related decision making in Luxembourg.

  6. 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

  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. 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.

  9. Oropharyngeal dermoid cyst in an infant with intermittent airway obstruction. A case report.

    PubMed

    Wagner, Matthias W; Haileselassie, Bereketeab; Kannan, Sujatha; Chen, Cynthia; Poretti, Andrea; Tunkel, David E; Huisman, Thierry A G M

    2014-10-01

    Dermoid cysts are benign epithelial inclusions and cystic lesions that may occur in several locations including the oropharynx. We describe the case of a two-month-old baby girl who presented with progressive respiratory distress, hypoxemia, and feeding difficulties because of an oropharyngeal dermoid cyst. The child had an airway work-up that included laryngoscopy. However, the mass remained undetected. This is most likely explained by the mobile nature of the lesion, prolapsing into the high nasopharynx in supine position. In our patient, magnetic resonance imaging (MRI), initially performed to rule out brainstem pathology, revealed an oropharyngeal dermoid cyst. This case shows the potential role of neuroimaging in the diagnostic work-up of a young child presenting with respiratory distress by excluding a central nervous system lesion and diagnosing an "unexpected" nasopharyngeal mass lesion. In addition, MRI allowed exclusion of skull base lesions of neural origin such as an anterior meningoencephalocele or heterotopic neuroglial tissue which would be managed differently from pharyngeal masses.

  10. 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.

  11. 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.

  12. Salvage surgery for oropharyngeal squamous cell carcinomas: A retrospective study from 2005 to 2013.

    PubMed

    Philouze, Pierre; Péron, Julien; Poupart, Marc; Pujo, Kevin; Buiret, Guillaume; Céruse, Philippe

    2017-09-01

    In the case of a locoregional recurrence of oropharyngeal squamous cell carcinoma, the curative standard of care is surgery. Our main purpose of this study was to determine the preoperative prognostic factors that would allow us to select the patients on whom we could expect good results with salvage surgery. We conducted a monocentric retrospective study from 2005 to 2013. It included all patients treated for a recurrence of oropharyngeal squamous cell carcinoma with surgery. Their initial treatment included radiotherapy. Fifty-two patients were included. Poor prognostic factors for survival were the cT status (P = .0039) and local recurrences versus secondary localizations in irradiated areas (P = .016) and a relapse less than a year after the end of the initial treatment (P = .050). Recurrence-free survival was 19% at 5 years. Twenty-nine percent of patients presented local complications, which were mainly fistulas and hemorrhaging at the surgical site. According to the high morbimortality, it is important to carefully select the right patients for surgery. © 2017 Wiley Periodicals, Inc.

  13. Clinical outcome of reconstruction of the lateral oropharyngeal wall with an anterolateral thigh free flap.

    PubMed

    Helmiö, Päivi M; Suominen, Sinikka; Vuola, Jyrki; Bäck, Leif; Mäkitie, Antti A

    2010-11-01

    The anterolateral thigh (ALT) free flap is widely used for various reconstructions in the head and neck. However, its use in the oropharynx has not been widely evaluated, so we have reviewed our experience. We retrospectively reviewed the medical records of 28 patients with oropharyngeal cancer, who were treated with immediate reconstruction with an ALT free flap after excision. We recorded history, stage of tumour, course of operation, postoperative period, oncological treatment, clinical outcome, and follow-up. The mean age of the patients was 61 years (range 44-83). Ten of the patients had clinically relevant coexisting conditions. Most of the patients had T3-4 tumours and involved neck nodes. The operations included resection of the tumour, neck dissection, and reconstruction of the oropharynx with an ALT free flap. All donor sites were closed primarily. Eight patients (29%) developed early local complications that required reoperation. Ten patients (36%) had postoperative cardiopulmonary problems. Twenty-seven flaps succeeded; one was lost. There were no other complications or late problems of the donor site except one seroma. Twenty-one patients were given postoperative radiotherapy. After the mean follow-up period of 40 months (range 13-68) 20 patients (71%) were disease-free. Three patients required a permanent gastrostomy and one a permanent tracheostomy. We conclude that the ALT free flap can be used successfully for reconstruction of a lateral oropharyngeal defect with manageable postoperative morbidity.

  14. 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.

  15. 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.

  16. Cephalometric evaluation of the oropharyngeal space in children with atypical deglutition.

    PubMed

    Machado, Almiro José; Crespo, Agrício N

    2012-02-01

    For several factors, not yet fully explained until now, infant deglutition may persist after changing the primary teeth and such swallowing is classified as atypical swallowing. Possible causes: finger sucking, bottle feeding, sucking the tongue and mouth breathing. There is no consensus about the etiology of atypical deglutition. The aim of this study was to compare the oropharyngeal space in side-view radiographs of children with atypical deglutition and normal deglutition. Retrospective study, by means of cephalometric analysis of side-view radiographs, measuring the anteroposterior distance of the lumen of the airway in two groups: 55 cephalograms from the experimental group (with atypical deglutition) and 55 side-view radiographs from the control group (normal deglutition). Measurements from the groups were compared using Mann-Whitney U test and a p value <0.05 was considered as an indication of statistical significance. The median in the control group was 10 mm and in the experimental group it was 7 mm, with a statistically significant difference (p <0.001). The oropharyngeal space is reduced in the group with atypical deglutition.

  17. Treatment: Outcome and Toxicity of Volumetric Modulated Arc Therapy in Oropharyngeal Carcinoma.

    PubMed

    Franzese, Ciro; Fogliata, Antonella; Franceschini, Davide; Clerici, Elena; D'Agostino, Giuseppe; Navarria, Piera; Mancosu, Pietro; Tomatis, Stefano; Cozzi, Luca; Scorsetti, Marta

    2016-07-01

    Radiotherapy is a common approach for treating squamous cell carcinoma (SCC) of the oropharynx. We aimed to analyze toxicity and outcome of patients affected by oropharyngeal SCC treated with volumetric modulated arc therapy (VMAT). Fifty-four patients presenting advanced orophayngeal carcinoma who were treated with radical radiotherapy were analyzed. All patients were treated with VMAT-RapidArc, with simultaneous integrated boost in 33 fractions for a dose of 69.96 Gy to the high-risk, and of 54.45 Gy to the low-risk volume. Median follow-up was 23 months. In eight cases, locoregional relapse was observed (median time to relapse=10.7 months). Four among eight local recurrences appeared in the high-dose target volume. The 1- and 2-year actuarial disease-free survival rates were 88% and 80%, respectively. The 1- and 2-year actuarial overall survival rates were 94% and 87%, respectively. VMAT for oropharyngeal SCC treatment is effective and safe, with interesting rates of control of disease and survival. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  18. Psychometric properties of questionnaires on functional health status in oropharyngeal dysphagia: a systematic literature review.

    PubMed

    Speyer, Renée; Cordier, Reinie; Kertscher, Berit; Heijnen, Bas J

    2014-01-01

    Questionnaires on Functional Health Status (FHS) are part of the assessment of oropharyngeal dysphagia. To conduct a systematic review of the literature on the psychometric properties of English-language FHS questionnaires in adults with oropharyngeal dysphagia. A systematic search was performed using the electronic databases Pubmed and Embase. The psychometric properties of the questionnaires were determined based on the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes and the COSMIN checklist using preset psychometric criteria. Three questionnaires were included: the Eating Assessment Tool (EAT-10), the Swallowing Outcome after Laryngectomy (SOAL), and the Self-report Symptom Inventory. The Sydney Swallow Questionnaire (SSQ) proved to be identical to the Modified Self-report Symptom Inventory. All FHS questionnaires obtained poor overall methodological quality scores for most measurement properties. The retrieved FHS questionnaires need psychometric reevaluation; if the overall methodological quality shows satisfactory improvement on most measurement properties, the use of the questionnaires in daily clinic and research can be justified. However, in case of insufficient validity and/or reliability scores, new FHS questionnaires need to be developed using and reporting on preestablished psychometric criteria as recommended in literature.

  19. Prospective evaluation of oro-pharyngeal dysphagia after severe traumatic brain injury.

    PubMed

    Terré, Rosa; Mearin, Fermín

    2007-12-01

    To evaluate clinical, videofluoroscopic findings and clinical evolution of neurogenic dysphagia and to establish the prognostic factors. Prospective cohort study. Forty-eight patients with severe traumatic brain injury (TBI) and clinically-suspected oro-pharyngeal dysphagia were studied. Clinical evaluation of oro-pharyngeal dysphagia and videofluoroscopic examination were performed. Clinical evolution was based on feeding mode at discharge, the presence of respiratory complications and body mass index (BMI) at admission and at discharge. Sixty-five per cent of patients had impaired gag reflex and 44% cough during oral feeding. Videofluoroscopy revealed some type of disorder in 90% of cases: 65% in the oral phase and 73% in the pharyngeal phase (aspiration in 62.5%, being silent in 41%). At discharge, 45% were on normal diet, 27% on a modified oral diet, 14% combined oral intake and gastrostomy feeding and 14% were fed exclusively by gastrostomy. Feeding mode at discharge substantially correlated with RLCF score at admission (p=0.04) and with RLCF (p=0.009) and DRS (p=0.02) scores at discharge. Aspiration is very frequent in patients with severe TBI, being silent in almost half. Cognitive function evaluated with the RLCF is the best prognostic factor. At discharge, 72% of the patients were on oral food intake despite having severe TBI.

  20. Effects of carbonated liquids on oropharyngeal swallowing measures in people with neurogenic dysphagia.

    PubMed

    Sdravou, Katerina; Walshe, Margaret; Dagdilelis, Lukas

    2012-06-01

    Aspiration is common in adults with neurogenic dysphagia and pharyngeal delay. This can lead to dehydration, malnutrition, and aspiration pneumonia. Diet modifications aimed at reducing thin liquid aspiration are partially successful or unpalatable or both. Carbonated liquids show some potential in influencing swallowing behavior. However, there is a paucity of evidence to support this intervention. This study compares the effects of carbonated thin liquids (CTL) with that of noncarbonated thin liquids (NCTL) on oropharyngeal swallowing in adults with neurogenic dysphagia and examines the palatability of the CTL stimulus. Seventeen people with pharyngeal delay attended for videofluoroscopy (VFSS). Outcome measures were oral transit time (OTT), pharyngeal transit time (PTT), stage transition duration (STD), initiation of the pharyngeal swallow (IPS), penetration-aspiration scale (PENASP), and pharyngeal retention (PR). A modification of Quartermaster Hedonic Scale (AQHS) was employed to assess palatability of the CTL. CTL vs. NCTL significantly decreased penetration and aspiration on 5-ml (P = 0.028) and 10-ml (P = 0.037) swallows. CTL had no significant effect on OTT, PTT, IPS, and PR for any volume of bolus. Only one participant disliked the CTL stimulus. These findings support the hypothesis that oropharyngeal swallowing can be modulated in response to sensory stimuli. Implications for research and clinical practice are discussed.

  1. Long-Term Results of External Upper Esophageal Sphincter Myotomy for Oropharyngeal Dysphagia

    PubMed Central

    David, Eric F.; Klinkenberg-Knol, Elly C.; Mahieu, Hans F.

    2009-01-01

    The aim of this work was to assess the efficacy of external myotomy of the upper esophageal sphincter (UES) for oropharyngeal dysphagia. In the period 1991–2006, 28 patients with longstanding dysphagia and/or aspiration problems of different etiologies underwent UES myotomy as a single surgical treatment. The main symptoms were difficulties in swallowing of a solid-food bolus, aspiration, and recurrent incidents of solid-food blockages. Pre- and postoperative manometry and videofluoroscopy were used to assess deglutition and aspiration. Outcome was defined as success in the case of complete relief or marked improvement of dysphagia and aspiration and as failure in the case of partial improvement or no improvement. Initial results showed success in 21 and failure in 7 patients. The best outcomes were observed in patients with dysphagia of unknown origin, noncancer-related iatrogenic etiology, and neuromuscular disease. No correlation was found between preoperative constrictor pharyngeal muscle activity and success rate. After follow-up of more than 1 year, 20 patients were marked as success and 3 as failure. All successful patients had full oral intake with a normal bolus consistency without clinically significant aspiration. We conclude that in select cases of oropharyngeal dysphagia success may be achieved by UES myotomy with restoration of oral intake of normal bolus consistency. PMID:19760460

  2. 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.

  3. Psychometric Properties of Questionnaires on Functional Health Status in Oropharyngeal Dysphagia: A Systematic Literature Review

    PubMed Central

    Speyer, Renée; Cordier, Reinie; Kertscher, Berit; Heijnen, Bas J

    2014-01-01

    Introduction. Questionnaires on Functional Health Status (FHS) are part of the assessment of oropharyngeal dysphagia. Objective. To conduct a systematic review of the literature on the psychometric properties of English-language FHS questionnaires in adults with oropharyngeal dysphagia. Methods. A systematic search was performed using the electronic databases Pubmed and Embase. The psychometric properties of the questionnaires were determined based on the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes and the COSMIN checklist using preset psychometric criteria. Results. Three questionnaires were included: the Eating Assessment Tool (EAT-10), the Swallowing Outcome after Laryngectomy (SOAL), and the Self-report Symptom Inventory. The Sydney Swallow Questionnaire (SSQ) proved to be identical to the Modified Self-report Symptom Inventory. All FHS questionnaires obtained poor overall methodological quality scores for most measurement properties. Conclusions. The retrieved FHS questionnaires need psychometric reevaluation; if the overall methodological quality shows satisfactory improvement on most measurement properties, the use of the questionnaires in daily clinic and research can be justified. However, in case of insufficient validity and/or reliability scores, new FHS questionnaires need to be developed using and reporting on preestablished psychometric criteria as recommended in literature. PMID:24877095

  4. Envelope glycans of immunodeficiency virions are almost entirely oligomannose antigens

    PubMed Central

    Doores, Katie J.; Bonomelli, Camille; Harvey, David J.; Vasiljevic, Snezana; Dwek, Raymond A.; Burton, Dennis R.; Crispin, Max; Scanlan, Christopher N.

    2010-01-01

    The envelope spike of HIV is one of the most highly N-glycosylated structures found in nature. However, despite extensive research revealing essential functional roles in infection and immune evasion, the chemical structures of the glycans on the native viral envelope glycoprotein gp120—as opposed to recombinantly generated gp120—have not been described. Here, we report on the identity of the N-linked glycans from primary isolates of HIV-1 (clades A, B, and C) and from the simian immunodeficiency virus. MS analysis reveals a remarkably simple and highly conserved virus-specific glycan profile almost entirely devoid of medial Golgi-mediated processing. In stark contrast to recombinant gp120, which shows extensive exposure to cellular glycosylation enzymes (>70% complex type glycans), the native envelope shows barely detectable processing beyond the biosynthetic intermediate Man5GlcNAc2 (<2% complex type glycans). This oligomannose (Man5–9GlcNAc2) profile is conserved across primary isolates and geographically divergent clades but is not reflected in the current generation of gp120 antigens used for vaccine trials. In the context of vaccine design, we also note that Manα1→2Man-terminating glycans (Man6–9GlcNAc2) of the type recognized by the broadly neutralizing anti-HIV antibody 2G12 are 3-fold more abundant on the native envelope than on the recombinant monomer and are also found on isolates not neutralized by 2G12. The Manα1→2Man residues of gp120 therefore provide a vaccine target that is physically larger and antigenically more conserved than the 2G12 epitope itself. This study revises and extends our understanding of the glycan shield of HIV with implications for AIDS vaccine design. PMID:20643940

  5. 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

  6. 48 CFR 452.247-72 - Packing for Domestic Shipment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Packing for Domestic... Packing for Domestic Shipment. As prescribed in 447.305-10(b), insert the following clause: Packing for Domestic Shipment (FEB 1988) Material shall be packed for shipment in such a manner that will...

  7. 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... Packing for Domestic Shipment. As prescribed in 447.305-10(b), insert the following clause: Packing for Domestic Shipment (FEB 1988) Material shall be packed for shipment in such a manner that will...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 21 CFR 880.5760 - Chemical cold pack snakebite kit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 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...

  13. 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 shall...

  14. 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 shall...

  15. 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 shall...

  16. 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 shall...

  17. 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 shall...

  18. 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 Central

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

    2017-01-01

    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. PMID:28107179

  19. 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.

  20. 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.