Sample records for occult nodal metastases

  1. Histopathological Parameters predicting Occult Nodal Metastases in Tongue Carcinoma Cases: An Indian Perspective.

    PubMed

    Jacob, Tina Elizabeth; Malathi, N; Rajan, Sharada T; Augustine, Dominic; Manish, N; Patil, Shankargouda

    2016-01-01

    It is a well-established fact that in squamous cell carcinoma cases, the presence of lymph node metastases decreased the 5-year survival rate by 50% and also caused the recurrence of the primary tumor with development of distant metastases. Till date, the predictive factors for occult cervical lymph nodes metastases in cases of tongue squamous cell carcinoma remain inconclusive. Therefore, it is imperative to identify patients who are at the greatest risk for occult cervical metastases. This study was thus performed with the aim to identify various histopathologic parameters of the primary tumor that predict occult nodal metastases. The clinicopathologic features of 56 cases of lateral tongue squamous cell carcinoma with cT1NoMo/cT2NoMo as the stage and without prior radiotherapy or chemotherapy were considered. The surgical excision of primary tumor was followed by elective neck dissection. The glossectomy specimen along with the neck nodes were fixed in formalin and 5 urn thick sections were obtained. The hematoxylin & eosin stained sections were then subjected to microscopic examination. The primary tumor characteristics that were analyzed include tumor grade, invading front, depth of tumor, lymphovascular invasion, perineural invasion and inflammatory response. The nodes were examined for possible metastases using hematoxylin & eosin followed by cytokeratin immunohistochemistry. A total of 12 cases were found with positive occult nodal metastases. On performing univariate analysis, the histopathologic parameters that were found to be statistically significant were lymphovascular invasion (p = 0.004) and perineural invasion (p = 0.003) along with a cut-off depth of infiltration more than 5 mm (p = 0.01). Histopathologic assessment of the primary tumor specimen therefore continues to provide information that is central to guide clinical management, particularly in cases of occult nodal metastases. Clinical significance The study highlights the importance of

  2. Amplification and protein overexpression of cyclin D1: Predictor of occult nodal metastasis in early oral cancer.

    PubMed

    Noorlag, Rob; Boeve, Koos; Witjes, Max J H; Koole, Ronald; Peeters, Ton L M; Schuuring, Ed; Willems, Stefan M; van Es, Robert J J

    2017-02-01

    Accurate nodal staging is pivotal for treatment planning in early (stage I-II) oral cancer. Unfortunately, current imaging modalities lack sensitivity to detect occult nodal metastases. Chromosomal region 11q13, including genes CCND1, Fas-associated death domain (FADD), and CTTN, is often amplified in oral cancer with nodal metastases. However, evidence in predicting occult nodal metastases is limited. In 158 patients with early tongue and floor of mouth (FOM) squamous cell carcinomas, both CCND1 amplification and cyclin D1, FADD, and cortactin protein expression were correlated with occult nodal metastases. CCND1 amplification and cyclin D1 expression correlated with occult nodal metastases. Cyclin D1 expression was validated in an independent multicenter cohort, confirming the correlation with occult nodal metastases in early FOM cancers. Cyclin D1 is a predictive biomarker for occult nodal metastases in early FOM cancers. Prospective research on biopsy material should confirm these results before implementing its use in routine clinical practice. © 2016 Wiley Periodicals, Inc. Head Neck 39: 326-333, 2017. © 2016 Wiley Periodicals, Inc.

  3. Occult Nodal Disease Prevalence and Distribution in Recurrent Laryngeal Cancer Requiring Salvage Laryngectomy.

    PubMed

    Birkeland, Andrew C; Rosko, Andrew J; Issa, Mohamad R; Shuman, Andrew G; Prince, Mark E; Wolf, Gregory T; Bradford, Carol R; McHugh, Jonathan B; Brenner, J Chad; Spector, Matthew E

    2016-03-01

    The indications for neck dissection concurrent with salvage laryngectomy in the clinically N0 setting remain unclear. Our goals were to determine the prevalence of occult nodal disease, analyze nodal disease distribution patterns, and identify predictors of occult nodal disease in a salvage laryngectomy cohort. Case series with planned data collection. Tertiary academic center. Patients with persistent or recurrent laryngeal squamous cell carcinoma (LSCC) after radiation/chemoradiation failure undergoing salvage laryngectomy with neck dissection. We analyzed a single-institution retrospective case series of patients between 1997 and 2014 and identified those who had clinically N0 (cN0) necks (n = 203). Clinical and pathologic data, including nodal prevalence and distribution, were collected and statistical analyses performed. Overall, cN0 necks had histologically positive occult nodes in 17% (n = 35) of cases. Univariate predictors of occult nodal positivity included recurrent T4 stage (34% T4 vs 12% non-T4; P = .0003) and supraglottic subsite (28% supraglottic vs 10% nonsupraglottic; P = .0006). Histologically positive nodes associated with supraglottic primaries were most frequently positive in ipsilateral levels II and III (17% and 16%). Positive nodes for glottic LSCC were most frequently positive in the ipsilateral and contralateral paratracheal nodes (11% and 9%). Histologically positive occult nodes are identified in 17% of cN0 patients undergoing salvage laryngectomy with neck dissection. Occult nodal disease varies in frequency and distribution based on tumor subsite. Predictors of high (>20%) occult nodal positivity include T4 tumors and supraglottic subsite. In glottic LSCC, the most frequent sites of occult nodal disease are the paratracheal nodal basins. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  4. Para-aortic nodal metastases in cervical cancer: a blind spot in the International Federation of Gynecology and Obstetrics staging system: current diagnosis and management.

    PubMed

    Hwang, Lindsay; Bailey, April; Lea, Jayanthi; Albuquerque, Kevin

    2015-01-01

    In cervical cancer, para-aortic nodal (PALN) metastases at presentation is a strong indicator of poor prognosis. Despite this, International Federation of Gynecology and Obstetrics staging system does not require evaluation of lymph node involvement and does not incorporate clinically detected PALN into the staging system. In the USA, despite screening, a significant number of women still present at an advanced stage often with nodal metastases. While the presence of PALN metastases often indicates occult systemic disease, it is possible with modern therapies to provide long-term control of disease in a percentage of patients. We review the epidemiology, diagnosis and treatment of PALN metastases in cervical cancer outlining advances in modern imaging and combined modality therapies (surgery, chemotherapy and radiation therapy).

  5. Effect of Occult Metastases on Survival in Node-Negative Breast Cancer

    PubMed Central

    Weaver, Donald L.; Ashikaga, Takamaru; Krag, David N.; Skelly, Joan M.; Anderson, Stewart J.; Harlow, Seth P.; Julian, Thomas B.; Mamounas, Eleftherios P.; Wolmark, Norman

    2011-01-01

    BACKGROUND Retrospective and observational analyses suggest that occult lymph-node metastases are an important prognostic factor for disease recurrence or survival among patients with breast cancer. Prospective data on clinical outcomes from randomized trials according to sentinel-node involvement have been lacking. METHODS We randomly assigned women with breast cancer to sentinel-lymph-node biopsy plus axillary dissection or sentinel-lymph-node biopsy alone. Paraffin-embedded tissue blocks of sentinel lymph nodes obtained from patients with pathologically negative sentinel lymph nodes were centrally evaluated for occult metastases deeper in the blocks. Both routine staining and immunohistochemical staining for cytokeratin were used at two widely spaced additional tissue levels. Treating physicians were unaware of the findings, which were not used for clinical treatment decisions. The initial evaluation at participating sites was designed to detect all macrometastases larger than 2 mm in the greatest dimension. RESULTS Occult metastases were detected in 15.9% (95% confidence interval [CI], 14.7 to 17.1) of 3887 patients. Log-rank tests indicated a significant difference between patients in whom occult metastases were detected and those in whom no occult metastases were detected with respect to overall survival (P = 0.03), disease-free survival (P = 0.02), and distant-disease–free interval (P = 0.04). The corresponding adjusted hazard ratios for death, any outcome event, and distant disease were 1.40 (95% CI, 1.05 to 1.86), 1.31 (95% CI, 1.07 to 1.60), and 1.30 (95% CI, 1.02 to 1.66), respectively. Five-year Kaplan-Meier estimates of overall survival among patients in whom occult metastases were detected and those without detectable metastases were 94.6% and 95.8%, respectively. CONCLUSIONS Occult metastases were an independent prognostic variable in patients with sentinel nodes that were negative on initial examination; however, the magnitude of the difference in

  6. Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases.

    PubMed

    Zhan, Kevin Y; Morgan, Patrick F; Neskey, David M; Kim, Joanne J; Huang, Andrew T; Garrett-Mayer, Elizabeth; Day, Terry A

    2018-05-14

    Nodal disease predicts survival in oral cavity squamous cell carcinoma (SCC). Currently, no large studies on predictors of occult nodal disease in cT1N0 oral cavity SCC exist. The National Cancer Database (NCDB) review for cT1N0 oral cavity SCC with surgical resection and elective neck dissection (END). The number of patients found with occult nodal disease was 2623 (15.1%). In multivariable regression, female sex and tumor differentiation predict occult nodal disease. Occult nodal disease incidence was 5.9% in well-differentiated tumors, 17.4% in moderately differentiated tumors, and 28.5% in poorly differentiated tumor (P < .001). Women with oral tongue tumors had higher occult nodal disease (19.1%) than men (12%; P = .001). Adjusted odds ratios (aORs) for occult nodal disease in women were: aOR 1.26; 95% confidence interval (CI) 1.01-1.59; P = .045; moderately differentiated aOR 3.52; 95% CI 2.47-5.01; P < .001; and poorly differentiated aOR 6.25; 95% CI 4.17-9.38; P < .001. Sex and tumor differentiation significantly predict occult nodal disease. END is recommended for all moderately and poorly differentiated cT1N0 oral cavity SCC, regardless of the depth of invasion. One can consider not performing END in well-differentiated tumors. © 2018 Wiley Periodicals, Inc.

  7. Occult Metastases in Pelvic Lymphadenectomy Specimens From Patients With Urothelial Carcinoma of the Bladder.

    PubMed

    Gordetsky, Jennifer; Gibson, Briana; Stevens, Todd M; Ellenburg, J Luke; Grizzle, William; Rais-Bahrami, Soroush

    2016-08-01

    To identify occult metastases within lymph nodes (LNs) reported as negative by routine histologic evaluation. In patients with high-grade, muscle-invasive urothelial carcinoma (UC) of the bladder, pelvic lymphadenectomy during radical cystectomy demonstrates a survival advantage, increasing with the number of LNs removed, even if negative for metastatic disease. This finding may potentially be explained by the presence of occult metastases. Radical cystectomy specimens with high-grade UC invading the perivesical tissue and negative LNs (pT3N0) between 2000 and 2014 were reviewed. Five levels were cut for each LN block. Two sections were cut per level: 1 stained for hematoxylin and eosin and 1 for AE1/AE3. Micrometastases were defined as tumor deposits >0.2 mm but <2 mm. Isolated tumor cells were defined as ≤0.2 mm. Medical records and survival data were reviewed. We identified 21 cases, consisting of 370 lymph nodes. Six of 21 patients (29%) had occult metastases, including 5 occult metastatic UC and 1 occult metastatic prostate adenocarcinoma. There were 10 positive LNs; 2 macrometastases, 2 micrometastases, and 6 with ITCs. Two of 6 patients (33%) had lymphovascular invasion identified in the primary tumor. Kaplan-Meier analysis showed no significant difference in overall survival between the group of patients who remained N0 versus those upstaged due to discovery of occult metastases (P-value = .42). In patients with pT3 UC undergoing cystectomy, we demonstrated the presence of occult metastases in 29% of patients. The high percentage of occult metastases present in these cases possibly explains the proven survival advantage of removing "negative" LNs. This finding might also have implications in the histologic evaluation of LNs. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Mapping of nodal disease in locally advanced prostate cancer: Rethinking the clinical target volume for pelvic nodal irradiation based on vascular rather than bony anatomy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shih, Helen A.; Harisinghani, Mukesh; Zietman, Anthony L.

    2005-11-15

    Purpose: Toxicity from pelvic irradiation could be reduced if fields were limited to likely areas of nodal involvement rather than using the standard 'four-field box.' We employed a novel magnetic resonance lymphangiographic technique to highlight the likely sites of occult nodal metastasis from prostate cancer. Methods and Materials: Eighteen prostate cancer patients with pathologically confirmed node-positive disease had a total of 69 pathologic nodes identifiable by lymphotropic nanoparticle-enhanced MRI and semiquantitative nodal analysis. Fourteen of these nodes were in the para-aortic region, and 55 were in the pelvis. The position of each of these malignant nodes was mapped to amore » common template based on its relation to skeletal or vascular anatomy. Results: Relative to skeletal anatomy, nodes covered a diffuse volume from the mid lumbar spine to the superior pubic ramus and along the sacrum and pelvic side walls. In contrast, the nodal metastases mapped much more tightly relative to the large pelvic vessels. A proposed pelvic clinical target volume to encompass the region at greatest risk of containing occult nodal metastases would include a 2.0-cm radial expansion volume around the distal common iliac and proximal external and internal iliac vessels that would encompass 94.5% of the pelvic nodes at risk as defined by our node-positive prostate cancer patient cohort. Conclusions: Nodal metastases from prostate cancer are largely localized along the major pelvic vasculature. Defining nodal radiation treatment portals based on vascular rather than bony anatomy may allow for a significant decrease in normal pelvic tissue irradiation and its associated toxicities.« less

  9. Overt Skeletal Metastases in a Patient of Occult (Microscopic) Follicular Thyroid Carcinoma: a Rare Case.

    PubMed

    Jha, Chandan Kumar; Agrawal, Vinita; Mishra, Anjali; Pradhan, P K

    2018-03-01

    Occult follicular thyroid carcinoma (FTC) presenting as distant metastases is a rare occurrence. However, despite being occult in majority of these cases, primary tumor can be detected on thyroid imaging or during surgery. Here, we present an extremely rare case of an occult FTC with overt skeletal metastases in which primary tumor was discernible only on microscopic examination.

  10. Image guidance improves localization of sonographically occult colorectal liver metastases

    NASA Astrophysics Data System (ADS)

    Leung, Universe; Simpson, Amber L.; Adams, Lauryn B.; Jarnagin, William R.; Miga, Michael I.; Kingham, T. Peter

    2015-03-01

    Assessing the therapeutic benefit of surgical navigation systems is a challenging problem in image-guided surgery. The exact clinical indications for patients that may benefit from these systems is not always clear, particularly for abdominal surgery where image-guidance systems have failed to take hold in the same way as orthopedic and neurosurgical applications. We report interim analysis of a prospective clinical trial for localizing small colorectal liver metastases using the Explorer system (Path Finder Technologies, Nashville, TN). Colorectal liver metastases are small lesions that can be difficult to identify with conventional intraoperative ultrasound due to echogeneity changes in the liver as a result of chemotherapy and other preoperative treatments. Interim analysis with eighteen patients shows that 9 of 15 (60%) of these occult lesions could be detected with image guidance. Image guidance changed intraoperative management in 3 (17%) cases. These results suggest that image guidance is a promising tool for localization of small occult liver metastases and that the indications for image-guided surgery are expanding.

  11. Prognostic significance of extranodal extension in head and neck squamous cell carcinoma cN0 patients with occult metastatic neck nodes.

    PubMed

    Lop, Joan; Rigó, Antoni; Codina, Alberto; de Juan, Julia; Quer, Miquel; León, Xavier

    Extranodal extension in nodal metastases is an independent adverse prognostic factor in head and neck squamous cell carcinoma patients. However, few studies specifically address the subgroup of patients with no clinical evidence of nodal disease. We retrospectively analysed data from 348 head and neck squamous cell carcinoma patients without any previous treatment and lacking clinical or radiological evidence of neck node metastases during the initial workup, treated with an elective neck dissection between 1992-2014. The incidence of occult metastatic neck nodes with extranodal extension and the impact of extranodal extension in survival were evaluated. The proportion of patients with occult neck node metastases was 33%. Of these, 23.5% had at least one metastatic neck node with extranodal extension. There were significant differences in the disease-specific survival rate according to neck node status. Five-year disease-specific survival for patients without histopathological metastases was 90%, for patients with occult neck node metastases without extranodal extension it was 71.2%, and for patients with occult neck node metastases with extranodal extension it was 25.9% (P=.0001). The multivariate analysis revealed that the presence of occult node metastases with extranodal extension was the factor with strongest impact on survival. The inclusion of the extranodal extension as a criterion of histopathological evaluation in the 8th TNM classification edition improves the prognostic capacity compared to previous TNM editions. Appearance of metastatic neck nodes with extranodal extension is an adverse prognostic factor in head and neck squamous cell carcinoma patients without clinical evidence of regional disease during the initial workup of the tumour. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  12. Tumour thickness as a predictor of nodal metastases in oral cancer: comparison between tongue and floor of mouth subsites.

    PubMed

    Balasubramanian, Deepak; Ebrahimi, Ardalan; Gupta, Ruta; Gao, Kan; Elliott, Michael; Palme, Carsten E; Clark, Jonathan R

    2014-12-01

    To identify whether tumour thickness as a predictor of nodal metastases in oral squamous cell carcinoma differs between tongue and floor of mouth (FOM) subsites. Retrospective review of 343 patients treated between 1987 and 2012. The neck was considered positive in the presence of pathologically proven nodal metastases on neck dissection or during follow-up. There were 222 oral tongue and 121 FOM tumours. In patients with FOM tumours 2.1-4mm thick, the rate of nodal metastases was 41.7%. In contrast, for tongue cancers of a similar thickness the rate was only 11.2%. This increased to 38.5% in patients with tongue cancers that were 4.1-6mm thick. Comparing these two subsites, FOM cancers cross the critical 20% threshold of probability for nodal metastases between 1 and 2mm whereas tongue cancers cross the 20% threshold just under 4mm thickness. On logistic regression adjusting for relevant covariates, there was a significant difference in the propensity for nodal metastases based on tumour thickness according to subsite (p=0.028). Thin FOM tumours (2.1-4mm) have a high rate of nodal metastases. Elective neck dissection is appropriate in FOM tumours ⩾2mm thick and in tongue tumours ⩾4mm thick. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. An Interesting Case of Retropharyngeal Lymph Nodal Metastases in a Case of Iodine-Refractory Thyroid Cancer.

    PubMed

    Harisankar, Chidambaram Natrajan Balasubramanian; Vijayabhaskar, Ramakrishnan

    2018-01-01

    Metastases to cervical lymph node are fairly common in differentiated thyroid cancer. In iodine-refractory disease, the disease may persist in the thyroid bed, cervical lymph nodes, lungs, or the bones commonly. Retropharyngeal lymph nodal involvement in thyroid cancer is unusual and may even be the presenting complaint. We represent a case of iodine-refractory thyroid cancer with retropharyngeal lymph nodal involvement in addition to lung metastases.

  14. Successful radioimmunotherapy for micro and occult metastases in a SCID mouse model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yokoyama, K.; Koshida, K.; Kinuya, S.

    1996-05-01

    It is often addressed that the most appropriate candidate, theoretically, for radioimmunotherapy (RIT) is not bulky tumor burden but for micro or occult metastatic foci, The major obstacles in the verification for veracious efficacy of RIT had been clinically and preclinically the difficulty in obtaining such a model. We have developed the model of testicular tumor (primary site) with visible small metastases to the lymph nodes (LNs) and non-visible (occult) lesions to distant organs in severe combined immunodeficient (SCID) mice. And thus, the suppression of minute tumor depositions after RIT was evaluated. One week after hemilateral intratesticular injection of 2more » million of HELA Hep 2 cells that expressed placental alkaline phosphatase (PLAP), the group of the mice were treated with a single dose of I-131 labeled HPMS-1, anti-PLAP MoAb or with saline control. The I-131 labeled HPMS-1 (5.6 MBq / 150 {mu}g) was intravenously administered and at 2 weeks after, the testis, retroperitoneal and intraperitoneal LNs and other gans were removed. For the control group, the testicular tumor and LNs metastases were found in 100% and 86% of the mice. The metastases in the liver and lung were not observed by histological examination but in all mouse samples, the PCR (polymerase chain reaction) assay could identify the human {beta}-globin gene derived from HeLa cells, indicating the presence of definitive metastases. For the treated group, the average testicular tumor weight was significantly reduced by the factor of 2.4 (132 mg vs 311 mg, p<0.01). The LNs metastases were even more distinctively suppressed by the factor of 45.7 (13 mg vs 599 mg, p,0.05). Remarkably, the PCR products from the occult metastases were almost completely controlled; 97% suppression found for the liver and 81% for the lung. Thus, we conclude that using I-131 as a label, RIT is justified to used for targeting and killing minute tumor foci.« less

  15. Cervical nodal metastases in squamous cell carcinoma of the head and neck: what to expect.

    PubMed

    Mukherji, S K; Armao, D; Joshi, V M

    2001-11-01

    The treatment and management of malignancies of the head and neck is directly altered by the presence of metastatic cervical adenopathy. The treatment of nodal metastases in squamous cell carcinoma of the head and neck (HNSCCA) is determined by the lymphatic drainage of the upper aerodigestive tract. The lymphatic drainage is site-specific and occurs in a predictable manner. The purpose of this text is to provide an overview of the normal routes of lymphatic drainage in the head and neck and correlate this with the current nodal classification system. The specific aims of this manuscript are to 1) illustrate the expected lymphatic drainage patterns of HNSCCA arising in the different subsites (nasopharynx, oropharynx, oral cavity, larynx, and hypopharynx) and 2) review the expected frequency of metastases within nodal groups for HNSCCA that arise in these locations. An understanding of the topographical distribution and incidence of cervical lymph node metastases plays an integral role in the physical examination and radiological evaluation of patients with HNSCCA. For the neuroradiologist, this information may increases the ability to identify those nodal groups at risk for metastatic involvement. Copyright 2001 John Wiley & Sons, Inc. Head Neck 23: 995-1005, 2001.

  16. Potential clinical value of PET/CT in predicting occult nodal metastasis in T1-T2N0M0 lung cancer patients staged by PET/CT

    PubMed Central

    Zhou, Xiang; Chen, Ruohua; Huang, Gang; Liu, Jianjun

    2017-01-01

    We assessed the clinical value of 2-fluoro-2-deoxyglucose (18F-FDG) PET/CT imaging for predicting occult nodal metastasis in non-small cell lung cancer (NSCLC) patients. This retrospective study included 54 patients with T1-2N0M0 NSCLC who had undergone 18F-FDG PET/CT before surgery. Occult nodal metastasis was detected in 25.9% (14/54) of the patients. Immunohistochemical analysis revealed that increased glucose transporter 1 expression was associated with occult nodal metastasis, but hexokinase 2 expression was not. Compared to the negative nodal metastasis group, the positive nodal metastasis group was associated with increased maximum standardized uptake value (SUVmax) and tumor size. Multivariate analysis indicated that SUVmax and tumor size were associated with nodal metastasis. Nodal metastasis could be predicted with a sensitivity of 92.9% and a specificity of 55.0% when the SUVmax cutoff was 4.35. When patients were divided into low-risk (tumor size ≤ 2.5 cm and SUVmax ≤ 4.35), moderate-risk (tumor size ≤ 2.5 cm and SUVmax > 4.35 or tumor size > 2.5 cm and SUVmax ≤ 4.35) and high-risk (tumor size > 2.5 cm and SUVmax > 4.35) groups, the lymph node metastasis rates were 4.3%, 22.7%, and 88.9%, respectively. These results indicate that the combination of SUVmax and tumor size has potential clinical value for predicting occult nodal metastasis in NSCLC patients. PMID:29137276

  17. Prospective Evaluation of Intrahepatic Microscopic Occult Tumor Foci in Patients with Numerous Colorectal Liver Metastases.

    PubMed

    Vigano, Luca; Di Tommaso, Luca; Mimmo, Antonio; Sollai, Mauro; Cimino, Matteo; Donadon, Matteo; Roncalli, Massimo; Torzilli, Guido

    2018-06-07

    Patients with numerous colorectal liver metastases (CLM) have high risk of early recurrence after liver resection (LR). The presence of intrahepatic occult microscopic metastases missed by imaging has been hypothesized, but it has never been assessed by pathology analyses. All patients with > 10 CLM who underwent LR between September 2015 and September 2016 were considered. A large sample of liver without evidence of disease ("healthy liver") was taken from the resected specimen and sent to the pathologist. One mm-thick sections were analyzed. Any metastasis, undetected by preoperative and intraoperative imaging, but identified by the pathologist was classified as occult microscopic metastasis. Ten patients were prospectively enrolled (median number of CLM n = 15). In a per-lesion analysis, the sensitivity of computed tomography and magnetic resonance imaging was 91 and 98% respectively. The pathology examination confirmed all the CLM. All patients had an adequate sample of "healthy liver" (median number of examined blocks per sample n = 14 [5-33]). No occult microscopic metastases were detected. After a median follow-up of 15 months, 5 patients were disease-free. Recurrence was hepatic and bilobar in all patients. Clinically relevant occult microscopic disease in patients with numerous CLM is excluded. These results support the indication to resection in such patients and exclude the need for de principe major hepatectomy to increase the completeness of surgery. © 2018 S. Karger AG, Basel.

  18. The Effect of Early Detection of Occult Brain Metastases in HER2-Positive Breast Cancer Patients on Survival and Cause of Death

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Niwinska, Anna, E-mail: alphaonetau@poczta.onet.p; Tacikowska, Malgorzata; Murawska, Magdalena

    2010-07-15

    Purpose: The aim of the study is to evaluate disease-free survival, survival from the detection of brain metastases, overall survival, and cause of death in patients with occult brain metastases (Group I) vs. patients with symptomatic brain metastases (Group II). Methods and Materials: In 80 HER2-positive breast cancer patients, treated with trastuzumab and cytostatic agents for metastatic disease, magnetic resonance imaging screening of the brain was performed, and in 29 patients (36%) occult brain metastasis was detected (Group I). Whole-brain radiotherapy was delivered to Group I. This first group was compared with 52 patients who had symptomatic brain metastases (Groupmore » II) and was treated the same way, at the same clinic, during the same time period. Results: Median disease-free survival was 17 months in Group I and 19.9 months in Group II (p = 0.58). The median time interval between the dissemination of the disease and the detection of occult or symptomatic brain metastases was 9 and 15 months, respectively (p = 0.11). When the brain metastases were detected, the median survival was 9 and 8.78 months, respectively (p = 0.80). The median overall survival was 53 and 51 months, respectively (p = 0.94). In the group with occult brain metastases (Group I) 16% of patients died because of progression within the brain. In the group with symptomatic brain metastases (Group II) the rate of cerebral death was 48% (p = 0.009). Conclusions: Whole-brain radiotherapy of occult brain metastases in HER2-positive breast cancer patients with visceral dissemination produces a three-fold decrease in cerebral deaths but does not prolong survival.« less

  19. Utility of bone scanning in detecting occult skeletal metastases from cervical carcinoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Katz, R.D.; Alderson, P.O.; Rosenshein, N.B.

    1979-11-01

    Bone scans were obtained in 100 patients with carcinoma of the cervix in order to search for occult skeletal metastases. Scans revealed metastases in 4 patients with advanced stages of disease, but the scans in 79 patients with Stage 0, I, or II disease were negative. The scans in 14 patients showed renal asymmetry; 11 of these had obstructive uropathy due to tumor invasion or radiation therapy. Bone scanning does not seem warranted as a screening test in asymptomatic patients with Stage 0, I, or II carcinoma. If the test is done, renal symmetry should be carefully evaluated.

  20. Association of maximum standardized uptake value with occult mediastinal lymph node metastases in cN0 non-small cell lung cancer.

    PubMed

    Lin, Jun-Tao; Yang, Xue-Ning; Zhong, Wen-Zhao; Liao, Ri-Qiang; Dong, Song; Nie, Qiang; Weng, Si-Xian; Fang, Xiao-Jing; Zheng, Jun-Yi; Wu, Yi-Long

    2016-11-01

    The management of non-small cell lung cancer (NSCLC) relies on the tumour-node-metastasis (TNM) stage, and the treatment regimen differs based on the N status. Positron emission tomography-computed tomography (PET-CT) has emerged as a powerful imaging tool for the detection of various cancers with a relatively low false-negative rate. We explored predictors to identify false-negative N2 disease in PET-CT. A total of 284 consecutive cN0 patients with peripheral NSCLC who underwent PET-CT scans followed by curative intent resections were enrolled as a training set to identify predictors of occult N2 metastases by multivariable analysis. The accuracy and cut-off values for the predictors were calculated using a receiver operating characteristic curve. Clinical and pathological data were analysed retrospectively. An additional 151 patients were collected as a test set to validate the results, including the occult N2 rate and accuracy. In total, 8.5% (24/284) PET-CT-diagnosed N0 NSCLC cases had pathologically diagnosed N2 metastases. The SUV max of the primary tumour was a unique independent risk factor for occult N2 NSCLC [P = 0.003, 95% confidence interval = 0.81-0.96, odds ratio (OR) = 0.88]. Occult N2 metastases occurred more frequently in the subcarinal (16/24) and right lower paratracheal lymph nodes (12/24). Accordingly, we divided the patients into two groups by SUV max : the occult N2 rates in the SUV max of <2.6 and SUV max of ≥2.6 groups were 1.0% (1/100) and 12.5% (23/184), respectively (P = 0.001). In the test set, the occult N2 incidence rate was 9.3% (14/151), with the highest rates occurring in the subcarinal (9/14) and right lower paratracheal lymph nodes (6/14). In the two groups defined by SUV max , the occult N2 rates were 4% (2/50) and 11.9% (12/101), respectively. The SUV max of the primary tumour was an independent risk factor for occult N2 metastases in NSCLC patients diagnosed as clinical N0 by PET-CT. SUV max of ≥2.6 of the primary tumour

  1. [Clinical application of positron-emission tomography for the identification of cervical nodal metastases of head and neck cancer compared with CT or MRI and clinical palpation].

    PubMed

    Chen, Zhong-Wei; Zhu, Li-Jun; Hou, Qing-Yi; Wang, Qi-Peng; Jiang, Sui; Feng, Hang

    2008-12-01

    To evaluate the value of positron-emission tomography (PET) for the identification of cervical nodal metastases of head and neck cancer compared with CT/MRI and clinical palpation. Forty patients of head and neck cancer underwent PET and CT/MRI examination 2 weeks before surgery. PET, CT/MRI and clinical palpation were interpreted separately to assess regional lymph node status. Histopathologic analysis was used as the gold standard for assessment of the lymph node involvement. Differences in sensitivity, specificity and accuracy among the imaging modalities and clinical palpation were analyzed. The sensitivity of PET for the identification of nodal metastases was 14.3% higher than that of CT/MRI (P = 0.648) and 14.3% higher than that of clinical palpation (P = 0.648), whereas the specificity of PET was 15.4% higher than that of CT/MRI (P = 0.188) and 7.7% higher than that of clinical palpation (P = 0.482). The accuracy of 18F-FDG PET, CT/MRI, and clinical palpation for the identification of cervical nodal metastases was 85.0%, 70.0% and 75.0% respectively. The sensitivity, specificity and accuracy of PET for the detection of cervical nodal metastases was higher than that of CT/MRI and clinical palpation. Although the results did not show a statistically significant difference, PET can still serve as a supplementary method for the identification of nodal metastases of head and neck cancer.

  2. Unusual presentation of Warthin variant of Papillary thyroid carcinoma with lymph nodal metastases in a patient of Graves' disease.

    PubMed

    Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga; Arun, B R

    2015-01-01

    Warthin-like Papillary thyroid carcinoma (WPTC) is a rare variant of papillary carcinoma of thyroid, PTC which derives its name by closely resembling Warthin's tumor of salivary gland. Hallmark histological feature of this variant is papillary folding lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. It is thought to be one of those differentiated thyroid cancers with favorable prognosis. We report a case of Graves' disease with a cold nodule harboring WPTC with initial presentation of lymph nodal metastases. It is important to identify this peculiar variant of PTC as 5 to 10% of them undergo dedifferentiation and 30% have the lymph nodal metastases and extra thyroidal extension.

  3. Occult nodal metastasis in solid carcinomata

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Moloy, P.J.; Nicolson, G.L.

    1987-01-01

    This book contains 23 selections. Some of the titles are: Rationale for radiotherapy in subclinical nodal disease; rationale of chemotherapy for nodal disease: The stabilization of topoisomerase II-DNA complexes as a mechanism of antineoplastic drug action; magnetic resonance imaging of malignant cervical adenopathy; and local and regional immune function in cancer patients.

  4. Delineation of Internal Mammary Nodal Target Volumes in Breast Cancer Radiation Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jethwa, Krishan R.; Kahila, Mohamed M.; Hunt, Katie N.

    Purpose: The optimal clinical target volume for internal mammary (IM) node irradiation is uncertain in an era of increasingly conformal volume-based treatment planning for breast cancer. We mapped the location of gross internal mammary lymph node (IMN) metastases to identify areas at highest risk of harboring occult disease. Methods and Materials: Patients with axial imaging of IMN disease were identified from a breast cancer registry. The IMN location was transferred onto the corresponding anatomic position on representative axial computed tomography images of a patient in the treatment position and compared with consensus group guidelines of IMN target delineation. Results: Themore » IMN location in 67 patients with 130 IMN metastases was mapped. The location was in the first 3 intercostal spaces in 102 of 130 nodal metastases (78%), whereas 18 of 130 IMNs (14%) were located caudal to the third intercostal space and 10 of 130 IMNs (8%) were located cranial to the first intercostal space. Of the 102 nodal metastases within the first 3 intercostal spaces, 54 (53%) were located within the Radiation Therapy Oncology Group consensus volume. Relative to the IM vessels, 19 nodal metastases (19%) were located medially with a mean distance of 2.2 mm (SD, 2.9 mm) whereas 29 (28%) were located laterally with a mean distance of 3.6 mm (SD, 2.5 mm). Ninety percent of lymph nodes within the first 3 intercostal spaces would have been encompassed within a 4-mm medial and lateral expansion on the IM vessels. Conclusions: In women with indications for elective IMN irradiation, a 4-mm medial and lateral expansion on the IM vessels may be appropriate. In women with known IMN involvement, cranial extension to the confluence of the IM vein with the brachiocephalic vein with or without caudal extension to the fourth or fifth interspace may be considered provided that normal tissue constraints are met.« less

  5. An evaluation of bone scans as screening procedures for occult metastases in primary breast cancer.

    PubMed Central

    Baker, R R; Holmes, E R; Alderson, P O; Khouri, N F; Wagner, H N

    1977-01-01

    Preoperative bone scans were obtained in 104 patients with operable breast cancer. Areas of increased radioactivity detected by the bone scan were correlated with appropriate radiographs. One of 64 patients (1.5%) with clinical Stage I and Stage II breast cancer had a metastatic lesion detected by the preoperative bone scan. In contrast, 10 of 41 patients (24%) with Stage III breast cancer had occult metastatic lesions detected by the preoperative bone scan. The majority of patients with abnormal bone scans and no radiographic evidence of a benign lesion to explain the cause of the increased radioactivity proved to have metastatic breast cancer on follow-examination. Even though 20% of patients with operable breast cancer will eventually develop bone metastases, our results indicate that preoperative bone scans are not an effective means of predicting which patients with Stage I and Stage II disease will develop metastatic breast cancer. Because of the considerably increased frequency of detection of occult metastases in patients with Stage III breast cancer, bone scans should be obtained routinely in the preoperative assessment of these patients. Images Figs. 1a and b. Figs. 2a and b. Figs. 3a-d. PMID:889378

  6. Total half-body systemic irradiation for occult metastases in non-small cell lung cancer: an Eastern Cooperative Oncology group pilot report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Salazar, O.M.; Scarantino, C.W.; Rubin, P.

    1980-11-01

    There is a high probability for patients with locally advanced, unresectable, nonmetastatic, nonsmall-cell bronchogenic carcinoma (NSCBC) to harbor subclinical distant metastases at diagnosis. Approximately 30% will disseminate in the first three months and an additional 50% will disseminate before a year has elapsed. Twenty advanced nonmetastatic patients wtith NSCBC were treated with localized split-course chest irradiation (LCI) plus total body (upper and lower half-body) irradiation for occult metastases. Thirty equally advanced, nonmetastatic patients, who were treated with only localized split-course chest irradiation, were matched and served as a retrospective control group. Apparently, the median recurrence free survival, metastatic free interval,more » and median survival were significantly prolonged, and there was a decrease in the incidence of liver metastases in patients receiving HBI for occult metastases over the patients of the control group. Although elective HBI seems to delay the appearance of distant metastases, it did not prevent their occurrence, alter patterns of first relapse, or significantly improve the overall survival. Nevertheless, a therapeutic gain may have been achieved and is discussed. The incidence of radiation pneumonitis with 800 rad of UHBI corrected for lung transmission was 9%. A hypothesis and a rationale for a more effective combined modality therapy in these patients is given.« less

  7. Histogram Analysis of Apparent Diffusion Coefficients for Occult Tonsil Cancer in Patients with Cervical Nodal Metastasis from an Unknown Primary Site at Presentation.

    PubMed

    Choi, Young Jun; Lee, Jeong Hyun; Kim, Hye Ok; Kim, Dae Yoon; Yoon, Ra Gyoung; Cho, So Hyun; Koh, Myeong Ju; Kim, Namkug; Kim, Sang Yoon; Baek, Jung Hwan

    2016-01-01

    To explore the added value of histogram analysis of apparent diffusion coefficient (ADC) values over magnetic resonance (MR) imaging and fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for the detection of occult palatine tonsil squamous cell carcinoma (SCC) in patients with cervical nodal metastasis from a cancer of an unknown primary site. The institutional review board approved this retrospective study, and the requirement for informed consent was waived. Differences in the bimodal histogram parameters of the ADC values were assessed among occult palatine tonsil SCC (n = 19), overt palatine tonsil SCC (n = 20), and normal palatine tonsils (n = 20). One-way analysis of variance was used to analyze differences among the three groups. Receiver operating characteristic curve analysis was used to determine the best differentiating parameters. The increased sensitivity of histogram analysis over MR imaging and (18)F-FDG PET/CT for the detection of occult palatine tonsil SCC was evaluated as added value. Histogram analysis showed statistically significant differences in the mean, standard deviation, and 50th and 90th percentile ADC values among the three groups (P < .0045). Occult palatine tonsil SCC had a significantly higher standard deviation for the overall curves, mean and standard deviation of the higher curves, and 90th percentile ADC value, compared with normal palatine tonsils (P < .0167). Receiver operating characteristic curve analysis showed that the standard deviation of the overall curve best delineated occult palatine tonsil SCC from normal palatine tonsils, with a sensitivity of 78.9% (15 of 19 patients) and a specificity of 60% (12 of 20 patients). The added value of ADC histogram analysis was 52.6% over MR imaging alone and 15.8% over combined conventional MR imaging and (18)F-FDG PET/CT. Adding ADC histogram analysis to conventional MR imaging can improve the detection sensitivity for occult

  8. Localization of malignant melanoma using monoclonal antibodies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wasselle, J.; Becker, J.; Cruse, W.

    1991-04-01

    Finding a screening test to evaluate patients with cancer for occult metastatic disease, as well as imaging all known disease, is a goal of research efforts. Twenty-nine evaluable patients with deeply invasive (stage I), regional nodal (stage II), or systemic (stage III) melanoma underwent imaging by administration of a preparation of the antimelanoma antibody labeled with technetium 99m. Scan results indicated that 28 of 32 confirmed metastatic sites were imaged with this technique (88% sensitivity). Analysis of the individual positive sites revealed that nodal basins and visceral metastases accounted for the highest percentage of metastatic sites imaged, with 14 (88%)more » of 16 nodal basin metastases and all four visceral metastases being detected through imaging. Occult nodal disease was detected in the iliac nodal chain in two of the 29 patients. The imaging of benign tumors and nodal basins not containing disease accounted for a confirmed false-positive rate of 21%. Three (10%) of the 29 scan results were confirmed to be false-negative. In vivo tumor localization with monoclonal antibodies showed a sensitivity similar to that of other roentgenographic procedures for identifying metastatic disease and was useful in two of three patients in identifying occult iliac nodal disease, a region that is difficult to evaluate with physical examination and other imaging modalities.« less

  9. Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Morikawa, Lisa K.; Memorial Sloan-Kettering Cancer Center; Roach, Mack, E-mail: mroach@radonc.ucsf.ed

    2011-05-01

    Over the past 15 years, there have been three major advances in the use of external beam radiotherapy in the management of men with clinically localized prostate made. They include: (1) image guided (IG) three-dimensional conformal/intensity modulated radiotherapy; (2) radiation dose escalation; and (3) androgen deprivation therapy. To date only the last of these three advances have been shown to improve overall survival. The presence of occult pelvic nodal involvement could explain the failure of increased conformality and dose escalation to prolong survival, because the men who appear to be at the greatest risk of death from clinically localized prostatemore » cancer are those who are likely to have lymph node metastases. This review discusses the evidence for prophylactic pelvic nodal radiotherapy, including the key trials and controversies surrounding this issue.« less

  10. Lymph node metastasis in melanoma: a debate on the significance of nodal metastases, conditional survival analysis and clinical trials.

    PubMed

    Faries, Mark B; Han, Dale; Reintgen, Michael; Kerivan, Lauren; Reintgen, Douglas; Caracò, Corrado

    2018-05-18

    While there is no doubt that regional lymph node metastases are an enormously important factor in melanoma staging and treatment, the biology behind this significance and its precise implications for treatment planning have been a leading controversy in melanoma and other solid tumors for over a century. Recent clinical data, including data from prospective randomized clinical trials have refined our understanding of the process of nodal metastases and the advantages and disadvantages of different clinical management strategies. This review presents two points of view in this debate and discusses the results of new data analyses as well as pivotal clinical trials informing the discussion.

  11. Patterns of nodal metastases on 18F-FDG PET/CT in patients with esophageal squamous cell carcinoma are useful to guide treatment planning of radiotherapy.

    PubMed

    Liu, Chia-Ju; Cheng, Jason Chia-Hsien; Lee, Jang-Ming; Cheng, Mei-Fang; Tzen, Kai-Yuan; Yen, Ruoh-Fang

    2015-05-01

    The aim of the study was to examine the patterns of lymph node metastases from esophageal squamous cell carcinoma (ESCC) and compare the laterality of lymphatic metastasis in cervical, supraclavicular, and paratracheal areas using F-FDG PET/CT. The data of 75 patients who underwent F-FDG PET/CT for staging of ESCC between January 2011 and March 2012 were reviewed. Fourteen groups of lymph nodes from the neck to abdomen were defined. Lateralization of the upper thoracic lymph nodes was defined in reference to the midline of the trachea. Frequencies of positive lymph nodes were used to determine the pattern of lymphatic spread and compare the lateralization of metastases in the cervical and upper thoracic regions. The right paratracheal region was the most frequent site of metastasis among all patients. Left paratracheal and paragastric nodes were more frequent in upper and lower third ESCC, respectively. Upward and downward lymphatic spread was equal in mid third ESCC. In all patients, there was a trend toward more frequent lymph node metastasis on the right side than the left side for the supraclavicular and paratracheal regions. Further stratified analysis with tumor location found that right paratracheal node metastasis was significantly associated with mid third ESCC (P = 0.03). Remote nodal metastasis was found in 10.5% of patients with upper third ESCC and 13% of patients with lower third ESCC, respectively. Remote nodal metastasis was associated with higher SUV of the primary tumor (P = 0.02) and worse survival (P = 0.03). Receiver operating characteristic analysis showed a cutoff SUV of 14.8 for predicting remote lymph node metastases. PET/CT provides important information before radiotherapy planning. Mid and lower third ESCC tends to metastasize to the right paratracheal/supraclavicular lymph nodes. Remote nodal metastases on PET/CT correlated with higher primary tumor SUV and worse survival.

  12. The Impact of the Size of Nodal Metastases on Recurrence Risk in Breast Cancer Patients With 1-3 Positive Axillary Nodes After Mastectomy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Harris, Eleanor E.R., E-mail: Eleanor.harris@moffitt.org; Freilich, Jessica; Lin, Hui-Yi

    Purpose: Use of postmastectomy radiation therapy (PMRT) in breast cancer patients with 1-3 positive nodes is controversial. The objective of this study was to determine whether the size of nodal metastases in this subset could predict who would benefit from PMRT. Methods and Materials: We analyzed 250 breast cancer patients with 1-3 positive nodes after mastectomy treated with contemporary surgery and systemic therapy at our institution. Of these patients, 204 did not receive PMRT and 46 did receive PMRT. Local and regional recurrence risks were stratified by the size of the largest nodal metastasis measured as less than or equalmore » to 5 mm or greater than 5 mm. Results: The median follow-up was 65.6 months. In the whole group, regional recurrences occurred in 2% of patients in whom the largest nodal metastasis measured 5 mm or less vs 6% for those with metastases measuring greater than 5 mm. For non-irradiated patients only, regional recurrence rates were 2% and 9%, respectively. Those with a maximal nodal size greater than 5 mm had a significantly higher cumulative incidence of regional recurrence (P=.013). The 5-year cumulative incidence of a regional recurrence in the non-irradiated group was 2.7% (95% confidence interval [CI], 0.7%-7.2%) for maximal metastasis size of 5 mm or less, 6.9% (95% CI, 1.7%-17.3%) for metastasis size greater than 5 mm, and 16% (95% CI, 3.4%-36.8%) for metastasis size greater than 10 mm. The impact of the maximal nodal size on regional recurrences became insignificant in the multivariable model. Conclusions: In patients with 1-3 positive lymph nodes undergoing mastectomy without radiation, nodal metastasis greater than 5 mm was associated with regional recurrence after mastectomy, but its effect was modified by other factors (such as tumor stage). The size of the largest nodal metastasis may be useful to identify high-risk patients who may benefit from radiation therapy after mastectomy.« less

  13. Concordance Between FISH Analysis of Her-2/Neu Gene in Breast Duct Carcinoma and Corresponding Axillary Nodal Metastases: Egyptian National Cancer Institute Experience.

    PubMed

    Badawy, Omnia M; Hassan, Hannan; ELBakey, Heba A; Mosaad, Maha

    2018-05-10

    Breast cancer is a major health problem in Egypt. Her-2/Neu gene is routinely assessed for all breast cancer patients primarily by immunohistochemistry. At National Cancer Institute (NCI), Cairo University, Flourescence In Situ hybridization (FISH) analysis of Her-2/Neu gene is carried out for Her-2/Neu score 2 and for some cases of score 3 (particularly those assessed outside NCI). The test is performed essentially on the primary tumor. However, some situations require testing on corresponding lymph node metastases. There is a debate about the concordance between Her-2/Neu status in the primary tumor and synchronous lymph node metastases in various studies. The aim of this study was to test for the concordance between Her-2/Neu status in the primary breast tumor and corresponding axillary nodal metastases. This is a retrospective study in which FISH analysis of Her-2/Neu was carried out simultaneously on archived material of 50 cases previously diagnosed as invasive duct carcinoma and the corresponding nodal metastases from the Pathology Department, NCI. There was complete concordance between Her-2 status in the primary tumor and the corresponding axillary lymph node metastatic deposits in which Her-2 was amplified in 44% of the studied cohort of Egyptian patients. Her-2/Neu gene assessed by FISH analysis on synchronous lymph node metastases is strongly correlated with the primary tumor. Hence, it is justified to carry out the Her-2/Neu test on synchronous lymph nodes to decide on whether to carry out anti-Her-2/Neu target therapy. Further studies on other metastatic sites is recommended.

  14. Truncated midkine as a marker of diagnosis and detection of nodal metastases in gastrointestinal carcinomas.

    PubMed Central

    Aridome, K.; Takao, S.; Kaname, T.; Kadomatsu, K.; Natsugoe, S.; Kijima, F.; Aikou, T.; Muramatsu, T.

    1998-01-01

    Midkine (MK) is a growth factor identified as a product of a retinoic acid-responsive gene. A truncated form of MK mRNA, which lacks a sequence encoding the N-terminally located domain, was recently found in cancer cells. We investigated the expression of the truncated MK mRNA in specimens of 47 surgically removed human gastrointestinal organs using polymerase chain reaction. Truncated MK was not detected in all of the 46 corresponding non-cancerous regions. On the other hand, this short MK mRNA was expressed in the primary tumours in 12 of 16 gastric cancers, 8 of 13 colorectal carcinomas, five of nine hepatocellular carcinomas, two of two oesophageal carcinomas and one ampullary duodenal cancer. In addition, truncated MK was detectable in all of the 14 lymph node metastases but in none of three metastatic sites in the liver, suggesting that truncated MK mRNA could become a good marker of nodal metastases in gastrointestinal tract. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:9716029

  15. Radioimmunoguided surgery in primary colon cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nieroda, C.A.; Mojzisik, C.; Sardi, A.

    1990-01-01

    Radioimmunoguided surgery (RIGS), the intraoperative use of a hand-held gamma detecting probe (GDP) to identify tissue containing radiolabeled monoclonal antibody (MAb), was performed upon 30 patients with primary colon carcinoma. Each patient received an intravenous injection of MAb B72.3 (1.0 to 0.25 mg) radiolabeled with {sup 125}I (5.0 to 1.0 mCi) 8 to 34 days before exploration. The GDP was used to measure radioactivity in colon tissue, tumor bed, nodal drainage areas, and areas of suspected metastases. Antibody localized to histologically documented tumor in 23 of 30 patients (77%). Tumor margins were more clearly defined in 20 of 30 patientsmore » (67%). GDP counts led to major alterations in surgical resection in five patients (17%) and changes in adjuvant therapy in four (14%). GDP counts identified occult liver metastases in two patients (7%) and correctly indicated the benign nature of liver masses in three (10%). In four patients (13%), occult nodal metastases were identified. RIGS can precisely delineate tumor margins, define the extent of nodal involvement, and localize occult tumor, providing a method of immediate intraoperative staging that may lessen recurrences and produce higher survival rates.« less

  16. The accuracy of preoperative axillary nodal staging in primary breast cancer by ultrasound is modified by nodal metastatic load and tumor biology

    PubMed Central

    Dihge, Looket; Grabau, Dorthe A.; Rasmussen, Rogvi W.; Bendahl, Pär-Ola; Rydén, Lisa

    2016-01-01

    Abstract Background The outcome of axillary ultrasound (AUS) with fine-needle aspiration biopsy (FNAB) in the diagnostic work-up of primary breast cancer has an impact on therapy decisions. We hypothesize that the accuracy of AUS is modified by nodal metastatic burden and clinico-pathological characteristics. Material and methods The performance of AUS and AUS-guided FNAB for predicting nodal metastases was assessed in a prospective breast cancer cohort subjected for surgery during 2009–2012. Predictors of accuracy were included in multivariate analysis. Results AUS had a sensitivity of 23% and a specificity of 95%, while AUS-guided FNAB obtained 73% and 100%, respectively. AUS-FNAB exclusively detected macro-metastases (median four metastases) and identified patients with more extensive nodal metastatic burden in comparison with sentinel node biopsy. The accuracy of AUS was affected by metastatic size (OR 1.11), obesity (OR 2.46), histological grade (OR 4.43), and HER2-status (OR 3.66); metastatic size and histological grade were significant in the multivariate analysis. Conclusions The clinical utility of AUS in low-risk breast cancer deserves further evaluation as the accuracy decreased with a low nodal metastatic burden. The diagnostic performance is modified by tumor and clinical characteristics. Patients with nodal disease detected by AUS-FNAB represent a group for whom neoadjuvant therapy should be considered. PMID:27050668

  17. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goldsmith, Benjamin; Baumann, Brian C.; He, Jiwei

    2014-03-01

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, andmore » external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy

  18. Primary Germ Cell Tumor of Testes with Extensive Lymph Nodal and Splenic Metastases Masquerading Lymphoma on 18-F-FDG PET/CT

    PubMed Central

    Tripathy, Sarthak; Mukherjee, Anirban; Bal, Chandrasekhar; Tripathi, Madhavi; Mallick, Saumyaranjan; Shamim, Shamim Ahmed

    2017-01-01

    Germ cell tumors (GCT) account for the 95% of the malignancies associated with testes. They are the most common solid malignancies affecting the males in the age group of 15–35 years. It is known to be bilateral in 3% of cases. We herein present FDG PET-CT findings of a case with biopsy proven GCT with multiple lymph nodal and splenic metastases mimicking lymphomatous neoplasm. PMID:28533651

  19. Depth of invasion, size and number of metastatic nodes predicts extracapsular spread in early oral cancers with occult metastases.

    PubMed

    Mair, Manish D; Shetty, Rathan; Nair, Deepa; Mathur, Yash; Nair, Sudhir; Deshmukh, Anuja; Thiagarajan, Shiva; Pantvaidya, Gouri; Lashkar, Sarbani; Prabhash, Kumar; Chaukar, Devendra; Pai, Prathmesh; Cruz, Anil D; Chaturvedi, Pankaj

    2018-06-01

    Presence of extracapsular spread (ECS) significantly decreases survival in oral cancer patients. Considering its prognostic impact, we have studied the incidence and factors predicting ECS in clinically node negative early oral cancers. We performed a retrospective chart review of 354 treatment naïve clinically node negative early oral cancer patients operated between 2012 and 2014. Chi-square test and logistic regression were used for identifying predictors of ECS, while cox-regression test was used for survival analysis. The incidence of occult nodal metastasis was 28.5% (101/354). Among them, ECS was seen in 15.3%(54/354) patients. The incidence of ECS in T1 and T2 lesion was 13.4% (21/157) and 16.8% (33/197), respectively. The overall incidence of ECS was 48% and 29% in lymph nodes smaller than 10 mm and 5 mm respectively. We found that tumor depth of invasion (>5 mm; p-0.027) and node (metastatic) size >15 mm (p-0.018) were significant predictors of ECS. p N2b disease was seen in 41/354 (11.6%) of which 31/354 (8.7%) had ECS, i.e. 75.6% of pN2b patients been ECS positive (p-0.000). The 3-year OS of patients without nodal metastasis, nodal metastasis without ECS and nodal metastasis with ECS was 88.4%, 66.9% and 59.2% (p-0.000) respectively. A significant number of patients with metastatic nodal size less than 1 cm have ECS which suggests aggressive behavior of the primary tumor. Thus, elective neck dissection is the only way of detecting ECS in these patients which may warrant treatment intensification. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Prognostic Value of Occult Isolated Tumour Cells within Regional Lymph Nodes of Dogs with Malignant Mammary Tumours.

    PubMed

    Coleto, A F; Wilson, T M; Soares, N P; Gundim, L F; Castro, I P; Guimarães, E C; Bandarra, M B; Medeiros-Ronchi, A A

    2018-01-01

    Canine mammary tumours (CMTs) are the most common type of neoplasm in bitches. As in women, the presence of metastasis in regional lymph nodes is an important prognostic factor in bitches with mammary carcinomas, but the clinical significance of occult isolated tumour cells (ITCs) within lymph nodes is still undefined in this species. The effectiveness of immunohistochemistry (IHC) in identifying occult ITCs and micrometastasis (MIC) was compared with that of the conventional haematoxylin and eosin staining technique. The relationship between tumour size, histological type, histological grade and the presence of metastasis was evaluated. The overall survival (OS) of female dogs with occult mammary carcinomas and ITCs within lymph nodes was analysed. Fragments of mammary carcinoma and regional lymph nodes of 59 female dogs were also evaluated. Histological sections of mammary carcinoma and lymph node samples were studied for tumour diagnosis and lymph node samples were tested by IHC using a pan-cytokeratin antibody. It was found that 35.2% of occult ITCs and 2.8% of hidden MIC were detected when IHC was used. There was a good correlation between the size of the tumour and metastasis to the lymph nodes (P = 0.77). ITCs were observed more frequently in the medullary region (60.7%) and metastases in the cortical region (44.4%). There was no significant difference in the OS between female dogs with occult ITCs and lymph nodes without ITCs. IHC can detect occult tumour cells in lymph nodes that are negative by histopathological examination. Female dogs with nodal ITCs do not have lower survival. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Prognostic implications of occult nodal tumour cells in stage I and II colon cancer: The correlation between micrometastasis and disease recurrence.

    PubMed

    Sloothaak, D A M; van der Linden, R L A; van de Velde, C J H; Bemelman, W A; Lips, D J; van der Linden, J C; Doornewaard, H; Tanis, P J; Bosscha, K; van der Zaag, E S; Buskens, C J

    2017-08-01

    Occult nodal tumour cells should be categorised as micrometastasis (MMs) and isolated tumour cells (ITCs). A recent meta-analysis demonstrated that MMs, but not ITCs, are prognostic for disease recurrence in patients with stage I/II colon cancer. The objective of this retrospective multicenter study was to correlate MMs and ITCs to characteristics of the primary tumour, and to determine their prognostic value in patients with stage I/II colon cancer. One hundred ninety two patients were included in the study with a median follow up of 46 month (IQR 33-81 months). MMs were found in eight patients (4.2%), ITCs in 37 (19.3%) and occult tumour cells were absent in 147 patients (76.6%). Between these groups, tumour differentiation and venous or lymphatic invasion was equally distributed. Advanced stage (pT3/pT4) was found in 66.0% of patients without occult tumour cells (97/147), 72.9% of patients with ITCs (27/37), and 100% in patients with MMs (8/8), although this was a non-significant trend. Patients with MMs showed a significantly reduced 3 year-disease free survival compared to patients with ITCs or patients without occult tumour cells (75.0% versus 88.0% and 94.8%, respectively, p = 0.005). When adjusted for T-stage, MMs independently predicted recurrence of cancer (OR 7.6 95% CI 1.5-37.4, p = 0.012). In this study, the incidence of MMs and ITCs in patients with stage I/II colon cancer was 4.2% and 19.3%, respectively. MMs were associated with an reduced 3 year disease free survival rate, but ITCs were not. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  2. Correlation of Various Biomarkers with Axillary Nodal Metastases: Can a Panel of Such Biomarkers Guide Selective Use of Axillary Surgery in T1 Breast Cancer?

    PubMed

    Dass, Tufale A; Rakesh, Sharma; Prakash, K Patil; Singh, Chandraveer

    2015-12-01

    To evaluate the correlation of various clinic-pathological variables with axillary nodal involvement in T1 breast cancer & to identify a sub-group of T1 cancers, on the basis of observed variables, with a low risk of axillary nodal metastases. Clinico-pathological variables observed included tumor size, lymphovascular invasion (LVI), histological grade of tumor, tumor palpability, estrogen/progesterone (ER/PR) & her2/neu receptors, age, family history, histological type of tumor, axillary nodal metastases for 100 patients without clinically palpable nodes who underwent axillary lymph node dissection in Bombay Hospital & Medical Research Center from March, 2009. Data compiled was analyzed by univariate & multivariate analysis. All the variables viz. tumor size, LVI, histological grade, tumor palpability & ER/PR/Her2 receptor profile, which were found to be significantly associated with axillary lymph node involvement (ALNI) on univariate analysis were also found to be independent predictors of ALNI on multivariate analysis. Age of the patient, family history & histological type of tumor were not significantly correlated with ALNI. None of the 12 patients with tumor biomarker profile of T1a-b tumors without LVI & with histological grade I, had ALNI. The risk of ALNI can be predicted by using various tumor biomarker variables. Based on the predicted risk of ALNI, the management strategy for axilla can be individualized. The omission of operative axillary staging may be considered in patients with low predictive risk of ALNI.

  3. Bone metastases of unknown origin: epidemiology and principles of management.

    PubMed

    Piccioli, Andrea; Maccauro, Giulio; Spinelli, Maria Silvia; Biagini, Roberto; Rossi, Barbara

    2015-06-01

    Metastases are the most common malignancies involving bone; breast, prostate, lung and thyroid are the main sites of primary cancer. However, up to 30 % of patients present with bone metastases of unknown origin, where the site of the primary neoplasm cannot be identified at the time of diagnosis despite a thorough history, physical examination, appropriate laboratory testing and modern imaging technology (CT, MRI, PET). Sometimes only extensive histopathological investigations on bone specimens from biopsy can suggest the primary malignancy. At other times, a bone lesion can have such a highly undifferentiated histological appearance that a precise pathological classification on routine hematoxylin-eosin-stained section is not possible. The authors reviewed the relevant literature in an attempt to investigate the epidemiology of the histological primaries finally identified in patients with bone metastases from occult cancer, and a strategy of management and treatment of bone metastases from occult carcinomas is suggested. Lung, liver, pancreas and gastrointestinal tract are common sites for primary occult tumors. Adenocarcinoma is the main histological type, accounting for 70 % of all cases, while undifferentiated cancer accounts for 20 %. Over the past 30 years, lung cancer is the main causative occult primary for bone metastases and has a poor prognosis with an average survival of 4-8 months. Most relevant literature focuses on the need for standardized diagnostic workup, as surgery for bone lesions should be aggressive only when they are solitary and/or the occult primaries have a good prognosis; in these cases, identification of the primary tumor may be important and warrants special diagnostic efforts. However, in most cases, the primary site remains unknown, even after autopsy. Thus, orthopedic surgery has a mainly palliative role in preventing or stabilizing pathological fractures, relieving pain and facilitating the care of the patient in an attempt

  4. Orbital Metastasis: Rare Initial Presentation of an Occult Gall Bladder Carcinoma.

    PubMed

    Jain, Tarun Kumar; Parihar, Ashwin Singh; Sood, Ashwani; Basher, Rajender Kumar; Bollampally, Neeraja; Shekhawat, Amit Singh; Mittal, Bhagwant Rai

    2018-03-01

    Orbital metastases are known to arise from primary breast carcinoma followed by prostate, malignant melanoma, and lung carcinoma. We report a case of orbital metastasis as the initial presentation of an occult primary gall bladder carcinoma. The FDG PET/CT helped in localizing the occult distant primary site, which previously escaped detection, and also enabled the evaluation of orbital metastasis.

  5. Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma. An international collaborative study

    PubMed Central

    Amit, Moran; Binenbaum, Yoav; Sharma, Kanika; Ramer, Naomi; Ramer, Ilana; Agbetoba, Abib; Glick, Joelle; Yang, Xinjie; Lei, Delin; Bjørndal, Kristine; Godballe, Christian; Mücke, Thomas; Wolff, Klaus-Dietrich; Fliss, Dan; Eckardt, André M.; Copelli, Chiara; Sesenna, Enrico; Palmer, Frank; Ganly, Ian; Patel, Snehal; Gil, Ziv

    2016-01-01

    Background The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. Methods We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. Results The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival. Conclusion Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity. PMID:25060927

  6. Detection of Occult Invasion in Melanoma In Situ.

    PubMed

    Bax, Michael J; Johnson, Timothy M; Harms, Paul W; Schwartz, Jennifer L; Zhao, Lili; Fullen, Douglas R; Chan, May P

    2016-11-01

    It is unclear why some patients with in situ melanoma develop metastases. Few reports demonstrate occult invasion with immunohistochemistry staining, which were discordant with reports interpreting such staining as false-positive. To investigate the occurrence of occult invasive disease within in situ melanoma by using methods to circumvent potential limitations in prior study designs. Unequivocal in situ melanoma without associated nevi or regression was identified using a consecutive sample of 33 cases plus 1 index case in an academic medical center. After cutting deeper into the most representative tissue block, 3 sequential slides were stained with hematoxylin-eosin (H-E), melanoma antigen (melan-A), and again with H-E. Melan-A-stained slides showing definitive invasion were double-stained with Sry-related HMg-Box gene 10 (SOX10) to confirm the melanocytic nature of the cells of interest. The study evaluated the possibilities of occult invasion detected by immunohistochemistry, sectioning deeper into the tissue block, or both. Slides were independently scored by 3 dermatopathologists with interrater reliability assessed. The study was conducted from January 1, 2012, to July 31, 2014. Assessment of the occurrence of occult invasion, diagnosis of invasion by immunohistochemistry alone vs cutting deeper into the tissue block, and occurrence of false-positive results using immunohistochemistry alone. Occult invasive melanoma was detected in 11 of 33 consecutive cases (33%) of previously diagnosed unequivocal in situ melanoma. Six of 11 melanomas (55%) were diagnosable only by immunohistochemistry. The remaining 5 tumors (45%) were diagnosable by both melan-A and H-E staining, likely as a result of simply cutting deeper into the tissue block. Four cases (12%) showed a few melan-A-positive cells in the dermis, which was insufficient for a diagnosis of invasive melanoma and most consistent on a cytomorphologic basis with occult nevi. Although rare, in situ melanoma

  7. Radiologically occult pulmonary lymphangitic carcinomatosis detected by /sup 67/Ga-citrate scintiscan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Band, P.R.; Lentle, B.C.; Amy, R.

    1976-10-01

    The use of gallium-67-citrate scintiscanning in the diagnosis of radiologically occult lung metastases is illustrated. The technique was used to demonstrate pulmonary lymphangitic carcinomatosis metastatic from breast cancer. (ERB)

  8. Implications of improved diagnostic imaging of small nodal metastases in head and neck cancer: Radiotherapy target volume transformation and dose de-escalation.

    PubMed

    van den Bosch, Sven; Vogel, Wouter V; Raaijmakers, Cornelis P; Dijkema, Tim; Terhaard, Chris H J; Al-Mamgani, Abrahim; Kaanders, Johannes H A M

    2018-05-03

    Diagnostic imaging continues to evolve, and now has unprecedented accuracy for detecting small nodal metastasis. This influences the tumor load in elective target volumes and subsequently has consequences for the radiotherapy dose required to control disease in these volumes. Small metastases that used to remain subclinical and were included in elective volumes, will nowadays be detected and included in high-dose volumes. Consequentially, high-dose volumes will more often contain low-volume disease. These target volume transformations lead to changes in the tumor burden in elective and "gross" tumor volumes with implications for the radiotherapy dose prescribed to these volumes. For head and neck tumors, nodal staging has evolved from mere palpation to combinations of high-resolution imaging modalities. A traditional nodal gross tumor volume in the neck typically had a minimum diameter of 10-15 mm, while nowadays much smaller tumor deposits are detected in lymph nodes. However, the current dose levels for elective nodal irradiation were empirically determined in the 1950s, and have not changed since. In this report the radiobiological consequences of target volume transformation caused by modern imaging of the neck are evaluated, and theoretically derived reductions of dose in radiotherapy for head and neck cancer are proposed. The concept of target volume transformation and subsequent strategies for dose adaptation applies to many other tumor types as well. Awareness of this concept may result in new strategies for target definition and selection of dose levels with the aim to provide optimal tumor control with less toxicity. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Prognostic value of site-specific metastases in pancreatic adenocarcinoma: A Surveillance Epidemiology and End Results database analysis.

    PubMed

    Oweira, Hani; Petrausch, Ulf; Helbling, Daniel; Schmidt, Jan; Mannhart, Meinrad; Mehrabi, Arianeb; Schöb, Othmar; Giryes, Anwar; Decker, Michael; Abdel-Rahman, Omar

    2017-03-14

    To evaluate the prognostic value of site-specific metastases among patients with metastatic pancreatic carcinoma registered within the Surveillance, Epidemiology and End Results (SEER) database. SEER database (2010-2013) has been queried through SEER*Stat program to determine the presentation, treatment outcomes and prognostic outcomes of metastatic pancreatic adenocarcinoma according to the site of metastasis. In this study, metastatic pancreatic adenocarcinoma patients were classified according to the site of metastases (liver, lung, bone, brain and distant lymph nodes). We utilized chi-square test to compare the clinicopathological characteristics among different sites of metastases. We used Kaplan-Meier analysis and log-rank testing for survival comparisons. We employed Cox proportional model to perform multivariate analyses of the patient population; and accordingly hazard ratios with corresponding 95%CI were generated. Statistical significance was considered if a two-tailed P value < 0.05 was achieved. A total of 13233 patients with stage IV pancreatic cancer and known sites of distant metastases were identified in the period from 2010-2013 and they were included into the current analysis. Patients with isolated distant nodal involvement or lung metastases have better overall and pancreatic cancer-specific survival compared to patients with isolated liver metastases (for overall survival: lung vs liver metastases: P < 0.0001; distant nodal vs liver metastases: P < 0.0001) (for pancreatic cancer-specific survival: lung vs liver metastases: P < 0.0001; distant nodal vs liver metastases: P < 0.0001). Multivariate analysis revealed that age < 65 years, white race, being married, female gender; surgery to the primary tumor and surgery to the metastatic disease were associated with better overall survival and pancreatic cancer-specific survival. Pancreatic adenocarcinoma patients with isolated liver metastases have worse outcomes compared to patients with isolated

  10. Fusion positron emission/computed tomography underestimates the presence of hilar nodal metastases in patients with resected non-small cell lung cancer.

    PubMed

    Carrillo, Sergio A; Daniel, Vincent C; Hall, Nathan; Hitchcock, Charles L; Ross, Patrick; Kassis, Edmund S

    2012-05-01

    The 5-year survival for patients with resected stage II (N1) non-small cell lung cancer ranges from 40% to 55%. No data exist addressing the benefit of neoadjuvant therapy for patients with stage II disease. This is largely in part due to the lack of a reliable, minimally invasive method to assess hilar nodes. This study is aimed at determining the ability of fusion positron emission/computed tomography (PET/CT) to identify hilar metastases in patients with resected non-small cell lung cancer. A retrospective review of surgically resected patients with fusion PET/CT within 30 days of resection was performed. The sensitivity, specificity, positive predictive value, and negative predictive value for PET/CT in detecting hilar nodal metastases was calculated for a range of maximum standardized uptake values (SUVmax). Hilar nodes from patients with falsely positive PET/CT scans were analyzed for the presence of histoplasmosis. Additionally, the impact of hilar node size greater than 1 centimeter on the calculated values was assessed. There were 119 patients evaluated. The number of lymph nodes resected ranged from 1 to 12 (X=2.98). There was decreased sensitivity and increased specificity with higher SUVmax cutoff values. At the standard SUVmax value of 2.5, the sensitivity and specificity were only 48.5% and 80.2%. The addition of size of hilar node by CT led to a modest improvement in sensitivity at all SUVmax cutoff values. Fusion PET/CT lacks sensitivity and specificity in identifying hilar nodal metastasis in patients with resected non-small cell lung cancer. Further prospective studies assessing the utility of PET/CT versus alternative sampling techniques are warranted. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma

    PubMed Central

    Pedersen, Nicklas Juel; Jensen, David Hebbelstrup; Lelkaitis, Giedrius; Kiss, Katalin; Charabi, Birgitte; Specht, Lena; von Buchwald, Christian

    2017-01-01

    It is challenging to identify at diagnosis those patients with early oral squamous cell carcinoma (OSCC), who have a poor prognosis and those that have a high risk of harboring occult lymph node metastases. The aim of this study was to develop a standardized and objective digital scoring method to evaluate the predictive value of tumor budding. We developed a semi-automated image-analysis algorithm, Digital Tumor Bud Count (DTBC), to evaluate tumor budding. The algorithm was tested in 222 consecutive patients with early-stage OSCC and major endpoints were overall (OS) and progression free survival (PFS). We subsequently constructed and cross-validated a binary logistic regression model and evaluated its clinical utility by decision curve analysis. A high DTBC was an independent predictor of both poor OS and PFS in a multivariate Cox regression model. The logistic regression model was able to identify patients with occult lymph node metastases with an area under the curve (AUC) of 0.83 (95% CI: 0.78–0.89, P <0.001) and a 10-fold cross-validated AUC of 0.79. Compared to other known histopathological risk factors, the DTBC had a higher diagnostic accuracy. The proposed, novel risk model could be used as a guide to identify patients who would benefit from an up-front neck dissection. PMID:28212555

  12. Liver resection for colorectal cancer metastases

    PubMed Central

    Gallinger, S.; Biagi, J.J.; Fletcher, G.G.; Nhan, C.; Ruo, L.; McLeod, R.S.

    2013-01-01

    Questions Should surgery be considered for colorectal cancer (crc) patients who have liver metastases plus (a) pulmonary metastases, (b) portal nodal disease, or (c) other extrahepatic metastases (ehms)? What is the role of chemotherapy in the surgical management of crc with liver metastases in (a) patients with resectable disease in the liver, or (b) patients with initially unresectable disease in the liver that is downsized with chemotherapy (“conversion”)? What is the role of liver resection when one or more crc liver metastases have radiographic complete response (rcr) after chemotherapy? Perspectives Advances in chemotherapy have improved survival in crc patients with liver metastases. The 5-year survival with chemotherapy alone is typically less than 1%, although two recent studies with folfox or folfoxiri (or both) reported rates of 5%–10%. However, liver resection is the treatment that is most effective in achieving long-term survival and offering the possibility of a cure in stage iv crc patients with liver metastases. This guideline deals with the role of chemotherapy with surgery, and the role of surgery when there are liver metastases plus ehms. Because only a proportion of patients with crc metastatic disease are considered for liver resection, and because management of this patient population is complex, multidisciplinary management is required. Methodology Recommendations in the present guideline were formulated based on a prepublication version of a recent systematic review on this topic. The draft methodology experts, and external review by clinical practitioners. Feedback was incorporated into the final version of the guideline. Practice Guideline These recommendations apply to patients with liver metastases from crc who have had or will have a complete (R0) resection of the primary cancer and who are being considered for resection of the liver, or liver plus specific and limited ehms, with curative intent. 1(a). Patients with liver and lung

  13. Prognostic Significance of the Location of Lymph Node Metastases in Patients With Adenocarcinoma of the Distal Esophagus or Gastroesophageal Junction.

    PubMed

    Anderegg, Maarten C J; Lagarde, Sjoerd M; Jagadesham, Vamshi P; Gisbertz, Suzanne S; Immanuel, Arul; Meijer, Sybren L; Hulshof, Maarten C C M; Bergman, Jacques J G H M; van Laarhoven, Hanneke W M; Griffin, S Michael; van Berge Henegouwen, Mark I

    2016-11-01

    To identify the prognostic significance of the location of lymph node metastases in patients with esophageal or gastroesophageal junction (GEJ) adenocarcinoma treated with neoadjuvant therapy followed by esophagectomy. Detection of lymph node metastases in the upper mediastinum and around the celiac trunk after neoadjuvant therapy and resection does not alter the TNM classification of esophageal carcinoma. The impact of these distant lymph node metastases on survival remains unclear. Between March 2003 and September 2013, 479 consecutive patients with adenocarcinoma of the distal esophagus or GEJ who underwent transthoracic esophagectomy with en bloc 2-field lymphadenectomy after neoadjuvant therapy were included, and survival was analyzed according to the location of positive lymph nodes in the resection specimen. Two hundred fifty-three patients had nodal metastases in the resection specimen. Of these patients, 92 patients had metastases in locoregional nodes, 114 patients in truncal nodes, 21 patients in the proximal field of the chest, and 26 patients had both positive truncal and proximal field nodes. Median disease-free survival was 170 months in the absence of nodal metastases, 35 months for metastases limited to locoregional nodes, 16 months for positive truncal nodes, 15 months for positive nodes in the proximal field, and 8 months for nodal metastases in both truncal and the proximal field. On multivariate analysis, location of lymph node metastases was independently associated with survival. Location of lymph node metastases is an independent predictor for survival. Relatively distant lymph node metastases along the celiac axis and/or the proximal field have a negative impact on survival. Location of lymph node metastases should therefore be considered in future staging systems of esophageal and GEJ adenocarcinoma.

  14. Human papillomavirus reduces the prognostic value of nodal involvement in tonsillar squamous cell carcinomas.

    PubMed

    Straetmans, Jos M J A A; Olthof, Nadine; Mooren, Jeroen J; de Jong, Jos; Speel, Ernst-Jan M; Kremer, Bernd

    2009-10-01

    Assessment of the prognostic value of nodal status in relation to human papillomavirus (HPV) status and the various treatment modalities in tonsillar squamous cell carcinomas (TSCC). Retrospective 5-year survival analysis. A 5-year follow-up of disease-free, disease-specific, and overall survival in a group of 81 patients with TSCC was conducted. The nodal status and integration of HPV-DNA in the genome (detected with fluorescence in situ hybridization) as prognostic indicators were examined while correcting for other clinical parameters (smoking habits, alcohol consumption, treatment modality, differentiation, TNM classification). Of TSCCs, 41% were positive for HPV type 16. In these TSCCs, the primary tumor was significantly smaller when compared to HVP-negative TSCCs (P = .04), whereas the percentage of cases with cervical metastases was identical. In the total population, it was not nodal involvement, but rather HPV manifestation, which was related to patient prognosis. Within the treatment modalities (surgery combined with radiotherapy and radiotherapy alone), neither nodal status nor HPV were prognostic indicators. Since a substantial percentage of TSCCs are HPV-positive and metastasizes to cervical lymph nodes in less advanced primary tumors, the N status is an unreliable prognostic indicator in TSCCs. HPV is only prognostically relevant in the total tumor population, but loses its value within patient groups receiving a single treatment modality. The value of HPV for prognosis of patients with TSCC requires further study.

  15. Incidence and sites of distant metastases from head and neck cancer.

    PubMed

    Ferlito, A; Shaha, A R; Silver, C E; Rinaldo, A; Mondin, V

    2001-01-01

    The incidence of distant metastases in head and neck squamous cell carcinoma (SCC) is relatively small in comparison to other malignancies. Distant metastases adversely impact survival and may significantly affect treatment planning. The incidence of distant metastases is influenced by location of the primary tumor, initial T and N stage of the neoplasm, and the presence or absence of regional control above the clavicle. Patients with advanced nodal disease have a high incidence of distant metastases, particularly in the presence of jugular vein invasion or extensive soft tissue disease in the neck. Primary tumors of advanced T stages in the hypopharynx, oropharynx and oral cavity are associated with the highest incidence of distant metastases. Pulmonary metastases are the most frequent in SCC, accounting for 66% of distant metastases. It may be difficult to distinguish pulmonary metastasis from a new primary tumor, particularly if solitary. Other metastatic sites include bone (22%), liver (10%), skin, mediastinum and bone marrow. An important question remains as to how intensely pre- and postoperative screening for distant metastases should be performed. Preoperative chest X-ray is warranted in all cases. If the primary tumor and nodal status place the patient at high risk for pulmonary metastasis, then preoperative computed tomography scan of the chest should be done. Screening for distant metastases at other sites is usually not indicated in SCC of the upper aerodigestive tract. Postoperatively, annual X-rays of the chest are usually sufficient, but in high-risk situations a chest X-ray performed every 3-6 months may be beneficial. Certain histologic types of primary tumor have greater or lesser propensity to metastasize distantly, and have a different natural history. Adenoid cystic carcinoma metastasizes frequently, even in the absence of extensive local or regional disease. Basaloid squamous cell carcinoma and neuroendocrine carcinomas also metastasize widely

  16. Dynamic Contrast-Enhanced Magnetic Resonance Imaging as a Predictor of Outcome in Head-and-Neck Squamous Cell Carcinoma Patients With Nodal Metastases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shukla-Dave, Amita, E-mail: davea@mskcc.org; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Lee, Nancy Y.

    2012-04-01

    Purpose: Dynamic contrast-enhanced MRI (DCE-MRI) can provide information regarding tumor perfusion and permeability and has shown prognostic value in certain tumors types. The goal of this study was to assess the prognostic value of pretreatment DCE-MRI in head and neck squamous cell carcinoma (HNSCC) patients with nodal disease undergoing chemoradiation therapy or surgery. Methods and Materials: Seventy-four patients with histologically proven squamous cell carcinoma and neck nodal metastases were eligible for the study. Pretreatment DCE-MRI was performed on a 1.5T MRI. Clinical follow-up was a minimum of 12 months. DCE-MRI data were analyzed using the Tofts model. DCE-MRI parameters weremore » related to treatment outcome (progression-free survival [PFS] and overall survival [OS]). Patients were grouped as no evidence of disease (NED), alive with disease (AWD), dead with disease (DOD), or dead of other causes (DOC). Prognostic significance was assessed using the log-rank test for single variables and Cox proportional hazards regression for combinations of variables. Results: At last clinical follow-up, for Stage III, all 12 patients were NED. For Stage IV, 43 patients were NED, 4 were AWD, 11 were DOD, and 4 were DOC. K{sup trans} is volume transfer constant. In a stepwise Cox regression, skewness of K{sup trans} (volume transfer constant) was the strongest predictor for Stage IV patients (PFS and OS: p <0.001). Conclusion: Our study shows that skewness of K{sup trans} was the strongest predictor of PFS and OS in Stage IV HNSCC patients with nodal disease. This study suggests an important role for pretreatment DCE-MRI parameter K{sup trans} as a predictor of outcome in these patients.« less

  17. Assessment of Ultrasound Features Predicting Axillary Nodal Metastasis in Breast Cancer: The Impact of Cortical Thickness

    PubMed Central

    Stachs, A.; Thi, A. Tra-Ha; Dieterich, M.; Stubert, J.; Hartmann, S.; Glass, Ä.; Reimer, T.; Gerber, B.

    2015-01-01

    Purpose: To evaluate the accuracy of axillary ultrasound (AUS) in detecting nodal metastasis in patients with early-stage breast cancer and to identify AUS features with high predictive power. Materials and Methods: Prospective single-center preliminary study in 105 patients with a primary diagnosis of breast cancer and clinically negative axilla. AUS was performed using a 12 MHz linear-array transducer before ultrasound-guided needle biopsy. Nodal characteristics (shape, longitudinal-transverse [LT] axis ratio, margins, cortical thickness, hyperechoic hilum) were correlated with histopathological nodal status after SLNB or axillary lymph node dissection (ALND). Results: Nodal metastases were present in 42/105 patients (40.0%). Univariate analyses showed that absence of hyperechoic hilum, round shape, LT axis ratio<2, sharp margins and cortical thickness>3 mm were associated with lymph node metastasis. Multivariate logistic regression analysis revealed cortical thickness > 3 mm as an independent predictive parameter for nodal involvement. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 66.7, 74.6, 63.6, 77.0% and 71.4% respectively when cortical thickness > 3 mm was applied as the criterion for AUS positivity. Axillary tumor volume was low in patients with pT1/2 tumors and negative AUS, since only 3.2% of patients had > 2 metastatic lymph nodes. Conclusion: Cortical thickness>3 mm is a reliable predictor of nodal metastatic involvement. Negative AUS does not exclude lymph node metastases, but extensive axillary tumor volume is rare. PMID:27689144

  18. [A retrospective analysis on occult neck lymphatic metastasis in early tongue cancer].

    PubMed

    Gong, Q L; Bian, C; Liu, H

    2016-10-07

    Objective: To investigate the number and level of occult neck lymphatic metastasis for squamous cell carcinoma of tongue in clinical stage Ⅰ/Ⅱ, and the relationship between cell differentiation and occult neck lymphatic metastasis. Methods: A total of 101 cases diagnosed preoperatively as having squamous cell carcinoma of tongue in clinical stage Ⅰ/Ⅱ (cT1/T2N0M0) between January 2005 and April 2015 were analysed retrospectively. Whether presence of occult neck lymphatic metastasis in these cases was studied. Results: Occult neck lymphatic metastases were found in 22 (21.78%) of 101 cases, 10 men and 12 women, with an age range of 22 to 83 years. There was not statistically significant association between tumor size or cell differentiation and occult neck lymphatic metastasis ( P >0.05). The metastasis occurred most commonly in level Ⅱ, followed by levelsⅠ, Ⅲ and Ⅳ. There was no lymph node metastasis in Level Ⅴ. There were total 20 cases with occult neck lymphatic metastasis in at least one of levelⅠ, Ⅱ, Ⅲ(90.9%), One of these case was skipping metastasis in level Ⅲ(4.6%). Conclusion: The early tongue cancer has a high rate of occult lymph metastasis, which occurs commonly in levels Ⅱ, Ⅰ and Ⅲ, but there is not significant association between the metastasis and tumor size or cell differentiation.

  19. The impact of the number of occult metastatic lymph nodes on postoperative relapse of resectable esophageal cancer.

    PubMed

    Morimoto, J; Tanaka, H; Ohira, M; Kubo, N; Muguruma, K; Sakurai, K; Yamashita, Y; Maeda, K; Sawada, T; Hirakawa, K

    2014-01-01

    Clinical stage II/III esophageal cancer (EC), as defined by the Japanese Classification, relapses at a moderately high rate even after curative resection. The number of lymph node metastases is known to be associated with tumor relapse. Recently, the prognostic significance of occult metastatic lymph nodes (MLNs), as well as that of overt MLNs, has been reported. The aim of this study was to investigate the impact of the total number of MLNs including occult MLNs on postoperative relapse in clinical stage II/III EC. One hundred and five patients with clinical stage II/III EC who underwent esophagectomy accompanied by radical lymphadenectomy at the Department of Surgical Oncology in Osaka City University Hospital between January 2000 and October 2008 were included in this study. Occult MLNs, metastases not detected by hematoxylin-eosin staining, were identified by immunohistochemistry (IHC) using antipancytokeratin antibody AE1/AE3. The clinicopathological features of occult MLNs were compared between the relapse and no relapse groups. A total of 6558 lymph nodes (1357 from two-field dissection and 5201 from three-field dissection) were examined by IHC staining; 362 overt MLNs and 143 occult MLNs were detected. The number of occult MLNs increased in proportion to the International Union Against Cancer pathological (p)N-status and pStage. When the number of occult MLNs was added to the number of pNs, the number of total MLNs was associated with postoperative relapse. With respect to tumor, node, metastasis stage, 6 of 22 patients (27%) who were pathological node-negative converted to node-positive by considering total MLNs. The number of N3 patients with relapse increased markedly with restaging by total MLNs. The number of total MLNs, but not overt MLNs, was an independent prognostic factor on multivariate analysis. These results suggest that occult MLNs were often found, and they were associated with postoperative relapse of resectable esophageal cancer. The total

  20. Fluorodeoxyglucose positron emission tomography–computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

    PubMed Central

    Bansal, Vandana; Damania, Kaizad; Sharma, Anshu Rajnish

    2011-01-01

    Introduction: Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers. Objective: We have done meta-analysis with an objective to evaluate the efficacy of FDG PET/CT and its current clinical role in early stage and operable cervical cancer. Materials and Methods: Studies in which FDG PET/CT was performed before surgery in patients with early stage cervical cancers were included for analysis. PET findings were confirmed with histopathological diagnosis rather than clinical follow-up. FDG PET/CT showed lower sensitivity and clinically unacceptable negative predictive value in detecting nodal metastases in early stage cervical cancer and therefore, can not replace surgicopathological staging. False negative results in presence of microscopic disease and sub-centimeter diseased nodes are still the area of concern for metabolic imaging. However, these studies are single institutional and performed in a small group of patients. There is enough available evidence of clinical utility of FDG PET/CT in locally advanced cervical cancer. But these results can not be extrapolated for early stage disease. Conclusion: The current data suggest that FDG PET/CT is suboptimal in nodal staging in early stage cervical cancer. PMID:23559711

  1. Predictors of axillary lymph node metastases in women with early breast cancer in Singapore.

    PubMed

    Tan, L G L; Tan, Y Y; Heng, D; Chan, M Y

    2005-12-01

    The presence of axillary lymph node metastases is an important prognostic factor in breast cancer. Sentinel lymph node biopsy (SLNB) is an emerging method for the staging of the axilla. It is hoped that with SLNB, the morbidity from axillary lymph node dissection (ALND) can be avoided without compromising the staging and management of early breast cancer. However, only patients found to be SLNB negative benefit from this procedure, as those with positive SLNB may still require ALND. Our objective is to study the various clinico-pathological factors to find predictive factors for axillary lymph node involvement in early breast cancer. It is hoped that with these factors, we will be better able to identify groups of patients most likely to benefit from SLNB. A retrospective study of 380 early breast cancer cases (stage T1 and T2, N0, N1, M0) in women treated in the Department of General Surgery, Tan Tock Seng Hospital, between January 1999 and August 2002, was conducted. Incidence of nodal metastases was correlated with clinico-pathological factors, and analysed by univariate and multivariate analyses. Approximately 35 percent of the 380 cases of early breast cancer had nodal metastases. Multivariate analyses revealed four independent predictors of node positivity: tumour size (p-value equals 0.0001), presence of lymphovascular invasion (p-value is less than 0.0001), tumours with histology other than invasive ductal or lobular carcinoma (p-value equals 0.04), and presence of progesterone receptors (p-value equals 0.05). We have found independent preoperative predictive factors in our local population for the presence of nodal metastases. This information can aid patient selection for SLNB and improve patient counselling.

  2. Sentinel Lymph Node Occult Metastases Have Minimal Survival Effect in Some Breast Cancer Patients

    Cancer.gov

    Detailed examination of sentinel lymph node tissue from breast cancer patients revealed previously unidentified metastases in about 16% of the samples, but the difference in 5-year survival between patients with and without these metastases was very small

  3. Omitting elective nodal irradiation during thoracic irradiation in limited-stage small cell lung cancer--evidence from a phase II trial.

    PubMed

    Colaco, Rovel; Sheikh, Hamid; Lorigan, Paul; Blackhall, Fiona; Hulse, Paul; Califano, Raffaele; Ashcroft, Linda; Taylor, Paul; Thatcher, Nicholas; Faivre-Finn, Corinne

    2012-04-01

    Omitting elective nodal irradiation (ENI) in limited-stage disease small cell lung cancer (LD-SCLC) is expected to result in smaller radiation fields. We report on data from a randomised phase II trial that omitted ENI in patients receiving concurrent chemo-radiotherapy for LD-SCLC. 38 patients with LD-SCLC were randomised to receive once-daily (66 Gy in 33 fractions) or twice-daily (45 Gy in 30 fractions) radiotherapy (RT). 3D-conformal RT was given concurrently with cisplatin and etoposide starting with the second cycle of a total of four cycles. The gross tumour volume was defined as primary tumour with involved lymph nodes (nodes ≥1 cm in short axis) identifiable with CT imaging. ENI was not used. Six recurrence patterns were identified: recurrence within planning target volume (PTV) only, recurrence within PTV+regional nodal recurrence and/or distant recurrence, isolated nodal recurrence outside PTV, nodal recurrence outside PTV+distant recurrence, distant metastases only and no recurrence. At median follow-up 16.9 months, 31/38 patients were evaluable and 14/31 patients had relapsed. There were no isolated nodal recurrences. Eight patients relapsed with intra-thoracic disease: 2 within PTV only, 4 within PTV and distantly and 2 with nodal recurrence outside PTV plus distant metastases. Rates of grade 3+ acute oesophagitis and pneumonitis in the 31 evaluable patients were 23 and 3% respectively. In our study of LD-SCLC, omitting ENI based on CT imaging was not associated with a high risk of isolated nodal recurrence, although further prospective studies are needed to confirm this. Routine ENI omission will be further evaluated prospectively in the ongoing phase III CONVERT trial (NCT00433563). Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. PET-NECK: a multicentre randomised Phase III non-inferiority trial comparing a positron emission tomography-computerised tomography-guided watch-and-wait policy with planned neck dissection in the management of locally advanced (N2/N3) nodal metastases in patients with squamous cell head and neck cancer.

    PubMed

    Mehanna, Hisham; McConkey, Chris C; Rahman, Joy K; Wong, Wai-Lup; Smith, Alison F; Nutting, Chris; Hartley, Andrew Gj; Hall, Peter; Hulme, Claire; Patel, Dharmesh K; Zeidler, Sandra Ventorin von; Robinson, Max; Sanghera, Bal; Fresco, Lydia; Dunn, Janet A

    2017-04-01

    Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND. Evidence is sparse and drawn mainly from retrospective single-institution studies, illustrating the need for a prospective randomised controlled trial. To determine the efficacy and cost-effectiveness of PET-CT-guided surveillance, compared with planned ND, in a multicentre, prospective, randomised setting. A pragmatic randomised non-inferiority trial comparing PET-CT-guided watch-and-wait policy with the current planned ND policy in HNSCC patients with locally advanced nodal metastases and treated with radical CRT. Patients were randomised in a 1 : 1 ratio. Primary outcomes were overall survival (OS) and cost-effectiveness [incremental cost per incremental quality-adjusted life-year (QALY)]. Cost-effectiveness was assessed over the trial period using individual patient data, and over a lifetime horizon using a decision-analytic model. Secondary outcomes were recurrence in the neck, complication rates and quality of life. The recruitment of 560 patients was planned to detect non-inferior OS in the intervention arm with a 90% power and a type I error of 5%, with non-inferiority defined as having a hazard ratio (HR) of no higher than 1.50. An intention-to-treat analysis was performed by Cox's proportional hazards model. Thirty-seven head and neck cancer-treating centres (43 NHS hospitals) throughout the UK. Patients with locally advanced nodal metastases of oropharynx, hypopharynx, larynx, oral or occult HNSCC receiving

  5. Three-dimensional conformal radiation therapy for esophageal squamous cell carcinoma: is elective nodal irradiation necessary?

    PubMed

    Zhao, Kuai-le; Ma, Jin-bo; Liu, Guang; Wu, Kai-liang; Shi, Xue-hui; Jiang, Guo-liang

    2010-02-01

    To evaluate the local control, survival, and toxicity associated with three-dimensional conformal radiotherapy (3D-CRT) for squamous cell carcinoma (SCC) of the esophagus, to determine the appropriate target volumes, and to determine whether elective nodal irradiation is necessary in these patients. A prospective study of 3D-CRT was undertaken in patients with esophageal SCC without distant metastases. Patients received 68.4 Gy in 41 fractions over 44 days using late-course accelerated hyperfractionated 3D-CRT. Only the primary tumor and positive lymph nodes were irradiated. Isolated out-of-field regional nodal recurrence was defined as a recurrence in an initially uninvolved regional lymph node. All 53 patients who made up the study population tolerated the irradiation well. No acute or late Grade 4 or 5 toxicity was observed. The median survival time was 30 months (95% confidence interval, 17.7-41.8). The overall survival rate at 1, 2, and 3 years was 77%, 56%, and 41%, respectively. The local control rate at 1, 2, and 3 years was 83%, 74%, and 62%, respectively. Thirty-nine of the 53 patients (74%) showed treatment failure. Seventeen of the 39 (44%) developed an in-field recurrence, 18 (46%) distant metastasis with or without regional failure, and 3 (8%) an isolated out-of-field nodal recurrence only. One patient died of disease in an unknown location. In patients treated with 3D-CRT for esophageal SCC, the omission of elective nodal irradiation was not associated with a significant amount of failure in lymph node regions not included in the planning target volume. Local failure and distant metastases remained the predominant problems. Copyright 2010 Elsevier Inc. All rights reserved.

  6. Radiosensitive orbital metastasis as presentation of occult colonic adenocarcinoma.

    PubMed

    Ludmir, Ethan B; McCall, Shannon J; Czito, Brian G; Palta, Manisha

    2014-09-19

    An 82-year-old man presented with progressive right frontal headaches. The patient's history was significant for benign polyps on surveillance colonoscopy 2 years prior, without high-grade dysplasia or carcinoma. MRI revealed an enhancing lesion arising within the superomedial aspect of the right orbit. Lesion biopsy demonstrated histological appearance and immunophenotype suggestive of colonic adenocarcinoma. Staging positron emission tomography/CT showed visceral metastases and diffuse activity in the posterior rectosigmoid, consistent with metastatic colon cancer. Treatment of the orbital lesion with external beam radiotherapy to 30 Gy resulted in significant palliation of the patient's headaches. The patient expired 2 months following treatment completion due to disease progression. Orbital metastasis as the initial presentation of an occult colorectal primary lesion is exceedingly rare, and occurred in this patient despite surveillance colonoscopy. Radiotherapy remains an efficacious modality for treatment of orbital metastases. 2014 BMJ Publishing Group Ltd.

  7. The distance between breast cancer and the skin is associated with axillary nodal metastasis.

    PubMed

    Eom, Yong Hwa; Kim, Eun Jin; Chae, Byung Joo; Song, Byung Joo; Jung, Sang Seol

    2015-06-01

    More superficially located tumors may be more likely than deeper tumors to metastasize to the axillary nodes via the lymphatics. The aim of this study was to determine whether breast cancer distance from the skin affects axillary node metastasis, ipsilateral breast cancer recurrence, or recurrence-free survival. A total of 1,005 consecutive patients with breast cancer who underwent surgery between January 2003 and December 2009 were selected. The distance of the tumor from the skin was measured from the skin to the most anterior hypoechoic leading edge of the lesion. In total, 603 (68%) patients had no axillary nodal metastasis, and 288 (32%) had axillary nodal metastasis. A breast cancer distance from the skin <3 mm induced more axillary nodal metastasis (P = 0.039). However, no significant correlation was observed between breast cancer distance from the skin <3 mm and ipsilateral breast cancer recurrence (P = 0.788) or recurrence-free survival (P = 0.353). Breast cancers located closer to the skin had a higher incidence of axillary nodal metastasis. Therefore, tumor distance from the skin should be considered when evaluating a patient with breast cancer and considering the risk of nodal metastasis. © 2015 Wiley Periodicals, Inc.

  8. Detection of lymph node metastases in pediatric and adolescent/young adult sarcoma: Sentinel lymph node biopsy versus fludeoxyglucose positron emission tomography imaging-A prospective trial.

    PubMed

    Wagner, Lars M; Kremer, Nathalie; Gelfand, Michael J; Sharp, Susan E; Turpin, Brian K; Nagarajan, Rajaram; Tiao, Gregory M; Pressey, Joseph G; Yin, Julie; Dasgupta, Roshni

    2017-01-01

    Lymph node metastases are an important cause of treatment failure for pediatric and adolescent/young adult (AYA) sarcoma patients. Nodal sampling is recommended for certain sarcoma subtypes that have a predilection for lymphatic spread. Sentinel lymph node biopsy (SLNB) may improve the diagnostic yield of nodal sampling, particularly when single-photon emission computed tomography/computed tomography (SPECT-CT) is used to facilitate anatomic localization. Functional imaging with positron emission tomography/computed tomography (PET-CT) is increasingly used for sarcoma staging and is a less invasive alternative to SLNB. To assess the utility of these 2 staging methods, this study prospectively compared SLNB plus SPECT-CT with PET-CT for the identification of nodal metastases in pediatric and AYA patients. Twenty-eight pediatric and AYA sarcoma patients underwent SLNB with SPECT-CT. The histological findings of the excised lymph nodes were then correlated with preoperative PET-CT imaging. A median of 2.4 sentinel nodes were sampled per patient. No wound infections or chronic lymphedema occurred. SLNB identified tumors in 7 of the 28 patients (25%), including 3 patients who had normal PET-CT imaging of the nodal basin. In contrast, PET-CT demonstrated hypermetabolic regional nodes in 14 patients, and this resulted in a positive predictive value of only 29%. The sensitivity and specificity of PET-CT for detecting histologically confirmed nodal metastases were only 57% and 52%, respectively. SLNB can safely guide the rational selection of nodes for biopsy in pediatric and AYA sarcoma patients and can identify therapy-changing nodal disease not appreciated with PET-CT. Cancer 2017;155-160. © 2016 American Cancer Society. © 2016 American Cancer Society.

  9. Long-term outcome of ultrasound-guided percutaneous ethanol ablation of selected "recurrent" neck nodal metastases in 25 patients with TNM stages III or IVA papillary thyroid carcinoma previously treated by surgery and 131I therapy.

    PubMed

    Hay, Ian D; Lee, Robert A; Davidge-Pitts, Caroline; Reading, Carl C; Charboneau, J William

    2013-12-01

    Ultrasound-guided percutaneous ethanol ablation (UPEA) of neck nodal metastases (NNM) has rarely been reported in papillary thyroid carcinoma (PTC) patients with advanced localized disease. We ablated 25 PTC patients with stage III or IVA disease (mean age 58 years) who had "recurrent" NNM after surgery and 131I therapy. Diagnosis of 37 selected NNM was proven by ultrasound-guided biopsy. UPEA was usually performed in 2 outpatient sessions. After UPEA, 35 of 37 NNM (95%) decreased in size. None had significant Doppler flow. Seventeen (46%) disappeared on rescanning. Serum thyroglobulin fell in 19 of 22 (86%) without thyroglobulin autoantibodies. None of the UPEA-treated NNM, followed on average for 5.4 years, required further intervention. Six patients (24%) subsequently developed 18 "new" recurrences. Of the 18, 15 (83%) were managed successfully by UPEA rather than operation. None of the 25 patients developed permanent hoarseness or have died from PTC. At our institution, where patients undergoing nodal dissections are charged $35-45,000, each outpatient UPEA procedure saves health providers approximately $38,400. Our 25 ablated patients, by avoiding 40 further neck reexplorations, on average, saved $61,440 in charges. UPEA for NNM in advanced localized PTC has proved safe and effective. It is also considerably less expensive than the conventional operative alternative of nodal dissection. Copyright © 2013 Mosby, Inc. All rights reserved.

  10. Platelet-derived growth factor receptor-α promotes lymphatic metastases in papillary thyroid cancer.

    PubMed

    Zhang, Jingdong; Wang, Peng; Dykstra, Mark; Gelebart, Pascale; Williams, David; Ingham, Robert; Adewuyi, Esther Ekpe; Lai, Raymond; McMullen, Todd

    2012-10-01

    Lymph node metastases are common in papillary thyroid cancer (PTC) and can be resistant to surgical extirpation or radioiodine ablation. We examined the role of platelet-derived growth factor receptor (PDGFR) in mediating lymph node metastases in PTC. Clinical specimens of PTC (n = 137) were surveyed in a tissue array and by western blots to examine the relationship between expression of the α and β subunits of PDGFR and lymph node metastases. PDGFR-α was found at high levels in primary tumours with known lymphatic metastases but not in those tumours lacking nodal involvement (p < 0.0001). However, PDGFR-β expression was not linked to metastatic disease (p = 0.78) as it was found in virtually all PTC specimens. A matching analysis in fresh PTC specimens (n = 13) confirmed that PDGFR-α expression was strongly linked to metastatic spread (p = 0.0047). PDGFR-α and -β were not found in normal thyroid tissue (p < 0.0001). PTC cell lines selectively expressing PDGFR-α or -β were assessed for invasive potential and activation of downstream signal transduction pathways. PTC cell lines expressing PDGFR-α responded to PDGF-BB stimulation with increased invasive potential and this process can be blocked by the tyrosine kinase receptor inhibitor sunitinib (p < 0.009). Cell lines with only PDGFR-β, or no PDGFR, did not show significant changes in invasive potential. Activation of PDGFR-α led to downstream up-regulation of both the MAPK/ERK and PI3K/Akt pathways and disruption of either pathway is sufficient to block PDGFR-mediated increases in invasive potential. Thus, PDGFR-α is associated with lymph node metastases in papillary thyroid carcinoma and PDGFR-α promotes increased invasive potential in PTC cell lines. PDGFR-α is a strong candidate for a diagnostic biomarker to identify patients at risk of nodal metastases. Our results also strengthen the rationale for selection of tyrosine kinase receptor inhibitors that target PDGFR in the treatment of progressive

  11. Reflective Occultation Mask for Evaluation of Occulter Designs for Planet Finding

    NASA Technical Reports Server (NTRS)

    Hagopian, John; Lyon, Richard; Shiri, Shahram; Roman, Patrick

    2011-01-01

    Advanced formation flying occulter designs utilize a large occulter mask flying in formation with an imaging telescope to block and null starlight to allow imaging of faint planets in exosolar systems. A paper describes the utilization of subscale reflective occultation masks to evaluate formation flying occulter designs. The use of a reflective mask allows mounting of the occulter by conventional means and simplifies the test configuration. The innovation alters the test set-up to allow mounting of the mask using standard techniques to eliminate the problems associated with a standard configuration. The modified configuration uses a reflective set-up whereby the star simulator reflects off of a reflective occulting mask and into an evaluation telescope. Since the mask is sized to capture all rays required for the imaging test, it can be mounted directly to a supporting fixture without interfering with the beam. Functionally, the reflective occultation mask reflects light from the star simulator instead of transmitting it, with a highly absorptive carbon nanotube layer simulating the occulter blocking mask. A subscale telescope images the star source and companion dim source that represents a planet. The primary advantage of this is that the occulter can be mounted conventionally instead of using diffractive wires or magnetic levitation.

  12. Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma.

    PubMed

    Seol, Ki Ho; Lee, Jeong Eun

    2016-03-01

    To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

  13. Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

    PubMed Central

    Seol, Ki Ho

    2016-01-01

    Purpose To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Materials and Methods Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4–72 Gy (39.6–45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. Results The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. Conclusion No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC. PMID:27104162

  14. Predicted occultation of Regulus

    NASA Astrophysics Data System (ADS)

    Waagen, Elizabeth O.

    2014-03-01

    The predicted occultation of Regulus (alpha Leo) by the magnitude-12.4 V asteroid (163) Erigone on 2014 March 20 at approximately 02:06 a.m. EDT (06:06 UT) is discussed. The occultation track includes Bermuda and northwest along a corridor stretching from the mid-Atlantic USA through Ontario, Canada. Unusual things about this occultation include the facts that the track includes major metropolitan areas such as New York City, and the star being occulted is one of the brightest in the Northern sky and is in a constellation pattern that makes it easy to find. The International Occultation Timing Association (IOTA) website (http://occultations.org/Regulus2014/) has comprehensive information about this predicted occultation and observing and reporting instructions, as well as links to other resources. In addition to witnessing a very rare event (Regulus is the brightest star ever to be predicted to be occulted from the USA), the possibilities for science include these three:! determining the shape of Erigone, detecting a possible companion of Erigone, and detecting the suspected white dwarf companion of Regulus. See the Alert Notice for details.

  15. Deep shadow occulter

    NASA Technical Reports Server (NTRS)

    Cash, Webster (Inventor)

    2010-01-01

    Methods and apparatus are disclosed for occulting light. The occulter shape suppresses diffraction at any given size or angle and is practical to build because it can be made binary to avoid scatter. Binary structures may be fully opaque or fully transmitting at specific points. The diffraction suppression is spectrally broad so that it may be used with incoherent white light. An occulter may also include substantially opaque inner portion and an at least partially transparent outer portion. Such occulters may be used on the ground to create a deep shadow in a short distance, or may be used in space to suppress starlight and reveal exoplanets.

  16. Axillary lymph node metastases in adenoid cystic carcinoma of the breast. A rare finding

    PubMed Central

    SPILIOPOULOS, D.; MITSOPOULOS, G.; KAPTANIS, S.; HALKIAS, C.

    2015-01-01

    Adenoid cystic carcinoma (ACC) of the breast is a rare malignant salivary-type neoplasm that has a good prognosis and represents less than 1% of all breast cancers. It is a triple negative carcinoma that presents as a painful mass. The mean age at the time of diagnosis is 50–60 years old. The solid variant of this type of tumour with basaloid features and presence of nodal metastases is very rare and considered to have a more aggressive clinical course. We present a case with presence of axillary lymph node metastases that was successfully treated with no evidence of recurrence one year after the diagnosis and review the literature. PMID:26712257

  17. Long-term survival in a patient with brain metastases of papillary thyroid carcinoma

    PubMed Central

    Guelho, Daniela; Ribeiro, Cristina; Melo, Miguel; Carrilho, Francisco

    2016-01-01

    We present the case of a 43-year-old woman who underwent total thyroidectomy with bilateral lymphadenectomy for a papillary thyroid carcinoma (PTC), solid variant (T4bN1bMx), with V600E BRAF mutation. After ablative therapy, she presented undetectable thyroglobulin (Tg) but progressively increasing anti-Tg antibodies (TgAbs). During follow-up, nodal, lung and brain metastases were identified. She was submitted to surgical excision of lung lesions, radiosurgery of brain metastases and five radioiodine treatments. The latest brain MRI showed no lesions, pulmonary CT showed stable micronodules and there was progressive reduction in TgAbs. This is a peculiar case of a PTC with lung and brain metastatic lesions detected through TgAbs. Initial histological and molecular study suggested a more aggressive clinical behaviour, which was eventually confirmed. Although PTC brain metastases are extremely rare and present poor prognosis, our patient presented a good response to treatment and longer survival than usually reported for similar cases. PMID:26961557

  18. Incidence of isolated nodal failure in non-small cell lung cancer patients included in a prospective study of the value of PET-CT.

    PubMed

    Kolodziejczyk, Milena; Bujko, Krzysztof; Michalski, Wojciech; Kepka, Lucyna

    2012-07-01

    Elective nodal irradiation (ENI) is not recommended in PET-CT-based radiotherapy for NSCLC despite a low level of evidence to support such guidelines. The aim of this investigation is to find out whether omitting ENI is safe. Sixty-seven patients treated within a frame of a previously published prospective trial of the value of PET-CT were included in the analysis. Seventeen (25%) patients received ENI due to higher initial nodal involvement and in the remaining 50 patients (75%) with N0-N1 or single N2 disease ENI was omitted. Isolated nodal failure (INF) was recorded if relapse occurred in the initially uninvolved regional lymph node without previous or simultaneous local recurrence regardless of the status of distant metastases. With a median follow-up of 32 months, the estimated 3-year overall survival was 42%, local progression-free interval was 55%, and distant metastases-free interval was 62%. Three patients developed INF; all had ENI omitted from treatment, giving a final result of three INFs in 50 (6%) patients treated without ENI. In this group of patients, the 3-year cause-specific cumulative incidence of INF was 6.4% (95% confidence interval: 0-17%). The omission of ENI appears to be not as safe as suggested by current recommendations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Experimental discovery of nodal chains

    NASA Astrophysics Data System (ADS)

    Yan, Qinghui; Liu, Rongjuan; Yan, Zhongbo; Liu, Boyuan; Chen, Hongsheng; Wang, Zhong; Lu, Ling

    2018-05-01

    Three-dimensional Weyl and Dirac nodal points1 have attracted widespread interest across multiple disciplines and in many platforms but allow for few structural variations. In contrast, nodal lines2-4 can have numerous topological configurations in momentum space, forming nodal rings5-9, nodal chains10-15, nodal links16-20 and nodal knots21,22. However, nodal lines are much less explored because of the lack of an ideal experimental realization23-25. For example, in condensed-matter systems, nodal lines are often fragile to spin-orbit coupling, located away from the Fermi level, coexist with energy-degenerate trivial bands or have a degeneracy line that disperses strongly in energy. Here, overcoming all these difficulties, we theoretically predict and experimentally observe nodal chains in a metallic-mesh photonic crystal having frequency-isolated linear band-touching rings chained across the entire Brillouin zone. These nodal chains are protected by mirror symmetry and have a frequency variation of less than 1%. We use angle-resolved transmission measurements to probe the projected bulk dispersion and perform Fourier-transformed field scans to map out the dispersion of the drumhead surface state. Our results establish an ideal nodal-line material for further study of topological line degeneracies with non-trivial connectivity and consequent wave dynamics that are richer than those in Weyl and Dirac materials.

  20. The natural history and patterns of metastases from mucosal melanoma: an analysis of 706 prospectively-followed patients.

    PubMed

    Lian, B; Cui, C L; Zhou, L; Song, X; Zhang, X S; Wu, D; Si, L; Chi, Z H; Sheng, X N; Mao, L L; Wang, X; Tang, B X; Yan, X Q; Kong, Y; Dai, J; Li, S M; Bai, X; Zheng, N; Balch, C M; Guo, J

    2017-04-01

    We examined whether mucosal melanomas are different in their clinical course and patterns of metastases when arising from different anatomic sites. Our hypothesis was that metastatic behavior would differ from primary mucosal melanomas at different anatomical sites. Clinical and pathological data from 706 patients were compared for their stage distribution, patterns of metastases, CKIT/BRAF mutation status, and overall survival for different anatomical sites. The anatomic sites of the primary mucosal melanomas were from the lower GI tract (26.5%), nasal cavity and paranasal sinuses (23%), gynecological sites (22.5%), oral cavity (15%), urological sites (5%), upper GI tract (5%), and other sites (3.0%). At initial diagnosis, 14.5% were stage I disease, 41% Stage II, 21.5% Stage III, and 23.0% stage IV. Predominant metastatic sites were regional lymph nodes (21.5%), lung (21%), liver (18.5%), and distant nodes (9%). Oral cavity mucosal melanoma had a higher incidence of regional nodal metastases (31.7% versus 19.8%, P = 0.009), and a higher incidence of lung metastases (32.5% versus 18.5%, P = 0.007) compared to other primary mucosal melanomas. There was a 10% incidence of CKIT mutation and 12% BRAF mutation. Mucosal melanomas from nasal pharyngeal and oral, gastrointestinal, gynecological, and urological had a similar survival with a 1-year survival rate (88%, 83%, 86%), 2-year survival rate (66%, 57%, 61%), 5-year survival rate (27%, 16%, 20%), respectively. The largest sample size allows, for the first time, a comparison of primary melanoma stage and patterns of metastases across anatomical sites. With few exceptions, the presenting stages, incidence of nodal and distant metastases, the site of predilection of distant metastases, or overall survival were similar despite different primary anatomic sites. These findings suggest that clinical trials involving mucosal melanomas and the administration of systemic therapy can be applied equally to mucosal

  1. Uranus occults SAO158687. [stellar occultation and planetary parametric observation

    NASA Technical Reports Server (NTRS)

    Elliot, J. L.; Veverka, J.; Millis, R. L.

    1977-01-01

    Experience gained in obtaining atmospheric parameters, oblatenesses, and diameters of Jupiter and Mars from recent stellar occultations by these planets is used to predict what can be learned from the March 1977 occultation of the star SAO158687 by Uranus. The spectra of this star and Uranus are compared to indicate the relative instrument intensities of the two objects, the four passbands where the relative intensities are most nearly equal are listed, and expected photon fluxes from the star are computed on the assumption that it has UBVRI colors appropriate for a K5 main-sequence object. It is shown that low photon noise errors can be achieved by choosing appropriate passbands for observation, and the rms error expected for the Uranus temperature profiles obtained from the occultation light curves is calculated. It is suggested that observers of this occultation should record their data digitally for optimum time resolution.

  2. The Occult Today: Why?

    ERIC Educational Resources Information Center

    Kessler, Gary E.

    1975-01-01

    Author offered some reflections on the "why" of the contemporary interest in the occult. He attempted to convince the reader that, if he or she has been surprised by the recent rise of occultism, sober reflection will dispell some fears and, perhaps, even convince him or her that occultism is not merely superstition. (Author/RK)

  3. Intensity-Modulated Radiotherapy for Cervical Lymph Node Metastases From Unknown Primary Cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Madani, Indira; Vakaet, Luc; Bonte, Katrien

    2008-07-15

    Purpose: To compare the effectiveness of intensity-modulated radiotherapy (IMRT) and conventional (two-dimensional) radiotherapy in the treatment of cervical lymph node metastases from unknown primary cancer (UPC). Methods and Materials: Between February 2003 and September 2006, 23 patients with UPC of squamous cell carcinoma were treated with IMRT. Extended putative mucosal and bilateral nodal sites were irradiated to a median dose of 66 Gy. In 19 patients, IMRT was performed after lymph node dissection, and in 4 patients primary radiotherapy was given. The conventional radiotherapy group (historical control group) comprised 18 patients treated to a median dose of 66 Gy betweenmore » August 1994 and October 2003. Results: Twenty patients completed treatment. As compared with conventional radiotherapy, the incidence of Grade 3 acute dysphagia was significantly lower in the IMRT group (4.5% vs. 50%, p = 0.003). By 6 months, Grade 3 xerostomia was detected in 11.8% patients in the IMRT group vs. 53.4% in the historical control group (p = 0.03). No Grade 3 dysphagia or skin fibrosis was observed after IMRT but these were noted after conventional radiotherapy (26.7%, p = 0.01) and 26.7%, p = 0.03) respectively). With median follow-up of living patients of 17 months, there was no emergence of primary cancer. One patient had persistent nodal disease and another had nodal relapse at 5 months. Distant metastases were detected in 4 patients. The 2-year overall survival and distant disease-free probability after IMRT did not differ significantly from those for conventional radiotherapy (74.8% vs. 61.1% and 76.3% vs. 68.4%, respectively). Conclusions: Use of IMRT for UPC resulted in lower toxicity than conventional radiotherapy, and was similar in efficacy.« less

  4. Adjuvant Radiotherapy for Palpable Melanoma Metastases to the Groin: When to Irradiate?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gojkovic-Horvat, Andreja; Jancar, Boris; Blas, Mateja

    2012-05-01

    Purpose: To determine the efficacy of and criteria for postoperative radiotherapy (PORT) in patients with palpable melanoma metastases to the groin. Methods and Materials: Patients with palpable metastases to the groin who were treated with therapeutic nodal dissection during 2000 to 2006 were identified in a prospective institutional database. Results: In 101 patients, 103 therapeutic nodal dissections were performed; 37 of these were treated with PORT to a median equivalent dose (eqTD{sub 2}) of 50.6 Gy (range, 50-72 Gy). In the surgery-only and PORT groups, 2-year regional control rates were 86% (95% confidence interval [CI] 76-95%) and 91% (95% CI,more » 81-100%), respectively (p = 0.395). Of five recurrences in radiation-treated patients, four were of dermal type, and in three of these cases, no bolus over the operative scar was used. PORT improved 2-year regional control (46% [95% CI, 11-82%] vs. 82% [95% CI, 63-100%], p = 0.022) among patients in which the sum of risk factors present (i.e., risk factor score) was {>=}2. In multivariate analysis, risk-factor score (<2 vs. {>=}2: HR, 2.93; 95% CI, 1.00-8.56; p < 0.0001) and PORT (yes vs. no: HR, 7.81; 95% CI, 2.83-21.74; p = 0.050) was predictive for regional control and on logistic-regression testing, number of involved lymph nodes was predictive for systemic dissemination (p = 0.011). Conclusions: PORT should follow therapeutic nodal dissection in cases with two or more adverse factors. More conventional fractionation ({<=}2.5 Gy), cumulative eqTD{sub 2} <60 Gy and use of bolus over the operative scar are recommended.« less

  5. [Evaluation of the causes of lymphatic metastases after surgical treatment of patients with laryngeal cancer].

    PubMed

    Semczuk, B; Sekuła, J; Szmeja, Z; Janczewski, G; Kruk-Zagajewska, A; Olszewski, E; Niedzielska, G; Horoch, A; Osuch-Wójcikiewicz, E; Sieradzki, A

    1990-01-01

    During the years 1980-1988 2458 laryngeal cancer patients were operated upon in 4 ENT AM Clinics in Kraków, Poznań, Lublin and Warszawa. 300 (12%) out of them have had the cervical node metastases in 18 months after the surgery. The cause analysis was performed. The primary localizations were in the epiglottic and ++post-cricoid areas. The causes of metastases to the ++lymph nodes were analyzed; the primary epiglottic and ++post-cricoid localization of the tumor, its extensiveness and advanced clinical stage. Twice more often were the nodal metastases stated before the primary treatment, a high degree of histological malignancy, probably insufficient radicality of the surgery and insufficient immunological resistance of the organism were taken in consideration. This group of patients presented a rather high percentage of early unsuccessful results of surgical treatment of the laryngeal cancer; this problem needs further analysis and observations.

  6. Level IIB Neck Dissection in Oral Squamous Cell Carcinoma: Science or Myth?

    PubMed

    Ghantous, Yasmine; Akrish, Sharon; Abd-Elraziq, Morad; El-Naaj, Imad Abu

    2016-06-01

    Selective neck dissection enables us to reduce the morbidity of neck dissection while maintaining the same oncological results, mainly in clinically negative neck N0. The most common morbidity associated with selective neck dissection is spinal accessory nerve dysfunction and related shoulder disability, which are encountered during dissection of level IIB.The aim of authors' study is to evaluate the incidence of sublevel IIB lymphatic metastasis in clinically N0 oral squamous cell carcinoma (OSCC) patients.The study group comprised 48 men (68%) and 22 women (32%). The median number of the lymph nodes removed from level IIB was 6.5. All the investigated necks were clinically classified as N0, of which 14 (20%) turned out to have an occult nodal metastasis, including only 1 patient (1.42%) of level IIB occult metastasis, which originated from the primary tumor located in the tongue and also metastasized to level IIA. The most associated morbidity was shoulder pain and dysfunction, which presented in 60% of the patients.Also, an electronic search was conducted to find relevant studies investigating the prevalence of level IIB metastasis in OSCC. Ten studies were included for full text review, including the current study. The overall incidence of level IIB metastasis is 4% (17 patients); of these 17 patients, only 4 patients had isolated level IIB nodal metastases (2%).To conclude, neck dissecting, including dissecting level IIB, remains the keystone of treating OSCC. Its prognostic and therapeutic value exceeds its associated morbidity; therefore, dissecting level IIB is recommended in treating OSCC in clinically N0 patients.

  7. Spinless hourglass nodal-line semimetals

    NASA Astrophysics Data System (ADS)

    Takahashi, Ryo; Hirayama, Motoaki; Murakami, Shuichi

    2017-10-01

    Nodal-line semimetals, one of the topological semimetals, have degeneracy along nodal lines where the band gap is closed. In many cases, the nodal lines appear accidentally, and in such cases it is impossible to determine whether the nodal lines appear or not, only from the crystal symmetry and the electron filling. In this paper, for spinless systems, we show that in specific space groups at 4 N +2 fillings (8 N +4 fillings including the spin degree of freedom), presence of the nodal lines is required regardless of the details of the systems. Here, the spinless systems refer to crystals where the spin-orbit coupling is negligible and the spin degree of freedom can be omitted because of the SU(2) spin degeneracy. In this case the shape of the band structure around these nodal lines is like an hourglass, and we call this a spinless hourglass nodal-line semimetal. We construct a model Hamiltonian as an example and we show that it is always in the spinless hourglass nodal-line semimetal phase even when the model parameters are changed without changing the symmetries of the system. We also establish a list of all the centrosymmetric space groups, under which spinless systems always have hourglass nodal lines, and illustrate where the nodal lines are located. We propose that Al3FeSi2 , whose space-group symmetry is Pbcn (No. 60), is one of the nodal-line semimetals arising from this mechanism.

  8. Studies in occultation astronomy

    NASA Technical Reports Server (NTRS)

    Veverka, J.

    1980-01-01

    Major scientific results are summarized for the following studies: (1) observations of the 8 April 1976 occultation of epsilon Geminorum by Mars; (2) studies in occultation techniques; and (3) the March 1974 occultation of Saturn by the Moon. A re-analysis of the 1974 lunar occultation of the Titan indicates that Titan is strongly limb darkened, with D approximately greater than 5800km; there is internal evidence in the data that Titan's atmosphere is inhomogeneous; and that observations are inconsistent with any sample homogeneous model atmosphere which matches the P (lambda) and Beta (lambda) observations of Titan.

  9. Occultation studies of the Solar System

    NASA Technical Reports Server (NTRS)

    Millis, Robert L.

    1987-01-01

    The planetary occultation program began at Lowell Observatory in 1973 with a worldwide campaign to observe mutual occultations and eclipses of the Galilean Satellites. Then the temperature profile of the Martian atmosphere was measured from data taken during the occultation of epsilon Geminorum, the Rings of Uranus were discovered as they occulted SAO 158687, and the dimensions of Pallas were measured when that minor planet occulted SAO 85009. In 1979 the present grant was initiated, providing funds for portable photometric instrumentation used to observe occultations by asteroids as well as by Uranus and Neptune. Software for predicting occultations of catalog stars by asteroids, planets, and comets was written in 1983. Lowell currently provides most of the available predictions for asteroid occultations. Realizing in 1983 that the lack of a high-quality astrometric telescope dedicated to occultation work was limiting progress, an 18-inch, F/8 lens was acquired and adapted to an existing mounting at Lowell. Although acquisition of the lens and implementation of the new telescope has been accomplished primarily with non-grant funds, the instrument makes a major contribution to occultation research.

  10. New Occultation Systems and the 2005 July 11 Charon Occultation

    NASA Astrophysics Data System (ADS)

    Young, L. A.; French, R. G.; Gregory, B.; Olkin, C. B.; Ruhland, C.; Shoemaker, K.; Young, E. F.

    2005-08-01

    Charon's density is an important input to models of its formation and internal structure. Estimates range from 1.59 to 1.83 g/cm3 (Olkin et al. 2003. Icarus 164, 254), with Charon's radius as the main source of uncertainty. Reported values of Charon's radius from mutual events range from 593±13 (Buie et al. 1992, Icarus 97, 211) to 621±21 km (Young & Binzel 1994, Icarus 108), while an occultation observed from a single site gives a lower limit on the radius of 601.5 km (Walker 1980 MNRAS 192, 47; Elliot & Young 1991, Icarus 89, 244). On 2005 July 11 UT (following this abstract submission date), Charon is predicted to occult the star C313.2. If successful, this event will be the first Charon occultation observed since 1980, and the first giving multiple chords across Charon's disk. This event is expected to measure Charon's radius to 1 km. Our team is observing from three telescopes in Chile, the 4.0-m Blanco and the 0.9-m telescopes at Cerro Tololo and the 4.2-m SOAR telescope at Cerro Pachon. At SOAR, we will be using the camera from our new PHOT systems (Portable High-speed Occultation Telescopes). The PHOT camera is a Princeton Instrument MicroMAX:512BFT from Roper Scientific, a 512×512 frame-transfer CCD with a readnoise of only 3 electrons at the 100 kHz digitization rate. The camera's exposures are triggered by a custom built, compact, stand-alone GPS-based pulse-train generator. A PHOT camera and pulse-train generator were used to observe the occultation of 2MASS 1275723153 by Pluto on 2005 June 15 UT from Sommers-Bausch Observatory in Boulder Colorado; preliminary analysis shows this was at best a grazing occultation from this site and a successful engineering run for the July 11 Charon occultation. The work was supported, in part, by NSF AST-0321338 (EFY) and NASA NNG-05GF05G (LAY).

  11. Limitations of PET/CT in the Detection of Occult N1 Metastasis in Clinical Stage I(T1-2aN0) Non-Small Cell Lung Cancer for Staging Prior to Stereotactic Body Radiotherapy.

    PubMed

    Akthar, Adil S; Ferguson, Mark K; Koshy, Matthew; Vigneswaran, Wickii T; Malik, Renuka

    2017-02-01

    Patients receiving stereotactic body radiotherapy for stage I non-small cell lung cancer are typically staged clinically with positron emission tomography-computed tomography. Currently, limited data exist for the detection of occult hilar/peribronchial (N1) disease. We hypothesize that positron emission tomography-computed tomography underestimates spread of cancer to N1 lymph nodes and that future stereotactic body radiotherapy patients may benefit from increased pathologic evaluation of N1 nodal stations in addition to N2 nodes. A retrospective study was performed of all patients with clinical stage I (T1-2aN0) non-small cell lung cancer (American Joint Committee on Cancer, 7th edition) by positron emission tomography-computed tomography at our institution from 2003 to 2011, with subsequent surgical resection and lymph node staging. Findings on positron emission tomography-computed tomography were compared to pathologic nodal involvement to determine the negative predictive value of positron emission tomography-computed tomography for the detection of N1 nodal disease. An analysis was conducted to identify predictors of occult spread. A total of 105 patients with clinical stage I non-small cell lung cancer were included in this study, of which 8 (7.6%) patients were found to have occult N1 metastasis on pathologic review yielding a negative predictive value for N1 disease of 92.4%. No patients had occult mediastinal nodes. The negative predictive value for positron emission tomography-computed tomography in patients with clinical stage T1 versus T2 tumors was 72 (96%) of 75 versus 25 (83%) of 30, respectively ( P = .03), and for peripheral versus central tumor location was 77 (98%) of 78 versus 20 (74%) of 27, respectively ( P = .0001). The negative predictive values for peripheral T1 and T2 tumors were 98% and 100%, respectively; while for central T1 and T2 tumors, the rates were 85% and 64%, respectively. Occult lymph node involvement was not associated with

  12. Limitations of PET/CT in the Detection of Occult N1 Metastasis in Clinical Stage I(T1-2aN0) Non-Small Cell Lung Cancer for Staging Prior to Stereotactic Body Radiotherapy

    PubMed Central

    Akthar, Adil S.; Ferguson, Mark K.; Koshy, Matthew; Vigneswaran, Wickii T.

    2016-01-01

    Purpose/Objectives: Patients receiving stereotactic body radiotherapy for stage I non-small cell lung cancer are typically staged clinically with positron emission tomography–computed tomography. Currently, limited data exist for the detection of occult hilar/peribronchial (N1) disease. We hypothesize that positron emission tomography–computed tomography underestimates spread of cancer to N1 lymph nodes and that future stereotactic body radiotherapy patients may benefit from increased pathologic evaluation of N1 nodal stations in addition to N2 nodes. Materials/Methods: A retrospective study was performed of all patients with clinical stage I (T1-2aN0) non-small cell lung cancer (American Joint Committee on Cancer, 7th edition) by positron emission tomography–computed tomography at our institution from 2003 to 2011, with subsequent surgical resection and lymph node staging. Findings on positron emission tomography–computed tomography were compared to pathologic nodal involvement to determine the negative predictive value of positron emission tomography–computed tomography for the detection of N1 nodal disease. An analysis was conducted to identify predictors of occult spread. Results: A total of 105 patients with clinical stage I non-small cell lung cancer were included in this study, of which 8 (7.6%) patients were found to have occult N1 metastasis on pathologic review yielding a negative predictive value for N1 disease of 92.4%. No patients had occult mediastinal nodes. The negative predictive value for positron emission tomography–computed tomography in patients with clinical stage T1 versus T2 tumors was 72 (96%) of 75 versus 25 (83%) of 30, respectively (P = .03), and for peripheral versus central tumor location was 77 (98%) of 78 versus 20 (74%) of 27, respectively (P = .0001). The negative predictive values for peripheral T1 and T2 tumors were 98% and 100%, respectively; while for central T1 and T2 tumors, the rates were 85% and 64

  13. The Pinhole/Occulter Facility

    NASA Technical Reports Server (NTRS)

    Tandberg-Hanssen, E. A. (Editor); Hudson, H. S. (Editor); Dabbs, J. R. (Editor); Baity, W. A. (Editor)

    1983-01-01

    Scientific objectives and requirements are discussed for solar X-ray observations, coronagraph observations, studies of coronal particle acceleration, and cosmic X-ray observations. Improved sensitivity and resolution can be provided for these studies using the pinhole/occulter facility which consists of a self-deployed boom of 50 m length separating an occulter plane from a detector plane. The X-ray detectors and coronagraphic optics mounted on the detector plane are analogous to the focal plane instrumentation of an ordinary telescope except that they use the occulter only for providing a shadow pattern. The occulter plane is passive and has no electrical interface with the rest of the facility.

  14. Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery

    PubMed Central

    Lagarde, Sjoerd M.; Anderegg, Martinus C. J.; Gisbertz, Suzanne S.; Meijer, Sybren L.; Hulshof, Maarten C. C. M.; Bergman, Jacques J. G. H. M.; van Laarhoven, Hanneke W. M.

    2018-01-01

    Background The aim of the present study is to identify the incidence and prognostic significance of lymph node metastases near the celiac trunk in patients who underwent neoadjuvant chemo(radio)therapy followed by esophagectomy. Methods Between March 1994 and September 2013 a total of 462 consecutive patients with cancer of the esophagus or gastroesophageal junction (GEJ) who underwent potentially curative esophageal resection after neoadjuvant chemotherapy (N=88; 19.0%) or neoadjuvant chemoradiotherapy (CRT) (N=374; 81.0%) were included. Results Seventy one (15.4%) patients had truncal node metastases in the resection specimen. Metastases to these nodes occurred more frequently in male patients with adenocarcinoma and in tumors at the gastro-esophageal junction. A lower response to neoadjuvant treatment, higher ypT and ypN stages and a poorer grade of differentiation were significantly related with truncal node metastases. Patients with tumor positive truncal nodes had a worse median overall survival (17 vs. 55 months). In multivariate analysis, truncal node metastases were independently associated with a worse survival. Only 22 (31.0%) of the 71 patients with tumor positive truncal nodes were identified preoperatively with EUS or CT. In contrast, 37 patients had suspicious truncal nodes on EUS or CT, but metastases in the pathology specimen were absent. Conclusions In the present study, it is demonstrated that positive truncal nodes in the resection specimen after neoadjuvant therapy, are associated with advanced tumor stages and are an independent factor for inferior survival. PMID:29707301

  15. Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery.

    PubMed

    Lagarde, Sjoerd M; Anderegg, Martinus C J; Gisbertz, Suzanne S; Meijer, Sybren L; Hulshof, Maarten C C M; Bergman, Jacques J G H M; van Laarhoven, Hanneke W M; van Berge Henegouwen, Mark I

    2018-03-01

    The aim of the present study is to identify the incidence and prognostic significance of lymph node metastases near the celiac trunk in patients who underwent neoadjuvant chemo(radio)therapy followed by esophagectomy. Between March 1994 and September 2013 a total of 462 consecutive patients with cancer of the esophagus or gastroesophageal junction (GEJ) who underwent potentially curative esophageal resection after neoadjuvant chemotherapy (N=88; 19.0%) or neoadjuvant chemoradiotherapy (CRT) (N=374; 81.0%) were included. Seventy one (15.4%) patients had truncal node metastases in the resection specimen. Metastases to these nodes occurred more frequently in male patients with adenocarcinoma and in tumors at the gastro-esophageal junction. A lower response to neoadjuvant treatment, higher ypT and ypN stages and a poorer grade of differentiation were significantly related with truncal node metastases. Patients with tumor positive truncal nodes had a worse median overall survival (17 vs. 55 months). In multivariate analysis, truncal node metastases were independently associated with a worse survival. Only 22 (31.0%) of the 71 patients with tumor positive truncal nodes were identified preoperatively with EUS or CT. In contrast, 37 patients had suspicious truncal nodes on EUS or CT, but metastases in the pathology specimen were absent. In the present study, it is demonstrated that positive truncal nodes in the resection specimen after neoadjuvant therapy, are associated with advanced tumor stages and are an independent factor for inferior survival.

  16. Measurement of stellar occultations

    NASA Astrophysics Data System (ADS)

    Eberle, Andreas

    2008-09-01

    Whenever an asteroid occults a star, we have the opportunity to study that asteroid in great detail. As frequently shown in the past, amateur astronomers1 have the necessary equipment to measure such events successfully2. Combined with the dense net of amateur observatories and online coordination tools3 for movable stations, they can create fine grids to detect even small bodies. The analysis of these events gives us the possibility to receive high precision astrometry data, to determine the asteroids size and shape (and therefore its albedo), and even to collect information on the star itself.4 While usually a set of several light curves is required to do so, a single recording5 of (10734) Wieck's occultation of HIP 22157 on 2008 Feb 08 was sufficient to retrieve the necessary data6. 1 Observation campaigns are organized by the International Occultation Timing Association (IOTA), http://www.iota-es.de/ 2 for results see e.g. euraster.net by E. Frappa, http://www.euraster.net/ 3 Occult Watcher by H. Pavlov, http://www.hristopavlov.net/OccultWatcher/OccultWatcher.html 4 see K. Miyashita's analysis of the observation of the occultation of TYC 1886-01206-1 by Kalliope and Linus, http://www005.upp.so-net.ne.jp/k miyash/occ02/kalliope/doublestar en.html 5 recording obtained by H. Michels, MPC Station Code 240 6 using Limovie by K. Miyashita

  17. Spherical Occulter Coronagraph Cubesat

    NASA Technical Reports Server (NTRS)

    Davila, Joseph M. (Inventor); Rabin, Douglas M. (Inventor); Reginald, Nelson (Inventor); Gong, Qian (Inventor); Shah, Neerav (Inventor); Chamberlin, Phillip C. (Inventor)

    2018-01-01

    The present invention relates to a space-based instrument which provides continuous coronal electron temperature and velocity images, for a predetermined period of time, thereby improving the understanding of coronal evolution and how the solar wind and Coronal Mass Ejection transients evolve from the low solar atmosphere through the heliosphere for an entire solar rotation. Specifically, the present invention relates to using a 6U spherical occulter coronagraph CubeSat, and a relative navigational system (RNS) that controls the position of the spacecraft relative to the occulting sphere. The present invention innovatively deploys a free-flying spherical occulter, and after deployment, the actively controlled CubeSat will provide an inertial formation flying with the spherical occulter and Sun.

  18. Esophagogastric metaplasia relates to nodal metastases in adenocarcinoma of esophagus and cardia.

    PubMed

    Ruffato, Alberto; Mattioli, Sandro; Perrone, Ottorino; Lugaresi, Marialuisa; Di Simone, Massimo Pierluigi; D'Errico, Antonietta; Malvi, Deborah; Aprile, Maria Rosaria; Raulli, Giandomenico; Frassineti, Luca

    2013-04-01

    Immunohistochemical profiles of esophageal and cardia adenocarcinoma differ according to the presence or absence of Barrett's epithelium (BIM) and gastric intestinal metaplasia (GIM) in the fundus and antrum. Different lymphatic spreading has been demonstrated in esophageal adenocarcinoma. We investigated the correlation among the presence or absence of intestinal metaplasia in the esophagus and stomach and lymphatic metastases in patients who underwent radical surgery for esophageal and cardia adenocarcinoma. The mucosa surrounding the adenocarcinoma and the gastric mucosa were analyzed. The BIM+ patients underwent subtotal esophagectomy and gastric pull up, and the BIM- patients underwent esophagectomy at the azygos vein, total gastrectomy, and esophagojejunostomy. The radical thoracic (station numbers 2, 3, 4R, 7, 8, and 9) and abdominal (station numbers 15 through 20) lymphadenectomy was identical in both procedures except for the greater curvature. One hundred ninety-four consecutive patients were collected in three major groups: BIM+/GIM-, 52 patients (26.8%); BIM-/GIM-, 90 patients (46.4%); BIM-/GIM+, 50 patients (25.8%). Two patients (1%) were BIM+/GIM+. A total of 6,010 lymph nodes were resected: 1,515 were recovered in BIM+, 1,587 in BIM-/GIM+, and 2,908 in BIM-/GIM- patients. The percentage of patients with pN+ stations 8 and 9 was higher in BIM+ (p=0.001), and the percentage of patients with pN+ perigastric stations was higher in BIM- (p=0.001). The BIM-/GIM- patients had a number of abdominal metastatic lymph nodes higher than did the BIM-/GIM+ patients (p=0.0001). According to the presence or absence of BIM and GIM in the esophagus and cardia, adenocarcinoma correspond to three different patterns of lymphatic metastasization, which may reflect different biologic and carcinogenetic pathways. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. [Clinical assessment of occult infections in children].

    PubMed

    Sporisević, L; Bajraktarević, A; Begić, Z

    2000-01-01

    Children's occult infections are characterised presenting pathogenic bacteries in blood of children in age 3 to 36 months, but they are good general aspect and orderly immunologic status and they don't have signs of focal infection. Manifestation of occult infections determined: age of child, increasing bodies temperature, testsphysical observance and clinical-biochemistry tests. Prevalence of manifestation occult infections is 3-8%, but they manifest ni a form occult bacteremia, occult pneumonia nad occult urinary infection. Methodic, systematic admission and adequate clinical-biochemical monitoring, we minimise sequeles of occult infections. Risk of serious sequeles at occult infections is importantly decreasing by epidemiological changes that it rises by using vaccination against Haemophilus influenzae and Streptococcus pneumoniae is leading ethiological source. Many contraversal opinions are presented in glance of therapeutic strategy at children's occult infection. Future of solutions at many hesitations ni context diagnosis and therapy of occult infections is established in using recent detectional tests /pneumococcus PCR, plasmas tumor reaction, interleukin lâ/ and preventive intervetions activities /conjugated pneumococcus vaccination/.

  20. 21 CFR 864.6550 - Occult blood test.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood is...

  1. 21 CFR 864.6550 - Occult blood test.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood is...

  2. 21 CFR 864.6550 - Occult blood test.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood is...

  3. 21 CFR 864.6550 - Occult blood test.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood is...

  4. 21 CFR 864.6550 - Occult blood test.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood is...

  5. Curative Chemoradiotherapy in Patients With Stage IVB Cervical Cancer Presenting With Paraortic and Left Supraclavicular Lymph Node Metastases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, Ji-Yoon; Kim, Joo-Young; Kim, Jin Hee

    2012-11-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with curative intent in patients with stage IVB cervical cancer initially presenting with paraortic and left supraclavicular lymph node metastases. Methods and Materials: The medical records of 25 patients with both paraortic and left supraclavicular lymph nodal metastases (group I) were reviewed and compared with those of 101 women with paraortic lymph node metastases alone (group II). Group I received a mean 59.4 Gy to the paraortic and left supraclavicular areas and 50.4 Gy to the pelvis, followed by 30 Gy of high-dose-rate brachytherapy in 6 fractions. Group IImore » received the same dose to the paraortic area and pelvis followed by intracavitary brachytherapy. All patients received platinum-based chemotherapy simultaneously. Results: Of the 25 patients in group I, 16 (64%) experienced acute grade 3-4 hematologic toxicities, and 1 had a late grade 3 genitourinary toxicity. Complete responses, including the primary mass and pelvic, paraortic, and left supraclavicular lymph nodes, were observed in 13 patients (52%). At a median follow-up of 32 months for surviving patients, 3 experienced in-field failure, 6 showed distant failure, and 9 showed both. The 3-year overall and disease-free survival rates were 49% and 33%, respectively. In comparison, of the 101 patients in group II, 16 showed in-field failure, 14 experienced distant failure, and 11 showed both. The 3-year overall and disease-free survival rates were 69% and 57%, respectively. Conclusions: Curative CCRT is feasible in patients with stage IVB cervical cancer presenting with paraortic and left supraclavicular lymph nodal metastases, with acceptable late toxicity and high response rates, despite high rates of acute hematologic toxicity.« less

  6. On the reduction of occultation light curves. [stellar occultations by planets

    NASA Technical Reports Server (NTRS)

    Wasserman, L.; Veverka, J.

    1973-01-01

    The two basic methods of reducing occultation light curves - curve fitting and inversion - are reviewed and compared. It is shown that the curve fitting methods have severe problems of nonuniqueness. In addition, in the case of occultation curves dominated by spikes, it is not clear that such solutions are meaningful. The inversion method does not suffer from these drawbacks. Methods of deriving temperature profiles from refractivity profiles are then examined. It is shown that, although the temperature profiles are sensitive to small errors in the refractivity profile, accurate temperatures can be obtained, particularly at the deeper levels of the atmosphere. The ambiguities that arise when the occultation curve straddles the turbopause are briefly discussed.

  7. Liver metastases

    MedlinePlus

    Metastases to the liver; Metastatic liver cancer; Liver cancer - metastatic; Colorectal cancer - liver metastases; Colon cancer - liver metastases; Esophageal cancer - liver metastases; Lung cancer - liver metastases; Melanoma - liver metastases

  8. Nodal surface semimetals: Theory and material realization

    NASA Astrophysics Data System (ADS)

    Wu, Weikang; Liu, Ying; Li, Si; Zhong, Chengyong; Yu, Zhi-Ming; Sheng, Xian-Lei; Zhao, Y. X.; Yang, Shengyuan A.

    2018-03-01

    We theoretically study the three-dimensional topological semimetals with nodal surfaces protected by crystalline symmetries. Different from the well-known nodal-point and nodal-line semimetals, in these materials, the conduction and valence bands cross on closed nodal surfaces in the Brillouin zone. We propose different classes of nodal surfaces, both in the absence and in the presence of spin-orbit coupling (SOC). In the absence of SOC, a class of nodal surfaces can be protected by space-time inversion symmetry and sublattice symmetry and characterized by a Z2 index, while another class of nodal surfaces are guaranteed by a combination of nonsymmorphic twofold screw-rotational symmetry and time-reversal symmetry. We show that the inclusion of SOC will destroy the former class of nodal surfaces but may preserve the latter provided that the inversion symmetry is broken. We further generalize the result to magnetically ordered systems and show that protected nodal surfaces can also exist in magnetic materials without and with SOC, given that certain magnetic group symmetry requirements are satisfied. Several concrete nodal-surface material examples are predicted via the first-principles calculations. The possibility of multi-nodal-surface materials is discussed.

  9. Triton stellar occultation candidates - 1992-1994

    NASA Technical Reports Server (NTRS)

    Mcdonald, S. W.; Elliot, J. T.

    1992-01-01

    A search for Triton stellar occultation candidates for the period 1992-1994 has been completed with CCD strip-scanning observations. The search reached an R magnitude of about 17.4 and found 129 candidates within 1.5 arcsec of Triton's ephemeris during this period. Of these events, around 30 occultations are expected to be visible from the earth, indicating that a number of Triton occultation events should be visible from major observatories. Even the faintest of the present candidate events could produce useful occultation data if observed with a large enough telescope. The present astrometric accuracy is inadequate to identify which of these appulse events will produce occultations on the earth; further astrometry is needed to refine the predictions for positive occultation identification. To aid in selecting candidates for additional astrometric and photometric studies, finder charts and earth-based visibility charts for each event are included.

  10. Occult bilateral invasive lobular carcinoma of the breast presenting as gastroduodenal metastases: a case report.

    PubMed

    Zuhair, Abu-Rahmeh; Maron, Abu-Rahmeh

    2015-01-01

    Breast cancer, after malignant melanoma, is the most common cancer metastasizing to the gastrointestinal tract [1,4]. Isolated gastrointestinal metastasis from breast cancer is a quite rare finding. We describe a female patient with a gastric metastasis from an undiagnosed breast cancer who presented to gastroenterology department with a symptoms of abdominal pain.

  11. Progress on the occulter experiment at Princeton

    NASA Astrophysics Data System (ADS)

    Cady, Eric; Balasubramanian, Kunjithapatham; Carr, Michael; Dickie, Matthew; Echternach, Pierre; Groff, Tyler; Kasdin, Jeremy; Laftchiev, Christian; McElwain, Michael; Sirbu, Dan; Vanderbei, Robert; White, Victor

    2009-08-01

    An occulter is used in conjunction with a separate telescope to suppress the light of a distant star. To demonstrate the performance of this system, we are building an occulter experiment in the laboratory at Princeton. This experiment will use an etched silicon mask as the occulter, with some modifications to try to improve the performance. The occulter is illuminated by a diverging laser beam to reduce the aberrations from the optics before the occulter. We present the progress of this experiment and expectations for future work.

  12. Comparison of a sentinel lymph node mapping algorithm and comprehensive lymphadenectomy in the detection of stage IIIC endometrial carcinoma at higher risk for nodal disease.

    PubMed

    Ducie, Jennifer A; Eriksson, Ane Gerda Zahl; Ali, Narisha; McGree, Michaela E; Weaver, Amy L; Bogani, Giorgio; Cliby, William A; Dowdy, Sean C; Bakkum-Gamez, Jamie N; Soslow, Robert A; Keeney, Gary L; Abu-Rustum, Nadeem R; Mariani, Andrea; Leitao, Mario M

    2017-12-01

    To determine if a sentinel lymph node (SLN) mapping algorithm will detect metastatic nodal disease in patients with intermediate-/high-risk endometrial carcinoma. Patients were identified and surgically staged at two collaborating institutions. The historical cohort (2004-2008) at one institution included patients undergoing complete pelvic and paraaortic lymphadenectomy to the renal veins (LND cohort). At the second institution an SLN mapping algorithm, including pathologic ultra-staging, was performed (2006-2013) (SLN cohort). Intermediate-risk was defined as endometrioid histology (any grade), ≥50% myometrial invasion; high-risk as serous or clear cell histology (any myometrial invasion). Patients with gross peritoneal disease were excluded. Isolated tumor cells, micro-metastases, and macro-metastases were considered node-positive. We identified 210 patients in the LND cohort, 202 in the SLN cohort. Nodal assessment was performed for most patients. In the intermediate-risk group, stage IIIC disease was diagnosed in 30/107 (28.0%) (LND), 29/82 (35.4%) (SLN) (P=0.28). In the high-risk group, stage IIIC disease was diagnosed in 20/103 (19.4%) (LND), 26 (21.7%) (SLN) (P=0.68). Paraaortic lymph node (LN) assessment was performed significantly more often in intermediate-/high-risk groups in the LND cohort (P<0.001). In the intermediate-risk group, paraaortic LN metastases were detected in 20/96 (20.8%) (LND) vs. 3/28 (10.7%) (SLN) (P=0.23). In the high-risk group, paraaortic LN metastases were detected in 13/82 (15.9%) (LND) and 10/56 (17.9%) (SLN) (%, P=0.76). SLN mapping algorithm provides similar detection rates of stage IIIC endometrial cancer. The SLN algorithm does not compromise overall detection compared to standard LND. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. The Effect of Anatomical Location of Lymph Node Metastases on Cancer Specific Survival in Patients with Clear Cell Renal Cell Carcinoma.

    PubMed

    Nini, Alessandro; Larcher, Alessandro; Cianflone, Francesco; Trevisani, Francesco; Terrone, Carlo; Volpe, Alessandro; Regis, Federica; Briganti, Alberto; Salonia, Andrea; Montorsi, Francesco; Bertini, Roberto; Capitanio, Umberto

    2018-01-01

    Positive nodal status (pN1) is an independent predictor of survival in renal cell carcinoma (RCC) patients. However, no study to date has tested whether the location of lymph node (LN) metastases does affect oncologic outcomes in a population submitted to radical nephrectomy (RN) and extended lymph node dissection (eLND). To describe nodal disease dissemination in clear cell RCC (ccRCC) patients and to assess the effect of the anatomical sites and the number of nodal areas affected on cancer specific mortality (CSM). The study included 415 patients who underwent RN and eLND, defined as the removal of hilar, side-specific (pre/paraaortic or pre/paracaval) and interaortocaval LNs for ccRCC, at two institutions. Descriptive statistics were used to depict nodal dissemination in pN1 patients, stratified according to nodal site and number of involved areas. Multivariable Cox regression analyses and Kaplan-Meier curves were used to explore the relationship between pN1 disease features and survival outcomes. Median number of removed LN was 14 (IQR 9-19); 23% of patients were pN1. Among patients with one involved nodal site, 54 and 26% of patients were positive only in side-specific and interaortocaval station, respectively. The most frequent nodal site was the interaortocaval and side-specific one, for right and left ccRCC, respectively. Interaortocaval nodal positivity (HR 2.3, CI 95%: 1.3-3.9, p < 0.01) represented an independent predictor of CSM. When ccRCC patient harbour nodal disease, its spreading can occur at any nodal station without involving the others. The presence of interoartocaval positive nodes does affect oncologic outcomes. Lymph node invasion in patients with clear cell renal cell carcinoma is not following a fixed anatomical pattern. An extended lymph node dissection, during treatment for primary kidney tumour, would aid patient risk stratification and multimodality upfront treatment.

  14. Several Well-observed Asteroidal Occultations in 2010

    NASA Astrophysics Data System (ADS)

    Timerson, Brad; Durech, J.; Abramson, H.; Brooks, J.; Caton, D.; Clark, D.; Conard, S.; Cooke, B.; Dunham, D. W.; Dunham, J.; Edberg, S.; Ellington, C.; Faircloth, J.; Herchak, S.; Iverson, E.; Jones, R.; Lucas, G.; Lyzenga, G.; Maley, P.; Martinez, L.; Menke, J.; Mroz, G.; Nolan, P.; Peterson, R.; Preston, S.; Rattley, G.; Ray, J.; Scheck, A.; Stamm, J.; Stanton, R.; Suggs, R.; Tatum, R.; Thomas, W.

    2011-10-01

    During 2010 IOTA observers in North America reported about 190 positive observations for 106 asteroid occultation events. For several asteroids, this included observations with multiple chords. For two events, an inversion model was available. An occultation by 16 Psyche on 2010 August 21 yielded a best-fit ellipse of 235.4 x 230.4 km. On 2010 December 24, an occultation by 93 Minerva produced a best-fit ellipse of 179.4 x 133.4 km. An occultation by 96 Aegle on 2010 October 29 yielded a best-fit ellipse of 124.9 x 88.0 km. An occultation by 105 Artemis on 2010 June 24 showed a best-fit ellipse of 125.0 x 92.0 km. An occultation by 375 Ursula on 2010 December 4 produced a best-fit ellipse of 125.0 km x 135.0 km. Of note are two events not summarized in this article. On 2010 August 31, an occultation by 695 Bella yielded a new double star. That event will be summarized in the JDSO. Finally, on 2010 April 6, an occultation of zeta Ophiuchi by 824 Anastasia was observed by 65 observers at 69 locations. Unfortunately a large shift in the path yielded only 4 chords. Results of that event, and all the events mentioned here, can be found on the North American Asteroidal Occultation Results web page.

  15. Intensity-Modulated Radiation Therapy for the Treatment of Squamous Cell Anal Cancer With Para-aortic Nodal Involvement

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hodges, Joseph C.; Das, Prajnan, E-mail: PrajDas@mdanderson.or; Eng, Cathy

    2009-11-01

    Purpose: To determine the rates of toxicity, locoregional control, distant control, and survival in anal cancer patients with para-aortic nodal involvement, treated with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy at a single institution. Methods and Materials: Between 2001 and 2007, 6 patients with squamous cell anal cancer and para-aortic nodal involvement were treated with IMRT and concurrent infusional 5-fluorouracil and cisplatin. The primary tumor was treated with a median dose of 57.5 Gy (range, 54-60 Gy), involved para-aortic, pelvic, and inguinal lymph nodes were treated with a median dose of 55 Gy (range, 50.5-55 Gy), and noninvolved nodal regions weremore » treated with a median dose of 45 Gy (range, 43.5-45 Gy). Results: After a median follow-up of 25 months, none of the patients had a recurrence at the primary tumor, pelvic/inguinal nodes, or para-aortic nodes, whereas 2 patients developed distant metastases to the liver. Four of the 6 patients are alive. The 3-year actuarial locoregional control, distant control, and overall survival rates were 100%, 56%, and 63%, respectively. Four of the 6 patients developed Grade 3 acute gastrointestinal toxicity during chemoradiation. Conclusions: Intensity-modulated radiotherapy and concurrent chemotherapy could potentially serve as definitive therapy in anal cancer patients with para-aortic nodal involvement. Adjuvant chemotherapy may be indicated in these patients, as demonstrated by the distant failure rates. These patients need to be followed carefully because of the potential for treatment-related toxicities.« less

  16. Stellar Occultation Studies of the Solar System

    NASA Technical Reports Server (NTRS)

    Elliot, James L.

    1998-01-01

    Earth-based observations of stellar occultations provide extremely high spatial resolution for bodies in the outer solar system, about 10,000 times better than that of traditional imaging observations. Stellar occultation data can be used to establish the structure of atmospheres and rings of solar system bodies at high spatial resolution. Airborne occultation observations are particularly effective, since the controlled mobility of the observing platform allows the observer to fly within the optimum part of the occultation shadow for most events that are visible from Earth. Airborne observations are carried out above any clouds and are nearly free of scintillation noise from the Earth's atmosphere. KAO occultation observations resulted in the first detection of gravity waves in the Martian atmosphere, discovery of the Uranian rings, the first detection of Pluto's atmosphere, the first Earth-based investigations of Triton's atmosphere, and the discovery of narrow jets from Chiron's nucleus. The first SOFIA occultation opportunity will be an investigation of Pluto's atmospheric structure in November, 2002, and will resolve a problem that has lingered since the KAO discovery observation fourteen years earlier. We plan to continue our successful airborne occultation program with the greatly enhanced capability provided by SOFIA. We propose here to replace our KAO occultation photometer with one having twice the throughput, half the noise, a somewhat wider wavelength range, four times the field of view, and ten times the frame rate to optimize its performance and to capitalize on the larger collecting area offered by SOFIA. It will also allow for simultaneous visible and IR occultation observations, greatly enriching the results that we can obtain from occultations. We call this new imaging occultation photometer HOPI (High-speed Occultation Photometer and Imager). HOPI will provide a signal-to-noise ratio two to four times that of our present photometer for a given

  17. Management of occult adrenocorticotropin-secreting bronchial carcinoids: limits of endocrine testing and imaging techniques.

    PubMed

    Loli, P; Vignati, F; Grossrubatscher, E; Dalino, P; Possa, M; Zurleni, F; Lomuscio, G; Rossetti, O; Ravini, M; Vanzulli, A; Bacchetta, C; Galli, C; Valente, D

    2003-03-01

    The differential diagnosis and the identification of the source of ACTH in occult ectopic Cushing's syndrome due to a bronchial carcinoid still represents a challenge for the endocrinologist. We report our experience in six patients with occult bronchial carcinoid in whom extensive hormonal, imaging, and scintigraphic evaluation was performed. All patients presented with hypercortisolism associated with high plasma ACTH values. The CRH test and high dose dexamethasone suppression test suggested an ectopic source of ACTH in three of six patients. During bilateral inferior petrosal sinus sampling, none of the patients showed a central to peripheral ACTH gradient. At the time of diagnosis, none of the patients had radiological evidence of the ectopic source of ACTH, whereas pentetreotide scintigraphy identified the lesion in two of four patients. Finally, a chest computed tomography scan revealed the presence of a bronchial lesion in all patients, and pentetreotide scintigraphy identified four of six lesions. In all patients a bronchial carcinoid was found and removed. In one patient with scintigraphic evidence of residual disease after two operations, radioguided surgery, using a hand-held gamma probe after iv administration of radiolabeled pentetreotide, was performed; this allowed detection and removal of residual multiple mediastinal lymph node metastases. In conclusion, our data show that there is not a single endocrine test or imaging procedure accurate enough to diagnose and localize occult ectopic ACTH-secreting bronchial carcinoids. Radioguided surgery appears to be promising in the presence of multiple tumor foci and previous incomplete removal of the tumor.

  18. Predicted occultations by Uranus - 1981-1984

    NASA Technical Reports Server (NTRS)

    Klemola, A. R.; Mink, D. J.; Elliot, J. L.

    1981-01-01

    Predictions are presented for 11 occultations by and appulses to Uranus and its ring system for ten stars from 1981 through 1984. The brightest stars are occulted on April 26, 1981 (BD - 19 deg 4222) and on April 22, 1982 (Hyd - 20 deg 51699). The ring system occults the same star twice during March 1983 (Hyd - 21 deg 64352).

  19. Radio occultation experiments with INAF-IRA radiotelescopes.

    NASA Astrophysics Data System (ADS)

    Pluchino, S.; Schillirò, F.; Salerno, E.; Pupillo, G.

    The Radio Occultation research program performed at the Medicina and Noto Radioastronomical Stations of the Istituto Nazionale di Astrofisica (INAF) - Istituto di Radioastronomia (IRA) includes observations of spacecraft by satellite and satellite by satellite events. The Lunar Radio Occultation (LRO) part of the program consists in collecting data of the lunar Total Electron Content (TEC), at different limb longitudes and at different time, in order to study long term variation of the Moon's ionosphere. The LRO program started at Medicina in September 2006 with the observation of the European probe SMART-1 during its impact on the lunar soil. It proceeded in 2007 with the observation of the lunar occultations of Saturn and Venus, and with the observation of Mars in 2008. On this occasion the probes Cassini, Venus Express, Mars Express, Mars Reconaissance Orbiter and Mars Odissey were respectively occulted by the moon. On Dec 1st 2008 a Venus lunar occultation occurred. On that occasion we performed the first Italian-VLBI (I-VLBI) tracking experiment by detecting the carrier signals coming from the Venus Express (VEX) spacecraft with both the IRA radiotelescopes together with the Matera antenna of the Italian Space Agency. The second part of the radio occultation program includes the observation of satellite by satellite occultation events, as well as mutual occultations of Jupiter satellites. These events are referred to as mutual phenomena (PHEMU). These observations are aimed to measure the radio flux variation during the occultation and to derive surface spatial characteristics such as Io's hot spots. In this work preliminary results of the Radio Occultation program will be presented.

  20. Radiologically occult medulloblastoma with hydrocephalus: case report.

    PubMed

    Honma, Hirokuni; Ogiwara, Hideki

    2017-09-01

    There have been no reports of occult medulloblastoma nor noncommunicating hydrocephalus due to radiologically occult brain tumors. Herein, we report radiologically occult medulloblastoma with noncommunicating hydrocephalus. A 3-year-old boy presented with macrocephaly, visual field constriction, and papilledema. Neuroimagings showed enlargement of the ventricles without any mass lesions. The CT cisternography did not show influx of the contrast into the ventricles, which suggested local cerebrospinal fluid (CSF) circulatory disturbance at the outlet of the fourth ventricle. Due to possible obstructive nature of hydrocephalus, endoscopic third ventriculostomy (ETV) was performed. Three months after the ETV, he presented with repeated vomiting. Neuroimagings showed a 3-cm fourth ventricular mass with progressive hydrocephalus. Surgical resection was performed, which revealed the pathology was medulloblastoma. We report the case of radiologically occult medulloblastoma which was demonstrated radiologically in the follow-up period of ETV for noncommunicating hydrocephalus of uncertain etiology. This is the first description of a radiologically occult medulloblastoma and also the first description of an occult brain tumor with noncommunicating hydrocephalus. The occult brain tumor may be included in the etiology of hydrocephalus.

  1. Robust doubly charged nodal lines and nodal surfaces in centrosymmetric systems

    NASA Astrophysics Data System (ADS)

    Bzdušek, Tomáš; Sigrist, Manfred

    2017-10-01

    Weyl points in three spatial dimensions are characterized by a Z -valued charge—the Chern number—which makes them stable against a wide range of perturbations. A set of Weyl points can mutually annihilate only if their net charge vanishes, a property we refer to as robustness. While nodal loops are usually not robust in this sense, it has recently been shown using homotopy arguments that in the centrosymmetric extension of the AI symmetry class they nevertheless develop a Z2 charge analogous to the Chern number. Nodal loops carrying a nontrivial value of this Z2 charge are robust, i.e., they can be gapped out only by a pairwise annihilation and not on their own. As this is an additional charge independent of the Berry π -phase flowing along the band degeneracy, such nodal loops are, in fact, doubly charged. In this manuscript, we generalize the homotopy discussion to the centrosymmetric extensions of all Atland-Zirnbauer classes. We develop a tailored mathematical framework dubbed the AZ +I classification and show that in three spatial dimensions such robust and multiply charged nodes appear in four of such centrosymmetric extensions, namely, AZ +I classes CI and AI lead to doubly charged nodal lines, while D and BDI support doubly charged nodal surfaces. We remark that no further crystalline symmetries apart from the spatial inversion are necessary for their stability. We provide a description of the corresponding topological charges, and develop simple tight-binding models of various semimetallic and superconducting phases that exhibit these nodes. We also indicate how the concept of robust and multiply charged nodes generalizes to other spatial dimensions.

  2. [Progress in research of occult hepatitis B virus infection].

    PubMed

    Huang, X Y; Shi, Q F; Huang, T

    2017-05-10

    Occult hepatitis B virus infection is a worldwide public health problem, which seriously affects the clinical diagnosis of hepatitis B and threatens the safety of blood transfusion. The concept of occult hepatitis B virus infection, the pathogenesis of occult hepatitis B virus infection, the prevalence of occult hepatitis B virus infection in different groups, including healthy population and different patients, and the possibility of transmission were summarized. The prevalence of occult hepatitis B virus infection was found in healthy population and different patients, and there is possibility of occult hepatitis B virus infection to be transmitted through blood transfusion. The paper provides a comprehensive introduction of the pathogenesis and prevalence of occult hepatitis B virus infection. More attention should be paid to occult hepatitis B virus infection.

  3. New perspectives in occult hepatitis C virus infection

    PubMed Central

    Carreño, Vicente; Bartolomé, Javier; Castillo, Inmaculada; Quiroga, Juan Antonio

    2012-01-01

    Occult hepatitis C virus (HCV) infection, defined as the presence of HCV RNA in liver and in peripheral blood mononuclear cells (PBMCs) in the absence of detectable viral RNA in serum by standard assays, can be found in anti-HCV positive patients with normal serum levels of liver enzymes and in anti-HCV negative patients with persistently elevated liver enzymes of unknown etiology. Occult HCV infection is distributed worldwide and all HCV genotypes seem to be involved in this infection. Occult hepatitis C has been found not only in anti-HCV positive subjects with normal values of liver enzymes or in chronic hepatitis of unknown origin but also in several groups at risk for HCV infection such as hemodialysis patients or family members of patients with occult HCV. This occult infection has been reported also in healthy populations without evidence of liver disease. Occult HCV infection seems to be less aggressive than chronic hepatitis C although patients affected by occult HCV may develop liver cirrhosis and even hepatocellular carcinoma. Thus, anti-HCV negative patients with occult HCV may benefit from antiviral therapy with pegylated-interferon plus ribavirin. The persistence of very low levels of HCV RNA in serum and in PBMCs, along with the maintenance of specific T-cell responses against HCV-antigens observed during a long-term follow-up of patients with occult hepatitis C, indicate that occult HCV is a persistent infection that is not spontaneously eradicated. This is an updated report on diagnosis, epidemiology and clinical implications of occult HCV with special emphasis on anti-HCV negative cases. PMID:22736911

  4. Stellar occultation studies of the solar system

    NASA Technical Reports Server (NTRS)

    Elliot, J. L.

    1979-01-01

    The paper covers the principles, observational procedures, and results relating to occultations of stars by solar system bodies other than the moon. Physical processes involved in occultations are presented including (1) extinction by ring material, (2) differential refraction by a planetary atmosphere, (3) extinction by a planetary atmosphere, and (4) Fresnel diffraction by sharp edges. It is noted that from a sufficient number of immersion and emersion timings of a stellar occultation, the radius and ellipticity of the occulting body can be accurately determined. From an occultation by a planet having an atmosphere, temperature, pressure, and number density profiles can be obtained along with information about the composition of the atmosphere and the extinction.

  5. Prognosis for Mammographically Occult, Early-Stage Breast Cancer Patients Treated With Breast-Conservation Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yang, Tzu-I. J.; Yang Qifeng; Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan

    2010-01-15

    Purpose: To compare mammographically occult (MamOcc) and mammographically positive (MamPos) early-stage breast cancer patients treated with breast-conservation therapy (BCT), to analyze differences between the two cohorts. Methods and Materials: Our two cohorts consisted of 214 MamOcc and 2168 MamPos patients treated with BCT. Chart reviews were conducted to assess mammogram reports and method of detection. All clinical-pathologic and outcome parameters were analyzed to detect differences between the two cohorts. Results: Median follow-up was 7 years. There were no differences in final margins, T stage, nodal status, estrogen/progesterone receptor status, or 'triple-negative' status. Significant differences included younger age at diagnosis (pmore » < 0.0001), more positive family history (p = 0.0033), less HER-2+ disease (p = 0.0294), and 1{sup o} histology (p < 0.0001). At 10 years, the differences in overall survival, cause-specific survival, and distant relapse between the two groups did not differ significantly. The MamOcc cohort had more breast relapses (15% vs. 8%; p = 0.0357), but on multivariate analysis this difference was not significant (hazard ratio 1.0, 95% confidence interval 0.993-1.007, p = 0.9296). Breast relapses were mammographically occult in 32% of the MamOcc and 12% of the MamPos cohorts (p = 0.0136). Conclusions: Although our study suggests that there are clinical-pathologic variations for the MamOcc cohort vs. MamPos patients that may ultimately affect management, breast relapse after BCT was not significantly different. Breast recurrences were more often mammographically occult in the MamOcc cohort; consideration should be given to closer follow-up and alternative imaging strategies (ultrasound, breast MRI) for routine posttreatment examination. To our knowledge, this represents the largest series addressing the prognostic significance of MamOcc cancers treated with BCT.« less

  6. Method of Modeling and Simulation of Shaped External Occulters

    NASA Technical Reports Server (NTRS)

    Lyon, Richard G. (Inventor); Clampin, Mark (Inventor); Petrone, Peter, III (Inventor)

    2016-01-01

    The present invention relates to modeling an external occulter including: providing at least one processor executing program code to implement a simulation system, the program code including: providing an external occulter having a plurality of petals, the occulter being coupled to a telescope; and propagating light from the occulter to a telescope aperture of the telescope by scalar Fresnel propagation, by: obtaining an incident field strength at a predetermined wavelength at an occulter surface; obtaining a field propagation from the occulter to the telescope aperture using a Fresnel integral; modeling a celestial object at differing field angles by shifting a location of a shadow cast by the occulter on the telescope aperture; calculating an intensity of the occulter shadow on the telescope aperture; and applying a telescope aperture mask to a field of the occulter shadow, and propagating the light to a focal plane of the telescope via FFT techniques.

  7. Occult Participation: Its Impact on Adolescent Development.

    ERIC Educational Resources Information Center

    Tennant-Clark, Cynthia M.; And Others

    1989-01-01

    Investigated relationship between occult participation, substance abuse, and level of self-esteem among 25 clinical (alcohol or drug treatment) and 25 nonclinical adolescents. Results indicated that adolescent substance abuse and occult participation were significantly related. Found significant differences between high versus low occult groups…

  8. Ultrasonographic detection of regional lymph node metastases in patients with intermediate or thick malignant melanoma.

    PubMed

    Brountzos, Elias N; Panagiotou, Irene E; Bafaloukos, Dimitrios I; Kelekis, Dimitrios A

    2003-01-01

    Careful monitoring of regional lymph nodes and early detection of metastases in malignant melanoma patients has an impact on their survival, since it may permit beneficial surgical therapy. Palpation is routinely used in clinical practice. The value of ultrasonography for routine follow-up of melanoma patients, still, is not generally accepted. The aim of our study was to assess the sensitivity and specificity of ultrasound and clinical examination respectively, in the detection of melanoma regional node metastases. Additionally, we evaluated whether early detection of metastases improved overall survival. One hundred and forty-eight melanoma patients with an intermediate or thick primary lesion were followed between January 1997 and May 2001. Clinical examination and concomitant regional lymph node ultrasonography were performed, every 3-4 months. If suspicious findings were identified, regional lymph node dissection was undertaken. Forty-four from the initial 148 patients relapsed with regional lymph nodal metastases. In 11 patients (25%) palpation failed to reveal the disease and metastases were depicted only by ultrasonography. In only 1 patient ultrasonography was false-negative. The sensitivity and specificity of palpation were 72.7 and 97% respectively, while those of ultrasonography were 97.7 (p<0.001) and 98% respectively. Ultrasonography was more sensitive in detecting lymph node metastases in the axilla (100%) and the groin (93.3%). When overall survival of patients presenting with local-regional recurrence was calculated--depending on the number of involved lymph nodes--a survival benefit (p<0.05) was found for patients with only one lymph node metastasis. In conclusion, ultrasonography is superior to clinical examination in the early detection of regional lymph node metastases from an intermediate or thick malignant melanoma and should be a part of those patients' surveillance.

  9. Hopf-link topological nodal-loop semimetals

    NASA Astrophysics Data System (ADS)

    Zhou, Yao; Xiong, Feng; Wan, Xiangang; An, Jin

    2018-04-01

    We construct a generic two-band model which can describe topological semimetals with multiple closed nodal loops. All the existing multi-nodal-loop semimetals, including the nodal-net, nodal-chain, and Hopf-link states, can be examined within the same framework. Based on a two-nodal-loop model, the corresponding drumhead surface states for these topologically different bulk states are studied and compared with each other. The connection of our model with Hopf insulators is also discussed. Furthermore, to identify experimentally these topologically different semimetal states, especially to distinguish the Hopf-link from unlinked ones, we also investigate their Landau levels. It is found that the Hopf-link state can be characterized by the existence of a quadruply degenerate zero-energy Landau band, regardless of the direction of the magnetic field.

  10. The Northrop Grumman External Occulter Testbed: Preliminary Results

    NASA Astrophysics Data System (ADS)

    Lo, Amy; Glassman, T.; Lillie, C.

    2007-05-01

    We have built a subscale testbed to demonstrate and validate the performance of the New Worlds Observer (NWO), a terrestrial planet finder external-occulter mission concept. The external occulter concept allows observations of nearby exo-Earths using two spacecraft: one carrying an occulter that is tens of meters in diameter and the other carrying a generic space telescope. The occulter is completely opaque, resembling a flower, with petals having a hypergaussian profile that enable 10-10 intensity suppression of stars that potentially harbor terrestrial planets. The baseline flight NWO system has a 30 meter occulter flying 30,000 km in front of a 4 meter class telescope. Testing the flight configuration on the ground is not feasible, so we have matched the Fresnel number of the flight configuration ( 10) using a subscale occulter. Our testbed consists of an 80 meter length evacuated tube, with a high precision occulter in the center of the tube. The occulter is 4 cm in diameter, manufactured with ¼ micron metrological accuracy and less than 2 micron tip truncation. This mimics a 30 meter occulter with millimeter figure accuracy and less than centimeter tip truncation. Our testbed is an evolving experiment, and we report here the first, preliminary, results using a single wavelength laser (532 nm) as the source.

  11. Nodal-chain metals.

    PubMed

    Bzdušek, Tomáš; Wu, QuanSheng; Rüegg, Andreas; Sigrist, Manfred; Soluyanov, Alexey A

    2016-10-06

    The band theory of solids is arguably the most successful theory of condensed-matter physics, providing a description of the electronic energy levels in various materials. Electronic wavefunctions obtained from the band theory enable a topological characterization of metals for which the electronic spectrum may host robust, topologically protected, fermionic quasiparticles. Many of these quasiparticles are analogues of the elementary particles of the Standard Model, but others do not have a counterpart in relativistic high-energy theories. A complete list of possible quasiparticles in solids is lacking, even in the non-interacting case. Here we describe the possible existence of a hitherto unrecognized type of fermionic excitation in metals. This excitation forms a nodal chain-a chain of connected loops in momentum space-along which conduction and valence bands touch. We prove that the nodal chain is topologically distinct from previously reported excitations. We discuss the symmetry requirements for the appearance of this excitation and predict that it is realized in an existing material, iridium tetrafluoride (IrF 4 ), as well as in other compounds of this class of materials. Using IrF 4 as an example, we provide a discussion of the topological surface states associated with the nodal chain. We argue that the presence of the nodal-chain fermions will result in anomalous magnetotransport properties, distinct from those of materials exhibiting previously known excitations.

  12. Clear cell renal cell carcinoma: a comparative study of histological and chromosomal characteristics between primary tumors and their corresponding metastases.

    PubMed

    Dagher, Julien; Kammerer-Jacquet, Solène-Florence; Dugay, Frédéric; Beaumont, Marion; Lespagnol, Alexandra; Cornevin, Laurence; Verhoest, Grégory; Bensalah, Karim; Rioux-Leclercq, Nathalie; Belaud-Rotureau, Marc-Antoine

    2017-07-01

    Clear cell renal cell carcinoma (ccRCC) has a poor prognosis with a 50% risk of metastases. Little is known about the phenotypic and molecular profiles of metastases regarding their corresponding primary tumors. This study aimed to screen phenotypic and genotypic differences between metastases and their corresponding primary tumors. We selected four cases with available frozen material. The histological, immunohistochemical (VEGFA, CD31, SMA, Ki67, p53, PAR-3), FISH (VHL gene), next-generation sequencing (VHL and c-MET genes), multiplex ligation-dependent probe amplification, and array-(comparative genomic hybridization) CGH analyses were realized. Metastases were nodal, hepatic (synchronous), adrenal, and pulmonary (metachronous). High-grade tumor cells were significantly more frequent in metastases (p = 0.019). Metastases and high-grade zones of primary tumors shared similar characteristics compared to low-grade zones: a lower microscopic vascular density (43.5 vs 382.5 vessels/mm 2 ; p = 0.0027), a higher expression of VEGF (73 vs 10%, p = 0.045), Ki67 (37.6 vs 8.3%; p = 0.011), and p53 (54 vs 10.6%; p = 0.081), and a cytoplasmic and membranous PAR-3 staining. Metastases exhibited more chromosomal imbalances than primary tumors in total (18.75 ± 6.8; p = 0.044) with more genomic gains (13.5 ± 7; p = 0.013). The loss of chromosome 9 and gain of Xq were found in both primary tumors and metastases but gains of loci or chromosomes 2p, 3q, 5, 8q, 12, and 20 were only found in metastases. The VHL gene status was similar in each tumor couple. Although metastases and primary tumors share common histological features, this study highlights chromosomal differences specific to metastases which could be involved in ccRCC metastatic evolution.

  13. Triton stellar occultation candidates: 1995-1999

    NASA Technical Reports Server (NTRS)

    Mcdonald, S. W.; Elliot, J. L.

    1995-01-01

    We have completed a search for candidates for stellar occultations by Triton over the years 1995-1999. CCd strip scan images provided star positions in the relevant sky area to a depth of about 17.5 R magnitude. Over this time period, we find that Triton passes within 1.0 arcsec of 75 stars. Appulses with geocentric minimum separations of less than 0.35 arcsec will result in stellar occultations, but further astrometry and photometry is necessary to refine individual predictions for identification of actual occultations. Finder charts are included to aid in further studies and prediction refinement. The two most promising potential occultations, Tr176 and Tr180, occur in 1997.

  14. Exploring the Solar System with Stellar Occultations

    NASA Technical Reports Server (NTRS)

    Elliot, J. L.; Dunham, E. W.

    1984-01-01

    By recording the light intensity as a function of time when a planet occults a relatively bright star, the thermal structure of the upper atmosphere of the planet can be probed. The main feature of stellar occultation observations is their high spatial resolution, typically several thousand times better than the resolution achievable with ground-based imaging. Five stellar occultations have been observed. The main results of these observations are summarized. Stellar occultations have been observed on Uranus, Mars, Pallas, Neptune and the Jovian Ring.

  15. Breast cancer metastases to the thyroid gland - an uncommon sentinel for diffuse metastatic disease: a case report and review of the literature.

    PubMed

    Plonczak, Agata M; DiMarco, Aimee N; Dina, Roberto; Gujral, Dorothy M; Palazzo, Fausto F

    2017-09-22

    Metastases to the thyroid are rare. The most common primary cancer to metastasize to the thyroid is renal cell carcinoma, followed by malignancies of the gastrointestinal tract, lungs, and skin, with breast cancer metastases to the thyroid being rare. Overall, the outcomes in malignancies that have metastasized to the thyroid are poor. There are no prospective studies addressing the role of surgery in metastatic disease of the thyroid. Isolated thyroidectomy has been proposed as a local disease control option to palliate and prevent the potential morbidity of tumor extension related to the airway. Here, we present a case of a patient with breast cancer metastases to the thyroid gland and discuss the role of thyroidectomy in the context of the current literature. A 62-year-old Afro-Caribbean woman was diagnosed as having bilateral breast carcinoma in 2004, for which she underwent bilateral mastectomy. The pathology revealed multifocal disease on the right, T2N0(0/20)M0 grade 1 and 2 invasive ductal carcinoma, and on the left side, T3N1(2/18)M0 grade 1 invasive ductal carcinoma. Surgery was followed by adjuvant chemotherapy and regional radiotherapy. The disease was under control on hormonal therapy until 2016, when she developed cervical lymphadenopathy. The fine-needle aspiration cytology of the thyroid was reported as papillary thyroid cancer; and the fine-needle biopsy of the left lateral nodal disease was more suggestive of breast malignancy. She underwent a total thyroidectomy and a clearance of the central compartment lymph nodes and a biopsy of the lateral nodal disease. The histopathological analysis was consistent with metastatic breast cancer in the thyroid and lymph nodes with no evidence of a primary thyroid malignancy. A past history of a malignancy elsewhere should raise the index of suspicion of metastatic disease in patients presenting with thyroid lumps with or without cervical lymphadenopathy. Detection of metastases to the thyroid generally

  16. Occult hemorrhage in children with severe ITP.

    PubMed

    Flores, Adolfo; Buchanan, George R

    2016-03-01

    Little is known about the frequency and significance of clinically unapparent or occult hemorrhage in ITP. Therefore, we prospectively explored the sites and frequency of occult bleeding in children with severe ITP at diagnosis or upon symptomatic relapse in a prospective, single-institution cohort study of patients ≤ 18 years of age and a platelet count ≤ 10,000/mm(3) . Data collected included bleeding severity assessment, urinalysis, fecal occult blood testing, and non-contrast brain MRI. Stool and urine samples were tested within 7 days of diagnosis or symptomatic relapse. Three months after diagnosis or relapse a noncontrast brain MRI evaluated hemosiderin deposits resulting from prior localized hemorrhage. Fifty-two ITP patients were enrolled with a mean platelet count of 4,000/mm(3) . A significant occurrence of occult hemorrhage was identified in the urine (27%) compared with clinically overt hematuria (0.91%, P < 0.0005). CNS microbleeding in the superficial cortex of the left frontal lobe was identified in one child with occult bleeding in the urinary tract. There was no relationship between occult hemorrhage and bleeding manifestations on physical examination. Occult hemorrhage was not a harbinger of subsequent bleeding. Our findings suggest that occult hemorrhage occurs with greater frequency than overt bleeding in children with severe ITP. CNS microbleeding is a potential risk in this patient population. Assessment of brain microbleeds and microscopic hematuria in this patient population require additional study. © 2015 Wiley Periodicals, Inc.

  17. The Effect of Anatomical Location of Lymph Node Metastases on Cancer Specific Survival in Patients with Clear Cell Renal Cell Carcinoma

    PubMed Central

    Nini, Alessandro; Larcher, Alessandro; Cianflone, Francesco; Trevisani, Francesco; Terrone, Carlo; Volpe, Alessandro; Regis, Federica; Briganti, Alberto; Salonia, Andrea; Montorsi, Francesco; Bertini, Roberto; Capitanio, Umberto

    2018-01-01

    Background Positive nodal status (pN1) is an independent predictor of survival in renal cell carcinoma (RCC) patients. However, no study to date has tested whether the location of lymph node (LN) metastases does affect oncologic outcomes in a population submitted to radical nephrectomy (RN) and extended lymph node dissection (eLND). Objective To describe nodal disease dissemination in clear cell RCC (ccRCC) patients and to assess the effect of the anatomical sites and the number of nodal areas affected on cancer specific mortality (CSM). Design, setting and partecipants The study included 415 patients who underwent RN and eLND, defined as the removal of hilar, side-specific (pre/paraaortic or pre/paracaval) and interaortocaval LNs for ccRCC, at two institutions. Outcome measurement and statistical analysis Descriptive statistics were used to depict nodal dissemination in pN1 patients, stratified according to nodal site and number of involved areas. Multivariable Cox regression analyses and Kaplan-Meier curves were used to explore the relationship between pN1 disease features and survival outcomes. Results and limitations Median number of removed LN was 14 (IQR 9–19); 23% of patients were pN1. Among patients with one involved nodal site, 54 and 26% of patients were positive only in side-specific and interaortocaval station, respectively. The most frequent nodal site was the interaortocaval and side-specific one, for right and left ccRCC, respectively. Interaortocaval nodal positivity (HR 2.3, CI 95%: 1.3–3.9, p < 0.01) represented an independent predictor of CSM. Conclusions When ccRCC patient harbour nodal disease, its spreading can occur at any nodal station without involving the others. The presence of interoartocaval positive nodes does affect oncologic outcomes. Patient summary Lymph node invasion in patients with clear cell renal cell carcinoma is not following a fixed anatomical pattern. An extended lymph node dissection, during treatment for primary

  18. Incidental nodal metastasis of differentiated thyroid carcinoma in neck dissection specimens from head and neck cancer patients.

    PubMed

    Lenzi, R; Marchetti, M; Muscatello, L

    2017-04-01

    Occult differentiated thyroid carcinomas are not uncommon. The initial presentation of a thyroid carcinoma is often detection of a metastatic cervical lymph node. A retrospective review was performed of the medical records of 304 patients who underwent neck dissection between 1996 and 2008 for squamous cell carcinoma of the head and neck. Ten patients (3.3 per cent) had nodal metastasis originating from papillary thyroid cancer. All of these patients underwent thyroidectomy and post-operative 131iodine radiometabolic therapy. No patient developed a thyroid tumour after surgery. Despite its metastatic spread, thyroid cancer does not affect the overall prognosis of patients who are already being treated for a more aggressive malignancy. However, in otherwise healthy patients, it is worth treating this second malignancy to avoid potential complications related to local disease or metastatic thyroid cancer.

  19. Optical performance of the New Worlds Occulter

    NASA Astrophysics Data System (ADS)

    Arenberg, Jonathan W.; Lo, Amy S.; Glassman, Tiffany M.; Cash, Webster

    2007-04-01

    The New Worlds Observer (NWO) is a multiple spacecraft mission that is capable of detecting and characterizing extra-solar planets and planetary systems. NWO consists of an external occulter and a generic space telescope, flying in tandem. The external occulter has specific requirements on its shape and size, while the telescope needs no special modification beyond that required to do high-quality astrophysical observations. The occulter is a petal-shaped, opaque screen that creates a high-suppression shadow large enough to accommodate the telescope. This article reports on the optical performance of the novel New Worlds occulter design. It also introduces two new aspects of its optical performance which enhance the detectability of extra-solar planets. We also include a brief discussion of the buildability and the tolerances of the occulter. It is also shown that an occulter design can be found for any set of science requirements. We show that NWO is a viable mission concept for the study of extra-solar planets. To cite this article: J.W. Arenberg et al., C. R. Physique 8 (2007).

  20. Experiment D005: Star occultation navigation

    NASA Technical Reports Server (NTRS)

    Silva, R. M.; Jorris, T. R.; Vallerie, E. M., III

    1971-01-01

    The usefulness of star occultation measurements for space navigation and the determination of a horizon density profile which could be used to update atmospheric models for horizon-based measurement systems were studied. The time of occultation of a known star by a celestial body, as seen by an orbiting observer, determines a cylinder of position, the axis of which is the line through the star and the body center, and the radius of which is equal to the occulting-body radius. The dimming percentage, with respect to the altitude of this grazing ray from the star to the observer, is a percentage altitude for occultation. That is, the star can be assumed to be occulted when it reaches a predetermined percentage of its unattenuated value. The procedure used was to measure this attenuation with respect to time to determine the usefulness of the measurements for autonomous space navigation. In this experiment, the crewmembers had to accomplish star acquisition, identification, calibration, and tracking. Instrumentation was required only for measurement of the relative intensity of the star as it set into the atmosphere.

  1. Evaluation for Occult Fractures in Injured Children

    PubMed Central

    French, Benjamin; Song, Lihai; Feudtner, Chris

    2015-01-01

    OBJECTIVES: To examine variation across US hospitals in evaluation for occult fractures in (1) children <2 years old diagnosed with physical abuse and (2) infants <1 year old with injuries associated with a high likelihood of abuse and to identify factors associated with such variation. METHODS: We performed a retrospective study in children <2 years old with a diagnosis of physical abuse and in infants <1 year old with non-motor vehicle crash–related traumatic brain injury or femur fractures discharged from 366 hospitals in the Premier database from 2009 to 2013. We examined across-hospital variation and identified child- and hospital-level factors associated with evaluation for occult fractures. RESULTS: Evaluations for occult fractures were performed in 48% of the 2502 children with an abuse diagnosis, in 51% of the 1574 infants with traumatic brain injury, and in 53% of the 859 infants with femur fractures. Hospitals varied substantially with regard to their rates of evaluation for occult fractures in all 3 groups. Occult fracture evaluations were more likely to be performed at teaching hospitals than at nonteaching hospitals (all P < .001). The hospital-level annual volume of young, injured children was associated with the probability of occult fracture evaluation, such that hospitals treating more young, injured patients were more likely to evaluate for occult fractures (all P < .001). CONCLUSIONS: Substantial variation in evaluation for occult fractures among young children with a diagnosis of abuse or injuries associated with a high likelihood of abuse highlights opportunities for quality improvement in this vulnerable population. PMID:26169425

  2. Evaluation for Occult Fractures in Injured Children.

    PubMed

    Wood, Joanne N; French, Benjamin; Song, Lihai; Feudtner, Chris

    2015-08-01

    To examine variation across US hospitals in evaluation for occult fractures in (1) children <2 years old diagnosed with physical abuse and (2) infants <1 year old with injuries associated with a high likelihood of abuse and to identify factors associated with such variation. We performed a retrospective study in children <2 years old with a diagnosis of physical abuse and in infants <1 year old with non-motor vehicle crash-related traumatic brain injury or femur fractures discharged from 366 hospitals in the Premier database from 2009 to 2013. We examined across-hospital variation and identified child- and hospital-level factors associated with evaluation for occult fractures. Evaluations for occult fractures were performed in 48% of the 2502 children with an abuse diagnosis, in 51% of the 1574 infants with traumatic brain injury, and in 53% of the 859 infants with femur fractures. Hospitals varied substantially with regard to their rates of evaluation for occult fractures in all 3 groups. Occult fracture evaluations were more likely to be performed at teaching hospitals than at nonteaching hospitals (all P < .001). The hospital-level annual volume of young, injured children was associated with the probability of occult fracture evaluation, such that hospitals treating more young, injured patients were more likely to evaluate for occult fractures (all P < .001). Substantial variation in evaluation for occult fractures among young children with a diagnosis of abuse or injuries associated with a high likelihood of abuse highlights opportunities for quality improvement in this vulnerable population. Copyright © 2015 by the American Academy of Pediatrics.

  3. Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

    PubMed Central

    Samal, Jasmine; Kandpal, Manish

    2012-01-01

    Summary: Chronic hepatitis B virus (HBV) infection is a complex clinical entity frequently associated with cirrhosis and hepatocellular carcinoma (HCC). The persistence of HBV genomes in the absence of detectable surface antigenemia is termed occult HBV infection. Mutations in the surface gene rendering HBsAg undetectable by commercial assays and inhibition of HBV by suppression of viral replication and viral proteins represent two fundamentally different mechanisms that lead to occult HBV infections. The molecular mechanisms underlying occult HBV infections, including recently identified mechanisms associated with the suppression of HBV replication and inhibition of HBV proteins, are reviewed in detail. The availability of highly sensitive molecular methods has led to increased detection of occult HBV infections in various clinical settings. The clinical relevance of occult HBV infection and the utility of appropriate diagnostic methods to detect occult HBV infection are discussed. The need for specific guidelines on the diagnosis and management of occult HBV infection is being increasingly recognized; the aspects of mechanistic studies that warrant further investigation are discussed in the final section. PMID:22232374

  4. ASTEROID SIZING BY RADIOGALAXY OCCULTATION AT 5 GHZ

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lehtinen, K.; Muinonen, K.; Poutanen, M.

    Stellar occultations by asteroids observed at visual wavelengths have been an important tool for studying the size and shape of asteroids and for revising the orbital parameters of asteroids. At radio frequencies, a shadow of an asteroid on the Earth is dominated by diffraction effects. Here, we show, for the first time, that a single observation of an occultation of a compact radio source at a frequency of 5 GHz can be used to derive the effective size of the occulting object and to derive the distance between the observer and the center of the occultation path on the Earth.more » The derived diameter of the occulting object, asteroid (115) Thyra, is 75 ± 6 km. The observed occultation profile shows features that cannot be explained by diffraction of a single asteroid.« less

  5. Histological changes associated with neoadjuvant chemotherapy are predictive of nodal metastases in high-risk prostate cancer patients

    PubMed Central

    O’Brien, Catherine; True, Lawrence D.; Higano, Celestia S.; Rademacher, Brooks L. S.; Garzotto, Mark; Beer, Tomasz M.

    2011-01-01

    Clinical trials are evaluating the effect of neoadjuvant chemotherapy on men with high risk prostate cancer. Little is known about the clinical significance of post-chemotherapy tumor histopathology. We assessed the prognostic and predictive value of histological features (intraductal carcinoma, vacuolated cell morphology, inconspicuous glands, cribriform architecture, and inconspicuous cancer cells) observed in 50 high-risk prostate cancers treated with pre-prostatectomy docetaxel and mitoxantrone. At a median follow-up of 65 months, the overall relapse-free survival (RFS) at 2 and 5 years was 65% and 49%, respectively. In univariate analyses (using Kaplan-Meier method and log-rank tests) intraductal (p=0.001) and cribriform (p=0.014) histologies were associated with shorter RFS. In multivariate analyses, using Cox’s proportional hazards regression, baseline PSA (p=0.004), lymph node metastases (p<0.001), and cribriform histology (p=0.007) were associated with shorter RFS. In multivariable logistic regression analysis, only intraductal pattern (p=0.007) predicted lymph node metastases. Intraductal and cribriform histologies apparently predict post-chemotherapy outcome. PMID:20231619

  6. Image Analysis of the 2012 Pluto (Near) Occultation

    DTIC Science & Technology

    2013-09-01

    Image Analysis of the 2012 Pluto (Near) Occultation Keith T. Knox Air Force Research Laboratory ABSTRACT Imagery was gathered at the AMOS...observatory on the 3.6-meter telescope for the expected occultation of a star by the dwarf planet, Pluto , on 29 June 2012. The imagery was taken at...5 Hz for 40 minutes before and after the expected time of occultation. The initial analysis of the photometry indicated that Pluto did not occult

  7. Occult pneumomediastinum in blunt chest trauma: clinical significance.

    PubMed

    Rezende-Neto, J B; Hoffmann, J; Al Mahroos, M; Tien, H; Hsee, L C; Spencer Netto, F; Speers, V; Rizoli, S B

    2010-01-01

    Thoracic injuries are potentially responsible for 25% of all trauma deaths. Chest X-ray is commonly used to screen patients with chest injury. However, the use of computed tomography (CT) scan for primary screening is increasing, particularly for blunt trauma. CT scans are more sensitive than chest X-ray in detecting intra-thoracic abnormalities such as pneumothoraces and pneumomediastinums. Pneumomediastinum detected by chest X-ray or "overt pneumomediastinum", raises the concern of possible aerodigestive tract injuries. In contrast, there is scarce information on the clinical significance of pneumomediastinum diagnosed by CT scan only or "occult pneumomediastinum". Therefore we investigated the clinical consequences of occult pneumomediastinum in our blunt trauma population. A 2-year retrospective chart review of all blunt chest trauma patients with initial chest CT scan admitted to a level I trauma centre. Data extracted from the medical records include; demographics, occult, overt, or no pneumomediastinum, the presence of intra-thoracic aerodigestive tract injuries (trachea, bronchus, and/or esophagus), mechanism and severity of injury, endotracheal intubation, chest thoracostomy, operations and radiological reports by an attending radiologist. All patients with intra-thoracic aerodigestive tract injuries from 1994 to 2004 were also investigated. Of 897 patients who met the inclusion criteria 839 (93.5%) had no pneumomediastinum. Five patients (0.6%) had overt pneumomediastinum and 53 patients (5.9%) had occult pneumomediastinum. Patients with occult pneumomediastinum had significantly higher ISS and AIS chest (p<0.0001) than patients with no pneumomediastinum. A chest thoracostomy tube was more common (p<0.0001) in patients with occult pneumomediastinum (47.2%) than patients with no pneumomediastinum (10.4%), as well as occult pneumothorax. None of the patients with occult pneumomediastinum had aerodigestive tract injuries (95%CI 0-0.06). Follow up CT scan of

  8. Occult urolithiasis in asymptomatic primary hyperparathyroidism.

    PubMed

    Tay, Yu-Kwang Donovan; Liu, Minghao; Bandeira, Leonardo; Bucovsky, Mariana; Lee, James A; Silverberg, Shonni J; Walker, Marcella D

    2018-05-01

    Recent international guidelines suggest renal imaging to detect occult urolithiasis in all patients with asymptomatic primary hyperparathyroidism (PHPT), but data regarding their prevalence and associated risk factors are limited. We evaluated the prevalence and risk factors for occult urolithiasis. Cross-sectional analysis of 96 asymptomatic PHPT patients from a university hospital in the United States with and without occult nephrolithiasis. Occult urolithiasis was identified in 21% of patients. Stone formers had 47% higher 24-hour urinary calcium excretion (p = 0.002). Although available in only a subset of patients (n = 28), activated vitamin D [1,25(OH) 2 D] was 29% higher (p = 0.02) in stone formers. There was no difference in demographics, BMI, calcium or vitamin D intake, other biochemistries, renal function, BMD, or fractures. Receiver operating characteristic curves indicated that urinary calcium excretion and 1,25(OH) 2 D had an area under the curve of 0.724 (p = 0.003) and 0.750 (p = 0.04), respectively. A urinary calcium threshold of >211mg/day provided a sensitivity of 84.2% and a specificity of 55.3% while a 1,25(OH) 2 D threshold of >91pg/mL provided a sensitivity and specificity of 62.5% and 90.0% respectively for the presence of stones. Occult urolithiasis is present in about one-fifth of patients with asymptomatic PHPT and is associated with higher urinary calcium and 1,25(OH) 2 D. Given that most patients will not have occult urolithiasis, targeted imaging in those most likely to have occult stones rather than screening all asymptomatic PHPT patients may be useful. The higher sensitivity of urinary calcium versus 1,25(OH) 2 D suggests screening those with higher urinary calcium may be an appropriate approach.

  9. Progress on an external occulter testbed at flight Fresnel numbers

    NASA Astrophysics Data System (ADS)

    Kim, Yunjong; Sirbu, Dan; Galvin, Michael; Kasdin, N. Jeremy; Vanderbei, Robert J.

    2016-01-01

    An external occulter is a spacecraft flown along the line-of-sight of a space telescope to suppress starlight and enable high-contrast direct imaging of exoplanets. Laboratory verification of occulter designs is necessary to validate the optical models used to design and predict occulter performance. At Princeton, we have designed and built a testbed that allows verification of scaled occulter designs whose suppressed shadow is mathematically identical to that of space occulters. The occulter testbed uses 78 m optical propagation distance to realize the flight Fresnel numbers. We will use an etched silicon mask as the occulter. The occulter is illuminated by a diverging laser beam to reduce the aberrations from the optics before the occulter. Here, we present first light result of a sample design operating at a flight Fresnel number and the mechanical design of the testbed. We compare the experimental results with simulations that predict the ultimate contrast performance.

  10. Earth rotation derived from occultation records

    NASA Astrophysics Data System (ADS)

    Sôma, Mitsuru; Tanikawa, Kiyotaka

    2016-04-01

    We determined the values of the Earth's rotation parameter, ΔT = T T - UT, around AD 500 after confirming that the value of the tidal acceleration, dot{n}, of the lunar motion remained unchanged during the period between ancient times and the present. For determining of ΔT, we used contemporaneous occultations of planets by the Moon. In general, occultation records are not useful. However, there are some records that give us a stringent condition for the range of ΔT. Records of the lunar occultations in AD 503 and AD 513 are such examples. In order to assure the usefulness of this occultation data, we used contemporaneous annular and total solar eclipses, which have not been used in the preceding work. This is the first work in which the lunar occultation data have been used as primary data to determine the value of ΔT together with auxiliary contemporaneous annular and total solar eclipses. Our ΔT value is less than a smoothed value (Stephenson 1997) by at least 450 s. The result is consistent with our earlier results obtained from solar eclipses.

  11. Quantum oscillations in nodal line systems

    NASA Astrophysics Data System (ADS)

    Yang, Hui; Moessner, Roderich; Lim, Lih-King

    2018-04-01

    We study signatures of magnetic quantum oscillations in three-dimensional nodal line semimetals at zero temperature. The extended nature of the degenerate bands can result in a Fermi surface geometry with topological genus one, as well as a Fermi surface of electron and hole pockets encapsulating the nodal line. Moreover, the underlying two-band model to describe a nodal line is not unique, in that there are two classes of Hamiltonian with distinct band topology giving rise to the same Fermi-surface geometry. After identifying the extremal cyclotron orbits in various magnetic field directions, we study their concomitant Landau levels and resulting quantum oscillation signatures. By Landau-fan-diagram analyses, we extract the nontrivial π Berry phase signature for extremal orbits linking the nodal line.

  12. Association of preS/S Mutations with Occult Hepatitis B Virus (HBV) Infection in South Korea: Transmission Potential of Distinct Occult HBV Variants

    PubMed Central

    Kim, Hong; Kim, Bum-Joon

    2015-01-01

    Occult hepatitis B virus infection (HBV) is characterized by HBV DNA positivity but HBV surface antigen (HBsAg) negativity. Occult HBV infection is associated with a risk of HBV transmission through blood transfusion, hemodialysis, and liver transplantation. Furthermore, occult HBV infection contributes to the development of cirrhosis and hepatocellular carcinoma. We recently reported the characteristic molecular features of mutations in the preS/S regions among Korean individuals with occult infections caused by HBV genotype C2; the variants of preS and S related to severe liver diseases among chronically infected patients were also responsible for the majority of HBV occult infections. We also reported that HBsAg variants from occult-infected Korean individuals exhibit lower HBsAg secretion capacity but not reduced HBV DNA levels. In addition, these variants exhibit increased ROS-inducing capacity compared with the wild-type strain, linking HBV occult infections to liver cell damage. Taken together, our previous reports suggest the transmission potential of distinct HBV occult infection-related variants in South Korea. PMID:26084041

  13. Association of preS/S Mutations with Occult Hepatitis B Virus (HBV) Infection in South Korea: Transmission Potential of Distinct Occult HBV Variants.

    PubMed

    Kim, Hong; Kim, Bum-Joon

    2015-06-15

    Occult hepatitis B virus infection (HBV) is characterized by HBV DNA positivity but HBV surface antigen (HBsAg) negativity. Occult HBV infection is associated with a risk of HBV transmission through blood transfusion, hemodialysis, and liver transplantation. Furthermore, occult HBV infection contributes to the development of cirrhosis and hepatocellular carcinoma. We recently reported the characteristic molecular features of mutations in the preS/S regions among Korean individuals with occult infections caused by HBV genotype C2; the variants of preS and S related to severe liver diseases among chronically infected patients were also responsible for the majority of HBV occult infections. We also reported that HBsAg variants from occult-infected Korean individuals exhibit lower HBsAg secretion capacity but not reduced HBV DNA levels. In addition, these variants exhibit increased ROS-inducing capacity compared with the wild-type strain, linking HBV occult infections to liver cell damage. Taken together, our previous reports suggest the transmission potential of distinct HBV occult infection-related variants in South Korea.

  14. A contemporary view of atrioventricular nodal physiology.

    PubMed

    Markowitz, Steven M; Lerman, Bruce B

    2018-06-16

    In delaying transmission of the cardiac impulse from the atria to the ventricles, the atrioventricular (AV) node serves a critical function in augmenting ventricular filling during diastole and limiting the ventricular response during atrial tachyarrhythmias. The complex structure of the nodal region, however, also provides the substrate for reentrant rhythms. Recent discoveries have elucidated the cellular basis and anatomical determinants of slow conduction in the node. Based on analysis of gap junction proteins, distinct structural components of the AV node have been defined, including the compact node, right and left inferior nodal extensions, the lower nodal bundle, and transitional tissue. Emerging evidence supports the role of the inferior nodal extensions in mediating slow pathway conduction. The most common form of reentry involving the node, slow-fast AV nodal reentrant tachycardia (AVNRT), utilizes the inferior nodal extensions for anterograde slow pathway conduction; the structures responsible for retrograde fast pathway activation in the superior septum are less well defined and likely heterogeneous. Atypical forms of AVNRT arise from circuits that activate at least one of the inferior extensions in the retrograde direction.

  15. Probing Titan's atmosphere with a stellar occultation

    NASA Technical Reports Server (NTRS)

    Hubbard, W. B.

    1991-01-01

    The 3 July, 1989 occultation of 28 Sgr by Titan is discussed. The star was readily detectable throughout the occultation, reaching a minimum normalized flux of about 0.05. The occultation probed Titan's atmosphere in a region not studied by the Voyager spacecraft. The region is important for the aerobraking of Titan entry probes, and direct information about its properties is important for the Cassini mission. Occultation data (normalized stellar flux vs universal time) is shown in chart form for NASA supported stations, along with data from a collaborating group at the Wise observatory in Israel. Strong scintillation data of the star is noticeable in the data records, and provides information on waves/turbulence in Titan's high atmosphere.

  16. Outcomes of simultaneous resections for patients with synchronous colorectal liver metastases.

    PubMed

    Slesser, A A P; Chand, M; Goldin, R; Brown, G; Tekkis, P P; Mudan, S

    2013-12-01

    The aim of this study was to determine the outcomes associated with simultaneous resections compared to patients undergoing sequential resections for synchronous colorectal liver metastases. Consecutive patients undergoing hepatic resections between 2000 and 2012 for synchronous colorectal liver metastases were identified from a prospectively maintained database. Of the 112 hepatic resections that were performed, 36 were simultaneous resections and 76 were sequential resections. There was no difference in disease severity: number of metastases (P 0.228), metastatic size (P 0.58), the primary tumour nodal status (P 0.283), CEA (P 0.387) or the presence of extra-hepatic metastases (P 1.0). Major hepatic resections were performed in 23 (64%) and 60 (79%) of patients in the simultaneous and sequential groups respectively (P 0.089). Intra-operatively no differences were found in blood loss (P 1.0), duration of surgery (P 0.284) or number of adverse events (P 1.0). There were no differences in post-operative complications (P 0.161) or post-operative mortality (P 0.241). The length of hospital stay was 14 (95% CI 12.0-18.0) and 18.5 (95% CI 16.0-23.0) days in the simultaneous and sequential groups respectively (P 0.03). The 3-year overall survival was 75% and 64% in the simultaneous and sequential groups respectively (P 0.379). The 3-year hepatic recurrence free survival was 61% and 46% in the simultaneous and sequential groups respectively (P 0.254). Simultaneous resections result in similar short-term and long-term outcomes as patients receiving sequential resections with comparable metastatic disease and are associated with a significant reduction in the length of stay. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Io hot spots - Infrared photometry of satellite occultations

    NASA Technical Reports Server (NTRS)

    Goguen, J. D.; Matson, D. L.; Sinton, W. M.; Howell, R. R.; Dyck, H. M.

    1988-01-01

    Io's active hot spots, which are presently mapped on the basis of IR photometry of this moon's occultation by other Gallilean satellites, are obtained with greatest spatial resolution near the sub-earth point. A model is developed for the occultation lightcurves, and its fitting to the data defines the apparent path of the occulting satellite relative to Io; the mean error in apparent relative position of occulting satellites is of the order of 178 km. A heretofore unknown, 20-km diameter hot spot is noted on Io's leading hemisphere.

  18. Strong scintillations during atmospheric occultations Theoretical intensity spectra. [radio scattering during spacecraft occultations by planetary atmospheres

    NASA Technical Reports Server (NTRS)

    Hinson, D. P.

    1986-01-01

    Each of the two Voyager spacecraft launched in 1977 has completed a reconnaissance of the Jovian and Saturnian systems. In connection with occultation experiments, strong scintillations were observed. Further theoretical work is required before these scintillations can be interpreted. The present study is, therefore, concerned with the derivation of a theory for strong scattering during atmospheric occultation experiments, taking into account as fundamental quantity of interest the spatial spectrum (or spectral density) of intensity fluctuations. Attention is given to a theory for intensity spectra, and numerical calculations. The new formula derived for Phi-i accounts for strong scattering of electromagnetic waves during atmospheric occultations.

  19. OCCULT-ORSER complete conversational user-language translator

    NASA Technical Reports Server (NTRS)

    Ramapriyan, H. K.; Young, K.

    1981-01-01

    Translator program (OCCULT) assists non-computer-oriented users in setting up and submitting jobs for complex ORSER system. ORSER is collection of image processing programs for analyzing remotely sensed data. OCCULT is designed for those who would like to use ORSER but cannot justify acquiring and maintaining necessary proficiency in Remote Job Entry Language, Job Control Language, and control-card formats. OCCULT is written in FORTRAN IV and OS Assembler for interactive execution.

  20. Sizes, Shapes, and Satellites of Asteroids from Occultations

    NASA Astrophysics Data System (ADS)

    Waring Dunham, David; Herald, David Russell; Preston, Steve; Timerson, Bradley; Maley, Paul; Frappa, Eric; Hayamizu, Tsutomu; Talbot, John; Poro, Atila

    2015-08-01

    For 40 years, the sizes and shapes of dozens of asteroids have been determined from observations of asteroidal occultations. Some of the first evidence for satellites of asteroids was obtained from the early efforts; now, the orbits and sizes of some satellites discovered by other means have been refined from occultation observations. Also, several close binary stars have been discovered, and the angular diameters of some stars have been measured from analysis of these observations. The International Occultation Timing Association (IOTA) coordinates this activity worldwide, from predicting and publicizing the events, to accurately timing the occultations from as many stations as possible, and publishing and archiving the observations.The release of the Hipparcos and Tycho catalogs in 1997, from ESA’s Hipparcos space mission, revolutionized asteroidal occultation work, increasing the routine accuracy of the predictions and the annual number of observations by an order of magnitude. IOTA developed an efficient procedure for predicting the occultations using a combination of new star catalogs, based on Hipparcos and new star catalogs, generated mainly at the U. S. Naval Observatory (USNO), and new observations of asteroids relative to the improved astrometric nets mainly from USNO’s Flagstaff Astrometric Scanning Transit Telescope and JPL’s Table Mountain Observatory. In addition, many IOTA observers now use inexpensive low-light-level video cameras and specially built GPS video time inserters to accurately time the events. This automation has also allowed some observers to deploy multiple remote video stations across occultation paths. Then, one observer can record several “chords” across the asteroid. The cameras are sensitive enough that easily-hidden telescopes, many of which can be packed in standard air travel suitcases, can be used for many of the predicted occultations. IOTA’s network of regional coordinators collect and reduce the observations

  1. The occult submucous cleft palate.

    PubMed

    Kaplan, E N

    1975-10-01

    We have studied 41 patients with classic submucous cleft and 32 cases with occult submucous cleft. Both groups have the same anatomic abnormality that leads to velar dysfunction-the insertion of the palate muscles onto the hard palate rather than onto the midline soft palate raphe. However, the occult submucous cleft palate does not have the classic triad of bifid uvula, hard palate bony notch, and furrow in the midline of the soft palate. Characteristic facial features, cephalmetric x-rays, and cine voice studies can help make a presumptive diagnosis of occult submucous cleft palate. Surgical management includes a diagnostic palate exploration to identify muscle configuration followed by levator muscle sling reconstruction, palate pushback, and pharyngeal flap. Excellent speech results are obtained except with patients having palate paresis.

  2. Predictive model of outcome of targeted nodal assessment in colorectal cancer.

    PubMed

    Nissan, Aviram; Protic, Mladjan; Bilchik, Anton; Eberhardt, John; Peoples, George E; Stojadinovic, Alexander

    2010-02-01

    Improvement in staging accuracy is the principal aim of targeted nodal assessment in colorectal carcinoma. Technical factors independently predictive of false negative (FN) sentinel lymph node (SLN) mapping should be identified to facilitate operative decision making. To define independent predictors of FN SLN mapping and to develop a predictive model that could support surgical decisions. Data was analyzed from 2 completed prospective clinical trials involving 278 patients with colorectal carcinoma undergoing SLN mapping. Clinical outcome of interest was FN SLN(s), defined as one(s) with no apparent tumor cells in the presence of non-SLN metastases. To assess the independent predictive effect of a covariate for a nominal response (FN SLN), a logistic regression model was constructed and parameters estimated using maximum likelihood. A probabilistic Bayesian model was also trained and cross validated using 10-fold train-and-test sets to predict FN SLN mapping. Area under the curve (AUC) from receiver operating characteristics curves of these predictions was calculated to determine the predictive value of the model. Number of SLNs (<3; P = 0.03) and tumor-replaced nodes (P < 0.01) independently predicted FN SLN. Cross validation of the model created with Bayesian Network Analysis effectively predicted FN SLN (area under the curve = 0.84-0.86). The positive and negative predictive values of the model are 83% and 97%, respectively. This study supports a minimum threshold of 3 nodes for targeted nodal assessment in colorectal cancer, and establishes sufficient basis to conclude that SLN mapping and biopsy cannot be justified in the presence of clinically apparent tumor-replaced nodes.

  3. The Accuracy of Integrated [18F] Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Detection of Pelvic and Para-aortic Nodal Metastasis in Patients with High Risk Endometrial Cancer

    PubMed Central

    Gholkar, Nikhil Shirish; Saha, Subhas Chandra; Prasad, GRV; Bhattacharya, Anish; Srinivasan, Radhika; Suri, Vanita

    2014-01-01

    Lymph nodal (LN) metastasis is the most important prognostic factor in high-risk endometrial cancer. However, the benefit of routine lymphadenectomy in endometrial cancer is controversial. This study was conducted to assess the accuracy of [18F] fluorodeoxyglucose-positron emission tomography/computed tomography ([18F] FDG-PET/CT) in detection of pelvic and para-aortic nodal metastases in high-risk endometrial cancer. 20 patients with high-risk endometrial carcinoma underwent [18F] FDG-PET/CT followed by total abdominal hysterectomy, bilateral salpingo-oophorectomy and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy. The findings on histopathology were compared with [18F] FDG-PET/CT findings to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of [18F] FDG-PET/CT. The pelvic nodal findings were analyzed on a patient and nodal chain based criteria. The para-aortic nodal findings were reported separately. Histopathology documented nodal involvement in two patients (10%). For detection of pelvic nodes, on a patient based analysis, [18F] FDG-PET/CT had a sensitivity of 100%, specificity of 61.11%, PPV of 22.22%, NPV of 100% and accuracy of 65% and on a nodal chain based analysis, [18F] FDG-PET/CT had a sensitivity of 100%, specificity of 80%, PPV of 20%, NPV of 100%, and accuracy of 80.95%. For detection of para-aortic nodes, [18F] FDG-PET/CT had sensitivity of 100%, specificity of 66.67%, PPV of 20%, NPV of 100%, and accuracy of 69.23%. Although [18F] FDG-PET/CT has high sensitivity for detection of LN metastasis in endometrial carcinoma, it had moderate accuracy and high false positivity. However, the high NPV is important in selecting patients in whom lymphadenectomy may be omitted. PMID:25538488

  4. Study of the technique of stellar occultation

    NASA Technical Reports Server (NTRS)

    Hays, P. B.; Graves, M. E.; Roble, R. G.; Shah, A. N.

    1973-01-01

    The results are reported of a study of the stellar occultation technique for measuring the composition of the atmosphere. The intensity of starlight was monitored during the occultation using the Wisconsin stellar ultraviolet photometers aboard the Orbiting Astronomical Observatory (OAO-A2). A schematic diagram of an occultation is shown where the change in intensity at a given wavelength is illustrated. The vertical projection of the attenuation region is typically 60 km deep for molecular oxygen and 30 km deep for ozone. Intensity profiles obtained during various occultations were analyzed by first determining the tangential columm density of the absorbing gases, and then Abel inverting the column densities to obtain the number density profile. Errors are associated with each step in the inversion scheme and have been considered as an integral part of this study.

  5. Role of staging laparoscopy in the management of Pancreatic Duct Carcinoma (PDAC): Single-center experience from a tertiary hospital in Brazil.

    PubMed

    de Jesus, Victor Hugo Fonseca; da Costa Junior, Wilson Luiz; de Miranda Marques, Tomás Mansur Duarte; Diniz, Alessandro Landskron; de Castro Ribeiro, Héber Salvador; de Godoy, André Luis; de Farias, Igor Correia; Coimbra, Felipe José Fernandez

    2018-04-01

    Proper staging is critical to the management of pancreatic ductal carcinoma (PDAC). Laparoscopy has been used to stage patients without gross metastatic disease with variable success. We aimed to identify the frequency of patients diagnosed by laparoscopy with occult metastatic disease. Also, we looked for variables related to a higher chance of occult metastasis. Patients with PDAC submitted to staging laparoscopy either immediately before pancreatectomy or as a separate procedure between January 2010 and December 2016 were included. None presented gross metastatic disease at initial staging. We used logistic regression to search for variables associated with metastatic disease. The study population consisted of 63 patients. Among all patients, nine (16.7%) had occult metastases at laparoscopy. Unresectable tumor (Odds ratio = 18.0, P = 0.03), increasing tumor size (Odds ratio = 1.36, P = 0.01), and abdominal pain (Odds ratio = 5.6, P = 0.04) significantly predicted the risk of occult metastases in univariate analysis. In multivariate analysis, only tumor size predicted the risk of occult metastases. Laparoscopy remains a valuable tool in PDAC staging. Patients with either large or unresectable tumors, or presenting with abdominal pain present the highest risk for occult intra-abdominal metastases. © 2018 Wiley Periodicals, Inc.

  6. Nodal signalling and asymmetry of the nervous system

    PubMed Central

    Signore, Iskra A.; Palma, Karina

    2016-01-01

    The role of Nodal signalling in nervous system asymmetry is still poorly understood. Here, we review and discuss how asymmetric Nodal signalling controls the ontogeny of nervous system asymmetry using a comparative developmental perspective. A detailed analysis of asymmetry in ascidians and fishes reveals a critical context-dependency of Nodal function and emphasizes that bilaterally paired and midline-unpaired structures/organs behave as different entities. We propose a conceptual framework to dissect the developmental function of Nodal as asymmetry inducer and laterality modulator in the nervous system, which can be used to study other types of body and visceral organ asymmetries. Using insights from developmental biology, we also present novel evolutionary hypotheses on how Nodal led the evolution of directional asymmetry in the brain, with a particular focus on the epithalamus. We intend this paper to provide a synthesis on how Nodal signalling controls left–right asymmetry of the nervous system. This article is part of the themed issue ‘Provocative questions in left–right asymmetry’. PMID:27821531

  7. Maternal nodal and zebrafish embryogenesis.

    PubMed

    Bennett, James T; Stickney, Heather L; Choi, Wen-Yee; Ciruna, Brian; Talbot, William S; Schier, Alexander F

    2007-11-08

    In fish and amphibians, the dorsal axis is specified by the asymmetric localization of maternally provided components of the Wnt signalling pathway. Gore et al. suggest that the Nodal signal Squint (Sqt) is required as a maternally provided dorsal determinant in zebrafish. Here we test their proposal and show that the maternal activities of sqt and the related Nodal gene cyclops (cyc) are not required for dorsoventral patterning.

  8. Testing for Occult Heartworm Infection

    PubMed Central

    Stogdale, L.

    1984-01-01

    Heartworm infection in dogs is endemic in southern Ontario but occurs only sporadically throughout the remainder of Canada. The disease may either be associated with microfilariae in the patient's blood, a patent infection, or it may be occult. This paper describes a case of occult dirofilariasis in a dog, with emphasis on the diagnosis. A patent infection could be missed if the clinician tests an insufficient amount of blood. He should perform multiple concentration tests using either the modified Knott's technique or a filtration method. Occult infections occur in prepatent or unisexual infections, when the worms become sterile following therapy, or when the host produces antibodies that result in the destruction of the microfilariae. The recent release of a kit which detects the presence of antibodies to the adult heartworms now enables veterinarians to make an accurate diagnosis in the vast majority of dogs. PMID:17422386

  9. Fecal Occult Blood Test (FOBT): MedlinePlus Lab Test Information

    MedlinePlus

    ... medlineplus.gov/labtests/fecaloccultbloodtestfobt.html Fecal Occult Blood Test (FOBT) To use the sharing features on this ... enable JavaScript. What is a Fecal Occult Blood Test? A fecal occult blood test (FOBT) looks at ...

  10. A Digital Video System for Observing and Recording Occultations

    NASA Astrophysics Data System (ADS)

    Barry, M. A. Tony; Gault, Dave; Pavlov, Hristo; Hanna, William; McEwan, Alistair; Filipović, Miroslav D.

    2015-09-01

    Stellar occultations by asteroids and outer solar system bodies can offer ground based observers with modest telescopes and camera equipment the opportunity to probe the shape, size, atmosphere, and attendant moons or rings of these distant objects. The essential requirements of the camera and recording equipment are: good quantum efficiency and low noise; minimal dead time between images; good horological faithfulness of the image timestamps; robustness of the recording to unexpected failure; and low cost. We describe an occultation observing and recording system which attempts to fulfil these requirements and compare the system with other reported camera and recorder systems. Five systems have been built, deployed, and tested over the past three years, and we report on three representative occultation observations: one being a 9 ± 1.5 s occultation of the trans-Neptunian object 28978 Ixion (m v =15.2) at 3 seconds per frame; one being a 1.51 ± 0.017 s occultation of Deimos, the 12 km diameter satellite of Mars, at 30 frames per second; and one being a 11.04 ± 0.4 s occultation, recorded at 7.5 frames per second, of the main belt asteroid 361 Havnia, representing a low magnitude drop (Δm v = ~0.4) occultation.

  11. Delineation of Supraclavicular Target Volumes in Breast Cancer Radiation Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brown, Lindsay C.; Diehn, Felix E.; Boughey, Judy C.

    Purpose: To map the location of gross supraclavicular metastases in patients with breast cancer, in order to determine areas at highest risk of harboring subclinical disease. Methods and Materials: Patients with axial imaging of gross supraclavicular disease were identified from an institutional breast cancer registry. Locations of the metastatic lymph nodes were transferred onto representative axial computed tomography images of the supraclavicular region and compared with the Radiation Therapy Oncology Group (RTOG) breast cancer atlas for radiation therapy planning. Results: Sixty-two patients with 161 supraclavicular nodal metastases were eligible for study inclusion. At the time of diagnosis, 117 nodal metastasesmore » were present in 44 patients. Forty-four nodal metastases in 18 patients were detected at disease recurrence, 4 of whom had received prior radiation to the supraclavicular fossa. Of the 161 nodal metastases, 95 (59%) were within the RTOG consensus volume, 4 nodal metastases (2%) in 3 patients were marginally within the volume, and 62 nodal metastases (39%) in 30 patients were outside the volume. Supraclavicular disease outside the RTOG consensus volume was located in 3 regions: at the level of the cricoid and thyroid cartilage (superior to the RTOG volume), in the posterolateral supraclavicular fossa (posterolateral to the RTOG volume), and in the lateral low supraclavicular fossa (lateral to the RTOG volume). Only women with multiple supraclavicular metastases had nodal disease that extended superiorly to the level of the thyroid cartilage. Conclusions: For women with risk of harboring subclinical supraclavicular disease warranting the addition of supraclavicular radiation, coverage of the posterior triangle and the lateral low supraclavicular region should be considered. For women with known supraclavicular disease, extension of neck coverage superior to the cricoid cartilage may be warranted.« less

  12. Ultrasound for diagnosing radiographically occult scaphoid fracture.

    PubMed

    Kwee, Robert M; Kwee, Thomas C

    2018-04-04

    To systematically review the literature on the performance of ultrasound in diagnosing radiographically occult scaphoid fracture. A systematic search was performed in the MEDLINE and Embase databases. Original studies investigating the performance of ultrasound in diagnosing radiographically occult scaphoid fracture in more than 10 patients were eligible for inclusion. Studies that included both radiographically apparent and occult scaphoid fractures (at initial radiography) were only included if independent data on radiographically occult fractures were reported. Methodological quality of the studies included was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Accuracy data were extracted. Sensitivity and specificity were pooled with a bivariate random-effects model. The inclusion criteria were met by 7 studies; total sample size comprised 314 patients. All studies, except 1, included cortical disruption of the scaphoid in their diagnostic criteria. The sensitivity and specificity of ultrasound in diagnosing radiographically occult scaphoid fracture ranged from 77.8% to 100% and from 71.4% to 100% respectively, with pooled estimates of 85.6% (95% CI: 73.9%, 92.6%) and 83.3% % (95% CI: 72.0%, 90.6%) respectively. Exclusion of two studies with a high risk of bias in any QUADAS-2 domain did not affect the pooled results. Ultrasound can diagnose radiographically occult scaphoid fracture with a fairly high degree of accuracy. Because of its relatively low costs and fairly high sensitivity, ultrasound seems more cost-effective than empiric cast immobilization and may be used when CT and MRI are not readily available.

  13. Chiron stellar occultation candidates: 1993-1996

    NASA Technical Reports Server (NTRS)

    Bus, S. J.; Wasserman, L. H.; Elliot, J. L.

    1994-01-01

    A photographic search was conducted for stars that may be occulted by the unusual solar system object (2060) Chiron during the period from fall 1993 through summer 1996. 44 candidates were identified to a limiting V magnitude of 16, and for which the minimum appulse separation with Chiron is predicted to be less than 2.5 arcsec. The successful observation of a stellar occultation by Chiron would give a direct measure of its diameter (currently estimated to be between 60 and 300 km), and would help considerably in constraining Chiron's surface properties and volatile makeup. If at the time of the occultation, Chiron exhibits a significant coma, there is also the potential for measuring the optical-depth profile of the dust in its inner coma.

  14. Cervical level IIb metastases in squamous cell carcinoma of the oral cavity: a systematic review and meta-analysis.

    PubMed

    Kou, Yurong; Zhao, Tengfei; Huang, Shaohui; Liu, Jie; Duan, Weiyi; Wang, Yunjing; Wang, Zechen; Li, Delong; Ning, Chunliu; Sun, Changfu

    2017-01-01

    The aim of this study was to clarify whether level IIb dissection should be performed or avoided in the treatment of oral squamous cell carcinoma by meta-analysis. Articles that were published before June 2017 were searched electronically in four databases (Web of Science, PubMed, Ovid and China National Knowledge Infrastructure) without any date or language restrictions by two independent reviewers. Abstracts and full-text papers which investigated the cervical metastases to level IIb from primary head and neck cancers and were deemed potentially relevant were screened. Data were analyzed using RevMan 5.3. Four hundred and fifty-five abstracts and 129 full-text papers were screened, and 22 studies were included in the analysis. Among the 2001 patients included, 112 patients had level IIb metastases, the pooled frequency of which was 6% (95% confidence interval [CI]: 4.0-7.0). Among the 400 patients with tongue squamous cell carcinoma from 12 studies, 37 patients had level IIb metastases, the pooled incidence of which was 7% (95% CI: 5.0-10.0). Metastases to level IIb always went together with level IIa, and only three patients were found to have isolated level IIb metastases without involving the other levels. Due to the low frequency of level IIb nodal metastases in oral squamous cell carcinoma patients and rare occurrence of isolated level IIb, level IIb dissection could be avoided when the primary lesions were in early stages (T1 and T2), with the exception of tongue cancer. It is recommended to dissect level IIb tongue cancers without considering the stages of primary lesions and the lymph nodes status. It is also suggested that level IIb dissection should be performed in patients preoperatively or intraoperatively found with multilevel neck metastasis, especially level IIa metastasis.

  15. Nondimensional Representations for Occulter Design and Performance Evaluation

    NASA Technical Reports Server (NTRS)

    Cady, Eric

    2011-01-01

    An occulter is a spacecraft with a precisely-shaped optical edges which ies in formation with a telescope, blocking light from a star while leaving light from nearby planets una ected. Using linear optimization, occulters can be designed for use with telescopes over a wide range of telescope aperture sizes, science bands, and starlight suppression levels. It can be shown that this optimization depends primarily on a small number of independent nondimensional parameters, which correspond to Fresnel numbers and physical scales and enter the optimization only as constraints. We show how these can be used to span the parameter space of possible optimized occulters; this data set can then be mined to determine occulter sizes for various mission scenarios and sets of engineering constraints.

  16. Sizes, Shapes, and Satellites of Asteroids from Occultations

    NASA Astrophysics Data System (ADS)

    Dunham, David W.; Herald, David; Preston, Steve; Timerson, Brad; Maley, Paul; Frappa, Eric; Hayamizu, Tsutomu; Talbot, John; Poro, Atila

    2016-01-01

    For 40 years, the sizes and shapes of many dozens of asteroids have been determined from observations of asteroidal occultations, and over a thousand high-precision positions of the asteroids relative to stars have been measured. Some of the first evidence for satellites of asteroids was obtained from the early efforts; now, the orbits and sizes of some satellites discovered by other means have been refined from occultation observations. Also, several close binary stars have been discovered, and the angular diameters of some stars have been measured from analysis of these observations. The International Occultation Timing Association (IOTA) coordinates this activity worldwide, from predicting and publicizing the events, to accurately timing the occultations from as many stations as possible, and publishing and archiving the observations.

  17. Mutations Associated With Occult Hepatitis B in HIV-Positive South Africans

    PubMed Central

    Powell, Eleanor A.; Gededzha, Maemu P.; Rentz, Michael; Rakgole, Nare J.; Selabe, Selokela G.; Seleise, Tebogo A.; Mphahlele, M. Jeffrey; Blackard, Jason T.

    2015-01-01

    Occult hepatitis B is characterized by the absence of hepatitis B surface antigen (HBsAg) but the presence of HBV DNA. Because diagnosis of hepatitis B virus (HBV) typically includes HBsAg detection, occult HBV remains largely undiagnosed. Occult HBV is associated with increased risk of hepatocellular carcinoma, reactivation to chronic HBV during immune suppression, and transmission during blood transfusion and liver transplant. The mechanisms leading to occult HBV infection are unclear, although viral mutations are likely a significant factor. In this study, sera from 394 HIV-positive South Africans were tested for HBV DNA and HBsAg. For patients with detectable HBV DNA, the overlapping surface and polymerase open reading frames (ORFs) were sequenced. Occult-associated mutations—those mutations found exclusively in individuals with occult HBV infection but not in individuals with chronic HBV infection from the same cohort or GenBank references—were identified. Ninety patients (22.8%) had detectable HBV DNA. Of these, 37 had detectable HBsAg, while 53 lacked detectable surface antigen. The surface and polymerase ORFs were cloned successfully for 19 patients with chronic HBV and 30 patients with occult HBV. In total, 235 occult-associated mutations were identified. Ten occult-associated mutations were identified in more than one patient. Additionally, 15 amino acid positions had two distinct occult-associated mutations at the same residue. Occult-associated mutations were common and present in all regions of the surface and polymerase ORFs. Further study is underway to determine the effects of these mutations on viral replication and surface antigen expression in vitro. PMID:25164924

  18. Mutations associated with occult hepatitis B in HIV-positive South Africans.

    PubMed

    Powell, Eleanor A; Gededzha, Maemu P; Rentz, Michael; Rakgole, Nare J; Selabe, Selokela G; Seleise, Tebogo A; Mphahlele, M Jeffrey; Blackard, Jason T

    2015-03-01

    Occult hepatitis B is characterized by the absence of hepatitis B surface antigen (HBsAg) but the presence of HBV DNA. Because diagnosis of hepatitis B virus (HBV) typically includes HBsAg detection, occult HBV remains largely undiagnosed. Occult HBV is associated with increased risk of hepatocellular carcinoma, reactivation to chronic HBV during immune suppression, and transmission during blood transfusion and liver transplant. The mechanisms leading to occult HBV infection are unclear, although viral mutations are likely a significant factor. In this study, sera from 394 HIV-positive South Africans were tested for HBV DNA and HBsAg. For patients with detectable HBV DNA, the overlapping surface and polymerase open reading frames (ORFs) were sequenced. Occult-associated mutations-those mutations found exclusively in individuals with occult HBV infection but not in individuals with chronic HBV infection from the same cohort or GenBank references-were identified. Ninety patients (22.8%) had detectable HBV DNA. Of these, 37 had detectable HBsAg, while 53 lacked detectable surface antigen. The surface and polymerase ORFs were cloned successfully for 19 patients with chronic HBV and 30 patients with occult HBV. In total, 235 occult-associated mutations were identified. Ten occult-associated mutations were identified in more than one patient. Additionally, 15 amino acid positions had two distinct occult-associated mutations at the same residue. Occult-associated mutations were common and present in all regions of the surface and polymerase ORFs. Further study is underway to determine the effects of these mutations on viral replication and surface antigen expression in vitro. © 2014 Wiley Periodicals, Inc.

  19. Design of an occulter testbed at flight Fresnel numbers

    NASA Astrophysics Data System (ADS)

    Sirbu, Dan; Kasdin, N. Jeremy; Kim, Yunjong; Vanderbei, Robert J.

    2015-01-01

    An external occulter is a spacecraft flown along the line-of-sight of a space telescope to suppress starlight and enable high-contrast direct imaging of exoplanets. Laboratory verification of occulter designs is necessary to validate the optical models used to design and predict occulter performance. At Princeton, we are designing and building a testbed that allows verification of scaled occulter designs whose suppressed shadow is mathematically identical to that of space occulters. Here, we present a sample design operating at a flight Fresnel number and is thus representative of a realistic space mission. We present calculations of experimental limits arising from the finite size and propagation distance available in the testbed, limitations due to manufacturing feature size, and non-ideal input beam. We demonstrate how the testbed is designed to be feature-size limited, and provide an estimation of the expected performance.

  20. Detection of bone metastases in breast cancer patients in the PET/CT era: Do we still need the bone scan?

    PubMed

    Caglar, M; Kupik, O; Karabulut, E; Høilund-Carlsen, P F

    2016-01-01

    To examine the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of bone metastasis in breast cancer patients and assess whether whole body bone scan (BS) with (99m)Tc-methylene diphosphonate provides any additional information. Study group comprised 150 patients, mean age 52 years (range 27-85) with breast cancer, suspected of having bone metastases. All patients had undergone both FDG-PET/CT and BS with or without single photon emission tomography/computed tomography (SPECT/CT) within a period of 6 weeks. The final diagnosis of bone metastasis was established by histopathological findings, additional imaging, or clinical follow-up longer than 10 months. Cancer antigen 15-3 (CA15-3) and carcinoembryogenic antigen (CEA) were measured in all patients. Histologically 83%, 7% and 10% had infiltrating ductal, lobular and mixed carcinoma respectively. Confirmed bone metastases were present in 86 patients (57.3%) and absent in 64 (42.7%). Mean CA15-3 and CEA values in patients with bone metastases were 74.6ng/mL and 60.4U/mL respectively, compared to 21.3ng/mL and 3.2U/mL without metastases (p<0.001). The sensitivity of FDG-PET/CT for the detection of bone metastases was 97.6% compared to 89.5% with SPECT/CT. In 57 patients, FDG-PET/CT correctly identified additional pulmonary, hepatic, nodal and other soft tissue metastases, not detected by BS. Our findings suggest that FDG-PET/CT is superior to BS with or without SPECT/CT. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  1. Nodal signalling determines biradial asymmetry in Hydra.

    PubMed

    Watanabe, Hiroshi; Schmidt, Heiko A; Kuhn, Anne; Höger, Stefanie K; Kocagöz, Yigit; Laumann-Lipp, Nico; Ozbek, Suat; Holstein, Thomas W

    2014-11-06

    In bilaterians, three orthogonal body axes define the animal form, with distinct anterior-posterior, dorsal-ventral and left-right asymmetries. The key signalling factors are Wnt family proteins for the anterior-posterior axis, Bmp family proteins for the dorsal-ventral axis and Nodal for the left-right axis. Cnidarians, the sister group to bilaterians, are characterized by one oral-aboral body axis, which exhibits a distinct biradiality of unknown molecular nature. Here we analysed the biradial growth pattern in the radially symmetrical cnidarian polyp Hydra, and we report evidence of Nodal in a pre-bilaterian clade. We identified a Nodal-related gene (Ndr) in Hydra magnipapillata, and this gene is essential for setting up an axial asymmetry along the main body axis. This asymmetry defines a lateral signalling centre, inducing a new body axis of a budding polyp orthogonal to the mother polyp's axis. Ndr is expressed exclusively in the lateral bud anlage and induces Pitx, which encodes an evolutionarily conserved transcription factor that functions downstream of Nodal. Reminiscent of its function in vertebrates, Nodal acts downstream of β-Catenin signalling. Our data support an evolutionary scenario in which a 'core-signalling cassette' consisting of β-Catenin, Nodal and Pitx pre-dated the cnidarian-bilaterian split. We presume that this cassette was co-opted for various modes of axial patterning: for example, for lateral branching in cnidarians and left-right patterning in bilaterians.

  2. Diagnostic strategy for occult hepatitis B virus infection

    PubMed Central

    Ocana, Sara; Casas, Maria Luisa; Buhigas, Ingrid; Lledo, Jose Luis

    2011-01-01

    In 2008, the European Association for the study of the liver (EASL) defined occult hepatitis B virus infection (OBI) as the “presence of hepatitis B virus (HBV) DNA in the liver (with detectable or undetectable HBV DNA in the serum) of individuals testing hepatitis B surface antigen (HBsAg) negative by currently available assays”. Several aspects of occult HBV infection are still poorly understood, including the definition itself and a standardized approach for laboratory-based detection, which is the purpose of this review. The clinical significance of OBI has not yet been established; however, in terms of public health, the clinical importance arises from the risk of HBV transmission. Consequently, it is important to detect high-risk groups for occult HBV infection to prevent transmission. The main issue is, perhaps, to identify the target population for screening OBI. Viremia is very low or undetectable in occult HBV infection, even when the most sensitive methods are used, and the detection of the viral DNA reservoir in hepatocytes would provide the best evaluation of occult HBV prevalence in a defined set of patients. However, this diagnostic approach is obviously unsuitable: blood detection of occult hepatitis B requires assays of the highest sensitivity and specificity with a lower limit of detection < 10 IU/mL for HBV DNA and < 0.1 ng/mL for HBsAg. PMID:21472120

  3. Portable high speed photometry systems for observing occultations

    NASA Astrophysics Data System (ADS)

    Elliot, J. L.; Dunham, E. W.

    1986-09-01

    Ring orbit studies for Uranus have been particularly fruitful because of the ability, through occultations, to obtain data of high spatial resolution at the rate of 1 to 2 times per year. The occultation program at M.I.T. involves: (1) identifying the scientific questions that can be answered by occultation events, (2) predicting the zone of visibility for the useful events, (3) maintaining and improving a set of portable high-speed photometric systems, (4) obtaining the observations, and (5) reducing the data and interpreting the results. Two stellar occultations by Uranus occurred in May 1985, and were observed with a network of large telescopes that encompassed the Northern and Southern Hemispheres. Portable quartz-oscillator time standards were used at all observatories, and were calibrated before and after each event. Observations obtained form Cerro Tololo and McDonald Observatories of the 4 May and 24 May 1985 occultations by the Uranian rings clearly show a companion to the delta ring on both the immersion and emersion traces. The occultation by Ceres that occurred on 12 November 1984 was observed. Preliminary results give a mean diameter of 933 + or - 10 km, which implies a geometric albedo, Pv = 0.07 + or - 0.01 and a density 2.7 + or - 0.3 gm cu/cm. Hence Ceres is likely composed of silicate material throughout.

  4. First results from stellar occultations in the "GAIA era"

    NASA Astrophysics Data System (ADS)

    Benedetti-Rossi, G.; Vieira-Martins, R.; Sicardy, B.

    2017-09-01

    Stellar occultation is a powerful technique to study distant solar system bodies. It allows high angular resolution of the occulting body from the analysis of a light curve acquired with high temporal resolution with uncertainties comparable as probes. In the "GAIA era", stellar occultations is now able to obtain even more impressive results such as the presence of atmosphere, rings and topographic features.

  5. Solar Occultation Retrieval Algorithm Development

    NASA Technical Reports Server (NTRS)

    Lumpe, Jerry D.

    2004-01-01

    This effort addresses the comparison and validation of currently operational solar occultation retrieval algorithms, and the development of generalized algorithms for future application to multiple platforms. initial development of generalized forward model algorithms capable of simulating transmission data from of the POAM II/III and SAGE II/III instruments. Work in the 2" quarter will focus on: completion of forward model algorithms, including accurate spectral characteristics for all instruments, and comparison of simulated transmission data with actual level 1 instrument data for specific occultation events.

  6. Occult Intertrochanteric Fracture Mimicking the Fracture of Greater Trochanter.

    PubMed

    Chung, Phil Hyun; Kang, Suk; Kim, Jong Pil; Kim, Young Sung; Lee, Ho Min; Back, In Hwa; Eom, Kyeong Soo

    2016-06-01

    Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures. This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013. Until January 2008, 9 cases were examined with 3D-CT only, while 14 cases were screened with both 3D-CT and MRI scans. We analyzed diagnostic accuracy and treatment results following 3D-CT and MRI scanning. Nine cases that underwent 3D-CT only were diagnosed with isolated greater trochanteric fractures without occult intertrochanteric fractures. Of these, a patient with displacement received surgical treatment. Of the 14 patients screened using both CT and MRI, 13 were diagnosed with occult intertrochanteric fractures. Of these, 11 were treated with surgical intervention and 2 with conservative management. Three-dimensional CT has very low diagnostic accuracy in diagnosing occult intertrochanteric fractures. For this reason, MRI is recommended to confirm a suspected occult intertrochanteric fracture and to determine the most appropriate mode of treatment.

  7. Primary nodal hemangiosarcoma in four dogs.

    PubMed

    Chan, Catherine M; Zwahlen, Courtney H; de Lorimier, Louis-Philippe; Yeomans, Stephen M; Hoffmann, Karon L; Moore, Antony S

    2016-11-01

    CASE DESCRIPTION 4 dogs with a slow-growing mass in the cervical region were evaluated. CLINICAL FINDINGS All dogs had no clinical signs at the time of the evaluation. There was no apparent evidence of visceral metastases or other primary tumor based on available CT or MRI data for any dog. TREATMENT AND OUTCOME For each dog, surgery to remove the mass was performed. Histologic examination of the excised tissue revealed a completely excised grade 1 or 2 lymph node hemangiosarcoma. All dogs received adjuvant chemotherapy; 2 dogs underwent curative intent chemotherapy, 1 dog underwent metronomic treatment with cyclophosphamide, and 1 dog underwent metronomic treatment with chlorambucil. The survival time was 259 days in 1 dog; 3 dogs were still alive 615, 399, and 365 days after surgery. CLINICAL RELEVANCE Primary nodal hemangiosarcoma in dogs is a rare and, to the authors' knowledge, previously undescribed disease that appears to develop in the cervical lymph nodes as a slow-growing mass or masses. Surgical excision and adjunct treatment resulted in long survival times for 3 of the 4 dogs of the present report. Given the aggressive biologic behavior of hemangiosarcomas in other body locations, adjunct chemotherapy should be considered for affected dogs, although its role in the cases described in this report was unclear. Additional clinical information is required to further characterize the biologic behavior of this tumor type and determine the expected survival times and associated risk factors in dogs.

  8. Regional Nodal Irradiation in Early-Stage Breast Cancer.

    PubMed

    Whelan, Timothy J; Olivotto, Ivo A; Parulekar, Wendy R; Ackerman, Ida; Chua, Boon H; Nabid, Abdenour; Vallis, Katherine A; White, Julia R; Rousseau, Pierre; Fortin, Andre; Pierce, Lori J; Manchul, Lee; Chafe, Susan; Nolan, Maureen C; Craighead, Peter; Bowen, Julie; McCready, David R; Pritchard, Kathleen I; Gelmon, Karen; Murray, Yvonne; Chapman, Judy-Anne W; Chen, Bingshu E; Levine, Mark N

    2015-07-23

    Most women with breast cancer who undergo breast-conserving surgery receive whole-breast irradiation. We examined whether the addition of regional nodal irradiation to whole-breast irradiation improved outcomes. We randomly assigned women with node-positive or high-risk node-negative breast cancer who were treated with breast-conserving surgery and adjuvant systemic therapy to undergo either whole-breast irradiation plus regional nodal irradiation (including internal mammary, supraclavicular, and axillary lymph nodes) (nodal-irradiation group) or whole-breast irradiation alone (control group). The primary outcome was overall survival. Secondary outcomes were disease-free survival, isolated locoregional disease-free survival, and distant disease-free survival. Between March 2000 and February 2007, a total of 1832 women were assigned to the nodal-irradiation group or the control group (916 women in each group). The median follow-up was 9.5 years. At the 10-year follow-up, there was no significant between-group difference in survival, with a rate of 82.8% in the nodal-irradiation group and 81.8% in the control group (hazard ratio, 0.91; 95% confidence interval [CI], 0.72 to 1.13; P=0.38). The rates of disease-free survival were 82.0% in the nodal-irradiation group and 77.0% in the control group (hazard ratio, 0.76; 95% CI, 0.61 to 0.94; P=0.01). Patients in the nodal-irradiation group had higher rates of grade 2 or greater acute pneumonitis (1.2% vs. 0.2%, P=0.01) and lymphedema (8.4% vs. 4.5%, P=0.001). Among women with node-positive or high-risk node-negative breast cancer, the addition of regional nodal irradiation to whole-breast irradiation did not improve overall survival but reduced the rate of breast-cancer recurrence. (Funded by the Canadian Cancer Society Research Institute and others; MA.20 ClinicalTrials.gov number, NCT00005957.).

  9. Role of Positron Emission Tomography in the Treatment of Occult Disease in Head-and-Neck Cancer: A Modeling Approach

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Phillips, Mark H., E-mail: markp@u.washington.ed; Smith, Wade P.; Parvathaneni, Upendra

    2011-03-15

    Purpose: To determine under what conditions positron emission tomography (PET) imaging will be useful in decisions regarding the use of radiotherapy for the treatment of clinically occult lymph node metastases in head-and-neck cancer. Methods and Materials: A decision model of PET imaging and its downstream effects on radiotherapy outcomes was constructed using an influence diagram. This model included the sensitivity and specificity of PET, as well as the type and stage of the primary tumor. These parameters were varied to determine the optimal strategy for imaging and therapy for different clinical situations. Maximum expected utility was the metric by whichmore » different actions were ranked. Results: For primary tumors with a low probability of lymph node metastases, the sensitivity of PET should be maximized, and 50 Gy should be delivered if PET is positive and 0 Gy if negative. As the probability for lymph node metastases increases, PET imaging becomes unnecessary in some situations, and the optimal dose to the lymph nodes increases. The model needed to include the causes of certain health states to predict current clinical practice. Conclusion: The model demonstrated the ability to reproduce expected outcomes for a range of tumors and provided recommendations for different clinical situations. The differences between the optimal policies and current clinical practice are likely due to a disparity between stated clinical decision processes and actual decision making by clinicians.« less

  10. Pattern of neck recurrence after lateral neck dissection for cervical metastases in papillary thyroid cancer.

    PubMed

    McNamara, William F; Wang, Laura Y; Palmer, Frank L; Nixon, Iain J; Shah, Jatin P; Patel, Snehal G; Ganly, Ian

    2016-06-01

    The objective of this study was to determine the rate and pattern of nodal recurrence in patients who underwent a therapeutic, lateral neck dissection (LND) for papillary thyroid cancer (PTC) with clinically evident cervical metastases and to determine if there was any correlation between the extent of initial dissection and the rate and pattern of neck recurrence. A total of 3,664 patients with PTC treated between 1986 and 2010 at Memorial Sloan Kettering Cancer Center were identified from our institutional database. Tumor factors, patient demographics, extent of initial LND, and adjuvant therapy were recorded. Patterns of recurrent lateral neck metastases by level involvement were recorded and outcomes calculated using the Kaplan-Meier method. A total of 484 patients had an LND for cervical metastases; 364 (75%) had a comprehensive LND (CLND) and 120 (25%) had a selective neck dissection (SND). The median duration of follow-up was 63.5 months. As expected, patients with CLND had a greater number of nodes removed as well as a greater number of positive nodes (P < .001). There was no difference in overall lateral neck recurrence-free status (CLND 94.4% vs SND 89.4%, P = .158), but in the dissected neck, the ipsilateral lateral neck recurrence-free status was superior in the CLND patients (97.7% vs 89.4%, P < .001). Patients with clinically evident neck metastases from PTC managed by CLND have lesser rates of recurrence in the dissected neck compared with patients managed by SND. SND should only be done in highly selected cases with small volume disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Pattern of neck recurrence after lateral neck dissection for cervical metastases in papillary thyroid cancer

    PubMed Central

    McNamara, William F.; Wang, Laura Y.; Palmer, Frank L.; Nixon, Iain J.; Shah, Jatin P.; Patel, Snehal G.; Ganly, Ian

    2016-01-01

    Background The objective of this study was to determine the rate and pattern of nodal recurrence in patients who underwent a therapeutic, lateral neck dissection (LND) for papillary thyroid cancer (PTC) with clinically evident cervical metastases and to determine if there was any correlation between the extent of initial dissection and the rate and pattern of neck recurrence. Methods A total of 3,664 patients with PTC treated between 1986 and 2010 at Memorial Sloan Kettering Cancer Center were identified from our institutional database. Tumor factors, patient demographics, extent of initial LND, and adjuvant therapy were recorded. Patterns of recurrent lateral neck metastases by level involvement were recorded and outcomes calculated using the Kaplan-Meier method. Results A total of 484 patients had an LND for cervical metastases; 364 (75%) had a comprehensive LND (CLND) and 120 (25%) had a selective neck dissection (SND). The median duration of follow-up was 63.5 months. As expected, patients with CLND had a greater number of nodes removed as well as a greater number of positive nodes (P < .001). There was no difference in overall lateral neck recurrence-free status (CLND 94.4% vs SND 89.4%, P = .158), but in the dissected neck, the ipsilateral lateral neck recurrence-free status was superior in the CLND patients (97.7% vs 89.4%, P < .001). Conclusion Patients with clinically evident neck metastases from PTC managed by CLND have lesser rates of recurrence in the dissected neck compared with patients managed by SND. SND should only be done in highly selected cases with small volume disease. PMID:26994486

  12. First light of an external occulter testbed at flight Fresnel numbers

    NASA Astrophysics Data System (ADS)

    Kim, Yunjong; Sirbu, Dan; Hu, Mia; Kasdin, Jeremy; Vanderbei, Robert J.; Harness, Anthony; Shaklan, Stuart

    2017-01-01

    Many approaches have been suggested over the last couple of decades for imaging Earth-like planets. One of the main candidates for creating high-contrast for future Earth-like planets detection is an external occulter. The external occulter is a spacecraft flown along the line-of-sight of a space telescope to suppress starlight and enable high-contrast direct imaging of exoplanets. The occulter is typically tens of meters in diameter and the separation from the telescope is of the order of tens of thousands of kilometers. Optical testing of a full-scale external occulter on the ground is impossible because of the long separations. Therefore, laboratory verification of occulter designs is necessary to validate the optical models used to design and predict occulter performance. At Princeton, we have designed and built a testbed that allows verification of scaled occulter designs whose suppressed shadow is mathematically identical to that of space occulters. The goal of this experiment is to demonstrate a pupil plane suppression of better than 1e-9 with a corresponding image plane contrast of better than 1e-11. The occulter testbed uses a 77.2 m optical propagation distance to realize the flight Fresnel number of 14.5. The scaled mask is placed at 27.2 m from the artificial source and the camera is located 50.0 m from the scaled mask. We will use an etched silicon mask, manufactured by the Microdevices Lab(MDL) of the Jet Propulsion Laboratory(JPL), as the occulter. Based on conversations with MDL, we expect that 0.5 μm feature size is an achievable resolution in the mask manufacturing process and is therefore likely the indicator of the best possible performance. The occulter is illuminated by a diverging laser beam to reduce the aberrations from the optics before the occulter. Here, we present first light result of a sample design operating at a flight Fresnel number and the experimental setup of the testbed. We compare the experimental results with simulations

  13. Possible occultation by Pluto from US East Coast

    NASA Astrophysics Data System (ADS)

    Waagen, Elizabeth O.

    2012-06-01

    We have been asked to help disseminate the news of a possible occultation by Pluto visible to observers on the US East coast. Although the AAVSO does not ordinarily issue announcements of upcoming occultations, in this case the object is Pluto and the NASA New Horizons mission (http://www.nasa.gov/mission_pages/newhorizons/main/index.html) will be visiting Pluto in 2015. The information below has been supplied by Dr. Leslie Young (Southwest Research Institute), who is coordinating this observing campaign on Pluto. Dr. Young is also Deputy Project Scientist for the New Horizons mission. ALERT: Possible Pluto occultation Wednesday night (2012/06/14 03:28 UT) from US East coast. CONTACT: Leslie Young (layoung@boulder.swri.edu; work: 303-546-6057; skype: drpluto). Also see our planning pages in progress at http://wiki.boulder.swri.edu/mediawiki/index.php/2012-06-14_Pluto_occultation. Pluto's thin, nitrogen atmosphere is in vapor-pressure equilibrium with the surface ice, and changes seasonally. We've seen it double since 1988, and now we measure its pressure once or twice a year. The technique we use is stellar occultation, when a star passes behind Pluto's atmosphere. The atmosphere defocuses the starlight. By the timing of the fading of the star, we measure the pressure and temperature in Pluto's atmosphere at ~10 km resolution. MORE INFORMATION: See http://wiki.boulder.swri.edu/mediawiki/index.php/2012-06-14_Pluto_occultation.

  14. Occultation Lightcurves for Selected Pluto Volatile Transport Models

    NASA Astrophysics Data System (ADS)

    Young, L. A.

    2004-11-01

    The stellar occultations by Pluto in 1988 and 2002 are demonstrably sensitive to changes in Pluto's atmosphere near one microbar (Elliot and Young 1992, AJ 103, 991; Elliot et al. 2003, Nature 424, 165; Sicardy 2003, Nature 424, 168). However, Pluto volatile-transport models focus on the changes in the atmospheric pressure at the surface (e.g., Hansen and Paige 1996, Icarus 20, 247; Stansberry and Yelle 1999, Icarus 141, 299). What's lacking is a connection between predictions about the surface properties and either temperature and pressure profiles measurable from stellar occultations, or the occultation light curve morphology itself. Radiative-conductive models can illuminate this connection. I will illustrate how Pluto's changing surface pressure, temperature, and heliocentric distance may affect occultation light curves for a selection of existing volatile transport models. Changes in the light curve include the presence or absence of an observable ``kink'' (or departure from an isothermal light curve), the appearance of non-zero minimum flux levels, and the detectability of the solid surface. These light curves can serve as examples of what we may anticipate during the upcoming Pluto occultation season, as Pluto crosses the galactic plane.

  15. The prognostic value of node status in different breast cancer subtypes

    PubMed Central

    Hou, Xin-Wei; Chi, Jiang-Rui; Ge, Jie; Wang, Xin; Cao, Xu-Chen

    2017-01-01

    Nodal metastases and breast cancer subtypes (BCS) are both well-recognized prognostic indicators. However, the association between nodal metastases and BCS, and the prognostic value of nodal metastases in different BCS are still remains unclear. Our aim was to investigate the association between nodal metastases and BCS, and the prognostic value of nodal metastases in the different BCS. We found that the breast cancer subtype was closely associated with the pN stage. pN stage and breast cancer subtype were significantly associated with disease-free survival. The subgroup analysis showed that the patients in higher pN stage had a poor outcome than patients in lower pN stage in each breast cancer subtype. Furthermore, when the analysis was stratified by breast cancer subtype, we found that even in the same pN stage (pN0-pN2), there was significant survival difference among patients in different BCS, and Luminal A breast cancer patients had the best survival outcome. However, there were no significant survival difference between Luminal A patients and other breast cancer subtype when patients in pN3 stage. Thus, our study suggested that both lymph node status and molecular subtype played important roles in the outcome of breast cancer patients and they cannot replace each other. PMID:27999188

  16. Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer

    PubMed Central

    Veta, Mitko; Johannes van Diest, Paul; van Ginneken, Bram; Karssemeijer, Nico; Litjens, Geert; van der Laak, Jeroen A. W. M.; Hermsen, Meyke; Manson, Quirine F; Balkenhol, Maschenka; Geessink, Oscar; Stathonikos, Nikolaos; van Dijk, Marcory CRF; Bult, Peter; Beca, Francisco; Beck, Andrew H; Wang, Dayong; Khosla, Aditya; Gargeya, Rishab; Irshad, Humayun; Zhong, Aoxiao; Dou, Qi; Li, Quanzheng; Chen, Hao; Lin, Huang-Jing; Heng, Pheng-Ann; Haß, Christian; Bruni, Elia; Wong, Quincy; Halici, Ugur; Öner, Mustafa Ümit; Cetin-Atalay, Rengul; Berseth, Matt; Khvatkov, Vitali; Vylegzhanin, Alexei; Kraus, Oren; Shaban, Muhammad; Rajpoot, Nasir; Awan, Ruqayya; Sirinukunwattana, Korsuk; Qaiser, Talha; Tsang, Yee-Wah; Tellez, David; Annuscheit, Jonas; Hufnagl, Peter; Valkonen, Mira; Kartasalo, Kimmo; Latonen, Leena; Ruusuvuori, Pekka; Liimatainen, Kaisa; Albarqouni, Shadi; Mungal, Bharti; George, Ami; Demirci, Stefanie; Navab, Nassir; Watanabe, Seiryo; Seno, Shigeto; Takenaka, Yoichi; Matsuda, Hideo; Ahmady Phoulady, Hady; Kovalev, Vassili; Kalinovsky, Alexander; Liauchuk, Vitali; Bueno, Gloria; Fernandez-Carrobles, M. Milagro; Serrano, Ismael; Deniz, Oscar; Racoceanu, Daniel; Venâncio, Rui

    2017-01-01

    Importance Application of deep learning algorithms to whole-slide pathology images can potentially improve diagnostic accuracy and efficiency. Objective Assess the performance of automated deep learning algorithms at detecting metastases in hematoxylin and eosin–stained tissue sections of lymph nodes of women with breast cancer and compare it with pathologists’ diagnoses in a diagnostic setting. Design, Setting, and Participants Researcher challenge competition (CAMELYON16) to develop automated solutions for detecting lymph node metastases (November 2015-November 2016). A training data set of whole-slide images from 2 centers in the Netherlands with (n = 110) and without (n = 160) nodal metastases verified by immunohistochemical staining were provided to challenge participants to build algorithms. Algorithm performance was evaluated in an independent test set of 129 whole-slide images (49 with and 80 without metastases). The same test set of corresponding glass slides was also evaluated by a panel of 11 pathologists with time constraint (WTC) from the Netherlands to ascertain likelihood of nodal metastases for each slide in a flexible 2-hour session, simulating routine pathology workflow, and by 1 pathologist without time constraint (WOTC). Exposures Deep learning algorithms submitted as part of a challenge competition or pathologist interpretation. Main Outcomes and Measures The presence of specific metastatic foci and the absence vs presence of lymph node metastasis in a slide or image using receiver operating characteristic curve analysis. The 11 pathologists participating in the simulation exercise rated their diagnostic confidence as definitely normal, probably normal, equivocal, probably tumor, or definitely tumor. Results The area under the receiver operating characteristic curve (AUC) for the algorithms ranged from 0.556 to 0.994. The top-performing algorithm achieved a lesion-level, true-positive fraction comparable with that of the pathologist

  17. Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer.

    PubMed

    Ehteshami Bejnordi, Babak; Veta, Mitko; Johannes van Diest, Paul; van Ginneken, Bram; Karssemeijer, Nico; Litjens, Geert; van der Laak, Jeroen A W M; Hermsen, Meyke; Manson, Quirine F; Balkenhol, Maschenka; Geessink, Oscar; Stathonikos, Nikolaos; van Dijk, Marcory Crf; Bult, Peter; Beca, Francisco; Beck, Andrew H; Wang, Dayong; Khosla, Aditya; Gargeya, Rishab; Irshad, Humayun; Zhong, Aoxiao; Dou, Qi; Li, Quanzheng; Chen, Hao; Lin, Huang-Jing; Heng, Pheng-Ann; Haß, Christian; Bruni, Elia; Wong, Quincy; Halici, Ugur; Öner, Mustafa Ümit; Cetin-Atalay, Rengul; Berseth, Matt; Khvatkov, Vitali; Vylegzhanin, Alexei; Kraus, Oren; Shaban, Muhammad; Rajpoot, Nasir; Awan, Ruqayya; Sirinukunwattana, Korsuk; Qaiser, Talha; Tsang, Yee-Wah; Tellez, David; Annuscheit, Jonas; Hufnagl, Peter; Valkonen, Mira; Kartasalo, Kimmo; Latonen, Leena; Ruusuvuori, Pekka; Liimatainen, Kaisa; Albarqouni, Shadi; Mungal, Bharti; George, Ami; Demirci, Stefanie; Navab, Nassir; Watanabe, Seiryo; Seno, Shigeto; Takenaka, Yoichi; Matsuda, Hideo; Ahmady Phoulady, Hady; Kovalev, Vassili; Kalinovsky, Alexander; Liauchuk, Vitali; Bueno, Gloria; Fernandez-Carrobles, M Milagro; Serrano, Ismael; Deniz, Oscar; Racoceanu, Daniel; Venâncio, Rui

    2017-12-12

    Application of deep learning algorithms to whole-slide pathology images can potentially improve diagnostic accuracy and efficiency. Assess the performance of automated deep learning algorithms at detecting metastases in hematoxylin and eosin-stained tissue sections of lymph nodes of women with breast cancer and compare it with pathologists' diagnoses in a diagnostic setting. Researcher challenge competition (CAMELYON16) to develop automated solutions for detecting lymph node metastases (November 2015-November 2016). A training data set of whole-slide images from 2 centers in the Netherlands with (n = 110) and without (n = 160) nodal metastases verified by immunohistochemical staining were provided to challenge participants to build algorithms. Algorithm performance was evaluated in an independent test set of 129 whole-slide images (49 with and 80 without metastases). The same test set of corresponding glass slides was also evaluated by a panel of 11 pathologists with time constraint (WTC) from the Netherlands to ascertain likelihood of nodal metastases for each slide in a flexible 2-hour session, simulating routine pathology workflow, and by 1 pathologist without time constraint (WOTC). Deep learning algorithms submitted as part of a challenge competition or pathologist interpretation. The presence of specific metastatic foci and the absence vs presence of lymph node metastasis in a slide or image using receiver operating characteristic curve analysis. The 11 pathologists participating in the simulation exercise rated their diagnostic confidence as definitely normal, probably normal, equivocal, probably tumor, or definitely tumor. The area under the receiver operating characteristic curve (AUC) for the algorithms ranged from 0.556 to 0.994. The top-performing algorithm achieved a lesion-level, true-positive fraction comparable with that of the pathologist WOTC (72.4% [95% CI, 64.3%-80.4%]) at a mean of 0.0125 false-positives per normal whole-slide image

  18. Structure of scintillations in Neptune's occultation shadow

    NASA Technical Reports Server (NTRS)

    Hubbard, W. B.; Lellouch, Emmanuel; Sicardy, Bruno; Brahic, Andre; Vilas, Faith

    1988-01-01

    An exceptionally high-quality data set from a Neptune occultation is used here to derive a number of new results about the statistical properties of the fluctuations of the intensity distribution in various parts of Neptune's occultation shadow. An approximate numerical ray-tracing model which successfully accounts for many of the qualitative aspects of the observed intensity fluctuation distribution is introduced. Strong refractive scintillation is simulated by including the effects of 'turbulence' with projected atmospheric properties allowed to vary in both the direction perpendicular and parallel to the limb, and an explicit two-dimensional picture of a typical intensity distribution throughout an occulting planet's shadow is presented. The results confirm the existence of highly anisotropic turbulence.

  19. Revisiting the 1988 Pluto Occultation

    NASA Astrophysics Data System (ADS)

    Bosh, Amanda S.; Dunham, Edward W.; Young, Leslie A.; Slivan, Steve; Barba née Cordella, Linda L.; Millis, Robert L.; Wasserman, Lawrence H.; Nye, Ralph

    2015-11-01

    In 1988, Pluto's atmosphere was surmised to exist because of the surface ices that had been detected through spectroscopy, but it had not yet been directly detected in a definitive manner. The key to making such a detection was the stellar occultation method, used so successfully for the discovery of the Uranian rings in 1977 (Elliot et al. 1989; Millis et al. 1993) and before that for studies of the atmospheres of other planets.On 9 June 1988, Pluto occulted a star, with its shadow falling over the South Pacific Ocean region. One team of observers recorded this event from the Kuiper Airborne Observatory, while other teams captured the event from various locations in Australia and New Zealand. Preceding this event, extensive astrometric observations of Pluto and the star were collected in order to refine the prediction.We will recount the investigations that led up to this important Pluto occultation, discuss the unexpected atmospheric results, and compare the 1988 event to the recent 2015 event whose shadow followed a similar track through New Zealand and Australia.

  20. Topological transport in Dirac nodal-line semimetals

    NASA Astrophysics Data System (ADS)

    Rui, W. B.; Zhao, Y. X.; Schnyder, Andreas P.

    2018-04-01

    Topological nodal-line semimetals are characterized by one-dimensional Dirac nodal rings that are protected by the combined symmetry of inversion P and time-reversal T . The stability of these Dirac rings is guaranteed by a quantized ±π Berry phase and their low-energy physics is described by a one-parameter family of (2+1)-dimensional quantum field theories exhibiting the parity anomaly. Here we study the Berry-phase supported topological transport of P T -invariant nodal-line semimetals. We find that small inversion breaking allows for an electric-field-induced anomalous transverse current, whose universal component originates from the parity anomaly. Due to this Hall-like current, carriers at opposite sides of the Dirac nodal ring flow to opposite surfaces when an electric field is applied. To detect the topological currents, we propose a dumbbell device, which uses surface states to filter charges based on their momenta. Suggestions for experiments and device applications are discussed.

  1. Occult Intertrochanteric Fracture Mimicking the Fracture of Greater Trochanter

    PubMed Central

    Chung, Phil Hyun; Kang, Suk; Kim, Jong Pil; Kim, Young Sung; Back, In Hwa; Eom, Kyeong Soo

    2016-01-01

    Purpose Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures. Materials and Methods This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013. Until January 2008, 9 cases were examined with 3D-CT only, while 14 cases were screened with both 3D-CT and MRI scans. We analyzed diagnostic accuracy and treatment results following 3D-CT and MRI scanning. Results Nine cases that underwent 3D-CT only were diagnosed with isolated greater trochanteric fractures without occult intertrochanteric fractures. Of these, a patient with displacement received surgical treatment. Of the 14 patients screened using both CT and MRI, 13 were diagnosed with occult intertrochanteric fractures. Of these, 11 were treated with surgical intervention and 2 with conservative management. Conclusion Three-dimensional CT has very low diagnostic accuracy in diagnosing occult intertrochanteric fractures. For this reason, MRI is recommended to confirm a suspected occult intertrochanteric fracture and to determine the most appropriate mode of treatment. PMID:27536653

  2. Risk of Nodal Metastasis in Major Salivary Gland Adenoid Cystic Carcinoma.

    PubMed

    Megwalu, Uchechukwu C; Sirjani, Davud

    2017-04-01

    Objective To determine the risk of nodal metastasis, examine risk factors for nodal metastasis, and evaluate the impact of nodal metastasis on survival in patients with major salivary gland adenoid cystic carcinoma. Study Design Retrospective cohort study from a large population- based cancer database. Methods Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 720 patients diagnosed with major salivary gland adenoid cystic carcinoma between 1988 and 2013. Results The overall rate of lymph node metastasis was 17%. T3 disease (odds ratio, 4.74) and T4 disease (odds ratio, 9.24) were associated with increased risk of nodal metastasis. Age, sex, and site were not associated with nodal metastasis. Nodal metastasis was associated with worse overall survival (hazard ratio, 2.56) and disease-specific survival (hazard ratio, 3.27), after adjusting for T stage, presence of distant metastasis, site, surgical resection, radiotherapy, neck dissection, age, sex, race, marital status, and year of diagnosis. Conclusion Major salivary gland adenoid cystic carcinoma carries significant risk of nodal metastasis. Advanced T stage is associated with increased risk of nodal metastasis. Nodal metastasis is associated with worse survival.

  3. Chiral topological insulating phases from three-dimensional nodal loop semimetals

    NASA Astrophysics Data System (ADS)

    Li, Linhu; Yin, Chuanhao; Chen, Shu; Araujo, Miguel

    We begin with a minimal model of three-dimensional nodal loop semimetals, and study the effect of anticommuting gap terms. The resulting topological insulating phases are protected by a chiral symmetry, and can be characterized by a winding number defined along the nodal loop. We illustrate the geometric relation between the nodal loop and the gap terms, which has a correspondence to the nodal loop winding number. We further investigate a lattice model and study its edge states under open boundary condition. The edge states hold Dirac cones with the same number as the summation of the winding numbers of each nodal loop in the first Brillouin zone.

  4. Increased expression of EZH2 in Merkel cell carcinoma is associated with disease progression and poorer prognosis.

    PubMed

    Harms, Kelly L; Chubb, Heather; Zhao, Lili; Fullen, Douglas R; Bichakjian, Christopher K; Johnson, Timothy M; Carskadon, Shannon; Palanisamy, Nallasivam; Harms, Paul W

    2017-09-01

    Enhancer of zeste homolog 2 (EZH2) is a histone methyltransferase that affects tumorigenesis by epigenetic gene silencing. Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine carcinoma that has a high risk of disease progression with nodal and distant metastases. Here, we evaluated EZH2 expression by immunohistochemistry in a cohort of 85 MCC tumors (29 primary tumors, 41 lymph node metastases, 13 in-transit metastases, and 2 distant metastases) with clinical follow-up. We show strong/moderate EZH2 expression in 54% of tumors. Importantly, weak expression of EZH2 in the primary tumor, but not nodal metastases, correlated with improved prognosis compared to moderate/strong EZH2 expression (5-year MCC-specific survival of 68% versus 22%, respectively, P=.024). In addition, EZH2 was expressed at higher levels in nodal metastases compared to primary tumors (P=.005). Our data demonstrate that EZH2 has prognostic value and may play an oncogenic role in MCC. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The Treatment of the Occult in General Encyclopedias.

    ERIC Educational Resources Information Center

    Sonnenfeld, Gary F.

    This paper is a content analysis of three general encyclopedias, "Encyclopedia Americana" (EA), "Encyclopaedia Brittanica" (EB), and "World Book Encyclopedia" (WBC), which quantifies the treatment of the occult. Entries are selected from each by starting with the article "Occultism" and tracing all…

  6. Topological Nodal-Net Semimetal in a Graphene Network Structure

    NASA Astrophysics Data System (ADS)

    Wang, Jian-Tao; Nie, Simin; Weng, Hongming; Kawazoe, Yoshiyuki; Chen, Changfeng

    2018-01-01

    Topological semimetals are characterized by the nodal points in their electronic structure near the Fermi level, either discrete or forming a continuous line or ring, which are responsible for exotic properties related to the topology of bulk bands. Here we identify by ab initio calculations a distinct topological semimetal that exhibits nodal nets comprising multiple interconnected nodal lines in bulk and have two coupled drumheadlike flat bands around the Fermi level on its surface. This nodal net semimetal state is proposed to be realized in a graphene network structure that can be constructed by inserting a benzene ring into each C- C bond in the bct-C4 lattice or by a crystalline modification of the (5,5) carbon nanotube. These results expand the realm of nodal manifolds in topological semimetals, offering a new platform for exploring novel physics in these fascinating materials.

  7. Stellar Occultation Probe of Triton's Atmosphere

    NASA Technical Reports Server (NTRS)

    Elliot, James L.

    1998-01-01

    The goals of this research were (i) to better characterize Triton's atmospheric structure by probing a region not well investigated by Voyager and (ii) to begin acquiring baseline data for an investigation of the time evolution of the atmosphere which will set limits on the thermal conductivity of the surface and the total mass of N2 in the atmosphere. Our approach was to use observations (with the Kuiper Airborne Observatory) of a stellar occultation by Triton that was predicted to occur on 1993 July 10. As described in the attached reprint, we achieved these objectives through observation of this occultation and a subsequent one with the KAO in 1995. We found new results about Triton's atmospheric structure from the analysis of the two occultations observed with the KAO and ground-based data. These stellar occultation observations made both in the visible and infrared, have good spatial coverage of Triton including the first Triton central-flash observations, and are the first data to probe the 20-100 km altitude level on Triton. The small-planet light curve model of Elliot and Young (AJ 103, 991-1015) was generalized to include stellar flux refracted by the far limb, and then fitted to the data. Values of the pressure, derived from separate immersion and emersion chords, show no significant trends with latitude indicating that Triton's atmosphere is spherically symmetric at approximately 50 km altitude to within the error of the measurements. However, asymmetry observed in the central flash indicates the atmosphere is not homogeneous at the lowest levels probed (approximately 20 km altitude). From the average of the 1995 occultation data, the equivalent-isothermal temperature of the atmosphere is 47 +/- 1 K and the atmospheric pressure at 1400 km radius (approximately 50 km altitude) is 1.4 +/- 0.1 microbar. Both of these are not consistent with a model based on Voyager UVS and RSS observations in 1989 (Strobel et al, Icarus 120, 266-289). The atmospheric

  8. All about Occultation.

    ERIC Educational Resources Information Center

    Riddle, Bob

    2001-01-01

    Describes occultation events involving the moon, when the moon blocks the view of planets or stars. Describes other events such as a partial solar eclipse, a penumbral lunar eclipse, meteor showers, and moon phases. Provides a list of internet resources related to these events. (DLH)

  9. Occult Carbon Monoxide Poisoning

    PubMed Central

    Kirkpatrick, John N.

    1987-01-01

    A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of carbon monoxide was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult carbon monoxide poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias, abdominal pain, diarrhea and unusual spells. PMID:3825110

  10. Occult carbon monoxide poisoning.

    PubMed

    Kirkpatrick, J N

    1987-01-01

    A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of carbon monoxide was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult carbon monoxide poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias, abdominal pain, diarrhea and unusual spells.

  11. Lung metastases

    MedlinePlus

    Metastases to the lung; Metastatic cancer to the lung; Lung cancer - metastases ... Metastatic tumors in the lungs are cancers that developed at other places in the body (or other parts of the lungs). They then spread through the bloodstream or lymphatic ...

  12. The clinical significance of occult gynecologic primary tumours in metastatic cancer.

    PubMed

    Hannouf, M B; Winquist, E; Mahmud, S M; Brackstone, M; Sarma, S; Rodrigues, G; Rogan, P K; Hoch, J S; Zaric, G S

    2017-10-01

    We estimated the frequency of occult gynecologic primary tumours (gpts) in patients with metastatic cancer from an uncertain primary and evaluated the effect on disease management and overall survival (os). We used Manitoba administrative health databases to identify all patients initially diagnosed with metastatic cancer during 2002-2011. We defined patients as having an "occult" primary tumour if the primary was classified at least 6 months after the initial diagnosis. Otherwise, we considered patients to have "obvious" primaries. We then compared clinicopathologic and treatment characteristics and 2-year os for women with occult and with obvious gpts. We used Cox regression adjustment and propensity score methods to assess the effect on os of having an occult gpt. Among the 5953 patients diagnosed with metastatic cancer, occult primary tumours were more common in women ( n = 285 of 2552, 11.2%) than in men ( n = 244 of 3401, 7.2%). In women, gpts were the most frequent occult primary tumours ( n = 55 of 285, 19.3%). Compared with their counterparts having obvious gpts, women with occult gpts ( n = 55) presented with similar histologic and metastatic patterns but received fewer gynecologic diagnostic examinations during diagnostic work-up. Women with occult gpts were less likely to undergo surgery, waited longer for radiotherapy, and received a lesser variety of chemotherapeutic agents. Having an occult compared with an obvious gpt was associated with decreased os (hazard ratio: 1.62; 95% confidence interval: 1.2 to 2.35). Similar results were observed in adjusted analyses. In women with metastatic cancer from an uncertain primary, gpts constitute the largest clinical entity. Accurate diagnosis of occult gpts early in the course of metastatic cancer might lead to more effective treatment decisions and improved survival outcomes.

  13. Nodal portraits of quantum billiards: Domains, lines, and statistics

    NASA Astrophysics Data System (ADS)

    Jain, Sudhir Ranjan; Samajdar, Rhine

    2017-10-01

    This is a comprehensive review of the nodal domains and lines of quantum billiards, emphasizing a quantitative comparison of theoretical findings to experiments. The nodal statistics are shown to distinguish not only between regular and chaotic classical dynamics but also between different geometric shapes of the billiard system itself. How a random superposition of plane waves can model chaotic eigenfunctions is discussed and the connections of the complex morphology of the nodal lines thereof to percolation theory and Schramm-Loewner evolution are highlighted. Various approaches to counting the nodal domains—using trace formulas, graph theory, and difference equations—are also illustrated with examples. The nodal patterns addressed pertain to waves on vibrating plates and membranes, acoustic and electromagnetic modes, wave functions of a "particle in a box" as well as to percolating clusters, and domains in ferromagnets, thus underlining the diversity and far-reaching implications of the problem.

  14. Occult spondyloarthritis in inflammatory bowel disease.

    PubMed

    Bandinelli, Francesca; Manetti, Mirko; Ibba-Manneschi, Lidia

    2016-02-01

    Spondyloarthritis (SpA) is a frequent extra-intestinal manifestation in patients with inflammatory bowel disease (IBD), although its real diffusion is commonly considered underestimated. Abnormalities in the microbioma and genetic predisposition have been implicated in the link between bowel and joint inflammation. Otherwise, up to date, pathogenetic mechanisms are still largely unknown and the exact influence of the bowel activity on rheumatic manifestations is not clearly explained. Due to evidence-based results of clinical studies, the interest on clinically asymptomatic SpA in IBD patients increased in the last few years. Actually, occult enthesitis and sacroiliitis are discovered in high percentages of IBD patients by different imaging techniques, mainly enthesis ultrasound (US) and sacroiliac joint X-ray examinations. Several diagnostic approaches and biomarkers have been proposed in an attempt to correctly classify and diagnose clinically occult joint manifestations and to define clusters of risk for patient screening, although definitive results are still lacking. The correct recognition of occult SpA in IBD requires an integrated multidisciplinary approach in order to identify common diagnostic and therapeutic strategies. The use of inexpensive and rapid imaging techniques, such as US and X-ray, should be routinely included in daily clinical practice and trials to correctly evaluate occult SpA, thus preventing future disability and worsening of quality of life in IBD patients.

  15. All-Sky Earth Occultation Observations with the Fermi Gamma-Ray Burst Monitor

    NASA Technical Reports Server (NTRS)

    Wilson-Hodge, C. A.; Beklen, E.; Bhat, P. N.; Briggs, M.; Camero-Arranz, A.; Case, G.; Jenke, P.; Chaplin, V.; Cherry, M.; Connaughton, V.; hide

    2009-01-01

    Using the Gamma Ray Burst Monitor (GBM) on-board Fermi, we are monitoring the hard X-ray/ soft gamma ray sky using the Earth occultation technique. Each time a source in our catalog is occulted by (or exits occultation by) the Earth, we measure its flux using the change in count rates due to the occultation. Currently we are using CTIME data with 8 energy channels spanning 8 keV to 1 MeV for the GBM NaI detectors and spanning 150 keV to 40 MeV for the GBM BGO detectors. Our preliminary catalog consists of galactic X-ray binaries, the Crab Nebula, and active galactic nuclei. In addition, to Earth occultations, we have observed numerous occultations with Fermi's solar panels.

  16. 47 CFR 101.503 - Digital Electronic Message Service Nodal Stations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Digital Electronic Message Service Nodal... AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.503 Digital Electronic Message Service Nodal Stations. 10.6 GHz DEMS Nodal Stations may be...

  17. All-Sky Earth Occultation Observations with the Fermi Gamma Ray Burst Monitor

    NASA Technical Reports Server (NTRS)

    Wilson-Hodge, C. A.; Beklen, E.; Bhat, P. N.; Briggs, M.; Camero-Arranz, A.; Case, G.; Chaplin, V.; Cherry, M.; Connaughton, V.; Finger, M.; hide

    2010-01-01

    Using the Gamma Ray Burst Monitor (GBM) on-board Fermi, we are monitoring the hard X-ray/soft gamma ray sky using the Earth occultation technique. Each time a source in our catalog is occulted by (or exits occultation by) the Earth, we measure its flux using the change in count rates due to the occultation. Currently we are using CTIME data with 8 energy channels spanning 8 keV to 1 MeV for the GBM NaI detectors and spanning 150 keV to 40 MeV for the GBM BGO detectors. Our preliminary catalog consists of galactic X-ray binaries, the Crab Nebula, and active galactic nuclei. New sources are added to our catalog as they become active or upon request. In addition to Earth occultations, we have observed numerous occultations with Fermi's solar panels. We will present early results. Regularly updated results will be found on our website http://gammaray.nsstc.nasa.gov/gbm/science/occultation.

  18. The Research and Education Collaborative Occultation Network: A System for Coordinated TNO Occultation Observations

    NASA Astrophysics Data System (ADS)

    Buie, Marc W.; Keller, John M.

    2016-03-01

    We describe a new system and method for collecting coordinated occultation observations of trans-Neptunian objects (TNOs). Occultations by objects in the outer solar system are more difficult to predict due to their large distance and limited span of the astrometric data used to determine their orbits and positions. This project brings together the research and educational community into a unique citizen-science partnership to overcome the difficulties of observing these distant objects. The goal of the project is to get sizes and shapes for TNOs with diameters larger than 100 km. As a result of the system design it will also serve as a probe for binary systems with spatial separations as small as contact systems. Traditional occultation efforts strive to get a prediction sufficiently good to place mobile ground stations in the shadow track. Our system takes a new approach of setting up a large number of fixed observing stations and letting the shadows come to the network. The nominal spacing of the stations is 50 km so that we ensure two chords at our limiting size. The spread of the network is roughly 2000 km along a roughly north-south line in the western United States. The network contains 56 stations that are committed to the project and we get additional ad hoc support from International Occultation Timing Association members. At our minimum size, two stations will record an event while the other stations will be probing the inner regions for secondary events. Larger objects will get more chords and will allow determination of shape profiles. The stations are almost exclusively sited and associated with schools, usually at the 9-12 grade level. We present a full description of the system we have developed for the continued exploration of the Kuiper Belt.

  19. The stellar occultation by the dwarf planet Haumea

    NASA Astrophysics Data System (ADS)

    Santos-Sanz, Pablo; Ortiz, Jose Luis; Sicardy, Bruno; Rossi, Gustavo; Berard, Diane; Morales, Nicolas; Duffard, Rene; Braga-Ribas, Felipe; Hopp, Ulrich; Ries, Christoph; Nascimbeni, Valerio; Marzari, Francesco; Granata, Valentina; Pál, András; Kiss, Csaba; Pribulla, Theodor; Milan Komzík, Richard; Hornoch, Kamil; Pravec, Petr; Bacci, Paolo; Maestripieri, Martina; Nerli, Luca; Mazzei, Leonardo; Bachini, Mauro; Martinelli, Fabio; Succi, Giacomo; Ciabattari, Fabrizio; Mikuz, Herman; Carbognani, Albino; Gaehrken, Bernd; Mottola, Stefano; Hellmich, Stephan; Rommel, Flavia; Fernández-Valenzuela, Estela; Campo Bagatin, Adriano; Haumea occultation international Collaboration: https://cloud.iaa.csic.es/public.php?service=files&t=d9276f8ab1a316cef13bee28bef75add

    2017-10-01

    The dwarf planet Haumea is a very peculiar Trans-Neptunian Object (TNO) with unique and exotic characteristics. It is currently classified as one of the five dwarf planets of the solar system, and it is the only one for which size, shape, albedo, density and other basic properties were not accurately known. To solve that we predicted an occultation of the star GaiaDR1 1233009038221203584 by Haumea and organized observations within the expected shadow path. Medium/large telescopes were needed to record the occultation with enough signal to noise ratio because the occulted star is of similar brightness as Haumea (R~17.7 mag). We will report results derived from this successful stellar occultation by Haumea on 2017 January 21st. The occultation was positive from 12 telescopes at 10 observing stations in Europe: the Asiago Observatory 1.8m telescope (Italy), the Mount Agliale Observatory 0.5m telescope (Italy), the Lajatico Astronomical Centre 0.5m telescope (Italy), the S.Marcello Pistoiese Observatory 0.6m telescope (Italy), the Crni Vrh Observatory 0.6m telescope (Slovenia), the Ondrejov Observatory 0.65m telescope (Czech Republic), the Bavarian Public Observatory 0.81m telescope (Germany), the Konkoly Observatory 1m and 0.6m telescopes (Hungary), the Skalnate Pleso Observatory 1.3m telescope (Slovakia), and the Wendelstein Observatory 2m and 0.4m telescopes (Germany). This is the occultation by a TNO with the largest number of chords ever recorded.Part of this work has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement No. 687378.

  20. Occult diaphragmatic injuries caused by stab wounds.

    PubMed

    Leppäniemi, Ari; Haapiainen, Reijo

    2003-10-01

    Missed diaphragmatic perforation caused by penetrating trauma can lead to subsequent strangulation of a hollow viscus, which has prompted the use of invasive diagnostic procedures to exclude occult diaphragmatic injuries in asymptomatic, high-risk patients. The objective of this study was to determine the incidence of occult diaphragmatic injuries caused by stab wounds of the lower chest and upper abdomen, and to examine the natural history and consequences of missed diaphragmatic injuries. On the basis of patient data from two previous randomized studies from our institution, a retrospective analysis was performed on 97 patients treated for anterior stab wounds located between the nipple line, the umbilical level, and the posterior axillary lines not having indications for immediate surgical exploration. The patients were divided into two groups on the basis of their initial randomized management (open or laparoscopic exploration vs. expectant observation). In the exploration group (n = 47), four diaphragmatic injuries (9%) were detected (three left-sided and one right-sided). Excluding patients with associated injuries requiring surgical repair, the incidence of occult diaphragmatic injuries was 3 of 43 (7%). In the observation group (n = 50), there were two patients (4%) with delayed presentation of missed left-sided diaphragmatic injury 2 and 23 months later, respectively. Both injuries resulted from stab wounds of the left flank and presented with herniation of the stomach or small bowel and colon. The overall incidence of occult diaphragmatic injuries in left-sided thoracoabdominal stab wounds was 4 of 24 (17%), and was much lower after stab wounds of left epigastrium (0%), right lower chest (0%), and right epigastrium (4%). In asymptomatic patients with anterior or flank stab wounds of the lower chest or upper abdominal area, the risk of an occult diaphragmatic injury is approximately 7% which, if undetected, is associated with a high risk of subsequent

  1. Occult Cushing's syndrome in type-2 diabetes.

    PubMed

    Catargi, Bogdan; Rigalleau, Vincent; Poussin, Agathe; Ronci-Chaix, Nathalie; Bex, Veronique; Vergnot, Vincent; Gin, Henri; Roger, Patrick; Tabarin, Antoine

    2003-12-01

    Subclinical Cushing's syndrome (SCS) caused by adrenal incidentalomas is frequently associated with overweight and insulin resistance. Metabolic syndrome X may therefore be a clue to the presence of CS. However, the incidence of CS in this situation remains unknown. We have conducted a prospective study to evaluate the prevalence of occult CS in overweight, type-2 diabetic patients devoided of specific clinical symptoms of CS. Two hundred overweight, type-2 diabetic patients, consecutively referred for poor metabolic control (HbA(1C) > 8%), were studied as inpatients. A first screening step was performed with the 1-mg overnight dexamethasone suppression test (DST) using a revised criterion for cortisol suppression (60 nmol/liter) to maximize the sensitivity of the procedure. A second confirmatory step of biochemical investigations (midnight plasma cortisol concentration, plasma cortisol circadian rhythm, morning plasma ACTH concentration, 24-h urinary free cortisol, and 4-mg i.v. DST) was performed in patients with impaired 1-mg DST. A third step of imaging studies was performed according to the results of second-step investigations. Fifty-two patients had impaired 1-mg DST. Among these, 47 were further evaluated. Thirty were considered as false positives of the 1-mg DST, whereas 17 displayed at least one additional biological abnormality of the hypothalamic-pituitary-adrenal axis. Definitive occult CS was identified in four patients (2% of the whole series) with Cushing's disease (n = 3) and surgically proven adrenal adenoma (n = 1). Definitive diagnosis remains to be established in seven additional patients (3.5%) with mild occult CS associated with unsuppressed plasma ACTH concentrations and a unilateral adrenal tumor of 10-29 mm in size showing prevalent uptake at radiocholesterol scintigraphy. In conclusion, a relatively high prevalence of occult CS was found in our study. Further studies are needed to evaluate the impact of the cure of occult CS on obesity

  2. Nodal domains of a non-separable problem—the right-angled isosceles triangle

    NASA Astrophysics Data System (ADS)

    Aronovitch, Amit; Band, Ram; Fajman, David; Gnutzmann, Sven

    2012-03-01

    We study the nodal set of eigenfunctions of the Laplace operator on the right-angled isosceles triangle. A local analysis of the nodal pattern provides an algorithm for computing the number νn of nodal domains for any eigenfunction. In addition, an exact recursive formula for the number of nodal domains is found to reproduce all existing data. Eventually, we use the recursion formula to analyse a large sequence of nodal counts statistically. Our analysis shows that the distribution of nodal counts for this triangular shape has a much richer structure than the known cases of regular separable shapes or completely irregular shapes. Furthermore, we demonstrate that the nodal count sequence contains information about the periodic orbits of the corresponding classical ray dynamics.

  3. Nodal weighting factor method for ex-core fast neutron fluence evaluation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chiang, R. T.

    The nodal weighting factor method is developed for evaluating ex-core fast neutron flux in a nuclear reactor by utilizing adjoint neutron flux, a fictitious unit detector cross section for neutron energy above 1 or 0.1 MeV, the unit fission source, and relative assembly nodal powers. The method determines each nodal weighting factor for ex-core neutron fast flux evaluation by solving the steady-state adjoint neutron transport equation with a fictitious unit detector cross section for neutron energy above 1 or 0.1 MeV as the adjoint source, by integrating the unit fission source with a typical fission spectrum to the solved adjointmore » flux over all energies, all angles and given nodal volume, and by dividing it with the sum of all nodal weighting factors, which is a normalization factor. Then, the fast neutron flux can be obtained by summing the various relative nodal powers times the corresponding nodal weighting factors of the adjacent significantly contributed peripheral assembly nodes and times a proper fast neutron attenuation coefficient over an operating period. A generic set of nodal weighting factors can be used to evaluate neutron fluence at the same location for similar core design and fuel cycles, but the set of nodal weighting factors needs to be re-calibrated for a transition-fuel-cycle. This newly developed nodal weighting factor method should be a useful and simplified tool for evaluating fast neutron fluence at selected locations of interest in ex-core components of contemporary nuclear power reactors. (authors)« less

  4. Cassini First Diametric Radio Occultation of Saturn's Rings

    NASA Astrophysics Data System (ADS)

    Marouf, E.; French, R.; Rappaport, N.; Kliore, A.; Flasar, M.; Nagy, A.; Ambrosini, R.; McGhee, C.; Schinder, P.; Anabtawi, A.; Barbinis, E.; Goltz, G.; Thomson, F.; Wong, K.

    2005-05-01

    We present preliminary results expected from the first planned Cassini radio occultation observation of Saturn's rings, to be conducted on May 3rd, 2005. The path of Cassini as seen from Earth (the occultation track) has been designed to cross the rings from the west to the east ansa almost diametrically, allowing for occultation of all major ring features at two widely separated longitudes (about 180 deg apart). The duration of the geometric occultation is about 1.5 hours on each side. During the occultation, Cassini transmits through the rings three coherent monochromatic radio signals of wavelength 0.94, 3.6, and 13 cm (Ka-, X-, and S-band respectively), a capability unique to Cassini. The perturbed signals received at the Earth are recorded at the NASA DSN complexes at Goldstone and Canberra. Both direct and forward-scattered components of the signal may be identified in spectrograms of the received signals. The time history of the extinction of the direct signal is expected to yield high-spatial-resolution optical depth and phase shift profiles of ring structure. The timing of the occultation was optimized to allow probing the rings when the ring-opening-angle B (the angle between the line-of-sight and the ring plane) is relatively large (B = 23 deg), hence maximizing chances of measuring for the first time the structure of the relatively optically thick Ring B. In a similar experiment by Voyager in 1980, excessive signal attenuation along the long path within the nearly closed rings (B = 5.9 deg) limited the utility of the observations in relatively thick ring regions, in particular the main Ring B. For the Cassini optimized occultation geometry, a large B, slow radial velocity along the occultation track, and much improved phase stability of the reference ultrastable oscillator (USO) on board Cassini combine to promise achievable radial resolution approaching 100 m over a good fraction of the rings. Measurement of the amplitude and phase of the diffracted

  5. Incidence of bone metastases and survival after a diagnosis of bone metastases in breast cancer patients.

    PubMed

    Harries, M; Taylor, A; Holmberg, L; Agbaje, O; Garmo, H; Kabilan, S; Purushotham, A

    2014-08-01

    Bone is the most common metastatic site associated with breast cancer. Using a database of women with breast cancer treated at Guy's Hospital, London 1976-2006 and followed until end 2010, we determined incidence of and survival after bone metastases. We calculated cumulative incidence of bone metastases considering death without prior bone metastases as a competing risk. Risk of bone metastases was modelled through Cox-regression. Survival after bone metastases diagnosis was calculated using Kaplan-Meier methodology. Of the 7064 women, 589 (22%) developed bone metastases during 8.4 years (mean). Incidence of bone metastases was significantly higher in younger women, tumour size >5 cm, higher tumour grade, lobular carcinoma and ≥ four positive nodes, but was not affected by hormone receptor status. Median survival after bone metastases diagnosis was 2.3 years in women with bone-only metastases compared with <1 year in women with visceral and bone metastases. There was a trend for decreased survival for patients who developed visceral metastases early, and proportionately fewer patients in this group. Incidence of bone metastases has decreased but bone metastases remain a highly relevant clinical problem due to the large number of patients being diagnosed with breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Close Double Stars from Occultation Video Recordings

    NASA Astrophysics Data System (ADS)

    Waring Dunham, David; George, Anthony; Loader, Brian; Herald, David Russell

    2015-08-01

    Astronomers around the world, both amateur and professional, have been recording lunar and asteroidal occultations of close double stars during the past several years using inexpensive but quite sensitive video cameras that are now available. Several new double stars have been discovered, and the parameters of many close systems have been determined. Besides rather good measurements of the relative magnitudes of the components, the actual separations and position angles can be measured if observations of the same event are made from two or more separate stations. These observations collected by the International Occultation Timing Association (IOTA) are published in the Journal of Double Star Observations. Recently, IOTA has encouraged the observation of occultations of stars in the Kepler 2 program, which is interested in data about close duplicity that affects their analyses for exoplanet transits.

  7. Nodal network generator for CAVE3

    NASA Technical Reports Server (NTRS)

    Palmieri, J. V.; Rathjen, K. A.

    1982-01-01

    A new extension of CAVE3 code was developed that automates the creation of a finite difference math model in digital form ready for input to the CAVE3 code. The new software, Nodal Network Generator, is broken into two segments. One segment generates the model geometry using a Tektronix Tablet Digitizer and the other generates the actual finite difference model and allows for graphic verification using Tektronix 4014 Graphic Scope. Use of the Nodal Network Generator is described.

  8. Observation of a nodal chain with Dirac surface states in Ti B2

    NASA Astrophysics Data System (ADS)

    Yi, C.-J.; Lv, B. Q.; Wu, Q. S.; Fu, B.-B.; Gao, X.; Yang, M.; Peng, X.-L.; Li, M.; Huang, Y.-B.; Richard, P.; Shi, M.; Li, G.; Yazyev, Oleg V.; Shi, Y.-G.; Qian, T.; Ding, H.

    2018-05-01

    Topological nodal-line semimetals (TNLSMs) are characterized by symmetry-protected band crossings extending along one-dimensional lines in momentum space. The nodal lines exhibit a variety of possible configurations, such as nodal ring, nodal link, nodal chain, and nodal knot. Here, using angle-resolved photoemission spectroscopy, we observe nodal rings on the orthogonal kz=0 and kx=0 planes of the Brillouin zone in Ti B2 . The nodal rings connect with each other on the intersecting line Γ-K of the orthogonal planes forming a remarkable nodal-chain structure. Furthermore, we observe surface states (SSs) on the (001) cleaved surface, which are consistent with the calculated SSs considering the contribution from both Ti and B terminations. The calculated SSs have novel Dirac-cone-like band structures, which are distinct from the usual drumhead SSs with a single flatband proposed in other TNLSMs.

  9. Nodal lines and nodal loops in nonsymmorphic odd-parity superconductors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Micklitz, T.; Norman, M. R.

    2017-01-01

    We discuss the nodal structure of odd-parity superconductors in the presence of nonsymmorphic crystal symmetries, both with and without spin-orbit coupling, and with and without time-reversal symmetry. We comment on the relation of our work to previous work in the literature, and also the implications for unconventional superconductors such as UPt3.

  10. Wave optics-based LEO-LEO radio occultation retrieval

    NASA Astrophysics Data System (ADS)

    Benzon, Hans-Henrik; Høeg, Per

    2016-06-01

    This paper describes the theory for performing retrieval of radio occultations that use probing frequencies in the XK and KM band. Normally, radio occultations use frequencies in the L band, and GPS satellites are used as the transmitting source, and the occultation signals are received by a GPS receiver on board a Low Earth Orbit (LEO) satellite. The technique is based on the Doppler shift imposed, by the atmosphere, on the signal emitted from the GPS satellite. Two LEO satellites are assumed in the occultations discussed in this paper, and the retrieval is also dependent on the decrease in the signal amplitude caused by atmospheric absorption. The radio wave transmitter is placed on one of these satellites, while the receiver is placed on the other LEO satellite. One of the drawbacks of normal GPS-based radio occultations is that external information is needed to calculate some of the atmospheric products such as the correct water vapor content in the atmosphere. These limitations can be overcome when a proper selected range of high-frequency waves are used to probe the atmosphere. Probing frequencies close to the absorption line of water vapor have been included, thus allowing the retrieval of the water vapor content. Selecting the correct probing frequencies would make it possible to retrieve other information such as the content of ozone. The retrieval is performed through a number of processing steps which are based on the Full Spectrum Inversion (FSI) technique. The retrieval chain is therefore a wave optics-based retrieval chain, and it is therefore possible to process measurements that include multipath. In this paper simulated LEO to LEO radio occultations based on five different frequencies are used. The five frequencies are placed in the XK or KM frequency band. This new wave optics-based retrieval chain is used on a number of examples, and the retrieved atmospheric parameters are compared to the parameters from a global European Centre for Medium

  11. Distribution of the GNSS-LEO occultation events over Egypt

    NASA Astrophysics Data System (ADS)

    Ghoniem, Ibrahim; Mousa, Ashraf El-Kutb; El-Fiky, Gamal

    2017-06-01

    The space-based GNSS RO technique is a promising tool for monitoring the Earth's atmosphere and ionosphere (Mousa et al., 2006). The current paper presents the distribution of the occultation events over Egypt using the operating LEO satellites and GNSS by its two operating systems. By the present research, Egypt could raise NWP Models efficiency by improving meteorological data quality. Twenty operating LEO missions (e.g. Argentinean SAC-C, European MetOp-A, German TerraSAR-X, Indian OceanSat-2, etc.) sent by different countries all over the world were used to derive the occultation events position through Egypt borders by receiving signal from the American global positioning system (GPS) and the Russian global navigation satellite system (GLONASS). Approximately 20,000 km Altitude satellites are transmitting enormous number of rays by the day to approximately 800 km satellites passing by the Earth atmosphere. Our mission is to derive all of these rays position (start and end) by calculating satellites position by the time, determine the rays in the occultation case and derive the atmosphere tangent point position for all occultating rays on the Earth surface (Occultation Events).

  12. Radio Occultation Measurements of Pluto's Atmosphere with New Horizons

    NASA Astrophysics Data System (ADS)

    Hinson, D. P.; Linscott, I.; Tyler, G. L.; Bird, M. K.; Paetzold, M.; Strobel, D. F.; Summers, M. E.; Woods, W. W.; Stern, A.; Weaver, H. A., Jr.; Olkin, C.; Young, L. A.; Ennico Smith, K.; Gladstone, R.; Greathouse, T.; Kammer, J.; Parker, A. H.; Parker, J. W.; Retherford, K. D.; Schindhelm, E.; Singer, K. N.; Steffl, A.; Tsang, C.; Versteeg, M.

    2015-12-01

    The reconnaissance of the Pluto System by New Horizons included radio occultations at both Pluto and Charon. This talk will present the latest results from the Pluto occultation. The REX instrument onboard New Horizons received and recorded uplink signals from two 70-m antennas and two 34-m antennas of the NASA Deep Space Network - each transmitting 20 kW at 4.2-cm wavelength - during a diametric occultation by Pluto. At the time this was written only a short segment of data at occultation entry (193°E, 17°S) was available for analysis. The REX measurements extend unequivocally to the surface, providing the first direct measure of the surface pressure and the temperature structure in Pluto's lower atmosphere. Preliminary analysis yields a surface pressure of about 10 microbars, smaller than expected. Data from occultation exit (16°E, 15°N) are scheduled to arrive on the ground in late August 2015. Those observations will yield an improved estimate of the surface pressure, a second temperature profile, and a measure of the diameter of Pluto with a precision of a few hundred meters.

  13. Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography.

    PubMed

    Matsumoto, Shokei; Sekine, Kazuhiko; Funabiki, Tomohiro; Orita, Tomohiko; Shimizu, Masayuki; Hayashida, Kei; Kazamaki, Taku; Suzuki, Tatsuya; Kishikawa, Masanobu; Yamazaki, Motoyasu; Kitano, Mitsuhide

    2016-01-01

    An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ultrasonography is an effective technique for detecting occult pneumothorax. The aim of this study was to evaluate the usefulness of OXR in the diagnosis of the occult pneumothorax and to compare OXR with ultrasonography. All consecutive blunt chest trauma patients with clinically suspected pneumothorax on arrival at the emergency department were prospectively included at our tertiary-care center. The patients underwent OXR and ultrasonography, and underwent computed tomography scans as the gold standard. Occult pneumothorax size on computed tomography was classified as minuscule, anterior, or anterolateral. One hundred and fifty-nine patients were enrolled. Of the 70 occult pneumothoraces found in the 318 thoraces, 19 were minuscule, 32 were anterior, and 19 were anterolateral. The sensitivity and specificity of OXR for detecting occult pneumothorax was 61.4 % and 99.2 %, respectively. The sensitivity and specificity of lung ultrasonography was 62.9 % and 98.8 %, respectively. Among 27 occult pneumothoraces that could not be detected by OXR, 16 were minuscule and 21 could be conservatively managed without thoracostomy. OXR appears to be as good method as lung ultrasonography in the detection of large occult pneumothorax. In trauma patients who are difficult to transfer to computed tomography scan, OXR may be effective at detecting occult pneumothorax with a risk of progression.

  14. Not all occult papillary carcinomas are minimal

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Allo, M.D.; Christianson, W.; Koivunen, D.

    1988-12-01

    Occult papillary carcinomas are characterized as small papillary tumors of less than 1.5 cm in maximum diameter, with or without bulky metastatic deposits in cervical nodes. The primary lesion is usually not palpable, and although the clinical behavior usually follows a benign course, tumors with unfavorable histologic features (invasiveness, multifocality) or extrathyroidal disease or a combination of both may not do so. In this report six cases are presented to illustrate this entity. No patient had a history of irradiation to the head or neck. All had primary lesions smaller than 1.5 cm. None had a palpable nodule or abnormalmore » thyroid scan results, and the diagnosis of thyroid cancer was based on cervical lymph node or lung biopsy specimens, which revealed papillary thyroid cancer. All of the patients underwent total or near-total thyroidectomies and were found to have small, invasive papillary lesions with additional metastases to cervical nodes noted at the time of thyroidectomy. Adjunctive treatment consisted of a 5 mCi iodine-131 scan, ablative iodine-131 therapy, and suppression with L-thyroxine. Although distant metastasis to lung or other organs is uncommon and the mortality rate is low (as in larger papillary cancers), these invasive lesions--despite their small size--have a high propensity for recurrence and should be considered to behave more like encapsulated papillary tumors with extrathyroidal extension than like their small, unencapsulated intrathyroidal counterparts.« less

  15. The clinical significance of occult gynecologic primary tumours in metastatic cancer

    PubMed Central

    Hannouf, M.B.; Winquist, E.; Mahmud, S.M.; Brackstone, M.; Sarma, S.; Rodrigues, G.; Rogan, P.K.; Hoch, J.S.; Zaric, G.S.

    2017-01-01

    Objective We estimated the frequency of occult gynecologic primary tumours (gpts) in patients with metastatic cancer from an uncertain primary and evaluated the effect on disease management and overall survival (os). Methods We used Manitoba administrative health databases to identify all patients initially diagnosed with metastatic cancer during 2002–2011. We defined patients as having an “occult” primary tumour if the primary was classified at least 6 months after the initial diagnosis. Otherwise, we considered patients to have “obvious” primaries. We then compared clinicopathologic and treatment characteristics and 2-year os for women with occult and with obvious gpts. We used Cox regression adjustment and propensity score methods to assess the effect on os of having an occult gpt. Results Among the 5953 patients diagnosed with metastatic cancer, occult primary tumours were more common in women (n = 285 of 2552, 11.2%) than in men (n = 244 of 3401, 7.2%). In women, gpts were the most frequent occult primary tumours (n = 55 of 285, 19.3%). Compared with their counterparts having obvious gpts, women with occult gpts (n = 55) presented with similar histologic and metastatic patterns but received fewer gynecologic diagnostic examinations during diagnostic work-up. Women with occult gpts were less likely to undergo surgery, waited longer for radiotherapy, and received a lesser variety of chemotherapeutic agents. Having an occult compared with an obvious gpt was associated with decreased os (hazard ratio: 1.62; 95% confidence interval: 1.2 to 2.35). Similar results were observed in adjusted analyses. Conclusions In women with metastatic cancer from an uncertain primary, gpts constitute the largest clinical entity. Accurate diagnosis of occult gpts early in the course of metastatic cancer might lead to more effective treatment decisions and improved survival outcomes. PMID:29089807

  16. Missing metastases as a model to challenge current therapeutic algorithms in colorectal liver metastases.

    PubMed

    Lucidi, Valerio; Hendlisz, Alain; Van Laethem, Jean-Luc; Donckier, Vincent

    2016-04-21

    In oncosurgical approach to colorectal liver metastases, surgery remains considered as the only potentially curative option, while chemotherapy alone represents a strictly palliative treatment. However, missing metastases, defined as metastases disappearing after chemotherapy, represent a unique model to evaluate the curative potential of chemotherapy and to challenge current therapeutic algorithms. We reviewed recent series on missing colorectal liver metastases to evaluate incidence of this phenomenon, predictive factors and rates of cure defined by complete pathologic response in resected missing metastases and sustained clinical response when they were left unresected. According to the progresses in the efficacy of chemotherapeutic regimen, the incidence of missing liver metastases regularly increases these last years. Main predictive factors are small tumor size, low marker level, duration of chemotherapy, and use of intra-arterial chemotherapy. Initial series showed low rates of complete pathologic response in resected missing metastases and high recurrence rates when unresected. However, recent reports describe complete pathologic responses and sustained clinical responses reaching 50%, suggesting that chemotherapy could be curative in some cases. Accordingly, in case of missing colorectal liver metastases, the classical recommendation to resect initial tumor sites might have become partially obsolete. Furthermore, the curative effect of chemotherapy in selected cases could lead to a change of paradigm in patients with unresectable liver-only metastases, using intensive first-line chemotherapy to intentionally induce missing metastases, followed by adjuvant surgery on remnant chemoresistant tumors and close surveillance of initial sites that have been left unresected.

  17. Pluto-Charon Stellar Occultation Candidates: 1990-1995

    NASA Technical Reports Server (NTRS)

    Dunham, E. W.; McDonald, S. W.; Elliot, J. L.

    1991-01-01

    We have carried out a search to identify stars that might be occulted by Pluto or Charon during the period 1990-1995 and part of 1996. This search was made with an unfiltered CCD camera operated in the strip scanning mode, and it reaches an R magnitude of approximately 17.5-about 1.5 mag fainter than previous searches. Circumstances for each of the 162 potential occultations are given, including an approximate R magnitude of the star, which allows estimation of the signal-to-noise ratio (S/N) for observation of each occultation. The faintest stars in our list would yield an S/N of about 20 for a 1 S integration when observed with a CCD detector on an 8 m telescope under a dark sky. Our astrometric precision (+/- 0.2 arcsec, with larger systematic errors possible for individual cases) is insufficient to serve as a final prediction for these potential occultations, but is sufficient to identify stars deserving of further, more accurate, astrometric observations. Statistically, we expect about 32 of these events to be observable somewhere on Earth. The number of events actually observed will be substantially smaller because of clouds and the sparse distribution of large telescopes. Finder charts for each of the 91 stars involved are presented.

  18. Pluto-Charon stellar occultation candidates - 1990-1995

    NASA Technical Reports Server (NTRS)

    Dunham, E. W.; Mcdonald, S. W.; Elliot, J. L.

    1991-01-01

    A search to identify stars that might be occulted by Pluto or Charon during the period 1990-1995 and part of 1996 is studied. This search was made with an unfiltered CCD camera operated in the strip scanning mode, and it reaches an R magnitude of approximately 17.5 - about 1.5 mag fainter than previous searches. Circumstances for each of the 162 potential occultations are given, including an approximate R magnitude of the star, which allows estimation of the signal-to-noise ratio (S/N) for observation of each occultation. The faintest stars in the list would yield an S/N of about 20 for a 1 s integration when observed with a CCD detector on an 8 m telescope under a dark sky. The astrometric precision (+/- 0.2 arcsec, with larger systematic errors possible for individual cases) is insufficient to serve as a final prediction for these potential occultations, but is sufficient to identify stars deserving of further, more accurate, astrometric observations. Statistically, about 32 of these events to be observable somewhere on earth are expected. The number of events actually observed will be substantially smaller because of clouds and the sparse distribution of large telescopes. Finder charts for each of the 91 stars involved are presented.

  19. CT detection of occult pneumothorax in head trauma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tocino, I.M.; Miller, M.H.; Frederick, P.R.

    1984-11-01

    A prospective evaluation for occult pneumothorax was performed in 25 consecutive patients with serious head trauma by combining a limited chest CT examination with the emergency head CT examination. Of 21 pneuomothoraces present in 15 patients, 11 (52%) were found only by chest CT and were not identified clinically or by supine chest radiograph. Because of pending therapeutic measures, chest tubes were placed in nine of the 11 occult pneumothoraces, regardless of the volume. Chest CT proved itself as the most sensitive method for detection of occult pneumothorax, permitting early chest tube placement to prevent transition to a tension pneumothoraxmore » during subsequent mechanical ventilation or emergency surgery under general anesthesia.« less

  20. Bone scanning in the detection of occult fractures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Batillas, J.; Vasilas, A.; Pizzi, W.F.

    1981-07-01

    The potential role of bone scanning in the early detection of occult fractures following acute trauma was investigated. Technetium 99m pyrophosphate bone scans were obtained in patients with major clinical findings and negative or equivocal roentgenograms following trauma. Bone scanning facilitated the prompt diagnosis of occult fractures in the hip, knee, wrist, ribs and costochondral junctions, sternum, vertebrae, sacrum, and coccyx. Several illustrative cases are presented. Roentgenographic confirmation occurred following a delay of days to weeks and, in some instances, the roentgenographic findings were subtle and could be easily overlooked. This study demonstrates bone scanning to be invaluable and definitivemore » in the prompt detection of occult fractures.« less

  1. Exploring the Solar System using stellar occultations

    NASA Astrophysics Data System (ADS)

    Sicardy, Bruno

    2018-04-01

    Stellar occultations by solar system objects allow kilometric accuracy, permit the detection of tenuous atmospheres (at nbar level), and the discovery of rings. The main limitation was the prediction accuracy, typically 40 mas, corresponding to about 1,000 km projected at the body. This lead to large time dedicated to astrometry, tedious logistical issues, and more often than not, mere miss of the event. The Gaia catalog, with sub-mas accuracy, hugely improves both the star positions, resulting in achievable accuracies of about 1 mas for the shadow track on Earth. This permits much more carefully planned campaigns, with success rate approaching 100%, weather permitting. Scientific perspectives are presented, e.g. central flashes caused by Plutos atmosphere revealing hazes and winds near its surface, grazing occultations showing topographic features, occultations by Chariklos rings unveiling dynamical features such as proper mode ``breathing''.

  2. Review: Occult hepatitis C virus infection: still remains a controversy.

    PubMed

    Vidimliski, Pavlina Dzekova; Nikolov, Igor; Geshkovska, Nadica Matevska; Dimovski, Aleksandar; Rostaing, Lionel; Sikole, Aleksandar

    2014-09-01

    Occult hepatitis C virus (HCV) infection is characterized by the presence of HCV RNA in the liver cells or peripheral blood mononuclear cells of the patients whose serum samples test negative for HCV RNA, with or without presence of HCV antibodies. The present study reviews the existing literature on the persistence of occult hepatitis C virus infection, with description of the clinical characteristics and methods for identification of occult hepatitis C. Occult hepatitis C virus infection was detected in patients with abnormal results of liver function tests of unknown origin, with HCV antibodies and HCV RNA negativity in serum, and also in patients with spontaneous or treatment-induced recovery from hepatitis C. The viral replication in the liver cells and/or peripheral blood mononuclear cells was present in all clinical presentations of occult hepatitis C. The peripheral blood mononuclear cells represent an extra-hepatic site of HCV replication. The reason why HCV RNA was not detectable in the serum of patients with occult hepatitis C, could be the low number of circulating viral particles not detectable by the diagnostic tests with low sensitivity. It is uncertain whether occult hepatitis C is a different clinical entity or just a form of chronic hepatitis C virus infection. Data accumulated over the last decade demonstrated that an effective approach to the diagnosis of HCV infection would be the implementation of more sensitive HCV RNA diagnostic assays, and also, examination of the presence of viral particles in the cells of the immune system. © 2014 Wiley Periodicals, Inc.

  3. Cassini Radio Occultation by Enceladus Plume

    NASA Astrophysics Data System (ADS)

    Kliore, A.; Armstrong, J.; Flasar, F.; French, R.; Marouf, E.; Nagy, A.; Rappaport, N.; McGhee, C.; Schinder, P.; Anabtawi, A.; Asmar, S.; Barbinis, E.; Fleischman, D.; Goltz, G.; Aguilar, R.; Rochblatt, D.

    2006-12-01

    A fortuitous Cassini radio occultation by Enceladus plume occurs on September 15, 2006. The occultation track (the spacecraft trajectory in the plane of the sky as viewed from the Earth) has been designed to pass behind the plume (to pass above the south polar region of Enceladus) in a roughly symmetrical geometry centered on a minimum altitude above the surface of about 20 km. The minimum altitude was selected primarily to ensure probing much of the plume with good confidence given the uncertainty in the spacecraft trajectory. Three nearly-pure sinusoidal signals of 0.94, 3.6, and 13 cm-wavelength (Ka-, X-, and S-band, respectively) are simultaneously transmitted from Cassini and are monitored at two 34-m Earth receiving stations of the Deep Space Network (DSN) in Madrid, Spain (DSS-55 and DSS-65). The occultation of the visible plume is extremely fast, lasting less than about two minutes. The actual observation time extends over a much longer time interval, however, to provide a good reference baseline for potential detection of signal perturbations introduced by the tenuous neutral and ionized plume environment. Given the likely very small fraction of optical depth due to neutral particles of sizes larger than about 1 mm, detectable changes in signal intensity is perhaps unlikely. Detection of plume plasma along the radio path as perturbations in the signals frequency/phase is more likely and the magnitude will depend on the electron columnar density probed. The occultation time occurs not far from solar conjunction time (Sun-Earth-probe angle of about 33 degrees), causing phase scintillations due to the solar wind to be the primary limiting noise source. We estimate a delectability limit of about 1 to 3E16 electrons per square meter columnar density assuming about 100 seconds integration time. Potential measurement of the profile of electron columnar density along the occultation track is an exciting prospect at this time.

  4. Predictions of stellar occultations by TNOs/Centaurs using Gaia

    NASA Astrophysics Data System (ADS)

    Desmars, Josselin; Camargo, Julio; Berard, Diane; Sicardy, Bruno; Leiva, Rodrigo; Vieira-Martins, Roberto; Braga-Ribas, Felipe; Assafin, Marcelo; Rossi, Gustavo; Chariklo occultations Team, Rio Group, Lucky Star Occultation Team, Granada Occultation Team

    2017-10-01

    Stellar occultations are the unique technique from the ground to access physical parameters of the distant solar system objects, such as the measure of the size and the shape at kilometric level, the detection of tenuous atmospheres (few nanobars), and the investigation of close vicinity (satellites, rings, jets).Predictions of stellar occultations require accurate positions of the star and the object.The Gaia DR1 catalog now allows to get stellar position to the milliarcsecond (mas) level. The main uncertainty in the prediction remains in the position of the object (tens to hundreds of mas).Now, we take advantage of the NIMA method for the orbit determination that uses the most recent observations reduced by the Gaia DR1 catalog and the astrometric positions derived from previous positive occultations.Up to now, we have detected nearly 50 positive occultations for about 20 objects that provide astrometric positions of the object at the time of the occultation. The uncertainty of these positions only depends on the uncertainty on the position of the occulted stars, which is a few mas with the Gaia DR1 catalog. The main limitation is now on the proper motion of the star which is only given for bright stars in the Tycho-Gaia Astrometric Solution. This limitation will be solved with the publicationof the Gaia DR2 expected on April 2018 giving proper motions and parallaxes for the Gaia stars. Until this date, we use hybrid stellar catalogs (UCAC5, HSOY) that provide proper motions derived from Gaia DR1 and another stellar catalog.Recently, the Gaia team presented a release of three preliminary Gaia DR2 stellar positions involved in the occultations by Chariklo (22 June and 23 July 2017) and by Triton (5 October 2017).Taking the case of Chariklo as an illustration, we will present a comparison between the proper motions of DR2 and the other catalogs and we will show how the Gaia DR2 will lead to a mas level precision in the orbit and in the prediction of stellar

  5. A search for stellar occultations by Uranus, Neptune, Pluto, and their satellites: 1990-1999

    NASA Technical Reports Server (NTRS)

    Mink, Douglas J.

    1991-01-01

    A search for occultations of stars by Uranus, Neptune, and Pluto between 1990 and 1999 was carried out by combining ephemeris information and star positions using very accurate occultation modeling software. Stars from both the Space Telescope Guide Catalog and photographic plates taken by Arnold Klemola at Lick Observatory were compared with planet positions from the JPL DE-130 ephemeris, with local modifications for Pluto and Charon. Some 666 possible occultations by the Uranian ring, 143 possible occultations by Neptune, and 40 possible occultations by Pluto and/or Charon were found among stars with visual magnitudes as faint as 16. Before the star positions could be obtained, the occultation prediction software was used to aid many observers in observing the occultation of 28 Sagitarii by Saturn in July 1989. As a test on other outer solar system objects, 17 possible occultations were found in a search of the Guide Star Catalog for occultations by 2060 Chiron, and interesting object between Saturn and Uranus which shows both cometary and asteroidal properties.

  6. A search for stellar occultations by Uranus, Neptune, Pluto, and their satellites: 1990-1999

    NASA Astrophysics Data System (ADS)

    Mink, Douglas J.

    1991-03-01

    A search for occultations of stars by Uranus, Neptune, and Pluto between 1990 and 1999 was carried out by combining ephemeris information and star positions using very accurate occultation modeling software. Stars from both the Space Telescope Guide Catalog and photographic plates taken by Arnold Klemola at Lick Observatory were compared with planet positions from the JPL DE-130 ephemeris, with local modifications for Pluto and Charon. Some 666 possible occultations by the Uranian ring, 143 possible occultations by Neptune, and 40 possible occultations by Pluto and/or Charon were found among stars with visual magnitudes as faint as 16. Before the star positions could be obtained, the occultation prediction software was used to aid many observers in observing the occultation of 28 Sagitarii by Saturn in July 1989. As a test on other outer solar system objects, 17 possible occultations were found in a search of the Guide Star Catalog for occultations by 2060 Chiron, and interesting object between Saturn and Uranus which shows both cometary and asteroidal properties.

  7. An unusual case of isolated, serial metastases of gallbladder carcinoma involving the chest wall, axilla, breast and lung parenchyma

    PubMed Central

    Jeyaraj, Pamela; Sio, Terence T.; Iott, Matthew J.

    2013-01-01

    In the English literature, only 9 cases of adenocarcinoma of the gallbladder with cutaneous metastasis have been reported so far. One case of multiple cutaneous metastases along with deposits in the breast tissue has been reported. We present a case of incidental metastatic gallbladder carcinoma with no intra-abdominal disease presenting as a series of four isolated cutaneous right chest wall, axillary nodal, breast, and pulmonary metastases following resection and adjuvant chemoradiation for her primary tumor. In spite of the metastatic disease coupled with the aggressive nature of the cancer, this patient reported that her energy level had returned to baseline with a good appetite and a stable weight indicating a good performance status and now is alive at 25 months since diagnosis. Her serially-presented, oligometastatic diseases were well-controlled by concurrent chemoradiotherapy and stereotactic radiation therapy. We report this case study because of its rarity and for the purpose of complementing current literature with an additional example of cutaneous metastasis from adenocarcinoma of the gallbladder. PMID:23772306

  8. Super-nodal methods for space-time kinetics

    NASA Astrophysics Data System (ADS)

    Mertyurek, Ugur

    The purpose of this research has been to develop an advanced Super-Nodal method to reduce the run time of 3-D core neutronics models, such as in the NESTLE reactor core simulator and FORMOSA nuclear fuel management optimization codes. Computational performance of the neutronics model is increased by reducing the number of spatial nodes used in the core modeling. However, as the number of spatial nodes decreases, the error in the solution increases. The Super-Nodal method reduces the error associated with the use of coarse nodes in the analyses by providing a new set of cross sections and ADFs (Assembly Discontinuity Factors) for the new nodalization. These so called homogenization parameters are obtained by employing consistent collapsing technique. During this research a new type of singularity, namely "fundamental mode singularity", is addressed in the ANM (Analytical Nodal Method) solution. The "Coordinate Shifting" approach is developed as a method to address this singularity. Also, the "Buckling Shifting" approach is developed as an alternative and more accurate method to address the zero buckling singularity, which is a more common and well known singularity problem in the ANM solution. In the course of addressing the treatment of these singularities, an effort was made to provide better and more robust results from the Super-Nodal method by developing several new methods for determining the transverse leakage and collapsed diffusion coefficient, which generally are the two main approximations in the ANM methodology. Unfortunately, the proposed new transverse leakage and diffusion coefficient approximations failed to provide a consistent improvement to the current methodology. However, improvement in the Super-Nodal solution is achieved by updating the homogenization parameters at several time points during a transient. The update is achieved by employing a refinement technique similar to pin-power reconstruction. A simple error analysis based on the relative

  9. Predictors of Nodal Upstaging in Clinical Node Negative Patients With Penile Carcinoma: A National Cancer Database Analysis.

    PubMed

    Winters, Brian R; Mossanen, Matthew; Holt, Sarah K; Lin, Daniel W; Wright, Jonathan L

    2016-10-01

    To examine the risk factors associated with upstaging at inguinal lymph node dissection (ILND) in men with penile cancer and clinically negative lymph nodes (cN0) using a large US cancer database. The National Cancer Data Base was queried from 1998 to 2012 to identify men with penile cancer who underwent ILND and had complete clinical or pathologic node status available. Lymphovascular invasion (LVI) was available after 2010. Multivariate logistic regression evaluated factors (cT stage, grade, LVI) associated with pathologic nodal upstaging in those with cN0 disease. Correlations between clinical and pathologic node status were also calculated with weighted kappa statistics. Complete clinical and pathologic LN status was available for 875 patients. Of these, 461 (53%) were cN0. Upstaging occurred in 111 (24%). When stratified by low, intermediate, and high-risk groups, the proportion with pathologically positive LNs was 16%, 20%, and 27%, respectively (P = .12). On multivariate analysis, limited to men with LVI data available (N = 206), LVI (odds ratio 3.10, 95% confidence interval 1.39-6.92), but not increasing stage (univariate only) or grade (univariate only), was significantly associated with upstaging at ILND. In this analysis, of 461 patients with node-negative penile cancer undergoing ILND, upstaging was observed in 24%. LVI was the strongest independent predictor of occult lymph node disease. These findings corroborate the presence of LVI as the significant risk factor for occult micrometastases and suggest a possible improvement in existing risk stratification groupings, with the presence of LVI, regardless of stage or grade, to be considered high-risk disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. [Lymph node and distant metastases of thyroid gland cancer. Metastases in the thyroid glands].

    PubMed

    Schmid, K W

    2015-11-01

    The different biological features of the various major entities of thyroid cancer, e.g. papillary, follicular, poorly differentiated, anaplastic and medullary, depend to a large extent on their different metastatic spread. Papillary thyroid cancer (PTC) has a propensity for cervical lymphatic spread that occurs in 20-50 % of patients whereas distant metastasis occurs in < 5 % of cases. Cervical lymphadenopathy may be the first symptom particularly of (micro) PTC. In contrast follicular thyroid cancer (FTC) has a marked propensity for vascular but not lymphatic invasion and 10-20 % of FTC develop distant metastases. At the time of diagnosis approximately one third of medullary thyroid cancer (MTC) cases show lymph node metastases, in 10-15 % distant metastases and 25 % develop metastases during the course of the disease. Poorly differentiated (PDTC) and anaplastic thyroid cancer (ATC) spread via both lymphatic and vascular invasion. Thus distant metastases are relatively uncommon in DTC and when they occur, long-term stable disease is the typical clinical course. The major sites of distant metastases are the lungs and bone. Metastases to the brain, breasts, liver, kidneys, muscle and skin are relatively rare or even rare. The thyroid gland itself can be a site of metastases from a variety of other tumors. In autopsy series of patients with disseminated cancer disease, metastases to the thyroid gland were found in up to 10 % of cases. Metastases from other primary tumors to the thyroid gland have been reported in 1.4-3 % of patients who have surgery for suspected cancer of the thyroid gland. The most common primary cancers that metastasize to the thyroid gland are renal cell (48.1 %), colorectal (10.4 %), lung (8.3 %) and breast cancer (7.8 %) and surprisingly often sarcomas (4.0 %).

  11. PET Probe-Guided Surgery in Patients with Breast Cancer: Proposal for a Methodological Approach.

    PubMed

    Orsaria, Paolo; Chiaravalloti, Agostino; Fiorentini, Alessandro; Pistolese, Chiara; Vanni, Gianluca; Granai, Alessandra Vittoria; Varvaras, Dimitrios; Danieli, Roberta; Schillaci, Orazio; Petrella, Giuseppe; Buonomo, Oreste Claudio

    2017-01-02

    Although it is valuable for detecting distant metastases, identifying recurrence, and evaluating responses to chemotherapy, the role of 18 F-fluorodeoxyglucose positron-emission tomography/computed tomography ( 18 F-FDG PET/CT) in assessing locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. In the current report, we describe a new PET probe-based clinical approach, with evaluation of the technical performance of a handheld high-energy gamma probe for intraoperative localization of breast carcinomas, and evaluation of lymph node metastases during radio-guided oncological surgery. Three patients underwent a PET/CT scan immediately prior to surgery following the standard clinical protocol. Intraoperatively, tumors were localized and resected with the assistance of a hand-held gamma probe. PET-guided assessment of the presence or absence of regional nodal spread of malignancy was compared with the reference standard of histopathological examination. In all three cases, perioperative 18 F-FDG PET/CT imaging and intraoperative gamma probe detection verified complete resection of the hypermetabolic lesions and demonstrated no additional suspicious occult disease. This innovative approach demonstrates great promise for providing real-time access to metabolic and morphological tumor information that may lead to an optimal disease-tailored approach. In carefully selected indications, a PET probe can be a useful adjunct in surgical practice, but further trials with a larger number of patients need to be performed to verify these findings. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  12. Exploring small bodies in the outer solar system with stellar occultations

    NASA Technical Reports Server (NTRS)

    Elliot, Jim L.; Dunham, Edward W.; Olkin, C. B.

    1995-01-01

    Stellar occultation observations probe the atmospheric structure and extinction of outer solar system bodies with a spatial resolution of a few kilometers, and an airborne platform allows the observation of occultations by small bodies that are not visible from fixed telescopes. Results from occultations by Triton, Pluto, and Chiron observed with KAO are discussed, and future directions for this program are presented.

  13. Diffraction-based analysis of tunnel size for a scaled external occulter testbed

    NASA Astrophysics Data System (ADS)

    Sirbu, Dan; Kasdin, N. Jeremy; Vanderbei, Robert J.

    2016-07-01

    For performance verification of an external occulter mask (also called a starshade), scaled testbeds have been developed to measure the suppression of the occulter shadow in the pupil plane and contrast in the image plane. For occulter experiments the scaling is typically performed by maintaining an equivalent Fresnel number. The original Princeton occulter testbed was oversized with respect to both input beam and shadow propagation to limit any diffraction effects due to finite testbed enclosure edges; however, to operate at realistic space-mission equivalent Fresnel numbers an extended testbed is currently under construction. With the longer propagation distances involved, diffraction effects due to the edge of the tunnel must now be considered in the experiment design. Here, we present a diffraction-based model of two separate tunnel effects. First, we consider the effect of tunnel-edge induced diffraction ringing upstream from the occulter mask. Second, we consider the diffraction effect due to clipping of the output shadow by the tunnel downstream from the occulter mask. These calculations are performed for a representative point design relevant to the new Princeton occulter experiment, but we also present an analytical relation that can be used for other propagation distances.

  14. The occultation of Kappa Geminorum by Eros. [stellar occultation observed for asteroid size and shape

    NASA Technical Reports Server (NTRS)

    Oleary, B.; Marsden, B. G.; Dragon, R.; Hauser, E.; Mcgrath, M.; Backus, P.; Robkoff, H.

    1976-01-01

    The paper discusses predictions and observations of the occultation of Kappa Gem by (433) Eros on January 24, 1975. Several positive and negative observations made in western New England are described. Local circumstances for the occultation are reconstructed, and the size and shape of Eros are determined analytically as well as graphically. The calculations yield two extremes for the cross section: a circle 23 km in diameter or a somewhat irregular figure 20 km by 6 or 7 km. Arguments based on the expected albedo of the asteroid suggest that the circle should be warped into an ellipse 21 by 13 km or that the irregular figure might be one component of a dumbbell-like profile.

  15. High Resolution Asteroid Profile by Multi Chord Occultation Observations

    NASA Astrophysics Data System (ADS)

    Degenhardt, Scott

    2009-05-01

    For millennia man has observed celestial objects occulting other bodies and distant stars. We have used these celestial synchronicities to measure the properties of objects. On January 1, 1801 Italian astronomer Giusappe Piazzi discovered the first asteroid that would soon be named Ceres. To date 190,000 of these objects have been catalogued, but only a fraction of these have accurate measurements of their true size and shape. The International Occultation Timing Association (IOTA) currently facilitates the prediction and reduction of asteroidal occultations. By measuring the shadow cast on the earth by an asteroid during a stellar occultation one can directly measure the physical size, shape, and position in space of this body to accuracies orders of magnitudes better than the best ground based adaptive optics telescope and can provide verification to 3D inverted reflective lightcurve prediction models. Recent novel methods developed by IOTA involving an individual making multiple observations through unattended remote observing stations have made way for numerous chords of occultation measurement through a single body yielding high resolution profiles of asteroid bodies. Methodology of how observing stations are deployed will be demonstrated, results of some of these observations are presented as comparisons to their inverted lightcurve are shown.

  16. Nodal Lymphangiogenesis and Metastasis

    PubMed Central

    Hirakawa, Satoshi; Detmar, Michael; Kerjaschki, Dontscho; Nagamatsu, Shogo; Matsuo, Keitaro; Tanemura, Atsushi; Kamata, Nobuyuki; Higashikawa, Koichiro; Okazaki, Hidenori; Kameda, Kenji; Nishida-Fukuda, Hisayo; Mori, Hideki; Hanakawa, Yasushi; Sayama, Koji; Shirakata, Yuji; Tohyama, Mikiko; Tokumaru, Sho; Katayama, Ichiro; Hashimoto, Koji

    2009-01-01

    Nodal lymphangiogenesis promotes distant lymph node (LN) metastasis in experimental cancer models. However, the role of nodal lymphangiogenesis in distant metastasis and in the overall survival of cancer patients remains unknown. Therefore, we investigated mechanisms that might facilitate regional and distant LN metastasis in extramammary Paget’s disease (EMPD). We retrospectively analyzed the impact of tumor-induced lymphatic vessel activation on the survival of 116 patients, the largest cohort with EMPD studied to date. Nodal lymphangiogenesis was significantly increased in metastatic, compared with tumor-free, LNs (P = 0.022). Increased lymphatic invasion within regional LNs was significantly associated with distant metastasis in LN (P = 0.047) and organs (P = 0.003). Thus, invasion within regional LNs is a powerful indicator of systemic tumor spread and reduced patient survival in EMPD (P = 0.0004). Lymphatic vessels associated with tumors expressed stromal cell-derived factor-1 (SDF-1), whereas CXCR4 was expressed on invasive Paget cells undergoing epithelial-mesenchymal transition (EMT)-like process. A431 cells overexpressing Snail expressed increased levels of CXCR4 in the presence of transforming growth factor-β1. Haptotactic migration assays confirmed that Snail-induced EMT-like process promotes tumor cell motility via the CXCR4-SDF-1 axis. Sinusoidal lymphatic endothelial cells and macrophages expressed SDF-1 in subcapsular sinuses of lymph nodes before Paget cell arrival. Our findings reveal that EMT-related features likely promote lymphatic metastasis of EMPD by activating the CXCR4-SDF-1 axis. PMID:19815713

  17. Earth Occultation Monitoring with the Fermi Gamma Ray Burst Monitor

    NASA Technical Reports Server (NTRS)

    Wilson-Hodge, Colleen A.

    2014-01-01

    Using the Gamma Ray Burst Monitor (GBM) on-board Fermi, we are monitoring the hard X-ray/soft gamma ray sky using the Earth occultation technique (EOT). Each time a source in our catalog is occulted by (or exits occultation by) the Earth, we measure its flux using the change in count rates due to the occultation. Currently we are using CTIME data with 8 energy channels spanning 8 keV to 1 MeV for the GBM NaI detectors for daily monitoring. Light curves, updated daily, are available on our website http://heastro.phys.lsu.edu/gbm. Our software is also capable of performing the Earth occultation monitoring using up to 128 energy bands, or any combination of those bands, using our 128-channel, 4-s CSPEC data. The GBM BGO detectors, sensitive from about 200 keV to 40 keV, can also be used with this technique. In our standard application of the EOT, we use a catalog of sources to drive the measurements. To ensure that our catalog is complete, our team has developed an Earth occultation imaging method. In this talk, I will describe both techniques and the current data products available. I will highlight recent and important results from the GBM EOT, including the current status of our observations of hard X-ray variations in the Crab Nebula.

  18. Analysis of a Triple Star System Occulted By Saturn’s Rings

    NASA Astrophysics Data System (ADS)

    Bratcher, Allison; Colwell, J. E.; Bolin, B.

    2012-10-01

    On January 4, 2012, the Ultraviolet Imaging Spectrograph aboard the Cassini Spacecraft observed Saturn’s rings as they occulted the triple star system, Iota Orionis. Remarkably, the brightest star was occulted by the moon Prometheus, and we provide the timing information of first and last contact for navigation purposes and a chord across the moon. The large separation of the individual stars projected in the ring plane makes it possible to measure the profiles of narrow features in the rings as they were occulted by each of the three stars. This occultation thus provides a unique opportunity to measure short-scale longitudinal variations in narrow ringlets with stellar occultation data that usually provide only a single longitudinal sample. Iota Orionis has a low elevation angle (B=1.4 degrees) above the plane of the rings, enhancing the sensitivity of the occultation (by a factor of 1/sin(B)=41) to the optically thin regions of the rings such as the C Ring and the Cassini Division as well as faint ringlets in the Encke gap. We distinguished the three signals by creating a model triple star signal using data from another occultation. We were able to identify several faint, narrow ringlets, including two in the Encke gap, occulted by two of the three stars and more prominent ringlets, such as the Huygens ringlet, in all three stellar light curves. We present the equivalent widths of these ringlets in the data from this triple star system and limits on ring variability over the azimuthal separation of the stars that ranges from 6000 km at the inner C ring to 200 km at the outer A ring.

  19. Observation and Interpretation of Lunar Occultations. Ph.D. Thesis; [Uranus and beta Capricorni

    NASA Technical Reports Server (NTRS)

    Radick, R. R.

    1978-01-01

    The importance of timings and high resolution astrometry in occultation observations is discussed as well as the occultation process itself. The design and operation of the telescope, photodetector, and data acquisition systems are described. Methods are presented for data analysis and model fitting. Observations of beta Capricorni and Uranus occultations are examined. General conclusions concerning occultation observations are explored and future activities at Prairie Observatory are discussed.

  20. A Nodal-independent and tissue-intrinsic mechanism controls heart-looping chirality

    NASA Astrophysics Data System (ADS)

    Noël, Emily S.; Verhoeven, Manon; Lagendijk, Anne Karine; Tessadori, Federico; Smith, Kelly; Choorapoikayil, Suma; den Hertog, Jeroen; Bakkers, Jeroen

    2013-11-01

    Breaking left-right symmetry in bilateria is a major event during embryo development that is required for asymmetric organ position, directional organ looping and lateralized organ function in the adult. Asymmetric expression of Nodal-related genes is hypothesized to be the driving force behind regulation of organ laterality. Here we identify a Nodal-independent mechanism that drives asymmetric heart looping in zebrafish embryos. In a unique mutant defective for the Nodal-related southpaw gene, preferential dextral looping in the heart is maintained, whereas gut and brain asymmetries are randomized. As genetic and pharmacological inhibition of Nodal signalling does not abolish heart asymmetry, a yet undiscovered mechanism controls heart chirality. This mechanism is tissue intrinsic, as explanted hearts maintain ex vivo retain chiral looping behaviour and require actin polymerization and myosin II activity. We find that Nodal signalling regulates actin gene expression, supporting a model in which Nodal signalling amplifies this tissue-intrinsic mechanism of heart looping.

  1. The Atmosphere of Titan from Cassini Radio Occultations

    NASA Astrophysics Data System (ADS)

    Schinder, Paul J.; Flasar, F. M.; Marouf, E. A.; French, R. G.; McGhee, C. A.; Kliore, A. J.; Rappaport, N.; Nagy, A. F.; Anabtawi, A.; Asmar, S.; Barbinis, E.; Fleischman, D. U.; Goltz, G. L.

    2006-09-01

    The first two radio occultations of Cassini by Titan occurred on March 19 and May 20, 2006. On March 19, the ingress occultation occurred at a latitude of 31 S, and egress at 53 S. On May 20, ingress was at 33 S, and egress at 34 S. We present the temperature-pressure profiles for the atmosphere of Titan for these 4 locations.

  2. Occult chemical deposition to a Maritime forest

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vong, R.J.; Kowalski, A.S.

    1996-12-31

    Studies of chemical fluxes from the atmosphere to vegetated surfaces have suggested that, along with conventional wet and dry processes, an additional chemical input occurs when wind-blown cloud droplets are directly intercepted by vegetation. This cloud water deposition process has been sometimes termed {open_quote}occult deposition{close_quote} because the water fluxes cannot ordinarily be observed using rain gauges. Such occult deposition of cloud water has rarely been measured directly, in part because of the complexity of the governing turbulent transfer process. However, reviews by the National Acidic Precipitation Assessment Program (NAPAP SoS/T-2,6) have suggested that the chemical flux to be forest declinemore » in the eastern USA. This paper presents direct field measurements occult chemical fluxes to a silver fir forest located in complex terrain on the Olympic Peninsula near the coast of Washington State, USA.« less

  3. Rules for Phase Shifts of Quantum Oscillations in Topological Nodal-Line Semimetals

    NASA Astrophysics Data System (ADS)

    Li, Cequn; Wang, C. M.; Wan, Bo; Wan, Xiangang; Lu, Hai-Zhou; Xie, X. C.

    2018-04-01

    Nodal-line semimetals are topological semimetals in which band touchings form nodal lines or rings. Around a loop that encloses a nodal line, an electron can accumulate a nontrivial π Berry phase, so the phase shift in the Shubnikov-de Haas (SdH) oscillation may give a transport signature for the nodal-line semimetals. However, different experiments have reported contradictory phase shifts, in particular, in the WHM nodal-line semimetals (W =Zr /Hf , H =Si /Ge , M =S /Se /Te ). For a generic model of nodal-line semimetals, we present a systematic calculation for the SdH oscillation of resistivity under a magnetic field normal to the nodal-line plane. From the analytical result of the resistivity, we extract general rules to determine the phase shifts for arbitrary cases and apply them to ZrSiS and Cu3 PdN systems. Depending on the magnetic field directions, carrier types, and cross sections of the Fermi surface, the phase shift shows rich results, quite different from those for normal electrons and Weyl fermions. Our results may help explore transport signatures of topological nodal-line semimetals and can be generalized to other topological phases of matter.

  4. Altimetry Using GPS-Reflection/Occultation Interferometry

    NASA Technical Reports Server (NTRS)

    Cardellach, Estel; DeLaTorre, Manuel; Hajj, George A.; Ao, Chi

    2008-01-01

    A Global Positioning System (GPS)- reflection/occultation interferometry was examined as a means of altimetry of water and ice surfaces in polar regions. In GPS-reflection/occultation interferometry, a GPS receiver aboard a satellite in a low orbit around the Earth is used to determine the temporally varying carrier- phase delay between (1) one component of a signal from a GPS transmitter propagating directly through the atmosphere just as the GPS transmitter falls below the horizon and (2) another component of the same signal, propagating along a slightly different path, reflected at glancing incidence upon the water or ice surface.

  5. Lymph node dissection technique is more important than lymph node count in identifying nodal metastases in radical cystectomy patients: a comparative mapping study.

    PubMed

    Dorin, Ryan P; Daneshmand, Siamak; Eisenberg, Manuel S; Chandrasoma, Shahin; Cai, Jie; Miranda, Gus; Nichols, Peter W; Skinner, Donald G; Skinner, Eila C

    2011-11-01

    The value of lymph node dissection (LND) in the treatment of bladder urothelial carcinoma is well established. However, standards for the quality of LND remain controversial. We compared the distribution of lymph node (LN) metastases in a two-institution cohort of patients undergoing radical cystectomy (RC) using a uniformly applied extended LND template. Patients undergoing RC at the University of Southern California (USC) Institute of Urology and at Oregon Health Sciences University (OHSU) were included if they met the following criteria: (1) no prior pelvic radiotherapy or LND; (2) lymphatic tissue submitted from all nine predesignated regions, including the paracaval and para-aortic LNs; (3) bladder primary; and (4) category M0 disease. The number and location of LN metastases were prospectively entered into corresponding databases. LN maps were constructed and correlated with preoperative and pathologic characteristics. Kaplan-Meier curves were constructed to estimate overall survival (OS) and recurrence free survival (RFS) among LN-positive (LN+) patients. Inclusion criteria were met by 646 patients (439 USC, 207 OHSU), and 23% had LN metastases at time of cystectomy. Although there was a difference in the median per-patient LN count between institutions, there were no significant interinstitutional differences in the incidence or distribution of positive LNs, which were found in 11% of patients with ≤pT2b and in 44% of patients with ≥pT3a tumors. Among LN+ patients, 41% had positive LNs above the common iliac bifurcation. Estimated 5-yr RFS and OS rates for LN+ patients were 45% and 33%, respectively, and did not differ significantly between institutions. LN metastases in regions outside the boundaries of standard LND are common. Adherence to meticulous dissection technique within an extended template is likely more important than total LN count for achieving optimal oncologic outcomes. Copyright © 2011 European Association of Urology. Published by

  6. Partially Transparent Petaled Mask/Occulter for Visible-Range Spectrum

    NASA Technical Reports Server (NTRS)

    Shiri, Ron Shahram; Wasylkiwskyj, Wasyl

    2013-01-01

    The presence of the Poisson Spot, also known as the spot of Arago, has been known since the 18th century. This spot is the consequence of constructive interference of light diffracted by the edge of the obstacle where the central position can be determined by symmetry of the object. More recently, many NASA missions require the suppression of this spot in the visible range. For instance, the exoplanetary missions involving space telescopes require telescopes to image the planetary bodies orbiting central stars. For this purpose, the starlight needs to be suppressed by several orders of magnitude in order to image the reflected light from the orbiting planet. For the Earth-like planets, this suppression needs to be at least ten orders of magnitude. One of the common methods of suppression involves sharp binary petaled occulters envisioned to be placed many thousands of miles away from the telescope blocking the starlight. The suppression of the Poisson Spot by binary sharp petal tips can be problematic when the thickness of the tips becomes smaller than the wavelength of the incident beam. First they are difficult to manufacture and also it invalidates the laws of physical optics. The proposed partially transparent petaled masks/occulters compensate for this sharpness with transparency along the surface of the petals. Depending on the geometry of the problem, this transparency can be customized such that only a small region of the petal is transparent and the remaining of the surface is opaque. This feature allows easy fabrication of this type of occultation device either as a mask or occulter. A partially transparent petaled mask/ occulter has been designed for the visible spectrum range. The mask/occulter can suppress the intensity along the optical axis up to ten orders of magnitude. The design process can tailor the mask shape, number of petals, and transparency level to the near-field and farfield diffraction region. The mask/occulter can be used in space

  7. General Information about Metastatic Squamous Neck Cancer with Occult Primary

    MedlinePlus

    ... Occult Primary Treatment (Adult) (PDQ®)–Patient Version General Information About Metastatic Squamous Neck Cancer with Occult Primary ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  8. Occult lymph node metastasis and risk of regional recurrence in papillary thyroid cancer after bilateral prophylactic central neck dissection: A multi-institutional study.

    PubMed

    Lee, Young Chan; Na, Se Young; Park, Gi Cheol; Han, Ju Hyun; Kim, Seung Woo; Eun, Young Gyu

    2017-02-01

    The impact of occult lymph node metastasis on regional recurrence after prophylactic central neck dissection for preoperative, nodal-negative papillary thyroid cancer is controversial. We investigated risk factors for regional lymph node recurrence in papillary thyroid cancer patients who underwent total thyroidectomy and bilateral prophylactic central neck dissection. Analysis was according to clinicopathologic characteristics and occult lymph node metastasis patterns. This multicenter study enrolled 211 consecutive patients who underwent total thyroidectomy with bilateral prophylactic central neck dissection for papillary thyroid cancer without evidence of central lymph node metastasis on preoperative imaging. Clinicopathologic features and central lymph node metastasis patterns were analyzed for predicting regional recurrence. Multivariate Cox regression analysis was used to identify independent factors for recurrence. Median follow-up time was 43 months (24-95 months). Ten patients (4.7%) showed regional lymph node recurrence. The estimated 5-year, regional recurrence-free survival was 95.2%. Tumor size ≥1 cm, central lymph node metastasis, lymph node ratio, and prelaryngeal lymph node metastasis were associated with regional recurrence in univariate analysis (P < .05). In multivariate analysis, a lymph node ratio ≥ 0.26 was a significant risk factor for regional lymph node recurrence (odds ratio = 11.63, P = .003). Lymph node ratio ≥ 0.26 was an independent predictor of worse recurrence-free survival on Cox regression analysis (hazard ratio = 11.49, P = .002). Although no significant association was observed between the presence of occult lymph node metastasis and regional recurrence, lymph node ratio ≥ 0.26 was an independent predictor of regional lymph node recurrence in papillary thyroid cancer patients who underwent total thyroidectomy and bilateral prophylactic central neck dissection. Copyright © 2016 Elsevier Inc. All rights

  9. Preablation 131-I scans with SPECT/CT in postoperative thyroid cancer patients: what is the impact on staging?

    PubMed

    Avram, Anca M; Fig, Lorraine M; Frey, Kirk A; Gross, Milton D; Wong, Ka Kit

    2013-03-01

    The utility of preablation radioiodine scans for the management of differentiated thyroid cancer remains controversial. To determine the contribution of preablation Iodine 131 (131-I) planar with single-photon emission computed tomography/computed tomography (SPECT/CT; diagnostic [Dx] scans) to differentiated thyroid cancer staging. Prospective sequential series at university clinic. Using American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging, seventh edition 320 patients post-total thyroidectomy were initially staged based on clinical and pathology data (pTN) and then restaged after imaging (TNM). The impact of Dx scans with SPECT/CT on N and M scores, and TNM stage, was assessed in younger, age <45 years, n = 138 (43%), and older, age ≥ 45 years, n = 182 (57%) patients, with subgroup analysis for T1a and T1b tumors. In younger patients Dx scans detected distant metastases in 5 of 138 patients (4%), and nodal metastases in 61 of 138 patients (44%), including unsuspected nodal metastases in 24 of 63 (38%) patients initially assigned pathologic (p) N0 or pNx. In older patients distant metastases were detected in 18 of 182 patients (10%), and nodal metastases in 51 of 182 patients (28%), including unsuspected nodal metastases in 26 of 108 (24%) patients initially assigned pN0 or pNx. Dx scans detected distant metastases in 2 of 49 (4%) T1a, and 3 of 67 (4.5%) T1b patients. Dx scans detected regional metastases in 35% of patients, and distant metastases in 8% of patients. Information acquired with Dx scans changed staging in 4% of younger, and 25% of older patients. Preablation scans with SPECT/CT contribute to staging of thyroid cancer. Identification of regional and distant metastases prior to radioiodine therapy has significant potential to alter patient management.

  10. Nodal aberration theory for wild-filed asymmetric optical systems

    NASA Astrophysics Data System (ADS)

    Chen, Yang; Cheng, Xuemin; Hao, Qun

    2016-10-01

    Nodal Aberration Theory (NAT) was used to calculate the zero field position in Full Field Display (FFD) for the given aberration term. Aiming at wide-filed non-rotational symmetric decentered optical systems, we have presented the nodal geography behavior of the family of third-order and fifth-order aberrations. Meanwhile, we have calculated the wavefront aberration expressions when one optical element in the system is tilted, which was not at the entrance pupil. By using a three-piece-cellphone lens example in optical design software CodeV, the nodal geography is testified under several situations; and the wavefront aberrations are calculated when the optical element is tilted. The properties of the nodal aberrations are analyzed by using Fringe Zernike coefficients, which are directly related with the wavefront aberration terms and usually obtained by real ray trace and wavefront surface fitting.

  11. Are metastases from metastases clinical relevant? Computer modelling of cancer spread in a case of hepatocellular carcinoma.

    PubMed

    Bethge, Anja; Schumacher, Udo; Wree, Andreas; Wedemann, Gero

    2012-01-01

    Metastasis formation remains an enigmatic process and one of the main questions recently asked is whether metastases are able to generate further metastases. Different models have been proposed to answer this question; however, their clinical significance remains unclear. Therefore a computer model was developed that permits comparison of the different models quantitatively with clinical data and that additionally predicts the outcome of treatment interventions. The computer model is based on discrete events simulation approach. On the basis of a case from an untreated patient with hepatocellular carcinoma and its multiple metastases in the liver, it was evaluated whether metastases are able to metastasise and in particular if late disseminated tumour cells are still capable to form metastases. Additionally, the resection of the primary tumour was simulated. The simulation results were compared with clinical data. The simulation results reveal that the number of metastases varies significantly between scenarios where metastases metastasise and scenarios where they do not. In contrast, the total tumour mass is nearly unaffected by the two different modes of metastasis formation. Furthermore, the results provide evidence that metastasis formation is an early event and that late disseminated tumour cells are still capable of forming metastases. Simulations also allow estimating how the resection of the primary tumour delays the patient's death. The simulation results indicate that for this particular case of a hepatocellular carcinoma late metastases, i.e., metastases from metastases, are irrelevant in terms of total tumour mass. Hence metastases seeded from metastases are clinically irrelevant in our model system. Only the first metastases seeded from the primary tumour contribute significantly to the tumour burden and thus cause the patient's death.

  12. Radio Occultation Measurements of Pluto’s Atmosphere with New Horizons

    NASA Astrophysics Data System (ADS)

    Hinson, David P.; Linscott, Ivan; Tyler, Len; Bird, Mike; Paetzold, Martin; Strobel, Darrell; Summers, Mike; Woods, Will; Stern, Alan; Weaver, Hal; Olkin, Cathy; Young, Leslie; Ennico, Kimberly; Gladstone, Randy; Greathouse, Tommy; Kammer, Josh; Parker, Alex; Parker, Joel; Retherford, Kurt; Schindhelm, Eric; Singer, Kelsi; Steffl, Andrew; Tsang, Con; Versteeg, Maarten

    2015-11-01

    The reconnaissance of the Pluto System by New Horizons included radio occultations at both Pluto and Charon. This talk will present the latest results from the Pluto occultation. The REX instrument onboard New Horizons received and recorded uplink signals from two 70-m antennas and two 34-m antennas of the NASA Deep Space Network - each transmitting 20 kW at 4.2-cm wavelength - during a diametric occultation by Pluto. At the time this was written only a short segment of data at occultation entry (193°E, 17°S) was available for analysis. The REX measurements extend unequivocally to the surface, providing the first direct measure of the surface pressure and the temperature structure in Pluto’s lower atmosphere. Data from occultation exit (16°E, 15°N) are scheduled to arrive on the ground in late August 2015. Those observations will yield an improved estimate of the surface pressure, a second temperature profile, and a measure of the diameter of Pluto with a precision of a few hundred meters. This work is supported by the NASA New Horizons Mission.

  13. Recent progress on external occulter technology for imaging exosolar planets

    NASA Astrophysics Data System (ADS)

    Kasdin, N. J.; Vanderbei, R. J.; Sirbu, D.; Samuels, J.; Shaklan, S.; Lisman, D.; Thomson, M.; Cady, E.; Martin, S.

    Imaging planets orbiting nearby stars requires a system for suppressing the host starlight by at least ten orders of magnitude. One such approach uses an external occulter, a satellite flying far from the telescope and employing a large screen, or starshade, to suppress the incoming starlight. This trades the added complexity of building the precisely shaped starshade and flying it in formation against simplifications in the telescope since extremely precise wavefront control is no longer necessary. Much progress has been made recently in designing, testing and manufacturing starshade technology. In this paper we describe the design of starshades and report on recent accomplishments in manufacturing and measuring a prototype occulter petal as part of NASA's first Technology Development for Exoplanet Missions (TDEM) program. We demonstrate that the as-built petal is consistent with a full-size occulter achieving better than 10-10 contrast. We also discuss laboratory testing at the Princeton Occulter Testbed. These experiments use sub-scale, long-distance beam propagation to verify the diffraction analysis associated with occulter starlight suppression. We demonstrate roughly 10-10 suppression in the laboratory and discuss the important challenges and limitations.

  14. Stellar occultation spikes as probes of atmospheric structure and composition. [for Jupiter

    NASA Technical Reports Server (NTRS)

    Elliot, J. L.; Veverka, J.

    1976-01-01

    The characteristics of spikes observed in occultation light curves of Beta Scorpii by Jupiter are discussed in terms of the gravity-gradient model. The occultation of Beta Sco by Jupiter on May 13, 1971, is reviewed, and the gravity-gradient model is defined as an isothermal atmosphere of constant composition in which the refractivity is a function only of the radial coordinate from the center of refraction, which is assumed to lie parallel to the local gravity gradient. The derivation of the occultation light curve in terms of the atmosphere, the angular diameter of the occulted star, and the occultation geometry is outlined. It is shown that analysis of the light-curve spikes can yield the He/H2 concentration ratio in a well-mixed atmosphere, information on fine-scale atmospheric structure, high-resolution images of the occulted star, and information on ray crossing. Observational limits are placed on the magnitude of horizontal refractivity gradients, and it is concluded that the spikes are the result of local atmospheric density variations: atmospheric layers, density waves, or turbulence.

  15. Orbital nodal surfaces: Topological challenges for density functionals

    NASA Astrophysics Data System (ADS)

    Aschebrock, Thilo; Armiento, Rickard; Kümmel, Stephan

    2017-06-01

    Nodal surfaces of orbitals, in particular of the highest occupied one, play a special role in Kohn-Sham density-functional theory. The exact Kohn-Sham exchange potential, for example, shows a protruding ridge along such nodal surfaces, leading to the counterintuitive feature of a potential that goes to different asymptotic limits in different directions. We show here that nodal surfaces can heavily affect the potential of semilocal density-functional approximations. For the functional derivatives of the Armiento-Kümmel (AK13) [Phys. Rev. Lett. 111, 036402 (2013), 10.1103/PhysRevLett.111.036402] and Becke88 [Phys. Rev. A 38, 3098 (1988), 10.1103/PhysRevA.38.3098] energy functionals, i.e., the corresponding semilocal exchange potentials, as well as the Becke-Johnson [J. Chem. Phys. 124, 221101 (2006), 10.1063/1.2213970] and van Leeuwen-Baerends (LB94) [Phys. Rev. A 49, 2421 (1994), 10.1103/PhysRevA.49.2421] model potentials, we explicitly demonstrate exponential divergences in the vicinity of nodal surfaces. We further point out that many other semilocal potentials have similar features. Such divergences pose a challenge for the convergence of numerical solutions of the Kohn-Sham equations. We prove that for exchange functionals of the generalized gradient approximation (GGA) form, enforcing correct asymptotic behavior of the potential or energy density necessarily leads to irregular behavior on or near orbital nodal surfaces. We formulate constraints on the GGA exchange enhancement factor for avoiding such divergences.

  16. Lung Cancer Brain Metastases.

    PubMed

    Goldberg, Sarah B; Contessa, Joseph N; Omay, Sacit B; Chiang, Veronica

    2015-01-01

    Brain metastases are common among patients with lung cancer and have been associated with significant morbidity and limited survival. However, the treatment of brain metastases has evolved as the field has advanced in terms of central nervous system imaging, surgical technique, and radiotherapy technology. This has allowed patients to receive improved treatment with less toxicity and more durable benefit. In addition, there have been significant advances in systemic therapy for lung cancer in recent years, and several treatments including chemotherapy, targeted therapy, and immunotherapy exhibit activity in the central nervous system. Utilizing systemic therapy for treating brain metastases can avoid or delay local therapy and often allows patients to receive effective treatment for both intracranial and extracranial disease. Determining the appropriate treatment for patients with lung cancer brain metastases therefore requires a clear understanding of intracranial disease burden, tumor histology, molecular characteristics, and overall cancer prognosis. This review provides updates on the current state of surgery and radiotherapy for the treatment of brain metastases, as well as an overview of systemic therapy options that may be effective in select patients with intracranial metastases from lung cancer.

  17. Preliminary evaluation of the diffraction behind the PROBA 3/ASPIICS optimized occulter

    NASA Astrophysics Data System (ADS)

    Baccani, Cristian; Landini, Federico; Romoli, Marco; Taccola, Matteo; Schweitzer, Hagen; Fineschi, Silvano; Bemporad, Alessandro; Loreggia, Davide; Capobianco, Gerardo; Pancrazzi, Maurizio; Focardi, Mauro; Noce, Vladimiro; Thizy, Cédric; Servaye, Jean-Sébastien; Renotte, Etienne

    2016-07-01

    PROBA-3 is a technological mission of the European Space Agency (ESA), devoted to the in-orbit demon- stration of formation flying (FF) techniques and technologies. ASPIICS is an externally occulted coronagraph approved by ESA as payload in the framework of the PROBA-3 mission and is currently in its C/D phase. FF offers a solution to investigate the solar corona close the solar limb using a two-component space system: the external occulter on one spacecraft and the optical instrument on the other, separated by a large distance and kept in strict alignment. ASPIICS is characterized by an inter-satellite distance of ˜144 m and an external occulter diameter of 1.42 m. The stray light due to the diffraction by the external occulter edge is always the most critical offender to a coronagraph performance: the designer work is focused on reducing the stray light and carefully evaluating the residuals. In order to match this goal, external occulters are usually characterized by an optimized shape along the optical axis. Part of the stray light evaluation process is based on the diffraction calculation with the optimized occulter and with the whole solar disk as a source. We used the field tracing software VirtualLabTM Fusion by Wyrowski Photonics [1] to simulate the diffraction. As a first approach and in order to evaluate the software, we simulated linear occulters, through as portions of the flight occulter, in order to make a direct comparison with the Phase-A measurements [2].

  18. Counting nodal domains on surfaces of revolution

    NASA Astrophysics Data System (ADS)

    Karageorge, Panos D.; Smilansky, Uzy

    2008-05-01

    We consider eigenfunctions of the Laplace-Beltrami operator on special surfaces of revolution. For this separable system, the nodal domains of the (real) eigenfunctions form a checkerboard pattern, and their number νn is proportional to the product of the angular and the 'surface' quantum numbers. Arranging the wavefunctions by increasing values of the Laplace-Beltrami spectrum, we obtain the nodal sequence, whose statistical properties we study. In particular, we investigate the distribution of the normalized counts \\frac{\

  19. Using GPS radio occultation data in the study of tropical cyclogenesis

    NASA Astrophysics Data System (ADS)

    Didlake, A. C., Jr.; Kuo, Y. B.; Metcalfe, T.

    2005-12-01

    Numerous studies have examined atmospheric conditions and patterns in tropical cyclogenesis. Although much has been accomplished, a complete understanding of tropical cyclogenesis is hindered by the lack of data in the regions where formation occurs. The GPS (Global Positioning System) radio occultation technique can provide valuable data in key areas. In GPS radio occultation, GPS satellites emit radio signals through the atmosphere that are received by another satellite in a low Earth orbit. Various atmospheric properties are calculated based on the alteration of the signal. This study assessed the value of GPS radio occultation data in the study of tropical cyclogenesis by examining storms of the 2002 Western North Pacific typhoon season. The signature of precursor disturbances to tropical cyclogenesis was determined by analyzing composites of data from the NCEP Aviation (AVN) analysis over four days. Similar composites of GPS radio occultation data were produced. The AVN analysis showed strong signals of precursor disturbances in the low-level wind fields and atmospheric refractivity. The GPS radio occultation data detected similarly increased refractivity values in corresponding regions, but had sizeable measurement differences with the AVN analysis. These differences were attributed to AVN analysis error due to the lack of input observational data and the high accuracy of GPS radio occultation measurements. Further comparisons showed that with the limited quantity of data currently available, GPS radio occultation by itself was not sufficient to detect precursor disturbances. It can best be used in data assimilation to improve the analysis and forecasts of tropical storms.

  20. Constraints on Pluto's Hazes from 2-Color Occultation Lightcurves

    NASA Astrophysics Data System (ADS)

    Hartig, Kara; Barry, T.; Carriazo, C. Y.; Cole, A.; Gault, D.; Giles, B.; Giles, D.; Hill, K. M.; Howell, R. R.; Hudson, G.; Loader, B.; Mackie, J. A.; Olkin, C. B.; Rannou, P.; Regester, J.; Resnick, A.; Rodgers, T.; Sicardy, B.; Skrutskie, M. F.; Verbiscer, A. J.; Wasserman, L. H.; Watson, C. R.; Young, E. F.; Young, L. A.; Buie, M. W.; Nelson, M.

    2015-11-01

    The controversial question of aerosols in Pluto's atmosphere first arose in 1988, when features in a Pluto occultation lightcurve were alternately attributed to haze opacity (Elliot et al. 1989) or a thermal inversion (Eshleman 1989). A stellar occultation by Pluto in 2002 was observed from several telescopes on Mauna Kea in wavelengths ranging from R- to K-bands (Elliot et al. 2003). This event provided compelling evidence for haze on Pluto, since the mid-event baseline levels were systematically higher at longer wavelengths (as expected if there were an opacity source that scattered more effectively at shorter wavelengths). However, subsequent occultations in 2007 and 2011 showed no significant differences between visible and IR lightcurves (Young et al. 2011).The question of haze on Pluto was definitively answered by direct imaging of forward-scattering aerosols by the New Horizons spacecraft on 14-JUL-2015. We report on results of a bright stellar occultation which we observed on 29-JUN-2015 in B- and H-bands from both grazing and central sites. As in 2007 and 2011, we see no evidence for wavelength-dependent extinction. We will present an analysis of haze parameters (particle sizes, number density profiles, and fractal aggregations), constraining models of haze distribution to those consistent with and to those ruled out by the occultation lightcurves and the New Horizons imaging.References:Elliot, J.L., et al., "Pluto's Atmosphere." Icarus 77, 148-170 (1989)Eshleman, V.R., "Pluto's Atmosphere: Models based on refraction, inversion, and vapor pressure equilibrium." Icarus 80 439-443 (1989)Elliot, J.L., et al., "The recent expansion of Pluto's atmosphere." Nature 424 165-168 (2003)Young, E.F., et al., "Search for Pluto's aerosols: simultaneous IR and visible stellar occultation observations." EPSC-DPS Joint Meeting 2011, held 2-7 October 2011 in Nantes, France (2011)

  1. Stellar Occultation Studies of Pluto, Triton, Charon, and Chiron

    NASA Technical Reports Server (NTRS)

    Elliot, James L.

    2002-01-01

    Bodies inhabiting the outer solar system are of interest because, due to the colder conditions, they exhibit unique physical processes. Also, some of the lessons learned from them can be applied to understanding what occurred in the outer solar system during its formation and early evolution. The thin atmospheres of Pluto and Triton have structure that is not yet understood, and they have been predicted to undergo cataclysmic seasonal changes. Charon may have an atmosphere - we don't know. Chiron exhibits cometary activity so far from the sun (much further than most comets), so that H2O sublimation cannot be the driving mechanism. Probing these bodies from Earth with a spatial resolution of a few kilometers can be accomplished only with the stellar occultation technique. In this program we find and predict stellar occultation events by small outer-solar system bodies and then attempt observations of the ones that can potentially answer interesting questions. We also develop new methods of data analysis for occultations and secure other observations that are necessary for interpretation of the occultation data.

  2. Wave optics of the central spot in planetary occultations

    NASA Technical Reports Server (NTRS)

    Hubbard, W. B.

    1977-01-01

    The detection of a bright central spot during the occultation of epsilon Geminorum by Mars demonstrates that an exponentially-stratified planetary atmosphere can act as a lens providing very high resolution of distant objects (e.g., quasars, white dwarfs, and pulsars). The diffraction nature of the central occultation spot is investigated, with special reference to Mars and Venus. In practice, however, central occultations by these planets are seldom observable from the earth's surface, and spacecraft would have to be used to obtain a suitable orientation for observers. Further difficulties may be encountered in image deconvolution needed for extended objects, in location of the image of a true point source, and in compensation for peculiarities of planets and their atmospheres.

  3. Classification of reflection-symmetry-protected topological semimetals and nodal superconductors

    NASA Astrophysics Data System (ADS)

    Chiu, Ching-Kai; Schnyder, Andreas P.

    2014-11-01

    While the topological classification of insulators, semimetals, and superconductors in terms of nonspatial symmetries is well understood, less is known about topological states protected by crystalline symmetries, such as mirror reflections and rotations. In this work, we systematically classify topological semimetals and nodal superconductors that are protected, not only by nonspatial (i.e., global) symmetries, but also by a crystal reflection symmetry. We find that the classification crucially depends on (i) the codimension of the Fermi surface (nodal line or point) of the semimetal (superconductor), (ii) whether the mirror symmetry commutes or anticommutes with the nonspatial symmetries, and (iii) how the Fermi surfaces (nodal lines or points) transform under the mirror reflection and nonspatial symmetries. The classification is derived by examining all possible symmetry-allowed mass terms that can be added to the Bloch or Bogoliubov-de Gennes Hamiltonian in a given symmetry class and by explicitly deriving topological invariants. We discuss several examples of reflection-symmetry-protected topological semimetals and nodal superconductors, including topological crystalline semimetals with mirror Z2 numbers and topological crystalline nodal superconductors with mirror winding numbers.

  4. Cerberus-Nodal-Lefty-Pitx signaling cascade controls left-right asymmetry in amphioxus.

    PubMed

    Li, Guang; Liu, Xian; Xing, Chaofan; Zhang, Huayang; Shimeld, Sebastian M; Wang, Yiquan

    2017-04-04

    Many bilaterally symmetrical animals develop genetically programmed left-right asymmetries. In vertebrates, this process is under the control of Nodal signaling, which is restricted to the left side by Nodal antagonists Cerberus and Lefty. Amphioxus, the earliest diverging chordate lineage, has profound left-right asymmetry as a larva. We show that Cerberus , Nodal , Lefty , and their target transcription factor Pitx are sequentially activated in amphioxus embryos. We then address their function by transcription activator-like effector nucleases (TALEN)-based knockout and heat-shock promoter (HSP)-driven overexpression. Knockout of Cerberus leads to ectopic right-sided expression of Nodal , Lefty , and Pitx , whereas overexpression of Cerberus represses their left-sided expression. Overexpression of Nodal in turn represses Cerberus and activates Lefty and Pitx ectopically on the right side. We also show Lefty represses Nodal , whereas Pitx activates Nodal These data combine in a model in which Cerberus determines whether the left-sided gene expression cassette is activated or repressed. These regulatory steps are essential for normal left-right asymmetry to develop, as when they are disrupted embryos may instead form two phenotypic left sides or two phenotypic right sides. Our study shows the regulatory cassette controlling left-right asymmetry was in place in the ancestor of amphioxus and vertebrates. This includes the Nodal inhibitors Cerberus and Lefty, both of which operate in feedback loops with Nodal and combine to establish asymmetric Pitx expression. Cerberus and Lefty are missing from most invertebrate lineages, marking this mechanism as an innovation in the lineage leading to modern chordates.

  5. An occultation satellite system for determining pressure levels in the atmosphere

    NASA Technical Reports Server (NTRS)

    Ungar, S. G.; Lusignan, B. B.

    1972-01-01

    An operational two-satellite microwave occultation system will establish a pressure reference level to be used in fixing the temperature-pressure profile generated by the SIRS infrared sensor as a function of altitude. In the final error analysis, simulated data for the SIRS sensor were used to test the performance of the occultation system. The results of this analysis indicate that the occultation system is capable of measuring the altitude of the 300-mb level to within 24 mrms, given a maximum error of 2 K in the input temperature profile. The effects of water vapor can be corrected by suitable climatological profiles, and improvements in the accuracy of the SIRS instrument should yield additional improvements in the performance of the occultation system.

  6. The Occult: Diabolica to Alchemists

    ERIC Educational Resources Information Center

    Delaney, Oliver J.

    1971-01-01

    The 91 items in this bibliography deal with works of occult science. The material is subdivided into biographies, dictionaries, encyclopedias, handbooks, noteworthy histories, indices, annuals, and a few miscellany works with treatises. (95 references) (Author)

  7. Rate of regional nodal metastases of cutaneous squamous cell carcinoma in the immunosuppressed patient.

    PubMed

    McLaughlin, Eamon J; Miller, Lauren; Shin, Thuzar M; Sobanko, Joseph F; Cannady, Steven B; Miller, Christopher J; Newman, Jason G

    Immunosuppressed solid organ transplant recipients (SOTRs) have an increased risk of developing cutaneous squamous cell carcinomas (cSCCs) with metastatic potential. This study sought to determine the rate of regional lymph node involvement in a large cohort of solid organ transplant patients with cutaneous head and neck squamous cell carcinoma. A retrospective chart review was performed on solid organ transplant patients with head and neck cutaneous squamous cell carcinoma treated at a tertiary academic medical center from 2005 to 2015. 130 solid organ transplant patients underwent resection of 383 head and neck cutaneous squamous cell carcinomas. The average age of the patient was 63. Seven patients (5%) developed regional lymph node metastases (3 parotid, 4 cervical lymph nodes). The mean time from primary tumor resection to diagnosis of regional lymphatic disease was 6.7months. Six of these patients underwent definitive surgical resection followed by adjuvant radiation; one patient underwent definitive chemoradiation. 6 of the 7 patients died of disease progression with a mean survival of 15months. The average follow up time was 3years (minimum 6months). Solid organ transplant recipients with cutaneous squamous cell carcinoma of the head and neck develop regional lymph node metastasis at a rate of 5%. Regional lymph node metastasis in this population has a poor prognosis and requires aggressive management and surveillance. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Hybrid nodal loop metal: Unconventional magnetoresponse and material realization

    NASA Astrophysics Data System (ADS)

    Zhang, Xiaoming; Yu, Zhi-Ming; Lu, Yunhao; Sheng, Xian-Lei; Yang, Hui Ying; Yang, Shengyuan A.

    2018-03-01

    A nodal loop is formed by a band crossing along a one-dimensional closed manifold, with each point on the loop a linear nodal point in the transverse dimensions, and can be classified as type I or type II depending on the band dispersion. Here, we propose a class of nodal loops composed of both type-I and type-II points, which are hence termed as hybrid nodal loops. Based on first-principles calculations, we predict the realization of such loops in the existing electride material Ca2As . For a hybrid loop, the Fermi surface consists of coexisting electron and hole pockets that touch at isolated points for an extended range of Fermi energies, without the need for fine-tuning. This leads to unconventional magnetic responses, including the zero-field magnetic breakdown and the momentum-space Klein tunneling observable in the magnetic quantum oscillations, as well as the peculiar anisotropy in the cyclotron resonance.

  9. Type-I and type-II topological nodal superconductors with s -wave interaction

    NASA Astrophysics Data System (ADS)

    Huang, Beibing; Yang, Xiaosen; Xu, Ning; Gong, Ming

    2018-01-01

    Topological nodal superconductors with protected gapless points in momentum space are generally realized based on unconventional pairings. In this work we propose a minimal model to realize these topological nodal phases with only s -wave interaction. In our model the linear and quadratic spin-orbit couplings along the two orthogonal directions introduce anisotropic effective unconventional pairings in momentum space. This model may support different nodal superconducting phases characterized by either an integer winding number in BDI class or a Z2 index in D class at the particle-hole invariant axes. In the vicinity of the nodal points the effective Hamiltonian can be described by either type-I or type-II Dirac equations, and the Lifshitz transition from type-I nodal phases to type-II nodal phases can be driven by external in-plane magnetic fields. We show that these nodal phases are robust against weak impurities, which only slightly renormalizes the momentum-independent parameters in the impurity-averaged Hamiltonian, thus these phases are possible to be realized in experiments with real semi-Dirac materials. The smoking-gun evidences to verify these phases based on scanning tunneling spectroscopy method are also briefly discussed.

  10. Seroprevalence of occult hepatitis B among Egyptian paediatric hepatitis C cancer patients.

    PubMed

    Raouf, H E; Yassin, A S; Megahed, S A; Ashour, M S; Mansour, T M

    2015-02-01

    Occult hepatitis B infection is characterized by the presence of hepatitis B virus (HBV) DNA in the serum in the absence of hepatitis B surface antigen (HBsAg). Prevalence of hepatitis C virus (HCV) infections in Egypt is among the highest in the world. In this study, we aim at analysing the rates of occult HBV infections among HCV paediatric cancer patients in Egypt. The prevalence of occult HBV was assessed in two groups of paediatric cancer patients (HCV positive and HCV negative), in addition to a third group of paediatric noncancer patients, which was used as a general control. All groups were negative for HBsAg and positive for HCV antibody. HBV DNA was detected by nested PCR and real-time PCR. HCV was detected by real-time PCR. Sequencing was carried out in order to determine HBV genotypes to all HBV patients as well as to detect any mutation that might be responsible for the occult phenotype. Occult hepatitis B infection was observed in neither the non-HCV paediatric cancer patients nor the paediatric noncancer patients but was found in 31% of the HCV-positive paediatric cancer patients. All the detected HBV patients belonged to HBV genotype D, and mutations were found in the surface genome of HBV leading to occult HBV. Occult HBV infection seems to be relatively frequent in HCV-positive paediatric cancer patients, indicating that HBsAg negativity is not sufficient to completely exclude HBV infection. These findings emphasize the importance of considering occult HBV infection in HCV-positive paediatric cancer patients especially in endemic areas as Egypt. © 2014 John Wiley & Sons Ltd.

  11. Occult Hepatitis B Virus Infection in a Previously Vaccinated Injection Drug User.

    PubMed

    Powell, Eleanor A; Razeghi, Sanam; Zucker, Stephen; Blackard, Jason T

    2016-02-01

    Occult hepatitis B virus (HBV) is defined by the presence of HBV DNA in patient sera in the absence of HBsAg. Occult HBV has been associated with hepatocellular carcinoma, reactivation during immune suppression, and transmission to others. While the hepatitis B vaccine is very effective at preventing chronic HBV infection, recent studies indicate it is less effective at preventing occult HBV following infant vaccination. No studies, however, have examined the efficacy of adult HBV vaccination at preventing occult HBV. Here, we present the first report of occult HBV following adult vaccination. A 21-year old Caucasian female presented with tricuspid valve endocarditis secondary to methicillin-susceptible Staphylococcus aureus with non-ischemic cardiomyopathy. She reported active use of intravenous drugs. Her liver enzymes were elevated (ALT = 1873 IU/mL; AST = 4518 IU/mL), and she was found to have HCV and occult HBV. HBV viral loads ranged from 4608 - 8364 copies IU/mL during hospitalization. The patient's HBV was sequenced and found to be genotype D3 without any known diagnostic escape mutations. Immune complexes that may have prevented HBsAg detection were not observed. HBV vaccination in infancy is effective at preventing chronic HBV infection but is less effective at preventing occult HBV infection. Similar studies examining the efficacy of adult HBV vaccination in preventing occult HBV have not been performed. This case highlights the importance of carefully determining the HBV status of high-risk individuals, as vaccination history and the presence of anti-HBs may not be adequate to rule out HBV infection, even in the absence of HBsAg.

  12. Nodal Topological Phases in s-wave Superfluid of Ultracold Fermionic Gases

    NASA Astrophysics Data System (ADS)

    Huang, Bei-Bing; Yang, Xiao-Sen

    2018-02-01

    The gapless Weyl superfluid has been widely studied in the three-dimensional ultracold fermionic superfluid. In contrast to Weyl superfluid, there exists another kind of gapless superfluid with topologically protected nodal lines, which can be regarded as the superfluid counterpart of nodal line semimetal in the condensed matter physics, just as Weyl superfluid with Weyl semimetal. In this paper we study the ground states of the cold fermionic gases in cubic optical lattices with one-dimensional spin-orbit coupling and transverse Zeeman field and map out the topological phase diagram of the system. We demonstrate that in addition to a fully gapped topologically trivial phase, some different nodal line superfluid phases appear when the Zeeman field is adjusted. The presence of topologically stable nodal lines implies the dispersionless zero-energy flat band in a finite region of the surface Brillouin zone. Experimentally these nodal line superfluid states can be detected via the momentum-resolved radio-frequency spectroscopy. The nodal line topological superfluid provide fertile grounds for exploring exotic quantum matters in the context of ultracold atoms. Supported by National Natural Science Foundation of China under Grant Nos. 11547047 and 11504143

  13. Periprosthetic Occult Fractures of the Acetabulum Occur Frequently During Primary THA.

    PubMed

    Hasegawa, Kazuhiro; Kabata, Tamon; Kajino, Yoshitomo; Inoue, Daisuke; Tsuchiya, Hiroyuki

    2017-02-01

    Periprosthetic fractures of the acetabulum occurring during primary THA are rare. Periprosthetic occult fractures are defined as those not identified by the surgeon during the procedure which might be missed on a routine postoperative radiograph. However, it is unclear how frequently these fractures occur and whether their presence affects functional recovery. In this study, using routine CT scans that were obtained as part of another primary hip arthroplasty study protocol, we retrospectively assessed (1) the prevalence of occult fractures of the acetabulum occurring during primary THA, (2) the location of occult fractures of the acetabulum during THA, and (3) risk factors contributing to such occult fractures. Between 2004 and 2013, our institute performed 585 primary THAs (cementless or hybrid) in 494 patients with DICOM pre- and postoperative CT; during the period in question, all patients undergoing THA underwent CT before and after surgery. Preoperative CT images were taken as part of a CT-based three-dimensional templating software and navigation system. Postoperative CT images were taken an average of 1 week after surgery as part of a different protocol to evaluate cup position, restoration of leg length and offset, volume of postoperative hematoma to assess anticoagulation effects after THA, and fractures that were not found on routine postoperative radiographs (which we defined as occult fractures). Patients with a history of prior pelvic osteotomy, trauma, and infection were excluded (88 patients/99 hips); 406 patients (102 males and 304 females; 486 hips) form the basis of this report. The mean age of the patients was 60 ± 11 years, with a mean BMI of 23 ± 4 kg/m 2 . The mean followup of the patients with periprosthetic fracture of the acetabulum was 58 ± 28 months (range, 12-131 months). Potential risk factors for occult acetabular fracture including age, sex, BMI, preoperative diagnosis, additional dome screw fixation, composition and size of each

  14. Occult cancer detection in patients with hemostatic disorder and venous thromboembolism.

    PubMed

    Husseinzadeh, Holleh; Carrier, Marc

    2018-03-01

    There are physiologic ties between Von Willebrand Factor (VWF) and circulating tumor cells. VWF appears to play a role in tumor biology, but it is unclear whether cancer behavior differs in Von Willebrand Disease. In patients presenting with venous thromboembolism (VTE), occult cancer is frequently considered as an underlying cause. The prevalence of occult cancer after provoked VTE is low (3%); therefore, cancer screening in these patients is not routinely recommended. In those with unprovoked VTE, occult cancer is more prevalent, estimated between 4 and 10%. Due to this elevated risk, occult cancer screening is recommended in this population. Multiple studies have investigated whether a "limited" approach (including history and physical exam, basic labs, and chest X-ray) versus "extensive" approach (addition of advanced imaging, such as computer tomography) is more effective. Current data fails to demonstrate extensive screening strategies diagnose more occult cancer, miss fewer cancers during follow up, or improve cancer-related mortality. Furthermore, many patients may be needlessly exposed to unnecessary diagnostic procedures with their associated complications and costs, as well as significant anxiety. Therefore, the decision to perform additional testing should be made on a case-by-case basis. Additional studies are needed to identify subgroups of patients with unprovoked VTE at highest risk for occult cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Astrometry of Single-Chord Occultations: Application to the 1993 Triton Event

    NASA Technical Reports Server (NTRS)

    Olkin, Catherine B.; Elliot, J. L.; Bus, Schelte J.; McDonald, Stephen W.; Dahn, Conrad C.

    1996-01-01

    This paper outlines a method for reducing astrometric data to derive the closest approach time and distance to the center of an occultation shadow for a single observer. The method applies to CCD frames, strip scans or photographic plates and uses a set of field stars of unknown positions to define a common coordinate system for all frames. The motion of the occulting body is used to establish the transformation between this common coordinate system and the celestial coordinate system of the body's ephemeris. This method is demonstrated by application to the Tr6O occultation by Triton on 1993 July 10 UT. Over an interval of four nights that included the occultation time, 80 frames of Triton and Tr6O were taken near the meridian with the U.S. Naval Observatory (USNO) 61-inch astrometric reflector. Application of the method presented here to these data yields a closest approach distance of 359 +/- 133 km (corresponding to 0.017 +/- 0.006 arcsec) for the occultation chord obtained with the Kuiper Airborne Observatory (KAO). Comparison of the astrometric closest approach time with the KAO light-curve midtime shows a difference of 2.2 +/- 4.1 s. Relative photometry of Triton and Tr6O, needed for photometric calibration of the occultation light curve, is also presented.

  16. [Occultism, parapsychology and the esoteric from the perspective of psychopathology].

    PubMed

    Scharfetter, C

    1998-10-01

    The concepts and main themes of occultism, parapsychology and esoterics are set in comparison to religion, spirituality, mysticism. The cultural relativity of these concepts is emphasised. Occultism means dealing with phenomena, processes, and/or powers which are not accessible to "normal perception". The manipulation of such powers is effected via (white, black, grey) magic. Parapsychology, in its popular sense, deals with occult phenomena, whereas scientific parapsychology investigates them empirically. Esoterics is a complex of beliefs within a hermetic tradition about occult processes and about desting after death. Transpersonal psychology deals with these issues while calling them "spiritual". Effects of paranormal experiences and actions on the side of the actor as well as the adept are discussed: personality types, interpersonal effects, crises and psychoses (mediumistic psychoses). The concept of dissociation of subpersonalities (subselves) appears to be a viable perspective to explain these phenomena. In mediumistic psychoses, the splitting of non-ego parts of the psyche leads to a manifestation of schizophrenic symptoms. Dangers for mental health are an ego inflation by self-attribution of "superhuman" power. A personality disposition for parapsychological perception and/or action may be seen in schizotypia and similar near-psychotic "personalities up the border". Adepts of occultism may present with a "false self" in the sense of Winnicott.

  17. Availability of sentinel lymph node biopsy for cutaneous squamous cell carcinoma.

    PubMed

    Maruyama, Hiroshi; Tanaka, Ryota; Fujisawa, Yasuhiro; Nakamura, Yasuhiro; Ito, Shusaku; Fujimoto, Manabu

    2017-04-01

    Cutaneous squamous cell carcinoma is the second common cutaneous cancer, especially in the elderly. Sentinel lymph node biopsy is generally performed in breast cancers and cutaneous melanomas to detect occult nodal metastases. The benefit of sentinel lymph node biopsy in improving cutaneous squamous cell carcinoma prognosis is doubtful. One hundred and sixty-nine patients who underwent treatment for cutaneous squamous cell carcinoma between 2004 and 2015, and who were followed up for at least 6 months or developed metastases within the follow-up period were included. Forty-nine patients underwent sentinel lymph node biopsy, whereas 120 patients did not, including 13 who exhibited clinical lymph node metastases before treatment. Of these 49 patients, nine (18.4%) presented with sentinel lymph node metastasis, which occurred after treatment in three (6.1%) of them (false-negative). Among the 107 patients who did not undergo lymph node biopsy, 12 (11.2%) developed post-treatment metastases. The metastasis-free and disease-specific survival rates were not significantly different in those who did or did not undergo sentinel lymph node biopsy. Patients with clinical lymph node metastases had a higher risk compared with those without. Patients with T2-T4 tumors had a higher risk compared with those with T1 tumors. When selecting for those with T2 tumors or greater, the same lack of relationship was observed. In conclusion, in this small retrospective cohort, in patients with cutaneous squamous cell carcinoma, there were no significant differences in metastasis-free and disease-specific survival rates between those who did or did not undergo sentinel lymph node biopsy, regardless of T staging. © 2016 Japanese Dermatological Association.

  18. Topological Phase Transitions in Line-nodal Superconductors

    NASA Astrophysics Data System (ADS)

    Cho, Gil Young; Han, Sangeun; Moon, Eun-Gook

    Fathoming interplay between symmetry and topology of many-electron wave-functions deepens our understanding in quantum nature of many particle systems. Topology often protects zero-energy excitation, and in a certain class, symmetry is intrinsically tied to the topological protection. Namely, unless symmetry is broken, topological nature is intact. We study one specific case of such class, symmetry-protected line-nodal superconductors in three spatial dimensions (3d). Mismatch between phase spaces of order parameter fluctuation and line-nodal fermion excitation induces an exotic universality class in a drastic contrast to one of the conventional ϕ4 theory in 3d. Hyper-scaling violation and relativistic dynamic scaling with unusually large quantum critical region are main characteristics, and their implication in experiments is discussed. For example, continuous phase transition out of line-nodal superconductors has a linear phase boundary in a temperature-tuning parameter phase-diagram. This work was supported by the Brain Korea 21 PLUS Project of Korea Government and KAIST start-up funding.

  19. ADC Histogram Analysis of Cervical Cancer Aids Detecting Lymphatic Metastases-a Preliminary Study.

    PubMed

    Schob, Stefan; Meyer, Hans Jonas; Pazaitis, Nikolaos; Schramm, Dominik; Bremicker, Kristina; Exner, Marc; Höhn, Anne Kathrin; Garnov, Nikita; Surov, Alexey

    2017-12-01

    Apparent diffusion coefficient (ADC) histogram analysis has been used to some extent in cervical cancer (CC) to distinguish between low-grade and high-grade tumors. Although this differentiation is undoubtedly helpful, it would be even more crucial in the presurgical setting to determine whether a tumor already gained the potential to metastasize via the lymphatic system. So far, no studies investigated the potential of 3T ADC histogram analysis in CC to differentiate between nodal-positive and nodal-negative entities. Therefore, the principal aim of our study was to investigate the potential of 3T ADC histogram analysis to differentiate between CC with and without lymph node metastasis. The second aim was to elucidate possible differences in ADC histogram parameters between CC with limited vs. advanced tumor stages and well-differentiated vs. undifferentiated lesions. Finally, correlations of p53 expression and Ki-67 index with ADC parameters were analyzed. Eighteen female patients (mean age 55.4 years, range 32-79 years) with histopathologically confirmed cervical squamous cell carcinoma of the uterine cervix were prospectively enrolled. Tumor stages, tumor grading, status of metastatic dissemination, Ki67-index, and p53 expression were assessed in these patients. Diffusion weighted imaging (DWI) was obtained in a 3T scanner using the following b values: b0 and b1000 s/mm 2 . Group comparisons using Mann-Whitney U test revealed the following findings: nodal-positive CC had statistically significant lower ADC parameters (ADCmin, ADCmean, median ADC, Mode, p10, p25, p75, and p90) in comparison to nodal-negative CC (all p < 0.05). ADCentropy was significantly elevated (p = 0.046) in tumors with advanced T stages (T3/4) compared to tumors with limited T stage (T2). ADCmin values were different in a statistically significant manner comparing G1/G2 and G3 tumors (40.45 ± 18.63 vs. 65.0 ± 23.63 × 10-5 mm2 s -1 , p = 0.035). Furthermore, Spearman Rho

  20. McDonald's and the Occult.

    ERIC Educational Resources Information Center

    Singer, Barry

    1979-01-01

    Discusses "occult" and "paranormal" literature which is often mistaken for nonfiction. Suggests that most publishers are unwilling to publish scientific perspectives on the paranormal because such writings would be unmarketable. Journal availability: see SO 507 190. (KC)

  1. Human chorionic gonadotropin radioantibodies in the radioimmunodetection of cancer and for disclosure of occult metastases.

    PubMed Central

    Goldenberg, D M; Kim, E E; DeLand, F H

    1981-01-01

    Radioimmunodetection (RaID) of tumors containing human chorionic gonadotropin (hCG; choriogonadotropin) was evaluated in 25 patients by injecting 131I-labeled goat antibody IgG against hCG and performing total-body photoscans with a gamma scintillation camera 24 and 48 hr later. All 10 testicular cancer patients with proven tumor sites had positive RaID results, whereas three cases without known tumor were negative. Four patients with hydatidiform mole and one with degenerative products of conception showed positive RaID results consistent with elevated serum hCG titers. Two putatively false-positive results were obtained in patients with lung or ovarian cancer, whereas a false-negative metastasis to the liver of a patient with lung cancer and an elevated serum hCG titer was observed. Of 14 tumor sites found by RaID in 10 testicular cancer patients, 4 were revealed by RaID prior to any other detection method used and provided a lead time to definitive diagnosis by other measures of a few days to greater than 1 yr. Although a number of patients had high serum hCG levels, even exceeding 3 microgram/ml, the xenogeneic antibody was capable of localizing in tumor. No adverse effects were noted in any of the patients studied. Thus, hCG RaID appears to be a safe and effective method of detecting and locating hCG-producing tumors and has been found to disclose occult testicular cancers. Images PMID:6278487

  2. Targeting nodal in conjunction with dacarbazine induces synergistic anticancer effects in metastatic melanoma.

    PubMed

    Hardy, Katharine M; Strizzi, Luigi; Margaryan, Naira V; Gupta, Kanika; Murphy, George F; Scolyer, Richard A; Hendrix, Mary J C

    2015-04-01

    Metastatic melanoma is a highly aggressive skin cancer with a poor prognosis. Despite a complete response in fewer than 5% of patients, the chemotherapeutic agent dacarbazine (DTIC) remains the reference drug after almost 40 years. More recently, FDA-approved drugs have shown promise but patient outcome remains modest, predominantly due to drug resistance. As such, combinatorial targeting has received increased attention, and will advance with the identification of new molecular targets. One attractive target for improving melanoma therapy is the growth factor Nodal, whose normal expression is largely restricted to embryonic development, but is reactivated in metastatic melanoma. In this study, we sought to determine how Nodal-positive human melanoma cells respond to DTIC treatment and to ascertain whether targeting Nodal in combination with DTIC would be more effective than monotherapy. A single treatment with DTIC inhibited cell growth but did not induce apoptosis. Rather than reducing Nodal expression, DTIC increased the size of the Nodal-positive subpopulation, an observation coincident with increased cellular invasion. Importantly, clinical tissue specimens from patients with melanomas refractory to DTIC therapy stained positive for Nodal expression, both in pre- and post-DTIC tumors, underscoring the value of targeting Nodal. In vitro, anti-Nodal antibodies alone had some adverse effects on proliferation and apoptosis, but combining DTIC treatment with anti-Nodal antibodies decreased cell growth and increased apoptosis synergistically, at concentrations incapable of producing meaningful effects as monotherapy. Targeting Nodal in combination with DTIC therapy holds promise for the treatment of metastatic melanoma. ©2015 American Association for Cancer Research.

  3. Changes in Pluto's Atmosphere Revealed by Occultations

    NASA Astrophysics Data System (ADS)

    Sicardy, Bruno; Widemann, Thomas; Lellouch, Emmanuel; Veillet, Christian; Colas, Francois; Roques, Francoise; Beisker, Wolfgang; Kretlow, Mike; Cuillandre, Jean-Charles; Hainaut, Olivier

    After the discovery and study of Pluto's tenuous atmosphere in 1985 and 1988 with stellar occultations 14 years were necessary before two other occultations by the planet could be observed on 20 July 2002 and 21 August 2002 from Northern Chile with a portable telescope and from CFHT in Hawaii respectively. These occultations reveal drastric changes in Pluto's nitrogen atmosphere whose pressure increased by a factor two or more since 1988. In spite of an increasing distance to the Sun (and a correlated decrease of solar energy input at Pluto) this increase can be explained by the fact that Pluto's south pole went from permanent darkness to permanent illumination between 1988 and 2002. This might cause the sublimation of the south polar cap and the increase of pressure which could go on till 2015 according to current nitrogen cycle models. Furthermore we detect temperature contrasts between the polar and the equatorial regions probed on Pluto possibly caused by different diurnally averaged insolations at those locations. Finally spikes observed in the light curves reveal a dynamical activity in Pluto's atmosphere.

  4. High spatial resolution multi-color observations of Neptune during occultation by the moon

    NASA Technical Reports Server (NTRS)

    Veverka, J.

    1976-01-01

    Preparations for the observation of Mars occultation using the 36 inch telescope on a C-141 airborne observatory were described, including technical improvements made to existing equipment. The abstracts of the following four publications supported by the grant were presented: (1) atmosphere composition from refractivity measurements made during occultations, (2) how big is lapetus?, (3) the diameter of Titan, (4) design and operating characteristics of voltage to frequency converters suited for occultation work. The planned observation of the April 8, 1976 occultation of the epsilon Gem star from the C-141 airborne observatory was described.

  5. Prevalence of occult inflammatory bowel disease in ankylosing spondylitis.

    PubMed Central

    Costello, P B; Alea, J A; Kennedy, A C; McCluskey, R T; Green, F A

    1980-01-01

    Fifty-five patients with ankylosing spondylitis and 16 control patients matched for sex and age were examined for evidence of occult inflammatory bowel disease. In all patients evaluation included history and physical examination, barium enema, sigmoidoscopy, and rectal biopsy. The results of this study suggest that there is no increased prevalence of occult inflammatory bowel disease in patients with ankylosing spondylitis. PMID:7436576

  6. Prevalence of occult inflammatory bowel disease in ankylosing spondylitis.

    PubMed

    Costello, P B; Alea, J A; Kennedy, A C; McCluskey, R T; Green, F A

    1980-10-01

    Fifty-five patients with ankylosing spondylitis and 16 control patients matched for sex and age were examined for evidence of occult inflammatory bowel disease. In all patients evaluation included history and physical examination, barium enema, sigmoidoscopy, and rectal biopsy. The results of this study suggest that there is no increased prevalence of occult inflammatory bowel disease in patients with ankylosing spondylitis.

  7. Probing Pluto's Atmosphere Using Ground-Based Stellar Occultations

    NASA Astrophysics Data System (ADS)

    Sicardy, Bruno; Rio de Janeiro Occultation Team, Granada Team, International Occultation and Timing Association, Royal Astronomical Society New Zealand Occultation Section, Lucky Star associated Teams

    2016-10-01

    Over the last three decades, some twenty stellar occultations by Pluto have been monitored from Earth. They occur when the dwarf planet blocks the light from a star for a few minutes as it moves on the sky. Such events led to the hint of a Pluto's atmosphere in 1985, that was fully confirmed during another occultation in 1988, but it was only in 2002 that a new occultation could be recorded. From then on, the dwarf planet started to move in front of the galactic center, which amplified by a large factor the number of events observable per year.Pluto occultations are essentially refractive events during which the stellar rays are bent by the tenuous atmosphere, causing a gradual dimming of the star. This provides the density, pressure and temperature profiles of the atmosphere from a few kilometers above the surface up to about 250 km altitude, corresponding respectively to pressure levels of about 10 and 0.1 μbar. Moreover, the extremely fine spatial resolution (a few km) obtained through this technique allows the detection of atmospheric gravity waves, and permits in principle the detection of hazes, if present.Several aspects make Pluto stellar occultations quite special: first, they are the only way to probe Pluto's atmosphere in detail, as the dwarf planet is far too small on the sky and the atmosphere is far too tenuous to be directly imaged from Earth. Second, they are an excellent example of participative science, as many amateurs have been able to record those events worldwide with valuable scientific returns, in collaboration with professional astronomers. Third, they reveal Pluto's climatic changes on decade-scales and constrain the various seasonal models currently explored.Finally, those observations are fully complementary to space exploration, in particular with the New Horizons (NH) mission. I will show how ground-based occultations helped to better calibrate some NH profiles, and conversely, how NH results provide some key boundary conditions

  8. Implications of inaccurate clinical nodal staging in pancreatic adenocarcinoma.

    PubMed

    Swords, Douglas S; Firpo, Matthew A; Johnson, Kirsten M; Boucher, Kenneth M; Scaife, Courtney L; Mulvihill, Sean J

    2017-07-01

    Many patients with stage I-II pancreatic adenocarcinoma do not undergo resection. We hypothesized that (1) clinical staging underestimates nodal involvement, causing stage IIB to have a greater percent of resected patients and (2) this stage-shift causes discrepancies in observed survival. The Surveillance, Epidemiology, and End Results (SEER) research database was used to evaluate cause-specific survival in patients with pancreatic adenocarcinoma from 2004-2012. Survival was compared using the log-rank test. Single-center data on 105 patients who underwent resection of pancreatic adenocarcinoma without neoadjuvant treatment were used to compare clinical and pathologic nodal staging. In SEER data, medium-term survival in stage IIB was superior to IB and IIA, with median cause-specific survival of 14, 9, and 11 months, respectively (P < .001). Seventy-two percent of stage IIB patients underwent resection vs 28% in IB and 36% in IIA (P < .001). In our institutional data, 12.4% of patients had clinical evidence of nodal involvement vs 69.5% by pathologic staging (P < .001). Among clinical stage IA-IIA patients, 71.6% had nodal involvement by pathologic staging. Both SEER and institutional data support substantial underestimation of nodal involvement by clinical staging. This finding has implications in decisions regarding neoadjuvant therapy and analysis of outcomes in the absence of pathologic staging. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Evaluation of cervical lymph nodes in head and neck cancer with CT and MRI: tips, traps, and a systematic approach.

    PubMed

    Hoang, Jenny K; Vanka, Jyotsna; Ludwig, Benjamin J; Glastonbury, Christine M

    2013-01-01

    In this article, we present a 4-step approach to evaluating lymph nodes in the setting of head and neck squamous cell and thyroid carcinoma and highlight important tips and traps. The presence and extent of nodal metastases in head and neck cancer has a great impact on treatment and prognosis. Pretreatment CT and MRI of the neck are commonly performed to evaluate for nodal metastases.

  10. Lunar occultation of Saturn. IV - Astrometric results from observations of the satellites

    NASA Technical Reports Server (NTRS)

    Dunham, D. W.; Elliot, J. L.

    1978-01-01

    The method of determining local lunar limb slopes, and the consequent time scale needed for diameter studies, from accurate occultation timings at two nearby telescopes is described. Results for photoelectric observations made at Mauna Kea Observatory during the occultation of Saturn's satellites on March 30, 1974, are discussed. Analysis of all observations of occultations of Saturn's satellites during 1974 indicates possible errors in the ephemerides of Saturn and its satellites.

  11. Pluto's Atmospheric Figure from the P131.1 Stellar Occultation

    NASA Astrophysics Data System (ADS)

    Person, M. J.; Elliot, J. L.; Clancy, K. B.; Kern, S. D.; Salyk, C. V.; Tholen, D. J.; Pasachoff, J. M.; Babcock, B. A.; Souza, S. P.; Ticehurst, D. R.; Hall, D.; Roberts, L. C., Jr.; Bosh, A. S.; Buie, M. W.; Dunham, E. W.; Olkin, C. B.; Taylor, B.; Levine, S. E.; Eikenberry, S. S.; Moon, D.-S.; Osip, D. J.

    2003-05-01

    The stellar occultation by Pluto of the 15th magnitude star designated P131.1 (McDonald and Elliot, AJ, 119, 1999) on 2002 August 21 (UT) provided the first significant chance to compare Pluto's atmospheric structure to that determined from the 1988 occultation of P8 (Millis, et al., Icarus, 105, 282). The P131.1 occultation was observed from several stations in Hawaii and the western United States (Elliot et al., Nature, in press, 2003). Numerous occultation chords were obtained enabling us to examine Pluto's atmospheric figure. The light curves from the observations were analyzed together in the occultation coordinate system of Elliot et al., (AJ, 106, 2544). The Mauna Kea and Lick datasets straddle the center of Pluto's figure, providing strong constraints on model fits to cross sections of the atmospheric shape. In 1988, Millis (et al., Icarus, 105, 282) did not report any deviation from sphericity in Pluto's atmospheric figure. From the 2002 data, Pluto;s isobars at the radii probed by the occultation ( 1250 km) appear to be distorted from a circular cross-section. Least-squares fits to this cross-section by elliptical models reveal ellipticities in the range 0.05-0.08 although the shape may be more complex than ellipsoidal. The orientation of the distortion appears uncorrelated with Pluto;s rotational axis. Taken at face value, this ellipticity could imply wind speeds of up to twice the sonic speed ( 200 m/s), which would be difficult to explain. Similar distortions have been reported for Triton's atmosphere (Elliot, J. L., et al., Icarus 148, 347). This work has been supported in part by Research Corporation, the Air Force Research Laboratory, NSF, and NASA.

  12. Detection of occult endocervical glandular dysplasia in cervical conization specimens for squamous lesions.

    PubMed

    Sopracordevole, F; Clemente, N; Alessandrini, L; Di Giuseppe, J; Cigolot, F; Buttignol, M; Ciavattini, A; Canzonieri, V

    2017-03-01

    The aim of this work was to evaluate the incidence of occult cervical glandular intraepithelial neoplasia (CGIN) and adenocarcinoma of the cervix (AC) in women treated with CO2-laser conization for cervical intraepithelial neoplasia (CIN) or squamocellular cervical cancer (SCC). The medical records of all women with a histological diagnosis of squamous lesions of the uterine cervix (persistent CIN1, CIN2, CIN3 and SCC) who were subsequently treated with CO2-laser conization at our institution, during the period from January 1991 to December 2014, were analyzed in a retrospective case series. Among the 1004 women fulfilling the study inclusion/exclusion criteria, 77 cases (7.7%) of occult glandular lesions (CGIN and AC) were detected on the final cone specimen (48 cases of occult low-grade cervical glandular intraepithelial neoplasia (LCGIN), 25 cases of occult high-grade cervical glandular intraepithelial neoplasia (HCGIN), and four cases of occult "usual-type" AC). No difference in the mean age between women diagnosed with occult glandular lesions and women without occult glandular lesions on the final specimen emerged (39.1±9.3 vs 38.4±9.4, p=0.5). In women with occult LCGIN on cone specimen, mean follow-up of 48 months was reported (range 7-206 months) and no cases of progression to HCGIN or AC were observed. In conclusion, a relatively high rate of occult glandular lesions was found in women treated for squamous lesions. The natural history of CGIN is still uncertain and, in particular, there are some controversies as to whether LCGIN is a precursor lesion of HCGIN or AC. In this context the role of pathologists become very important since the appropriate diagnosis of these lesions could have potential implications in the clinical management of these patients. Copyright © 2017 Elsevier GmbH. All rights reserved.

  13. Evaluation of the use of nodal methods for MTR neutronic analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Reitsma, F.; Mueller, E.Z.

    1997-08-01

    Although modern nodal methods are used extensively in the nuclear power industry, their use for research reactor analysis has been very limited. The suitability of nodal methods for material testing reactor analysis is investigated with the emphasis on the modelling of the core region (fuel assemblies). The nodal approach`s performance is compared with that of the traditional finite-difference fine mesh approach. The advantages of using nodal methods coupled with integrated cross section generation systems are highlighted, especially with respect to data preparation, simplicity of use and the possibility of performing a great variety of reactor calculations subject to strict timemore » limitations such as are required for the RERTR program.« less

  14. The diameter of Juno from its occultation of AG + 0 deg 1022

    NASA Technical Reports Server (NTRS)

    Millis, R. L.; Wasserman, L. H.; Bowell, E.; Franz, O. G.; White, N. M.; Lockwood, G. W.; Nye, R.; Bertram, R.; Klemola, A.; Dunham, E.; hide

    1981-01-01

    The occultation on Dec. 11, 1979, of AG + 0 deg 1022 by Juno was observed photoelectrically from 15 sites distributed across the occultation track. The observations are well represented by a mean elliptical limb profile having semimajor and semiminor axes of 145.2 + or 0.8 and 122.8 + or - 1.9 km, respectively. The corresponding effective diameter of Juno is 267 + or - 5 km, where the uncertainty has been conservatively increased to reflect the presence of limb irregularities clearly seen in the observations. Published radiometric and polarimetric diameters for Juno are 6% to 7% smaller than the occultation result. No secondary occultations attributable to possible satellites of Juno were recorded at any of 23 photoelectrically equipped observing sites.

  15. Ground Support Network for Operational Radio Occultation Missions

    NASA Astrophysics Data System (ADS)

    Zandbergen, R.; Enderle, W.; Marquardt, C.; Wollenweber, F.

    2012-04-01

    The EUMETSAT/ESA Metop/EPS GRAS radio occultation mission stands out for its operational nature. From the beginning, EUMETSAT has decided to rely on an operational system for provision of the auxiliary GPS products that are needed in the occultation processing. This system is the GRAS Ground Support Network (GSN), operated in the Navigation Facility of ESOC in Darmstadt, which was first presented at EGU in 2008. The GRAS GSN is driven primarily by timeliness, availability and accuracy requirements. The performance of the GSN, measured on a monthly basis, has not only consistently met these requirements since the start of its operations, but has also been improved through several system enhancements. Currently, an additional service is being delivered on an experimental basis, consisting of a near-real time Navigation Bit Stream product, which will allow the processing of open-loop data, further increasing the scientific return of the GRAS instrument, or any other radio occultation mission using this data. This paper will present the GRAS GSN in its current configuration, and demonstrate its excellent performance in terms of accuracy, availability and timeliness. The application of the bit stream data will be shown. Some future evolution perspectives of the GRAS GSN will also be addressed. It will be demonstrated that the GRAS GSN has the potential of serving also other present and future radio occultation missions.

  16. Impact of fecal occult blood on obscure gastrointestinal bleeding: Observational study

    PubMed Central

    Kobayashi, Yuka; Watabe, Hirotsugu; Yamada, Atsuo; Suzuki, Hirobumi; Hirata, Yoshihiro; Yamaji, Yutaka; Yoshida, Haruhiko; Koike, Kazuhiko

    2015-01-01

    AIM: To elucidate the association between small bowel diseases (SBDs) and positive fecal occult blood test (FOBT) in patients with obscure gastrointestinal bleeding (OGIB). METHODS: Between February 2008 and August 2013, 202 patients with OGIB who performed both capsule endoscopy (CE) and FOBT were enrolled (mean age; 63.6 ± 14.0 years, 118 males, 96 previous overt bleeding, 106 with occult bleeding). All patients underwent immunochemical FOBTs twice prior to CE. Three experienced endoscopists independently reviewed CE videos. All reviews and consensus meeting were conducted without any information on FOBT results. The prevalence of SBDs was compared between patients with positive and negative FOBT. RESULTS: CE revealed SBDs in 72 patients (36%). FOBT was positive in 100 patients (50%) and negative in 102 (50%). The prevalence of SBDs was significantly higher in patients with positive FOBT than those with negative FOBT (46% vs 25%, P = 0.002). In particular, among patients with occult OGIB, the prevalence of SBDs was higher in positive FOBT group than negative FOBT group (45% vs 18%, P = 0.002). On the other hand, among patients with previous overt OGIB, there was no significant difference in the prevalence of SBDs between positive and negative FOBT group (47% vs 33%, P = 0.18). In disease specific analysis among patients with occult OGIB, the prevalence of ulcer and tumor were higher in positive FOBT group than negative FOBT group. In multivariate analysis, only positive FOBT was a predictive factors of SBDs in patients with OGIB (OR = 2.5, 95%CI: 1.4-4.6, P = 0.003). Furthermore, the trend was evident among patients with occult OGIB who underwent FOBT on the same day or a day before CE. The prevalence of SBDs in positive vs negative FOBT group were 54% vs 13% in patients with occult OGIB who underwent FOBT on the same day or the day before CE (P = 0.001), while there was no significant difference between positive and negative FOBT group in those who underwent

  17. Impact of fecal occult blood on obscure gastrointestinal bleeding: observational study.

    PubMed

    Kobayashi, Yuka; Watabe, Hirotsugu; Yamada, Atsuo; Suzuki, Hirobumi; Hirata, Yoshihiro; Yamaji, Yutaka; Yoshida, Haruhiko; Koike, Kazuhiko

    2015-01-07

    To elucidate the association between small bowel diseases (SBDs) and positive fecal occult blood test (FOBT) in patients with obscure gastrointestinal bleeding (OGIB). Between February 2008 and August 2013, 202 patients with OGIB who performed both capsule endoscopy (CE) and FOBT were enrolled (mean age; 63.6 ± 14.0 years, 118 males, 96 previous overt bleeding, 106 with occult bleeding). All patients underwent immunochemical FOBTs twice prior to CE. Three experienced endoscopists independently reviewed CE videos. All reviews and consensus meeting were conducted without any information on FOBT results. The prevalence of SBDs was compared between patients with positive and negative FOBT. CE revealed SBDs in 72 patients (36%). FOBT was positive in 100 patients (50%) and negative in 102 (50%). The prevalence of SBDs was significantly higher in patients with positive FOBT than those with negative FOBT (46% vs 25%, P = 0.002). In particular, among patients with occult OGIB, the prevalence of SBDs was higher in positive FOBT group than negative FOBT group (45% vs 18%, P = 0.002). On the other hand, among patients with previous overt OGIB, there was no significant difference in the prevalence of SBDs between positive and negative FOBT group (47% vs 33%, P = 0.18). In disease specific analysis among patients with occult OGIB, the prevalence of ulcer and tumor were higher in positive FOBT group than negative FOBT group. In multivariate analysis, only positive FOBT was a predictive factors of SBDs in patients with OGIB (OR = 2.5, 95%CI: 1.4-4.6, P = 0.003). Furthermore, the trend was evident among patients with occult OGIB who underwent FOBT on the same day or a day before CE. The prevalence of SBDs in positive vs negative FOBT group were 54% vs 13% in patients with occult OGIB who underwent FOBT on the same day or the day before CE (P = 0.001), while there was no significant difference between positive and negative FOBT group in those who underwent FOBT two or more days

  18. Optical conductivity of three and two dimensional topological nodal-line semimetals

    NASA Astrophysics Data System (ADS)

    Barati, Shahin; Abedinpour, Saeed H.

    2017-10-01

    The peculiar shape of the Fermi surface of topological nodal-line semimetals at low carrier concentrations results in their unusual optical and transport properties. We analytically investigate the linear optical responses of three- and two-dimensional nodal-line semimetals using the Kubo formula. The optical conductivity of a three-dimensional nodal-line semimetal is anisotropic. Along the axial direction (i.e., the direction perpendicular to the nodal-ring plane), the Drude weight has a linear dependence on the chemical potential at both low and high carrier dopings. For the radial direction (i.e., the direction parallel to the nodal-ring plane), this dependence changes from linear into quadratic in the transition from low into high carrier concentration. The interband contribution into optical conductivity is also anisotropic. In particular, at large frequencies, it saturates to a constant value for the axial direction and linearly increases with frequency along the radial direction. In two-dimensional nodal-line semimetals, no interband optical transition could be induced and the only contribution to the optical conductivity arises from the intraband excitations. The corresponding Drude weight is independent of the carrier density at low carrier concentrations and linearly increases with chemical potential at high carrier doping.

  19. Scaled model guidelines for solar coronagraphs' external occulters with an optimized shape.

    PubMed

    Landini, Federico; Baccani, Cristian; Schweitzer, Hagen; Asoubar, Daniel; Romoli, Marco; Taccola, Matteo; Focardi, Mauro; Pancrazzi, Maurizio; Fineschi, Silvano

    2017-12-01

    One of the major challenges faced by externally occulted solar coronagraphs is the suppression of the light diffracted by the occulter edge. It is a contribution to the stray light that overwhelms the coronal signal on the focal plane and must be reduced by modifying the geometrical shape of the occulter. There is a rich literature, mostly experimental, on the appropriate choice of the most suitable shape. The problem arises when huge coronagraphs, such as those in formation flight, shall be tested in a laboratory. A recent contribution [Opt. Lett.41, 757 (2016)OPLEDP0146-959210.1364/OL.41.000757] provides the guidelines for scaling the geometry and replicate in the laboratory the flight diffraction pattern as produced by the whole solar disk and a flight occulter but leaves the conclusion on the occulter scale law somehow unjustified. This paper provides the numerical support for validating that conclusion and presents the first-ever simulation of the diffraction behind an occulter with an optimized shape along the optical axis with the solar disk as a source. This paper, together with Opt. Lett.41, 757 (2016)OPLEDP0146-959210.1364/OL.41.000757, aims at constituting a complete guide for scaling the coronagraphs' geometry.

  20. Characterization of the occult nature of injury for frequently occurring motor vehicle crash injuries.

    PubMed

    Schoell, Samantha L; Doud, Andrea N; Weaver, Ashley A; Talton, Jennifer W; Barnard, Ryan T; Winslow, James E; Stitzel, Joel D

    2017-01-01

    Occult injuries are not easily detected and can be potentially life-threatening. The purpose of this study was to quantify the perceived occultness of the most frequent motor vehicle crash injuries according to emergency medical services (EMS) professionals. An electronic survey was distributed to 1,125 EMS professionals who were asked to quantify the likelihood that first responders would miss symptoms related to a particular injury on a 5-point Likert scale. The Occult Score for each injury was computed from the average of all the survey responses and normalized to be a continuous metric ranging from 0 to 1 where 0 is a non-occult (highly apparent on initial presentation) injury and 1 is an occult (unapparent on initial presentation) injury. Overall, 110,671 survey responses were collected. The Occult Score ranged from 0 to 1 with a mean, median, and standard deviation of 0.443, 0.450, and 0.233, respectively. When comparing the Occult Score of an injury to its corresponding AIS severity, there was no relationship between the metrics. When stratifying by body region, injury type, and AIS severity, it was evident that AIS 2-4 abdominal injuries with lacerations, hemorrhage, or contusions were perceived as the most occult injuries. Timely triage is key to reduce the morbidity and mortality associated with occult injuries. The Occult Score developed in this study to describe the predictability of an injury in a motor vehicle crash will be used as part of a larger effort, including incorporation into an advanced automatic crash notification (AACN) algorithm to detect crash conditions associated with a patient's need for prompt treatment at a trauma center. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Winding numbers of nodal points in Fe-based superconductors

    NASA Astrophysics Data System (ADS)

    Chichinadze, Dmitry V.; Chubukov, Andrey V.

    2018-03-01

    We analyze the nodal points in multiorbital Fe-based superconductors from a topological perspective. We consider the s+- gap structure with accidental nodes, and the d -wave gap with nodes along the symmetry directions. In both cases, the nodal points can be moved by varying an external parameter, e.g., a degree of interpocket pairing. Eventually, the nodes merge and annihilate via a Lifshitz-type transition. We discuss the Lifshitz transition in Fe-based superconductors from a topological point of view. We show, both analytically and numerically, that the merging nodal points have winding numbers of opposite sign. This is consistent with the general reasoning that the total winding number is a conserved quantity in the Lifshitz transition.

  2. Enabling Narrow(est) IWA Coronagraphy with STIS BAR5 and BAR10 Occulters

    NASA Astrophysics Data System (ADS)

    Schneider, Glenn; Gaspar, Andras; Debes, John; Gull, Theodore; Hines, Dean; Apai, Daniel; Rieke, George

    2017-09-01

    The Space Telescope Imaging Spectrograph's (STIS) BAR5 coronagraphic occulter was designed to provide high-contrast, visible-light, imaging in close (> 0.15") angular proximity to bright point-sources. We explored and verified the functionality and utility of the BAR5 occulter. We also investigated, and herein report on, the use of the BAR10 rounded corners as narrow-angle occulters and compare IWA vs. contrast performance for the BAR5, BAR10, and Wedge occulters. With that, we provide recommendations for the most efficacious BAR5 and BAR10 use on-orbit in support of GO science.

  3. Occult Klebsiella pneumoniae bacteremia at emergency department: A single center experience.

    PubMed

    Chang, Eileen Kevyn; Kao, Kai-Liang; Tsai, Mao-Song; Yang, Chia-Jui; Huang, Yu-Tsung; Liu, Chia-Ying; Liao, Chun-Hsing

    2015-12-01

    Patients with undetected bacteremia when discharged from a hospital are considered to have occult bacteremia. Klebsiella pneumoniae bacteremia (KPB) is endemic to Taiwan. Our purpose was to study the impact of occult KPB. We retrospectively reviewed the records of patients who were discharged from our emergency department (ED) and subsequently diagnosed with KPB (occult bacteremia), from January 2008 to March 2014. All patients are followed for at least 3 months after the index ED visit. The study group was compared to KPB patients who were directly hospitalized (DH) from ED in 2008. Thirty-day mortality was the primary endpoint. A total of 913 patients were admitted to our ED with KPB, and 88 of these patients (9.6%) had occult KPB. Among them, 43 had second ED visit and 41 were admitted. The overall 30-day mortality was 2.3%. Relative to patients with occult KPB, DH patients had more respiratory tract infections (p < 0.001) but fewer other intra-abdominal infections (p = 0.015). Liver abscess was the major diagnosis for the second ED visit (37.2%). DH patients had significantly greater 30-day mortality than that of overall patients with KPB (19.2% vs.2.3%, p < 0.001). Most patients with occult KPB had favorable outcomes, but about half of them required a second ED visit. Clinicians should aggressively follow patients with occult KPB and should seek to identify the focus of infection in this endemic area. Copyright © 2015. Published by Elsevier B.V.

  4. Occult HBV infection in HIV-infected adults and evaluation of pooled NAT for HBV.

    PubMed

    Dinesha, T R; Boobalan, J; Sivamalar, S; Subashini, D; Solomon, S S; Murugavel, K G; Balakrishnan, P; Smith, D M; Saravanan, S

    2018-06-01

    The study aimed to determine the prevalence of occult hepatitis B virus infection among HIV-infected persons and to evaluate the use of a pooling strategy to detect occult HBV infection in the setting of HIV infection. Five hundred and two HIV-positive individuals were tested for HBV, occult HBV and hepatitis C and D with serologic and nucleic acid testing (NAT). We also evaluated a pooled NAT strategy for screening occult HBV infection among the HIV-positive individuals. The prevalence of HBV infection among HIV-positive individuals was 32 (6.4%), and occult HBV prevalence was 10%. The pooling HBV NAT had a sensitivity of 66.7% and specificity of 100%, compared to HBV DNA NAT of individual samples. In conclusion, this study found a high prevalence of occult HBV infection among our HIV-infected population. We also demonstrated that pooled HBV NAT is highly specific, moderately sensitive and cost-effective. As conventional HBV viral load assays are expensive in resource-limited settings such as India, pooled HBV DNA NAT might be a good way for detecting occult HBV infection and will reduce HBV-associated complications. © 2018 John Wiley & Sons Ltd.

  5. Pathology of nodal marginal zone lymphomas.

    PubMed

    Pileri, Stefano; Ponzoni, Maurilio

    Nodal marginal zone B cell lymphomas (NMZLs) are a rare group of lymphoid disorders part of the spectrum of marginal zone B-cell lymphomas, which encompass splenic marginal one B-cell lymphoma (SMZL) and extra nodal marginal zone of B-cell lymphoma (EMZL), often of MALT-type. Two clinicopathological forms of NMZL are recognized: adult-type and pediatric-type, respectively. NMZLs show overlapping features with other types of MZ, but distinctive features as well. In this review, we will focus on the salient distinguishing features of NMZL mostly under morphological/immunophenotypical/molecular perspectives in views of the recent acquisitions and forthcoming updated 2016 WHO classification of lymphoid malignancies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. David Levy's Guide to Eclipses, Transits, and Occultations

    NASA Astrophysics Data System (ADS)

    Levy, David H.

    2010-08-01

    Introduction; Part I. The Magic and History of Eclipses: 1. Shakespeare, King Lear, and the Great Eclipse of 1605; 2. Three centuries later: Einstein, relativity, and the solar eclipse of 1919; 3. What causes solar and lunar eclipses; Part II. Observing Solar Eclipses: 4. Safety considerations; 5. What to expect during a partial eclipse; 6. Annular eclipses and what to see in them; 7. Total eclipse of the Sun: introduction to the magic; 8. The onset: temperature drop, Baily's Beads, Diamond Ring; 9. Totality: Corona, Prominences, Chromosphere, and surrounding area; 10. Photographing and imaging a solar eclipse; Part III. Observing Lunar Eclipses: 11. Don't forget the penumbral eclipses!; 12. Partial lunar eclipses; 13. Total lunar eclipses; 14. Photographing and imaging lunar eclipses; Part IV. Occultations: 15. When the Moon occults a star; Part V. Transits: 16. When planets cross the Sun; Part VI. My Favorite Eclipses: 17. A personal canon of eclipses, occultations, and transits I have seen; Appendices; Index.

  7. Occult traumatic hemothorax: when can sleeping dogs lie?

    PubMed

    Bilello, John F; Davis, James W; Lemaster, Deborah M

    2005-12-01

    Size of traumatic occult hemothorax on admission requiring drainage has not been defined. Computed axial tomography (CAT) may guide drainage criteria. A retrospective review of patients with hemothoraces on CAT was performed. Extrapolating previously described methods of pleural fluid measurement, hemothoraces were quantified using the fluid stripe in the dependent pleural "gutter." Data included patient age, injury severity, and intervention (thoracentesis or tube thoracostomy). Seventy-eight patients with 99 occult hemothoraces met the criteria for study inclusion: 52 hemothoraces qualified as "minimal" and 47 as "moderate/large." Eight patients (15%) in the minimal group and 31 patients (66%) in the moderate/large group underwent intervention (P < .001). There was no difference in patient age, injury severity, ventilator requirement, or presence of pulmonary contusion. CAT in stable blunt-trauma patients can predict which patients with occult hemothorax are likely to undergo intervention. Patients with hemothorax > or = 1.5 cm on CAT were 4 times more likely to undergo drainage intervention compared with those having hemothorax < 1.5 cm.

  8. Differentiated and Medullary Thyroid Cancer: Surgical Management of Cervical Lymph Nodes

    PubMed Central

    Asimakopoulos, P.; Nixon, I.J.; Shaha, A.R.

    2017-01-01

    Thyroid cancer metastasises to the central and lateral compartments of the neck frequently and early. The impact of nodal metastases on outcome is affected by the histological subtype of the primary tumour and the patient’s age, as well as the size, number and location of those metastases. The impact of extranodal extension has recently been highlighted as an important prognosticating factor. Although clinically evident nodal disease in the lateral neck compartments has a significant impact on both survival and recurrence, microscopic metastases to the central or the lateral neck in well-differentiated thyroid cancer do not significantly affect outcome. Here we discuss the surgical management of neck metastases in well-differentiated and medullary thyroid carcinoma. PMID:28094086

  9. Sensing Water Vapon via Spacecraft Radio Occultation Observations

    NASA Technical Reports Server (NTRS)

    Kursinski, E. Robert; Hajj, George A.

    2000-01-01

    The radio occultation technique has been used to characterize planetary atmospheres since the 1960's spanning atmospheric pressures from 16 microbars to several bars. In 1988, the use of GPS signals to make occultation observations of Earth's atmosphere was realized by Tom Yunck and Gunnar Lindal at JPL. In the GPS to low-Earth-orbiter limb- viewing occultation geometry, Fresnel diffraction yield a unique combination of high vertical resolution of 100 m to 1 km at long wavelengths (approx. 20 cm) insensitive to particulate scattering which allows routine limb sounding from the lower mesosphere through the troposphere. A single orbiting GPS/GLONASS receiver can observe - 1000 to 1400 daily occultations providing as many daily, high vertical resolution soundings as the present global radiosonde network, but with far more evenly distributed, global coverage. The occultations yield profiles of refractivity as a function of height. In the cold, dry conditions of the upper troposphere and above (T less than 240 K), profiles of density, pressure (geopotential), and temperature can be derived. Given additional temperature information, water vapor can be derived in the midddle and lower troposphere with a unique combination of vertical resolution, global distribution and insensitivity to clouds and precipitation to an accuracy of approx. 0.2 g/kg. At low latitudes, moisture profiles will be accurate to 1-5% within the convective boundary layer and better than 20% below 6 to 7 km. Accuracies of climatological averages should be approx. 0. 1 g/kg limited by the biases in the temperature estimates. To use refractivity to constrain water vapor, knowledge of temperature is required. The simplest approach is to use the temperature field from an analysis such as the 6 hour ECMWF global analysis interpolated to the locations of each occultation. A better approach is to combine the temperature and moisture fields from such an analysis with the occultation refractivity in a weighting

  10. A quantitative description of normal AV nodal conduction curve in man.

    PubMed

    Teague, S; Collins, S; Wu, D; Denes, P; Rosen, K; Arzbaecher, R

    1976-01-01

    The AV nodal conduction curve generated by the atrial extrastimulus technique has been described only qualitatively in man, making clinical comparison of known normal curves with those of suspected AV nodal dysfunction difficult. Also, the effects of physiological and pharmacological interventions have not been quantifiable. In 50 patients with normal AV conduction as defined by normal AH (less than 130 ms), normal AV nodal effective and functional refractory periods (less than 380 and less than 500 ms), and absence of demonstrable dual AV nodal pathways, we found that conduction curves (at sinus rhythm or longest paced cycle length) can be described by an exponential equation of the form delta = Ae-Bx. In this equation, delta is the increase in AV nodal conduction time of an extrastimulus compared to that of a regular beat and x is extrastimulus interval. The natural logarithm of this equation is linear in the semilogarithmic plane, thus permitting the constants A and B to be easily determined by a least-squares regression analysis with a hand calculator.

  11. Targeting Nodal in Conjunction with Dacarbazine Induces Synergistic Anti-cancer Effects in Metastatic Melanoma

    PubMed Central

    Hardy, Katharine M.; Strizzi, Luigi; Margaryan, Naira V.; Gupta, Kanika; Murphy, George F.; Scolyer, Richard A.; Hendrix, Mary J.C.

    2015-01-01

    Metastatic melanoma is a highly aggressive skin cancer with a poor prognosis. Despite a complete response in fewer than 5% of patients, the chemotherapeutic agent Dacarbazine (DTIC) remains the reference drug after almost 40 years. More recently FDA approved drugs have shown promise but patient outcome remains modest, predominantly due to drug resistance. As such, combinatorial targeting has received increased attention, and will advance with the identification of new molecular targets. One attractive target for improving melanoma therapy is the growth factor Nodal, whose normal expression is largely restricted to embryonic development, but is reactivated in metastatic melanoma. In this study, we sought to determine how Nodal-positive human melanoma cells respond to DTIC treatment and to ascertain if targeting Nodal in combination with DTIC would be more effective than monotherapy. A single treatment with DTIC inhibited cell growth but did not induce apoptosis. Rather than reducing Nodal expression, DTIC increased the size of the Nodal-positive subpopulation, an observation coincident with increased cellular invasion. Importantly, clinical tissue specimens from patients with melanomas refractory to DTIC therapy stained positive for Nodal expression, both in pre- and post-DTIC tumors, underscoring the value of targeting Nodal. In vitro, anti-Nodal antibodies alone had some adverse effects on proliferation and apoptosis, but combining DTIC treatment with anti-Nodal antibodies decreased cell growth and increased apoptosis synergistically, at concentrations incapable of producing meaningful effects as monotherapy. Implications Targeting Nodal in combination with DTIC therapy holds promise for the treatment of metastatic melanoma. PMID:25767211

  12. Biopsy of CT-Occult Bone Lesions Using Anatomic Landmarks for CT Guidance.

    PubMed

    Hillen, Travis J; Talbert, Robert J; Friedman, Michael V; Long, Jeremiah R; Jennings, Jack W; Wessell, Daniel E; Baker, Jonathan C

    2017-07-01

    The purpose of this study is to evaluate the histopathologic diagnostic yield, sample size, procedural time, and dose-length product (DLP) for the biopsy of CT-occult lesions found at MRI or PET or both. A retrospective review of our radiology information system for biopsies of CT-occult lesions using CT guidance from January 1, 2010, through December 31, 2014, was performed and compared with a selection of CT-guided biopsies of CT-evident bone lesions during the same period. The data were then evaluated for diagnostic yield of histopathologic diagnosis, procedural time, use of sedation medication, DLP, and size of specimens obtained. A total of 30 CT-occult biopsies met the inclusion criteria. Twenty-seven of those biopsies had results that were concordant with the patient's primary histopathologic diagnosis, imaging findings, and clinical course. In the CT-evident lesion group, concordant histopathologic abnormalities were identified in 27 of 30 patients. There was a statistically significant increase in number of samples obtained for the CT-evident lesions compared with CT-occult lesions. There was no statistically significant difference in total specimen length, DLP, number of CT scans, procedural time, or use of sedation medication between the CT-occult and CT-evident biopsy groups. Biopsy of CT-occult lesions using anatomic landmarks achieves diagnostic yields similar to those for CT-guided biopsy of CT-evident lesions.

  13. Cilia are required for asymmetric nodal induction in the sea urchin embryo.

    PubMed

    Tisler, Matthias; Wetzel, Franziska; Mantino, Sabrina; Kremnyov, Stanislav; Thumberger, Thomas; Schweickert, Axel; Blum, Martin; Vick, Philipp

    2016-08-23

    Left-right (LR) organ asymmetries are a common feature of metazoan animals. In many cases, laterality is established by a conserved asymmetric Nodal signaling cascade during embryogenesis. In most vertebrates, asymmetric nodal induction results from a cilia-driven leftward fluid flow at the left-right organizer (LRO), a ciliated epithelium present during gastrula/neurula stages. Conservation of LRO and flow beyond the vertebrates has not been reported yet. Here we study sea urchin embryos, which use nodal to establish larval LR asymmetry as well. Cilia were found in the archenteron of embryos undergoing gastrulation. Expression of foxj1 and dnah9 suggested that archenteron cilia were motile. Cilia were polarized to the posterior pole of cells, a prerequisite of directed flow. High-speed videography revealed rotating cilia in the archenteron slightly before asymmetric nodal induction. Removal of cilia through brief high salt treatments resulted in aberrant patterns of nodal expression. Our data demonstrate that cilia - like in vertebrates - are required for asymmetric nodal induction in sea urchin embryos. Based on these results we argue that the anterior archenteron represents a bona fide LRO and propose that cilia-based symmetry breakage is a synapomorphy of the deuterostomes.

  14. Laboratory Verification of Occulter Contrast Performance and Formation Flight

    NASA Astrophysics Data System (ADS)

    Sirbu, Dan

    2014-01-01

    Direct imaging of an exo-Earth is a difficult technical challenge. First, the intensity ratio between the parent star and its dim, rocky planetary companion is expected to be ten billion times. Additionally, for a planetary companion in the habitable zone the angular separation to the star is very small, such that only nearby stars are feasible targets. An external occulter is a spacecraft that is flown in formation with the observing space telescope and blocks starlight prior to the entrance pupil. Its shape must be specially designed to control for diffraction and be tolerant of errors such as misalignment, manufacturing, and deformations. In this dissertation, we present laboratory results pertaining to the optical verification of the contrast performance of a scaled occulter and implementation of an algorithm for the alignment of the telescope in the shadow of the occulter. The experimental testbed is scaled from space dimensions to the laboratory by maintaining constant Fresnel numbers while preserving an identical diffraction integral. We present monochromatic results in the image plane showing contrast better than 10 orders of magnitude, consistent with the level required for imaging an Exo-earth, and obtained using an optimized occulter shape. We compare these results to a baseline case using a circular occulter and to the theoretical predictions. Additionally, we address the principal technical challenge in the formation flight problem through demonstration of an alignment algorithm that is based on out-of-band leaked light. Such leaked light can be used a map to estimate the location of the telescope in the shadow and perform fine alignment during science observations.

  15. Occurrence of occult CSF leaks during standard FESS procedures.

    PubMed

    Bucher, S; Kugler, A; Probst, E; Epprecht, L; Stadler, R S; Holzmann, D; Soyka, M B

    2018-03-18

    To determine the incidence of occult cerebrospinal fluid leaks (CSF) after functional endoscopic sinus surgery (FESS) and to evaluate the diagnostic performance of beta2-transferrin in blood-contaminated conditions. Prospective cohort study. An analysis of 57 intraoperative samples using hydrogel 6 beta2-transferrin assay after FESS was undertaken. In case of CSF positive samples and continuing rhinorrhea, reanalysis after more than 1 year was conducted. In-vivo analysis of a primary spontaneous CSF leak sample took place to verify difficulties in detecting beta2-transferrin in blood-contaminated settings. Own titrations were performed to evaluate detection limits of CSF by beta2-transferrin and beta-trace protein assays in these settings. An incidence of 13% for occult CSF leaks after FESS was found. In blood-contaminated conditions, routine beta2-transferrin assays showed low sensitivity. In over 1 year follow-up, all samples were negative for CSF and none of them developed clinical relevant CSF leaks or meningitis. Occult and clinically irrelevant CSF leaks do occur in a significant proportion of patients during and shortly after FESS. Intra- and postoperatively, routine beta2-transferrin assays show low sensitivity. They should not be used in these settings. The clinical course of patients with occult CSF leaks indicated possibility of an uneventful follow-up.

  16. Toddler signaling regulates mesodermal cell migration downstream of Nodal signaling

    PubMed Central

    Norris, Megan L; Pauli, Andrea; Gagnon, James A; Lord, Nathan D; Rogers, Katherine W; Mosimann, Christian; Zon, Leonard I

    2017-01-01

    Toddler/Apela/Elabela is a conserved secreted peptide that regulates mesendoderm development during zebrafish gastrulation. Two non-exclusive models have been proposed to explain Toddler function. The ‘specification model’ postulates that Toddler signaling enhances Nodal signaling to properly specify endoderm, whereas the ‘migration model’ posits that Toddler signaling regulates mesendodermal cell migration downstream of Nodal signaling. Here, we test key predictions of both models. We find that in toddler mutants Nodal signaling is initially normal and increasing endoderm specification does not rescue mesendodermal cell migration. Mesodermal cell migration defects in toddler mutants result from a decrease in animal pole-directed migration and are independent of endoderm. Conversely, endodermal cell migration defects are dependent on a Cxcr4a-regulated tether of the endoderm to mesoderm. These results suggest that Toddler signaling regulates mesodermal cell migration downstream of Nodal signaling and indirectly affects endodermal cell migration via Cxcr4a-signaling. PMID:29117894

  17. Nodal patterning without Lefty inhibitory feedback is functional but fragile

    PubMed Central

    Gagnon, James A; Pauli, Andrea; Zimmerman, Steven; Aksel, Deniz C; Reyon, Deepak; Tsai, Shengdar Q; Joung, J Keith

    2017-01-01

    Developmental signaling pathways often activate their own inhibitors. Such inhibitory feedback has been suggested to restrict the spatial and temporal extent of signaling or mitigate signaling fluctuations, but these models are difficult to rigorously test. Here, we determine whether the ability of the mesendoderm inducer Nodal to activate its inhibitor Lefty is required for development. We find that zebrafish lefty mutants exhibit excess Nodal signaling and increased specification of mesendoderm, resulting in embryonic lethality. Strikingly, development can be fully restored without feedback: Lethal patterning defects in lefty mutants can be rescued by ectopic expression of lefty far from its normal expression domain or by spatially and temporally uniform exposure to a Nodal inhibitor drug. While drug-treated mutants are less tolerant of mild perturbations to Nodal signaling levels than wild type embryos, they can develop into healthy adults. These results indicate that patterning without inhibitory feedback is functional but fragile. PMID:29215332

  18. Calculated occultation profiles of Io and the hot spots

    NASA Technical Reports Server (NTRS)

    Mcewen, A. S.; Soderblom, L. A.; Matson, D. L.; Johnson, T. V.; Lunine, J. I.

    1986-01-01

    Occultations of Io by other Galilean satellites in 1985 provide a means to locate volcanic hot spots and to model their temperatures. The expected time variations in the integral reflected and emitted radiation of the occultations are computed as a function of wavelength (visual to 8.7 microns). The best current ephemerides were used to calculate the geometry of each event as viewed from earth. Visual reflectances were modeled from global mosaics of Io. Thermal emission from the hot spots was calculated from Voyager 1 IRIS observations and, for regions unobserved by IRIS, from a model based on the distribution of low-albedo features. The occultations may help determine (1) the location and temperature distribution of Loki; (2) the source(s) of excess emission in the region from long 50 deg to 200 deg and (3) the distribution of small, high-temperature sources.

  19. Optimization of the occulter for the Solar Orbiter/METIS coronagraph

    NASA Astrophysics Data System (ADS)

    Landini, Federico; Vivès, Sébastien; Romoli, Marco; Guillon, Christophe; Pancrazzi, Maurizio; Escolle, Clement; Focardi, Mauro; Antonucci, Ester; Fineschi, Silvano; Naletto, Giampiero; Nicolini, Gianalfredo; Nicolosi, Piergiorgio; Spadaro, Daniele

    2012-09-01

    METIS (Multi Element Telescope for Imaging and Spectroscopy investigation), selected to fly aboard the Solar Orbiter ESA/NASA mission, is conceived to perform imaging (in visible, UV and EUV) and spectroscopy (in EUV) of the solar corona, by means of an integrated instrument suite located on a single optical bench and sharing the same aperture on the satellite heat shield. As every coronagraph, METIS is highly demanding in terms of stray light suppression. Coronagraphs history teaches that a particular attention must be dedicated to the occulter optimization. The METIS occulting system is of particular interest due to its innovative concept. In order to meet the strict thermal requirements of Solar Orbiter, METIS optical design has been optimized by moving the entrance pupil at the level of the external occulter on the S/C thermal shield, thus reducing the size of the external aperture. The scheme is based on an inverted external-occulter (IEO). The IEO consists of a circular aperture on the Solar Orbiter thermal shield. A spherical mirror rejects back the disk-light through the IEO. A breadboard of the occulting assembly (BOA) has been manufactured in order to perform stray light tests in front of two solar simulators (in Marseille, France and in Torino, Italy). A first measurement campaign has been carried on at the Laboratoire d'Astrophysique de Marseille. In this paper we describe the BOA design, the laboratory set-up and the preliminary results.

  20. Outcomes of uterine cervical cancer patients with pelvic lymph node metastases after radiotherapy without boost irradiation of metastases.

    PubMed

    Yoshizawa, Eriko; Koiwai, Keiichiro; Ina, Hironobu; Fukazawa, Ayumu; Sakai, Katsuya; Ozawa, Takesumi; Matsushita, Hirohide; Kadoya, Masumi

    2017-04-01

    The aim of this study was to evaluate the outcomes of uterine cervical cancer patients with pelvic lymph node (PLN) metastases after radiotherapy without boost irradiation of the metastases and to clarify the necessity of the boost irradiation of metastatic lesions. Thirty-two patients with uterine cervical cancer metastasizing only to the PLN were treated with definitive radiotherapy without boost irradiation of the metastases between 2008 and 2012 at our institution and were selected for this study. The pattern of progression, overall survival, and progression-free survival were analyzed. Ninety percent of the PLN metastases were controlled by radiotherapy. Twenty-two of 32 patients (69%) experienced progression. Distant metastases as initial progression were observed in 21 of these 22 patients (95%). Only two patients experienced failures in pre-treatment metastatic PLN as initial progression, along with other failures. Severe late lower gastrointestinal toxicities were not observed in any patients. Two-year cumulative overall survival and progression-free survival were 74% and 31%, respectively. Boost irradiation of PLN metastases is not necessarily indispensable. Further studies to examine the necessity of boost irradiation of PLN metastases in radiotherapy for uterine cervical cancer patients with metastases are required. © 2017 Japan Society of Obstetrics and Gynecology.

  1. Forthcoming Occultations of Astrometric Radio Sources by Planets

    NASA Technical Reports Server (NTRS)

    L'vov, Victor; Malkin, Zinovy; Tsekmeister, Svetlana

    2010-01-01

    Astrometric observations of radio source occultations by solar system bodies may be of large interest for testing gravity theories, dynamical astronomy, and planetary physics. In this paper, we present an updated list of the occultations of astrometric radio sources by planets expected in the coming years. Such events, like solar eclipses, generally speaking can only be observed in a limited region. A map of the shadow path is provided for the events that will occurr in regions with several VLBI stations and hence will be the most interesting for radio astronomy experiments.

  2. Sensitive molecular detection of small nodal metastasis in uterine cervical cancer using HPV16-E6/CK19/MUC1 cancer biomarkers

    PubMed Central

    Samouëlian, Vanessa; Mechtouf, Nawel; Leblanc, Eric; Cardin, Guillaume B.; Lhotellier, Valérie; Querleu, Denis; Révillion, Françoise; Rodier, Francis

    2018-01-01

    Metastatic nodal involvement is a critical prognostic factor in uterine cervical cancer (UCC). To improve current methods of detecting UCC metastases in lymph nodes (LNs), we used quantitative PCR (qPCR) to assess mRNA expression of potential metastatic biomarkers. We found that expression of HPV16-E6, cytokeratin19 (CK19), and mucin1 (MUC1) is consistently upregulated in tumors and metastatic tissues, supporting a role for these genes in UCC progression. These putative biomarkers were able to predict the presence of histologically positive metastatic LNs with respective sensitivities and specificities of 82% and 99% (CK19), 76% and 95% (HPV16-E6), and 76% and 78% (MUC1). While the biomarkers failed to detect 1.7% to 2.2% of the histologically positive LNs when used individually, combining CK19 and HPV16-E6 enhanced sensitivity and specificity to 100% and 94%, respectively. To explore the sensitivity of qPCR-based detection of varying proportions of invading HPV16-positive UCC cells, we designed a LN metastasis model that achieved a fresh cell detection limit of 0.008% (1:12500 HPV16-positive to HPV16-negative cells), and a paraffin-embedded, formalin-fixed (PEFF) detection limit of 0.02% (1:5000 HPV16-positive to HPV16-negative cells), both of which are within the theoretical detection limit for micrometastasis. Thus, HPV E6/E7 oncogenes may be useful targets for the ultrasensitive detection of nodal involvements like micrometastases in fresh or archived tissue samples. Moreover, our results suggest that the biomarker combination of CK19/HPV-E6 could support a real-time intraoperative strategy for the detection of small, but potentially lethal, metastatic nodal involvements in fresh UCC tissues. PMID:29774091

  3. Sensitive molecular detection of small nodal metastasis in uterine cervical cancer using HPV16-E6/CK19/MUC1 cancer biomarkers.

    PubMed

    Samouëlian, Vanessa; Mechtouf, Nawel; Leblanc, Eric; Cardin, Guillaume B; Lhotellier, Valérie; Querleu, Denis; Révillion, Françoise; Rodier, Francis

    2018-04-24

    Metastatic nodal involvement is a critical prognostic factor in uterine cervical cancer (UCC). To improve current methods of detecting UCC metastases in lymph nodes (LNs), we used quantitative PCR (qPCR) to assess mRNA expression of potential metastatic biomarkers. We found that expression of HPV16-E6, cytokeratin19 (CK19), and mucin1 (MUC1) is consistently upregulated in tumors and metastatic tissues, supporting a role for these genes in UCC progression. These putative biomarkers were able to predict the presence of histologically positive metastatic LNs with respective sensitivities and specificities of 82% and 99% (CK19), 76% and 95% (HPV16-E6), and 76% and 78% (MUC1). While the biomarkers failed to detect 1.7% to 2.2% of the histologically positive LNs when used individually, combining CK19 and HPV16-E6 enhanced sensitivity and specificity to 100% and 94%, respectively. To explore the sensitivity of qPCR-based detection of varying proportions of invading HPV16-positive UCC cells, we designed a LN metastasis model that achieved a fresh cell detection limit of 0.008% (1:12500 HPV16-positive to HPV16-negative cells), and a paraffin-embedded, formalin-fixed (PEFF) detection limit of 0.02% (1:5000 HPV16-positive to HPV16-negative cells), both of which are within the theoretical detection limit for micrometastasis. Thus, HPV E6/E7 oncogenes may be useful targets for the ultrasensitive detection of nodal involvements like micrometastases in fresh or archived tissue samples. Moreover, our results suggest that the biomarker combination of CK19/HPV-E6 could support a real-time intraoperative strategy for the detection of small, but potentially lethal, metastatic nodal involvements in fresh UCC tissues.

  4. Radioimmune localization of occult carcinoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Duda, R.B.; Zimmer, A.M.; Rosen, S.T.

    1990-07-01

    Patients with a rising serum carcinoembryonic antigen level and no clinical or roentgenographic evidence of recurrent or metastatic cancer present a treatment dilemma. Eleven such patients, 10 with a previously treated colorectal carcinoma and 1 with a previously treated breast carcinoma, received an injection of the anticarcinoembryonic antigen monoclonal antibody ZCE-025 labeled with the radioisotope indium 111. Nuclear scintigraphy was performed on days 3 and 5 through 7 to detect potential sites of tumor recurrence. The monoclonal antibody scan accurately predicted the presence or absence of occult malignancy in 7 (64%) patients. Second-look laparotomy confirmed the monoclonal antibody scan resultsmore » in the patients with colorectal cancer, and magnetic resonance imaging confirmed metastatic breast cancer. This study demonstrates that In-ZCE-025 can localize occult carcinoma and may assist the surgeon in facilitating the operative exploration. In-ZCE-025 assisted in the initiation of adjuvant therapy for the patient with breast cancer.« less

  5. Stray light rejection in giant externally-occulted solar coronagraphs: experimental developments

    NASA Astrophysics Data System (ADS)

    Venet, M.; Bazin, C.; Koutchmy, S.; Lamy, P.

    2017-11-01

    The advent of giant, formation-flight, externally-occulted solar coronagraphs such as ASPIICS (Association de Satellites Pour l'Imagerie et l'Interférométrie de la Couronne Solaire [1,2,3,4]) selected by the European Space Agency (ESA) for its third PROBA (Project for On-Board Autonomy) mission of formation flying demonstration (presently in phase B) and Hi-RISE proposed in the framework of ESA Cosmic Vision program, presents formidable challenges for the study and calibration of instrumental stray light. With distances between the external occulter (EO) and the optical pupil (OP) exceeding hundred meters and occulter sizes larger than a meter, it becomes impossible to perform tests at the real scale. The requirement to limit the over-occultation to less than 1.05 Rsun, orders of magnitude to what has been achieved so far in past coronagraphs, further adds to the challenge. We are approaching the problem experimentally using reduced scale simulators and present below a progress report of our work.

  6. Molecular insights into melanoma brain metastases.

    PubMed

    Westphal, Dana; Glitza Oliva, Isabella C; Niessner, Heike

    2017-06-01

    Substantial proportions of patients with metastatic melanoma develop brain metastases during the course of their disease, often resulting in significant morbidity and death. Despite recent advances with BRAF/MEK and immune-checkpoint inhibitors in the treatment of patients who have melanoma with extracerebral metastases, patients who have melanoma brain metastases still have poor overall survival, highlighting the need for further therapy options. A deeper understanding of the molecular pathways involved in the development of melanoma brain metastases is required to develop more brain-specific therapies. Here, the authors summarize the currently known preclinical data and describe steps involved in the development of melanoma brain metastases. Only by knowing the molecular background is it possible to design new therapeutic agents that can be used to improve the outcome of patients with melanoma brain metastases. Cancer 2017;123:2163-75. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Characterization of the occult nature of frequently occurring pediatric motor vehicle crash injuries.

    PubMed

    Doud, Andrea N; Schoell, Samantha L; Talton, Jennifer W; Barnard, Ryan T; Petty, John K; Stitzel, Joel D; Weaver, Ashley A

    2018-04-01

    Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC). The most frequent MVC injuries were determined for 0-4, 5-9, 10-14 and 15-18 year olds. For each age-specific injury, experts with pediatric trauma expertise were asked to rate the likelihood that the injury may be missed by first responders. An occult score (ranging from 0-1) was calculated by averaging and normalizing the responses of the experts polled. Evaluation of all injuries across all age groups demonstrated greater occult scores for the younger age groups compared to older age groups (mean occult score 0-4yo: 0.61 ± 0.23, 5-9yo: 0.53 ± 0.25, 10-14yo: 0.48 ± 0.23, and 15-18yo: 0.42 ± 0.22, p < 0.01). Body-region specific occult scores revealed that experts judged abdominal, spine and thoracic injuries to be more occult than injuries to other body regions. The occult scores suggested that injuries are more difficult to detect in younger age groups, likely given their inability to express symptoms. An AACN algorithm that can predict the presence of clinically undetectable injuries at the scene can improve triage of children with these injuries to higher levels of care. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. [Occult hepatitis B virus infection in normal population, Xiamen].

    PubMed

    He, Shuizhen; Su, Chenghao; Shen, Litong; Niu, Jianjun

    2015-02-01

    To investigate the prevalence of occult HBV infection in the normal population in Xiamen. 4 437 registered permanent residents, aged 1-59 years old, were selected in Xiamen using stratified random sampling method from September to October in 2006. Serum samples were obtained, the basic characteristics, inoculation of HBV vaccine, and liver disease were surveyed. The serum samples were tested five HBV seroimmunological markers. The HBsAg-negative specimens were subjected to HBV-DNA detection by nested PCR targeting for multiple gene segments. The amplified products were sequenced and the sequence was used for determination of HBV genotype and mutation analysis of amino acids located in HBsAg "a" epitope. Subjects with serum detectable HBV-DNA and negative result of HBsAg were considered as occult HBV infection. Among the 4 437 subjects, 482 individuals were observed HBsAg positive and 3 944 were observed negative. Of the 3 955 HBsAg- negative specimens, 27 occult HBV infections were determined with the positive rate of 0.68% (27/3 955). There were 16 samples with genotype B and 11 with genotype C. 3 types of amino acid (AA) mutation (M133T, T140I, G145R) that influence "a" epitope conformation were observed in 9 subjects with occult HBV infection. S region was successfully sequenced in 312 of the 482 HBsAg positive samples. In subjects with occult HBV infection, the infection rate of genotype C HBV (40.74%, 11/27), inoculation rate of HBV vaccine (62.96%, 17/27), positive rate of HBsAb (51.85%, 14/27), and mutation rate of critical amino acid of "a" epitope (33.33%, 9/27) were higher than HBsAg positive individuals (22.76% (71/312), 13.78% (43/312),0.32% (1/312),0.99% (31/312), respectively), and all the difference were significant (χ(2) = 4.29, 41.26, 156.00, 13.07, respectively, and P value = 0.038, <0.001, <0.001, <0.001, respectively). While the average age in subjects with occult HBV infection (18.3 ± 16.2) were lower than that in HBsAg positive infection (34

  9. [Muscular metastases from renal cell carcinoma].

    PubMed

    Montagnac, Richard; Champion, Justine; Pradel, Jean; Takin, Romulus; Eychenne, Dominique; Schendel, Adeline

    2016-12-01

    Renal cell carcinoma can metastasize to several locations but rarely in muscles. However, this possibility must never be overlooked because muscle metastases may occur a very long time after the initial nephrectomy. So the post-operative follow-up, according to the recommendations, with thoraco-abdomino-pelvic imaging (computed tomography or nuclear magnetic resonance) allowing to detect metastases, including muscle metastases in the trunk, does not have to neglect the metastases located in the members. This search is based upon a thorough clinical examination, completed by targeted imaging in case of symptoms and/or palpable mass. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  10. Stellar occultation candidates from the guide star catalog. I - Saturn, 1991-1999

    NASA Technical Reports Server (NTRS)

    Bosh, A. S.; Mcdonald, S. W.

    1992-01-01

    A list of 203 potential occultations by Saturn and its ring of stars from the HST Guide Star Catalog (GSC) during the years 1991-1999 is presented. This list features many fainter candidates than do current occultation candidate lists for Saturn; these fainter stars can also provide a high signal-to-noise ratio if observed with a large telescope or in the IR where Saturn and its rings have absorption bands. The occultation circumstances are listed, as well as star information found in the GSC.

  11. 47 CFR 101.503 - Digital Electronic Message Service Nodal Stations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... DEMS Nodal Station licenses should specify the maximum number of 10.6 GHz DEMS User Stations to be served by that nodal station. Any increase in that number must be applied for pursuant to § 1.913 of this... Stations. 101.503 Section 101.503 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

  12. 47 CFR 101.503 - Digital Electronic Message Service Nodal Stations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... DEMS Nodal Station licenses should specify the maximum number of 10.6 GHz DEMS User Stations to be served by that nodal station. Any increase in that number must be applied for pursuant to § 1.913 of this... Stations. 101.503 Section 101.503 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

  13. 47 CFR 101.503 - Digital Electronic Message Service Nodal Stations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DEMS Nodal Station licenses should specify the maximum number of 10.6 GHz DEMS User Stations to be served by that nodal station. Any increase in that number must be applied for pursuant to § 1.913 of this... Stations. 101.503 Section 101.503 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

  14. 47 CFR 101.503 - Digital Electronic Message Service Nodal Stations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DEMS Nodal Station licenses should specify the maximum number of 10.6 GHz DEMS User Stations to be served by that nodal station. Any increase in that number must be applied for pursuant to § 1.913 of this... Stations. 101.503 Section 101.503 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

  15. Elsevier Trophoblast Research Award lecture: The multifaceted role of Nodal signaling during mammalian reproduction.

    PubMed

    Park, C B; Dufort, D

    2011-03-01

    Nodal, a secreted signaling protein in the transforming growth factor-beta (TGF-β) superfamily, has established roles in vertebrate development. However, components of the Nodal signaling pathway are also expressed at the maternal-fetal interface and have been implicated in many processes of mammalian reproduction. Emerging evidence indicates that Nodal and its extracellular inhibitor Lefty are expressed in the uterus and complex interactions between the two proteins mediate menstruation, decidualization and embryo implantation. Furthermore, several studies have shown that Nodal from both fetal and maternal sources may regulate trophoblast cell fate and facilitate placentation as both embryonic and uterine-specific Nodal knockout mouse strains exhibit disrupted placenta morphology. Here we review the established and prospective roles of Nodal signaling in facilitating successful pregnancy, including recent evidence supporting a potential link to parturition and preterm birth. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Tumor microvessel density–associated mast cells in canine nodal lymphoma

    PubMed Central

    Mann, Elizabeth; Whittington, Lisa

    2014-01-01

    Objective: Mast cells are associated in angiogenesis in various human and animal neoplasms. However, association of mast cells with tumor microvessel density in canine lymphoma was not previously documented. The objective of the study is to determine if mast cells are increased in canine nodal lymphomas and to evaluate their correlation with tumor microvessel density and grading of lymphomas. Methods: Nodal lymphomas from 33 dogs were studied and compared with nonneoplastic lymph nodes from 6 dogs as control. Mast cell count was made on Toluidine blue stained sections. Immunohistochemistry using antibody against Factor VIII was employed to visualize and determine microvessel density. Results: The mast cell count in lymphoma (2.95 ± 2.4) was significantly higher (p < 0.05) than that in the control (0.83 ± 0.3) and was positively correlated with tumor microvessel density (r = 0.44, p = 0.009). Significant difference was not observed in mast cell count and tumor microvessel density among different gradings of lymphomas. Conclusions: Mast cells are associated with tumor microvessel density in canine nodal lymphoma with no significant difference among gradings of lymphomas. Mast cells may play an important role in development of canine nodal lymphomas. Further detailed investigation on the role of mast cells as important part of tumor microenvironment in canine nodal lymphomas is recommended. PMID:26770752

  17. Advanced Electrocardiography Can Identify Occult Cardiomyopathy in Doberman Pinschers

    NASA Technical Reports Server (NTRS)

    Spiljak, M.; Petric, A. Domanjko; Wilberg, M.; Olsen, L. H.; Stepancic, A.; Schlegel, T. T.; Starc, V.

    2011-01-01

    Recently, multiple advanced resting electrocardiographic (A-ECG) techniques have improved the diagnostic value of short-duration ECG in detection of dilated cardiomyopathy (DCM) in humans. This study investigated whether 12-lead A-ECG recordings could accurately identify the occult phase of DCM in dogs. Short-duration (3-5 min) high-fidelity 12-lead ECG recordings were obtained from 31 privately-owned, clinically healthy Doberman Pinschers (5.4 +/- 1.7 years, 11/20 males/females). Dogs were divided into 2 groups: 1) 19 healthy dogs with normal echocardiographic M-mode measurements: left ventricular internal diameter in diastole (LVIDd . 47mm) and in systole (LVIDs . 38mm) and normal 24-hour ECG recordings (<50 ventricular premature complexes, VPCs); and 2) 12 dogs with occult DCM: 11/12 dogs had increased M-mode measurements (LVIDd . 49mm and/or LVIDs . 40mm) and 5/11 dogs had also >100 VPCs/24h; 1/12 dogs had only abnormal 24-hour ECG recordings (>100 VPCs/24h). ECG recordings were evaluated via custom software programs to calculate multiple parameters of high-frequency (HF) QRS ECG, heart rate variability, QT variability, waveform complexity and 3-D ECG. Student's t-tests determined 19 ECG parameters that were significantly different (P < 0.05) between groups. Principal component factor analysis identified a 5-factor model with 81.4% explained variance. QRS dipolar and non-dipolar voltages, Cornell voltage criteria and QRS waveform residuum were increased significantly (P < 0.05), whereas mean HF QRS amplitude was decreased significantly (P < 0.05) in dogs with occult DCM. For the 5 selected parameters the prediction of occult DCM was performed using a binary logistic regression model with Chi-square tested significance (P < 0.01). ROC analyses showed that the five selected ECG parameters could identify occult ECG with sensitivity 89% and specificity 83%. Results suggest that 12-lead A-ECG might improve diagnostic value of short-duration ECG in earlier detection

  18. Cutaneous metastases of internal tumors.

    PubMed

    Fernández-Antón Martínez, M C; Parra-Blanco, V; Avilés Izquierdo, J A; Suárez Fernández, R M

    2013-12-01

    Cutaneous metastases are relatively rare in clinical practice and their diagnosis requires a high index of suspicion because clinical findings can be subtle. These metastases reveal the presence of disseminated malignant disease and can lead to the diagnosis of unsuspected internal tumors or the spread or recurrence of an already diagnosed tumor. Early recognition of cutaneous metastases can facilitate prompt and accurate diagnosis resulting in early treatment; however, they are generally indicative of a poor prognosis. Some tumors have a predilection to metastasize to specific areas. Recognition of these patterns provides essential information that can guide the search for the underlying tumor. Copyright © 2011 Elsevier España, S.L. y AEDV. All rights reserved.

  19. Risk factors of occult malignancy in patients with unprovoked venous thromboembolism.

    PubMed

    Robin, Philippe; Le Roux, Pierre-Yves; Tromeur, Cécile; Planquette, Benjamin; Prévot-Bitot, Nathalie; Lavigne, Christian; Pastre, Jean; Merah, Adel; Couturaud, Francis; Le Gal, Grégoire; Salaun, Pierre-Yves

    2017-11-01

    Venous thromboembolism (VTE) can occur as the first manifestation of an underlying occult malignancy. It remains unclear whether or not a better selection of high risk patients might lead to more efficient occult cancer screening strategies. Our aim was to assess the predictors of occult malignancy diagnosis in patients with unprovoked VTE. Univariate analyses were performed to assess the effect of candidate predictors on occult cancer detection in patients enrolled in a prospective, multicenter, randomized, controlled study (MVTEP study) whose primary aim was to compare a limited screening strategy with a strategy combining limited screening and FDG PET/CT in patients with unprovoked VTE. This trial is completed and registered with ClinicalTrials.gov, number NCT00964275. Between March 3, 2009, and August 18, 2012, 399 patients were included. Five patients withdrew consent and refused the use of their data, and no VTE was confirmed in 2 patients who were excluded from this analysis. A total of 25 (6.4%) out of the 392 analysed patients received a new diagnosis of malignancyduring the 2-years follow-up. Age≥50years (p=0.01), male gender (p=0.04), leukocytes count (p=0.01), and platelets count (p=0.03) were associated with occult cancer detection. Patients with leukocytosis or thrombocytosis had a risk of cancer way above 10%. Previous VTE and smoker status (combining previous and current smokers) were not associated with occult cancer diagnosis (p>0.05). Demographic characteristics (age and sex), and laboratory tests (high platelets and leukocytes counts) may be associated with cancer detection in patients withunprovoked VTE. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Magnitudes of selected stellar occultation candidates for Pluto and other planets, with new predictions for Mars and Jupiter

    NASA Technical Reports Server (NTRS)

    Sybert, C. B.; Bosh, A. S.; Sauter, L. M.; Elliot, J. L.; Wasserman, L. H.

    1992-01-01

    Occultation predictions for the planets Mars and Jupiter are presented along with BVRI magnitudes of 45 occultation candidates for Mars, Jupiter, Saturn, Uranus, and Pluto. Observers can use these magnitudes to plan observations of occultation events. The optical depth of the Jovian ring can be probed by a nearly central occultation on 1992 July 8. Mars occults an unusually red star in early 1993, and the occultations for Pluto involving the brightest candidates would possibly occur in the spring of 1992 and the fall of 1993.

  1. Evaluation and Improved Use of Fecal Occult Blood Test in the Constipated Child.

    PubMed

    Kilway, Denise M

    2016-01-01

    This quality improvement project examined the use of fecal occult blood test in the constipated child in a pediatric gastroenterology outpatient clinic. A retrospective chart review was completed on 100 children seen for an initial visit with the gastroenterology provider. The number of fecal occult blood tests performed and the child's coinciding symptoms were tallied and compared with the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations. An educational intervention was held with the pediatric gastroenterology providers consisting of a PowerPoint presentation summarizing aims of the quality improvement project and reviewing recommendations for use of fecal occult blood test in the constipated child. Pre- and post-intervention chart review data sets were compared. Results showed a 19.6% decrease in the use of fecal occult blood tests performed during the post-intervention timeframe. However, when used in conjunction with North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations, the appropriateness of fecal occult blood test use increased by 71.4% in the post-intervention patients. Reviewing the recommendations with gastroenterology providers assisted in optimizing the meaningful use of fecal occult blood test, improving quality and safety of care for children seen in the pediatric gastroenterology outpatient clinic.

  2. Utility of PET-CT in detecting nodal metastasis in cN0 early stage oral cavity squamous cell carcinoma.

    PubMed

    Zhang, Han; Seikaly, Hadi; Biron, Vincent L; Jeffery, Caroline C

    2018-05-01

    Management of the clinically node-negative neck (cN0) in patients with early stage oral cavity squamous cell carcinoma (OCSCC) is challenging. Accurate imaging alternatives to elective neck dissections would help reduce surgical morbidity. While pooled studies suggest that imaging modalities have similar accuracy in predicting occult nodal disease, no study has examined the utility of PET-CT in this specific population of low-volume, clinically T1 and T2 OCSCC patients. A retrospective review of patients in the Alberta Cancer Registry who were diagnosed with cT1 or T2N0M0 OCSCC who underwent elective unilateral or bilateral neck dissections was performed. Pre-operative PET-CT and CT necks were reviewed for number of radiographically suspicious lymph nodes. Surgical pathology reports were reviewed to obtain the total number of nodes sampled and number of malignant nodes. Between 2009 and 2013, 148 patients were diagnosed with cT1 or T2N0M0 OCSCC. Of these, 96 patients underwent elective neck dissections. All patients underwent preoperative CT of the neck with 32 patients having undergone additional preoperative PET-CT. Based on finally surgical pathology, the overall rate of occult metastasis was 13.5% (13/96). The overall sensitivity and specificity of PET-CT in this cohort was 21.4% and 98.4%, respectively with a negative predictive value of 99.1%. Although sensitivity improved in patients with tumors ≥2 cm and depth ≥4 mm, specificity remained unchanged. In patients with cT1 and T2N0 OCSCC, PET-CT has high negative predictive value. These patients can be considered for treatment with single modality surgical resection and elective neck dissection. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Occultation Predictions Using CCD Strip-Scanning Astrometry

    NASA Technical Reports Server (NTRS)

    Dunham, Edward W.; Ford, C. H.; Stone, R. P. S.; McDonald, S. W.; Olkin, C. B.; Elliot, J. L.; Witteborn, Fred C. (Technical Monitor)

    1994-01-01

    We are developing the method of CCD strip-scanning astrometry for the purpose of deriving reliable advance predictions for occultations involving small objects in the outer solar system. We are using a camera system based on a Ford/Loral 2Kx2K CCD with the Crossley telescope at Lick Observatory for this work. The columns of die CCD are aligned East-West, the telescope drive is stopped, and the CCD is clocked at the same rate that the stars drift across it. In this way we obtain arbitrary length strip images 20 arcmin wide with 0.58" pixels. Since planets move mainly in RA, it is possible to obtain images of the planet and star to be occulted on the same strip well before the occultation occurs. The strip-to-strip precision (i.e. reproducibility) of positions is limited by atmospheric image motion to about 0.1" rms per strip. However, for objects that are nearby in R.A., the image motion is highly correlated and their relative positions are good to 0.02" rms per strip. We will show that the effects of atmospheric image motion on a given strip can be removed if a sufficient number of strips of a given area have been obtained. Thus, it is possible to reach an rms precision of 0.02" per strip, corresponding to about 0.3 of Pluto or Triton's angular radius. The ultimate accuracy of a prediction based on strip-scanning astrometry is currently limited by the accuracy of the positions of the stars in the astrometric network used and by systematic errors most likely due to the optical system. We will show the results of . the prediction of some recent occultations as examples of the current capabilities and limitations of this technique.

  4. Turbulence in planetary occultations. IV - Power spectra of phase and intensity fluctuations

    NASA Technical Reports Server (NTRS)

    Haugstad, B. S.

    1979-01-01

    Power spectra of phase and intensity scintillations during occultation by turbulent planetary atmospheres are significantly affected by the inhomogeneous background upon which the turbulence is superimposed. Such coupling is particularly pronounced in the intensity, where there is also a marked difference in spectral shape between a central and grazing occultation. While the former has its structural features smoothed by coupling to the inhomogeneous background, such features are enhanced in the latter. Indeed, the latter power spectrum peaks around the characteristic frequency that is determined by the size of the free-space Fresnel zone and the ray velocity in the atmosphere; at higher frequencies strong fringes develop in the power spectrum. A confrontation between the theoretical scintillation spectra computed here and those calculated from the Mariner 5 Venus mission by Woo et al. (1974) is inconclusive, mainly because of insufficient statistical resolution. Phase and/or intensity power spectra computed from occultation data may be used to deduce characteristics of the turbulence and to distinguish turbulence from other perturbations in the refractive index. Such determinations are facilitated if observations are made at two or more frequencies (radio occultation) or in two or more colors (stellar occultation).

  5. Density Waves in Saturn's Rings from Cassini Radio Occultations

    NASA Astrophysics Data System (ADS)

    French, R. G.; Rappaport, N. J.; Marouf, E. A.; McGhee, C. A.

    2005-12-01

    The Cassini Radio Science Team conducted a set of optimized diametric occultations by Saturn and its rings from May to September 2005, providing 11 separate probes of Saturn's ionosphere and atmosphere, and 12 optical depth profiles of the complete ring system. Each event was observed by the stations of the Deep Space Net (DSN) at three radio frequencies (S, X, Ka bands, with corresponding wavelengths of ? = 13, 3.6, and 0.9 cm). Very accurate pointing by the spacecraft and ground antennas resulted in stable baseline signal levels, and the relatively large ring opening angle (B=19-25°) permitted us to probe even quite dense ring regions with excellent SNR. The RSS occultation technique enables us to recover very fine detailed radial structure by correcting for diffraction effects. Multiple occultation chords, covering a variety of ring longitudes and ring opening angles, reveal the structure of the rings in remarkable detail, including density and bending waves, satellite wakes, and subtle variations at the 100-m radius scale. Janus and Epimetheus are responsible for a particularly rich set of density waves, and their coorbital interactions result in a complex interplay of time-variable ring structure over the 8-year libration period of the two satellites. We compare the first-order 2:1, 4:3, 5:4, and 6:5 coorbital density waves from multiple occultation chords to linear density wave models based on a dynamical model of the orbital exchange between the moons. From the observed dispersion relation of the wave crests, we infer the surface mass density and eccentricity gradient of particle streamlines, and match the detailed shapes of the wave crests using a non-linear analysis. Second-order coorbital features are also evident, and there are even hints of third-order density waves in the high SNR radio occultation data.

  6. On Combining Thermal-Infrared and Radio-Occultation Data of Saturn's Atmosphere

    NASA Technical Reports Server (NTRS)

    Flasar, F. M.; Schinder, P. J.; Conrath, B. J.

    2008-01-01

    Radio-occultation and thermal-infrared measurements are complementary investigations for sounding planetary atmospheres. The vertical resolution afforded by radio occultations is typically approximately 1 km or better, whereas that from infrared sounding is often comparable to a scale height. On the other hand, an instrument like CIRS can easily generate global maps of temperature and composition, whereas occultation soundings are usually distributed more sparsely. The starting point for radio-occultation inversions is determining the residual Doppler-shifted frequency, that is the shift in frequency from what it would be in the absence of the atmosphere. Hence the positions and relative velocities of the spacecraft, target atmosphere, and DSN receiving station must be known to high accuracy. It is not surprising that the inversions can be susceptible to sources of systematic errors. Stratospheric temperature profiles on Titan retrieved from Cassini radio occultations were found to be very susceptible to errors in the reconstructed spacecraft velocities (approximately equal to 1 mm/s). Here the ability to adjust the spacecraft ephemeris so that the profiles matched those retrieved from CIRS limb sounding proved to be critical in mitigating this error. A similar procedure can be used for Saturn, although the sensitivity of its retrieved profiles to this type of error seems to be smaller. One issue that has appeared in inverting the Cassini occultations by Saturn is the uncertainty in its equatorial bulge, that is, the shape in its iso-density surfaces at low latitudes. Typically one approximates that surface as a geopotential surface by assuming a barotropic atmosphere. However, the recent controversy in the equatorial winds, i.e., whether they changed between the Voyager (1981) era and later (after 1996) epochs of Cassini and some Hubble observations, has made it difficult to know the exact shape of the surface, and it leads to uncertainties in the retrieved

  7. Metastasizing leiomyoma to heart.

    PubMed

    Consamus, Erin N; Reardon, Michael J; Ayala, Alberto G; Schwartz, Mary R; Ro, Jae Y

    2014-01-01

    Cardiac smooth muscle tumors are rare. Three different clinical settings for these tumors have been reported, including benign metastasizing leiomyoma from the uterus, primary cardiac leiomyoma and leiomyosarcoma, and intravenous cardiac extension of pelvic leiomyoma, which is the most common. We present a case of a 55-year-old woman with a benign metastasizing leiomyoma to the heart 17 years after hysterectomy and 16 years after metastasis to the lung. Immunohistochemical stains for smooth muscle actin, desmin, and estrogen and progesterone receptors were positive, indicating a smooth muscle tumor of uterine origin. To our knowledge, this is only the fourth reported case of benign metastasizing leiomyoma to the heart and the first case of long-delayed cardiac metastasis after successful treatment of pulmonary metastasis. It illustrates that benign metastasizing leiomyoma should be included in the differential diagnosis of cardiac tumors in patients with a history of uterine leiomyoma, especially when associated with pulmonary metastasis.

  8. James Webb Space Telescope Observations of Stellar Occultations by Solar System Bodies and Rings

    NASA Technical Reports Server (NTRS)

    Santos-Sanz, P.; French, R. G.; Pinilla-Alonso, N.; Stansberry, J.; Lin, Z-Y.; Zhang, Z-W.; Vilenius, E.; Mueller, Th.; Ortiz, J. L.; Braga-Ribas, F.; hide

    2016-01-01

    In this paper, we investigate the opportunities provided by the James Webb Space Telescope (JWST) for significant scientific advances in the study of Solar System bodies and rings using stellar occultations. The strengths and weaknesses of the stellar occultation technique are evaluated in light of JWST's unique capabilities. We identify several possible JWST occultation events by minor bodies and rings and evaluate their potential scientific value. These predictions depend critically on accurate a priori knowledge of the orbit of JWST near the Sun–Earth Lagrange point 2 (L2). We also explore the possibility of serendipitous stellar occultations by very small minor bodies as a byproduct of other JWST observing programs. Finally, to optimize the potential scientific return of stellar occultation observations, we identify several characteristics of JWST's orbit and instrumentation that should be taken into account during JWST's development.

  9. Occult cancer-related first venous thromboembolism is associated with an increased risk of recurrent venous thromboembolism.

    PubMed

    Gran, O V; Braekkan, S K; Paulsen, B; Skille, H; Rosendaal, F R; Hansen, J-B

    2017-07-01

    Essentials Recurrence risk after an occult cancer-related incident venous thromboembolism (VTE) is unknown. We compared the risk of VTE recurrence in occult-, overt- and non-cancer related first VTE. Patients with occult-cancer related first VTE had the highest risk of VTE recurrence. The high recurrence risk in occult cancer is likely due to the advanced cancers. Background Although venous thromboembolism (VTE) is associated with a high recurrence rate, the absolute recurrence rates for cancer-related VTE, particularly occult cancer, are not well known. Objectives To investigate the risk of VTE recurrence in patients with occult and overt cancer-related VTE. Methods Incident VTE events among participants of the first to sixth Tromsø surveys occurring in the period 1994-2012 were included. Occult cancer was defined as cancer diagnosed within a year following a VTE, and overt cancer was defined as cancer diagnosed within the 2 years before a VTE. Results Among 733 patients with incident VTE, 110 had overt cancer and 40 had occult cancer. There were 95 recurrent VTE events during a median of 3.2 years of follow-up. The 1-year cumulative incidence of VTE recurrence was 38.6% in subjects with occult cancer, 15.5% in subjects with overt cancer, and 3.8% in non-cancer subjects. The 1-year risk of recurrence was 12-fold (hazard ratio [HR] 12.4, 95% confidence interval [CI] 5.9-26.3) higher in subjects with occult cancer and four-fold (HR 4.3, 95% CI 2.0-9.2) higher in subjects with overt cancer than in non-cancer subjects. The occult cancers associated with VTE recurrence were typically located at prothrombotic sites (i.e. lung and gastrointestinal) and presented at advanced stages. The majority (69%) of recurrences in subjects with occult cancer occurred before or shortly after cancer diagnosis, and were therefore not treatment-related. Conclusion Our findings suggest that the increased risk of recurrence in patients with occult cancer is mainly attributable to the

  10. Risk Factors for Central Neck Lymph Node Metastases in Micro- Versus Macro- Clinically Node Negative Papillary Thyroid Carcinoma.

    PubMed

    Sessa, Luca; Lombardi, Celestino Pio; De Crea, Carmela; Tempera, Serena Elisa; Bellantone, Rocco; Raffaelli, Marco

    2018-03-01

    Tumor size has been advocated as possible risk factors for occult central lymph node metastases (CNM) in papillary thyroid carcinoma (PTC) patients. This prospective study evaluated factors that could identify patients at higher risk of occult CNM, especially comparing micro-PTC and macro-PTC. One hundred and eighty-six patients were recruited. All the patients had cN0 clinically unifocal PTC and underwent total thyroidectomy and bilateral prophylactic central neck dissection. Risk factors for occult CNM in micro- and macro-PTC patients were evaluated. Eighty-two patients showed CNM. The rate of CNM did not differ among different sizes cut off (≤20 mm, ≤10 mm, ≤5 mm P = NS). Significantly more pN1a than pN0 patients had pT3 tumors (35/82 vs. 26/104) (P < 0.05), extracapsular invasion (35/82 vs. 22/104) (P < 0.01) and microscopic multifocal disease (50/82 vs. 47/104) (P < 0.05). Independent risk factors for CNM were extracapsular invasion and multifocality at multivariate analysis. Risk factors for CNM in 77 micro-PTC were extracapsular invasion (16/31 pN1 vs. 10/46 pN0, P < 0.05) and multifocality (21/31 pN1 vs. 16/46 pN0, P < 0.01). Among 109 macro-PTC, risk factors for CNM were angioinvasion (15/51 pN1 vs. 7/58 pN0, P < 0.05) and classic PTC at the final histology (PTC vs. tall cell variant vs. follicular variant PTC) (P < 0.05). Risk factors for CNM can differ between micro- and macro-PTC, but no preoperatively known clinical parameter is predictor of CNM in cN0 clinically unifocal PTC.

  11. Unsuccesfull occultation observation of stars by asteroids

    NASA Astrophysics Data System (ADS)

    Gaina, Alex; Maley, Paul D.

    2010-12-01

    A report is given about an attempt to observe occultations of stars HIP 7268 and TYC1868-02234-01 by asteroids Tisiphone and Thisbe on 3 november 2010 in Chisinau, The Republic of Moldova, which was placed very close to the central line of the occultations in spite of. The main cause of the insucces was weather. Few days before a cyclon developed above the Black Sea, while above the Western Europe, including Greece the sky was covered during many days. Some critics are made concerning the preparation of astronomical facilities in the Republic of Moldova for succesfull observations. The meteo conditions in Lozova-Ciuciuleni were better, but bad, than in other parts of the Republic of Moldova.

  12. Response of millet and sorghum to a varying water supply around the primary and nodal roots

    PubMed Central

    Rostamza, M.; Richards, R. A.; Watt, M.

    2013-01-01

    Background and Aims Cereals have two root systems. The primary system originates from the embryo when the seed germinates and can support the plant until it produces grain. The nodal system can emerge from stem nodes throughout the plant's life; its value for yield is unclear and depends on the environment. The aim of this study was to test the role of nodal roots of sorghum and millet in plant growth in response to variation in soil moisture. Sorghum and millet were chosen as both are adapted to dry conditions. Methods Sorghum and millet were grown in a split-pot system that allowed the primary and nodal roots to be watered separately. Key Results When primary and nodal roots were watered (12 % soil water content; SWC), millet nodal roots were seven times longer than those of sorghum and six times longer than millet plants in dry treatments, mainly from an 8-fold increase in branch root length. When soil was allowed to dry in both compartments, millet nodal roots responded and grew 20 % longer branch roots than in the well-watered control. Sorghum nodal roots were unchanged. When only primary roots received water, nodal roots of both species emerged and elongated into extremely dry soil (0·6–1·5 % SWC), possibly with phloem-delivered water from the primary roots in the moist inner pot. Nodal roots were thick, short, branchless and vertical, indicating a tropism that was more pronounced in millet. Total nodal root length increased in both species when the dry soil was covered with plastic, suggesting that stubble retention or leaf mulching could facilitate nodal roots reaching deeper moist layers in dry climates. Greater nodal root length in millet than in sorghum was associated with increased shoot biomass, water uptake and water use efficiency (shoot mass per water). Millet had a more plastic response than sorghum to moisture around the nodal roots due to (1) faster growth and progression through ontogeny for earlier nodal root branch length and (2

  13. Response of millet and sorghum to a varying water supply around the primary and nodal roots.

    PubMed

    Rostamza, M; Richards, R A; Watt, M

    2013-07-01

    Cereals have two root systems. The primary system originates from the embryo when the seed germinates and can support the plant until it produces grain. The nodal system can emerge from stem nodes throughout the plant's life; its value for yield is unclear and depends on the environment. The aim of this study was to test the role of nodal roots of sorghum and millet in plant growth in response to variation in soil moisture. Sorghum and millet were chosen as both are adapted to dry conditions. Sorghum and millet were grown in a split-pot system that allowed the primary and nodal roots to be watered separately. When primary and nodal roots were watered (12 % soil water content; SWC), millet nodal roots were seven times longer than those of sorghum and six times longer than millet plants in dry treatments, mainly from an 8-fold increase in branch root length. When soil was allowed to dry in both compartments, millet nodal roots responded and grew 20 % longer branch roots than in the well-watered control. Sorghum nodal roots were unchanged. When only primary roots received water, nodal roots of both species emerged and elongated into extremely dry soil (0.6-1.5 % SWC), possibly with phloem-delivered water from the primary roots in the moist inner pot. Nodal roots were thick, short, branchless and vertical, indicating a tropism that was more pronounced in millet. Total nodal root length increased in both species when the dry soil was covered with plastic, suggesting that stubble retention or leaf mulching could facilitate nodal roots reaching deeper moist layers in dry climates. Greater nodal root length in millet than in sorghum was associated with increased shoot biomass, water uptake and water use efficiency (shoot mass per water). Millet had a more plastic response than sorghum to moisture around the nodal roots due to (1) faster growth and progression through ontogeny for earlier nodal root branch length and (2) partitioning to nodal root length from primary roots

  14. Comparison of Modal to Nodal Approaches for Wavefront Correction,

    DTIC Science & Technology

    1986-02-01

    the influence function of the wavefront corrector. (Implicit here is the assumption that the influence function is the same for every node, which is...To implement a nodal correction, the wavefront to be corrected is -. .. decomposed using a basis which is determined by the nodal (actuator) influence ... function of the wavefront corrector. This decomposition results in a set of coefficients which correspond to the drive signal required at the

  15. Recurring sets of recurring starspot occultations on exoplanet host Qatar-2

    NASA Astrophysics Data System (ADS)

    Močnik, T.; Southworth, J.; Hellier, C.

    2017-10-01

    We announce the detection of recurring sets of recurring starspot occultation events in the short-cadence K2 light curve of Qatar-2, a K dwarf star transited every 1.34 d by a hot Jupiter. In total, we detect 34 individual starspot occultation events, caused by five different starspots, occulted in up to five consecutive transits or after a full stellar rotation. The longest recurring set of recurring starspot occultations spans over three stellar rotations, setting a lower limit for the longest starspot lifetime of 58 d. Starspot analysis provided a robust stellar rotational period measurement of 18.0 ± 0.2 d and indicates that the system is aligned, having a sky-projected obliquity of 0° ± 8°. A pronounced rotational modulation in the light curve has a period of 18.2 ± 1.6 d, in agreement with the rotational period derived from the starspot occultations. We tentatively detect an ellipsoidal modulation in the phase curve, with a semi-amplitude of 18 ppm, but cannot exclude the possibility that this is the result of red noise or imperfect removal of the rotational modulation. We detect no transit-timing and transit-duration variations with upper limits of 15 s and 1 min, respectively. We also reject any additional transiting planets with transit depths above 280 ppm in the orbital period region 0.5-30 d.

  16. Feasibility of Juno radio occultations of the Io plasma torus

    NASA Astrophysics Data System (ADS)

    Phipps, P. H.; Withers, P.

    2016-12-01

    Jupiter's magnetosphere is driven by internally produced plasma. The innermost Galilean satellite, Io, isthe dominant source of this plasma. Volcanoes on Io's surface create an atmosphere of sulfur and oxygenwhich escapes into Jupiter's magnetosphere and becomes ionized. This ionized material is trapped byJupiter's magnetic field and creates a torus of plasma centered at Io's orbital radius, called the Io plasmatorus. This torus is divided into three regions distinct in both density and composition. Densities in thistorus can be probed by spacecraft via radio occultations. A radio occultation occurs when plasma comesbetween a spacecraft and a receiver during a time when the spacecraft is sending a radio signal. The Junospacecraft, which arrived in orbit around Jupiter in July 2016, is in an orbit which will be ideal forperforming radio occultations of the Io plasma torus. We test the feasibility of using thetelecommunications system on the Juno spacecraft to perform a radio occultation. Io plasma torusdensities derived from Voyager 1 data are used in creating a model torus. Using the Ka and X-band radiofrequencies we derive vertical profiles for the total electron content of the modeled Io plasma torus. AMarkov Chain Monte Carlo fit is performed on the derived profiles to extract, for each of the torusregions, the scale height and peak total electron content. The scale height can be used to derive atemperature for the torus while the peak total electron content can be used to derive the peak electrondensity. We show that Juno radio occultation measurements of the Io plasma torus are feasible andscientifically valuable.

  17. A method to detect occult pneumothorax with chest radiography.

    PubMed

    Matsumoto, Shokei; Kishikawa, Masanobu; Hayakawa, Koichi; Narumi, Atsushi; Matsunami, Katsutoshi; Kitano, Mitsuhide

    2011-04-01

    Small pneumothoraces are often not visible on supine screening chest radiographs because they develop anteriorly to the lung. These pneumothoraces are termed occult. Occult pneumothoraces account for an astonishingly high 52% to 63% of all traumatic pneumothoraces. A 19-year-old obese woman was involved in a head-on car accident. The admission anteroposterior chest radiographs were unremarkable. Because of the presence of right chest tenderness and an abrasion, we suspected the presence of a pneumothorax. Thus, we decided to take a supine oblique chest radiograph of the right side of the thorax, which clearly revealed a visceral pleural line, consistent with a diagnosis of traumatic pneumothorax. A pneumothorax may be present when a supine chest radiograph reveals either an apparent deepening of the costophrenic angle (the "deep sulcus sign") or the presence of 2 diaphragm-lung interfaces (the "double diaphragm sign"). However, in practice, supine chest radiographs have poor sensitivity for occult pneumothoraces. Oblique chest radiograph is a useful and fast screening tool that should be considered for cases of blunt chest trauma, especially when transport of critically ill patients to the computed tomographic suite is dangerous or when imminent transfer to another hospital is being arranged and early diagnosis of an occult pneumothorax is essential. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  18. Overview of SPICAV occultation results for the UV channel

    NASA Astrophysics Data System (ADS)

    Montmessin, Franck; Bertaux, Jean-Loup; Belyaev, Denis; Marcq, Emmanuel; Korablev, Oleg; Vandaele, Ann-Carine; Fedorova, Anna

    The SPICAV instrument onboard the Venus Express spacecraft is a multi-channel suite cov-ering the far ultraviolet to the mid-infrared. In this presentation, we will focus on the results obtained by the UV channel during stellar occultations observations. Stellar occultation tech-nique possesses well-known advantages: self-calibration, low sensitivity to instrument aging, simple laws of radiative transfer. In addition, occultation with stars permit to cover a broad range of latitudes at any given season and they provide optimal geometrical registration. Since Venus Express orbit insertion, several hundreds of occultations have been performed by SPI-CAV, yielding profiles of atmospheric constituents between 80 and 140 km. In the SPICAV UV range, CO2 possesses a broad signature shortward of 200 nm which allows one to retrieve CO2 concentration and subsequently to deduce atmospheric pressure and temperature profiles in the upper mesosphere and in the thermosphere. The Venusian thermosphere shows excessive variability, with the equivalent of more than three scale heights change in density in less than a few days. No other spectral signature besides that of CO2 and haze particles was expected to appear in SPICAV ultraviolet spectra at this altitude range but a consistent search was undertaken, revealing the presence of aan ozone at 100 km (¡108 cm-3) and of sulfur dioxide above 90 km at a concentration of 0.1 to 1 ppm.

  19. On the Nodal Lines of Eisenstein Series on Schottky Surfaces

    NASA Astrophysics Data System (ADS)

    Jakobson, Dmitry; Naud, Frédéric

    2017-04-01

    On convex co-compact hyperbolic surfaces {X=Γ backslash H2}, we investigate the behavior of nodal curves of real valued Eisenstein series {F_λ(z,ξ)}, where {λ} is the spectral parameter, {ξ} the direction at infinity. Eisenstein series are (non-{L^2}) eigenfunctions of the Laplacian {Δ_X} satisfying {Δ_X F_λ=(1/4+λ^2)F_λ}. As {λ} goes to infinity (the high energy limit), we show that, for generic {ξ}, the number of intersections of nodal lines with any compact segment of geodesic grows like {λ}, up to multiplicative constants. Applications to the number of nodal domains inside the convex core of the surface are then derived.

  20. Developing an Optical Lunar Occultation Measurement Reduction System for Observations at Kaau Observatory

    NASA Astrophysics Data System (ADS)

    Malawi, Abdulrahman A.

    2013-06-01

    We present here a detailed explanation of the reduction method that we use to determine the angular diameters of the stars occulted by the dark limb of the moon. This is a main part of the lunar occultation observation program running at King Abdul Aziz University observatory since late 1993. The process is based on the least square model fitting method of analyzing occultation data, first introduced by Nather et al. (Astron. J. 75:963, 1970).

  1. Occult hepatitis B virus infection in hematopoietic stem cell donors in a hepatitis B virus endemic area.

    PubMed

    Hui, Chee-kin; Sun, Jian; Au, Wing-yan; Lie, Albert K W; Yueng, Yui-hung; Zhang, Hai-ying; Lee, Nikki P; Hou, Jin-ling; Liang, Raymond; Lau, George K K

    2005-06-01

    The acquisition of hepatitis B virus (HBV) infection following organ transplantation from donors with occult HBV infection is an important cause of morbidity and mortality. The aim of this study is to determine the prevalence of occult HBV in allogeneic hematopoietic stem cell (HSC) transplantation donors. We performed a retrospective study on 124 consecutive hepatitis B surface antigen negative HSC donors. Their serum samples were analyzed by PCR for the pre-S/S, pre-core/core and X regions of the virus. Samples reactive by at least two PCR assays were considered HBV-DNA positive. Nineteen of the 124 HSC donors (15.3%) had occult HBV infection. Sixteen of these 19 donors with occult HBV infection (84.2%) tested positive for hepatitis B core antibody while 78 of 105 subjects (74.3%) without occult HBV infection were also positive (P=0.56). Fourteen of the 19 donors (73.7%) with occult HBV infection tested positive for hepatitis B surface antibody while 67 of the 105 subjects without occult HBV infection were also positive (P=0.45). The prevalence of occult HBV infection among HSC donors in Hong Kong is high. Anti-HBc and anti-HBs status had no significant correlation with the presence of occult HBV infection.

  2. Profiles of Brain Metastases: Prioritization of Therapeutic Targets.

    PubMed

    Ferguson, Sherise D; Zheng, Siyuan; Xiu, Joanne; Zhou, Shouhao; Khasraw, Mustafa; Brastianos, Priscilla K; Kesari, Santosh; Hu, Jethro; Rudnick, Jeremy; Salacz, Michael E; Piccioni, David; Huang, Suyun; Davies, Michael A; Glitza, Isabella C; Heymach, John V; Zhang, Jianjun; Ibrahim, Nuhad K; DeGroot, John F; McCarty, Joseph; O'Brien, Barbara J; Sawaya, Raymond; Verhaak, Roeland G W; Reddy, Sandeep K; Priebe, Waldemar; Gatalica, Zoran; Spetzler, David; Heimberger, Amy B

    2018-06-19

    We sought to compare the tumor profiles of brain metastases from common cancers with those of primary tumors and extracranial metastases in order to identify potential targets and prioritize rational treatment strategies. Tumor samples were collected from both the primary and metastatic sites of non-small cell lung cancer, breast cancer, and melanoma from patients in locations worldwide, and these were submitted to Caris Life Sciences for tumor multiplatform analysis, including gene sequencing (Sanger and next-generation sequencing with a targeted 47-gene panel), protein expression (assayed by immunohistochemistry), and gene amplification (assayed by in situ hybridization). The data analysis considered differential protein expression, gene amplification, and mutations among brain metastases, extracranial metastases, and primary tumors. The analyzed population included: 16,999 unmatched primary tumor and/or metastasis samples: 8178 non-small cell lung cancers (5098 primaries; 2787 systemic metastases; 293 brain metastases), 7064 breast cancers (3496 primaries; 3469 systemic metastases; 99 brain metastases), and 1757 melanomas (660 primaries; 996 systemic metastases; 101 brain metastases). TOP2A expression was increased in brain metastases from all 3 cancers, and brain metastases overexpressed multiple proteins clustering around functions critical to DNA synthesis and repair and implicated in chemotherapy resistance, including RRM1, TS, ERCC1, and TOPO1. cMET was overexpressed in melanoma brain metastases relative to primary skin specimens. Brain metastasis patients may particularly benefit from therapeutic targeting of enzymes associated with DNA synthesis, replication, and/or repair. This article is protected by copyright. All rights reserved. © 2018 UICC.

  3. Topological nodal-line fermions in spin-orbit metal PbTaSe2

    DOE PAGES

    Bian, Guang; Chang, Tay-Rong; Sankar, Raman; ...

    2016-02-02

    Here we discuss how topological semimetals can support one-dimensional Fermi lines or zero-dimensional Weyl points in momentum space, where the valence and conduction bands touch. While the degeneracy points in Weyl semimetals are robust against any perturbation that preserves translational symmetry, nodal lines require protection by additional crystalline symmetries such as mirror reflection. Here we report, based on a systematic theoretical study and a detailed experimental characterization, the existence of topological nodal-line states in the non-centrosymmetric compound PbTaSe 2 with strong spin-orbit coupling. Remarkably, the spin-orbit nodal lines in PbTaSe 2 are not only protected by the reflection symmetry butmore » also characterized by an integer topological invariant. Our detailed angle-resolved photoemission measurements, first-principles simulations and theoretical topological analysis illustrate the physical mechanism underlying the formation of the topological nodal-line states and associated surface states for the first time, thus paving the way towards exploring the exotic properties of the topological nodal-line fermions in condensed matter systems.« less

  4. Topological nodal-line fermions in spin-orbit metal PbTaSe2

    PubMed Central

    Bian, Guang; Chang, Tay-Rong; Sankar, Raman; Xu, Su-Yang; Zheng, Hao; Neupert, Titus; Chiu, Ching-Kai; Huang, Shin-Ming; Chang, Guoqing; Belopolski, Ilya; Sanchez, Daniel S.; Neupane, Madhab; Alidoust, Nasser; Liu, Chang; Wang, BaoKai; Lee, Chi-Cheng; Jeng, Horng-Tay; Zhang, Chenglong; Yuan, Zhujun; Jia, Shuang; Bansil, Arun; Chou, Fangcheng; Lin, Hsin; Hasan, M. Zahid

    2016-01-01

    Topological semimetals can support one-dimensional Fermi lines or zero-dimensional Weyl points in momentum space, where the valence and conduction bands touch. While the degeneracy points in Weyl semimetals are robust against any perturbation that preserves translational symmetry, nodal lines require protection by additional crystalline symmetries such as mirror reflection. Here we report, based on a systematic theoretical study and a detailed experimental characterization, the existence of topological nodal-line states in the non-centrosymmetric compound PbTaSe2 with strong spin-orbit coupling. Remarkably, the spin-orbit nodal lines in PbTaSe2 are not only protected by the reflection symmetry but also characterized by an integer topological invariant. Our detailed angle-resolved photoemission measurements, first-principles simulations and theoretical topological analysis illustrate the physical mechanism underlying the formation of the topological nodal-line states and associated surface states for the first time, thus paving the way towards exploring the exotic properties of the topological nodal-line fermions in condensed matter systems. PMID:26829889

  5. Optimizing treatment for children and adolescents with papillary thyroid carcinoma in post-Chernobyl exposed region: The roles of lymph node dissections in the central and lateral neck compartments.

    PubMed

    Fridman, Mikhail; Krasko, Olga; Lam, Alfred King-Yin

    2018-06-01

    There is lack of data to predict lymph node metastases in pediatric thyroid cancer. The aims are to study (1) the factors affecting the lymph node metastases in children and adolescence with papillary thyroid carcinoma in region exposed to radiation and (2) to evaluate the predictive significance of these factors for lateral compartment lymphadenectomy. Five hundred and nine patients with papillary thyroid carcinoma underwent total thyroidectomy and lymph nodes resection (central and lateral compartments of the neck) surgery during the period of 1991-2010 in Belarus were recruited. The factors related to lymph node metastases were studied in these patients. In the patients with papillary thyroid carcinoma, increase number of cancer-positive lymph nodes in the central neck compartment were associated with a risk to develop lateral nodal disease as well as bilateral nodal disease. Futhermore, positive lateral compartment nodal metastases are associated with age and gender of the patients, tumour size, minimal extra-thyroidal extension, solid architectonic, extensive desmoplasia in carcinoma, presence of psammoma bodies, extensive involvement of the thyroid and metastatic ratio index revealed after examination of the central cervical chain lymph nodes. The presence of nodal disease, degree of lymph node involvement and the distribution of lymph node metastases significantly increase the recurrence rates of patients with papillary thyroid carcinoma. To conclude, the lymph nodes metastases in young patients with papillary thyroid carcinoma in post-Chernobyl exposed region are common and the pattern could be predicted by many clinical and pathological factors. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  6. The optimization of the inverted occulter of the solar orbiter/METIS coronagraph/spectrometer

    NASA Astrophysics Data System (ADS)

    Landini, F.; Vives, S.; Romoli, M.; Guillon, C.; Pancrazzi, M.; Escolle, C.; Focardi, M.; Fineschi, S.; Antonucci, E.; Nicolini, G.; Naletto, G.; Nicolosi, P.; Spadaro, D.

    2017-11-01

    The coronagraph/spectrometer METIS (Multi Element Telescope for Imaging and Spectroscopy), selected to fly aboard the Solar Orbiter ESA/NASA mission, is conceived to perform imaging (in visible, UV and EUV) and spectroscopy (in EUV) of the solar corona. It is an integrated instrument suite located on a single optical bench and sharing a unique aperture on the satellite heat shield. As every coronagraph, METIS is highly demanding in terms of stray light suppression. In order to meet the strict thermal requirements of Solar Orbiter, METIS optical design has been optimized by moving the entrance pupil at the level of the external occulter on the S/C thermal shield, thus reducing the size of the external aperture. The scheme is based on an inverted external-occulter (IEO). The IEO consists of a circular aperture on the Solar Orbiter thermal shield. A spherical mirror rejects back the disk-light through the IEO. The experience built on all the previous space coronagraphs forces designers to dedicate a particular attention to the occulter optimization. Two breadboards were manufactured to perform occulter optimization measurements: BOA (Breadboard of the Occulting Assembly) and ANACONDA (AN Alternative COnfiguration for the Occulting Native Design Assembly). A preliminary measurement campaign has been carried on at the Laboratoire d'Astrophysique de Marseille. In this paper we describe BOA and ANACONDA designs, the laboratory set-up and the preliminary results.

  7. TGF-β promotes glioma cell growth via activating Nodal expression through Smad and ERK1/2 pathways

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sun, Jing; Liu, Su-zhi; Lin, Yan

    Highlights: •TGF-β promoted Nodal expression in glioma cells. •TGF-β promoted Nodal expression via activating Smad and ERK1/2 pathways. •TGF-β promotes glioma cell growth via activating Nodal expression. -- Abstract: While there were certain studies focusing on the mechanism of TGF-β promoting the growth of glioma cells, the present work revealed another novel mechanism that TGF-β may promote glioma cell growth via enhancing Nodal expression. Our results showed that Nodal expression was significantly upregulated in glioma cells when TGF-β was added, whereas the TGF-β-induced Nodal expression was evidently inhibited by transfection Smad2 or Smad3 siRNAs, and the suppression was especially significantmore » when the Smad3 was downregulated. Another, the attenuation of TGF-β-induced Nodal expression was observed with blockade of the ERK1/2 pathway also. Further detection of the proliferation, apoptosis, and invasion of glioma cells indicated that Nodal overexpression promoted the proliferation and invasion of tumor cells and inhibited their apoptosis, resembling the effect of TGF-β addition. Downregulation of Nodal expression via transfection Nodal-specific siRNA in the presence of TGF-β weakened the promoting effect of the latter on glioma cells growth, and transfecting Nodal siRNA alone in the absence of exogenous TGF-β more profoundly inhibited the growth of glioma cells. These results demonstrated that while both TGF-β and Nodal promoted glioma cells growth, the former might exert such effect by enhancing Nodal expression, which may form a new target for glioma therapy.« less

  8. [Surgical Diagnosis and Treatment of Primary Hyperthyroidism Complicated with Occult Thyroid Carcinoma].

    PubMed

    Wu, Xin; Yu, Jian-chun; Kang, Wei-ming; Ma, Zhi-qiang; Ye, Xin

    2015-08-01

    To evaluate the surgical diagnosis and treatment of primary hyperthyroidism complicated with occult thyroid carcinoma. Data of 51 cases of primary hyperthyroidism complicated with occult thyroid carcinoma admitted during January 2004 to November 2014 were analyzed retrospectively. The incidence of occult thyroid carcinoma was 5.03% in hyperthyroidism,and 47 cases (92.16%) were female. The preoperative diagnosis of all these 51 cases was primary hyperthyroidism and 11 cases were diagnosed thyroid carcinoma at the same time;25 cases were diagnosed thyroid carcinoma by frozen section and the remaining 26 cases were diagnosed by postoperative pathology. Finally,26 cases underwent subtotal thyroidectomy,4 cases underwent total thyroidectomy, and 21 cases underwent total thyroidectomy with lymphadenectomy. The tumor size ranged from 0.1 to 1.0 cm [mean:(0.63 ± 0.35) cm]. The lesions were less than or equal to 0.5 cm in 28 cases (54.9%). The follow-up lasted from 1 to 121 months [mean:(28.6 ± 22.7)months] in 43 patients,and all of them survived. Primary hyperthyroidism complicated with occult thyroid carcinoma is commonly found in female patients. Preoperative diagnosis is difficult. Ultrasound is the major examining method. Frozen section can increase the detection rate. The postoperative prognosis of hyperthyroidism complicated with occult thyroid carcinoma is satisfactory.

  9. [Stellar Occultation Studies of Small Bodies in the Outer Solar System: Accomplishments, Status, and Plans

    NASA Technical Reports Server (NTRS)

    Elliott, James

    2005-01-01

    Bodies residing in the outer solar system exhibit unique physical processes, and some of the lessons learned from them can be applied to understanding what occurred in the outer solar system during its formation and early evolution. Pluto, the largest known Kuiper Belt object (KBO), and its near twin Triton--an ex-KBO that has been captured by Neptune--have nitrogen atmospheres that are in vapor-pressure equilibrium with surface ice. These atmospheres are most sensitively probed from Earth by the technique of Stellar occultations, which can provide the temperature and pressure profiles of these atmospheres at a spatial resolution of a few kilometers. Recent results from occultations show that the surface pressure of Triton's atmosphere has been increasing and that the shape of the atmosphere deviates from its expected spherical figure. With the occultation technique we can also learn the sizes of smaller bodies that have formed in the outer solar system: Charon, the Centaurs, and KBOs. Our proposed program involves identifying occultation candidates, predicting occultations, observing occultations, analysis of the data, and synthesis of the occultation results with other data. The main goals for our proposed work are to (i) further observe occultations by Triton with the objectives of understanding its pressure changes, distortion, and enigmatic thermal structure (ii) determine whether the abrupt drop in Pluto's stellar occultation light curve is caused by a sharp thermal gradient near its surface or by atmospheric haze, (iii) further observations to characterize the potential collapse of Pluto's atmosphere as it recedes from the sun (information that should be of interest to the Pluto-Kuiper Express), ( iv ) determine Charon's radius more accurately than can be done with the mutual events to derive a better estimate of Charon's density, and ( v ) directly determine the size (and albedo) of Centaurs with the goal of more accurately estimating the sizes of KBOS.

  10. Occult fractures of the knee: tomographic evaluation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Apple, J.S.; Martinez, S.; Allen, N.B.

    1983-08-01

    Seven adults with painful effusions of the knee were examined for occult fractures using pluridirectional tomograph in the coronal and lateral planes. Six patients (ages 50 to 82 years) were osteopenic and gave histories ranging from none to mild trauma; one 26-year-old man was not osteopenic and had severe trauma. In all cases, routine radiographs were interpreted as negative, but tomography demonstrated a fracture. Five fractures were subchondral. Bone scans in 2 patients were positive. The authors conclude that osteopenic patients with a painful effusion of the knee should be considered to have an occult fracture. While bone scans maymore » be helpful, tomography is recommended as the procedure of choice to define the location and extent of the fracture.« less

  11. Off-diagonal Jacobian support for Nodal BCs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Peterson, John W.; Andrs, David; Gaston, Derek R.

    In this brief note, we describe the implementation of o-diagonal Jacobian computations for nodal boundary conditions in the Multiphysics Object Oriented Simulation Environment (MOOSE) [1] framework. There are presently a number of applications [2{5] based on the MOOSE framework that solve complicated physical systems of partial dierential equations whose boundary conditions are often highly nonlinear. Accurately computing the on- and o-diagonal Jacobian and preconditioner entries associated to these constraints is crucial for enabling ecient numerical solvers in these applications. Two key ingredients are required for properly specifying the Jacobian contributions of nonlinear nodal boundary conditions in MOOSE and nite elementmore » codes in general: 1. The ability to zero out entire Jacobian matrix rows after \

  12. Barrier tunneling of the loop-nodal semimetal in the hyperhoneycomb lattice

    NASA Astrophysics Data System (ADS)

    Guan, Ji-Huan; Zhang, Yan-Yang; Lu, Wei-Er; Xia, Yang; Li, Shu-Shen

    2018-05-01

    We theoretically investigate the barrier tunneling in the 3D model of the hyperhoneycomb lattice, which is a nodal-line semimetal with a Dirac loop at zero energy. In the presence of a rectangular potential, the scattering amplitudes for different injecting states around the nodal loop are calculated, by using analytical treatments of the effective model, as well as numerical simulations of the tight binding model. In the low energy regime, states with remarkable transmissions are only concentrated in a small range around the loop plane. When the momentum of the injecting electron is coplanar with the nodal loop, nearly perfect transmissions can occur for a large range of injecting azimuthal angles if the potential is not high. For higher potential energies, the transmission shows a resonant oscillation with the potential, but still with peaks being perfect transmissions that do not decay with the potential width. These strikingly robust transports of the loop-nodal semimetal can be approximately explained by a momentum dependent Dirac Hamiltonian.

  13. Predictive Power of Distal Radial Metaphyseal Tenderness for Diagnosing Occult Fracture.

    PubMed

    Glickel, Steven Z; Hinojosa, Lauren; Eden, Claire M; Balutis, Elaine; Barron, O Alton; Catalano, Louis W

    2017-10-01

    To correlate the physical examination finding of distal radial metaphyseal tenderness with plain radiographic and magnetic resonance imaging after acute wrist injury to diagnose occult distal radius fractures. We hypothesized that persistent distal radial metaphyseal tenderness 2 weeks after acute injuries is predictive of an occult fracture. Twenty-nine adult patients presented, after acute trauma, with distal radial metaphyseal tenderness and initial plain radiographs and/or fluoroscopic images that did not show a distal radius fracture. Patients were reevaluated clinically and radiographically at approximately 2 weeks after initial presentation. Patients with persistent distal radial tenderness and negative radiographs underwent magnetic resonance imaging to definitively diagnose an occult distal radius fracture. We calculated the sensitivity and positive predictive value for persistent distal radial metaphyseal tenderness using a 95% confidence interval and standard formulas. Both radiographs and magnetic resonance imaging were used as our endpoint diagnosis for a distal radius fracture. We diagnosed 28 occult distal radius fractures, 8 by follow-up radiograph and 20 by magnetic resonance imaging. The positive predictive value for patients who completed the protocol was 96%. One patient who did not have an occult distal radius fracture had a fracture of the ulnar styloid. Tenderness of the distal radial metaphysis after wrist injury is strongly suggestive of a distal radius fracture despite both normal plain radiographs and fluoroscopic images. Diagnostic III. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  14. Quantum anomalies in nodal line semimetals

    NASA Astrophysics Data System (ADS)

    Burkov, A. A.

    2018-04-01

    Topological semimetals are a new class of condensed matter systems with nontrivial electronic structure topology. Their unusual observable properties may often be understood in terms of quantum anomalies. In particular, Weyl and Dirac semimetals, which have point band-touching nodes, are characterized by the chiral anomaly, which leads to the Fermi arc surface states, anomalous Hall effect, negative longitudinal magnetoresistance, and planar Hall effect. In this paper, we explore analogous phenomena in nodal line semimetals. We demonstrate that such semimetals realize a three-dimensional analog of the parity anomaly, which is a known property of two-dimensional Dirac semimetals arising, for example, on the surface of a three-dimensional topological insulator. We relate one of the characteristic properties of nodal line semimetals, namely, the drumhead surface states, to this anomaly, and derive the field theory, which encodes the corresponding anomalous response.

  15. Occult HCV Infection: The Current State of Knowledge

    PubMed Central

    Rezaee-Zavareh, Mohammad Saeid; Hadi, Reza; Karimi-Sari, Hamidreza; Hossein Khosravi, Mohammad; Ajudani, Reza; Dolatimehr, Fardin; Ramezani-Binabaj, Mahdi; Miri, Seyyed Mohammad; Alavian, Seyed Moayed

    2015-01-01

    Context Occult HCV infection (OCI) is defined as the presence of HCV-RNA in hepatocytes and the absence of HCV in the serum according to usual tests. We aimed to define OCI and provide information about the currently available diagnostic methods. Then we focus on specific groups that are at high risk of OCI and finally investigate immune responses to OCI and the available treatment approaches. Evidence Acquisition PubMed, Scopus and Google Scholar were comprehensively searched with combination of following keywords: “occult”, “hepatitis C virus” and “occult HCV infection”. The definition of OCI, diagnostic methods, specific groups that are at high risk and available treatment approaches were extract from literature. An analysis of available articles on OCI also was done based on Scopus search results. Results OCI has been reported in several high-risk groups, especially in hemodialysis patients and subjects with cryptogenic liver disease. Furthermore, some studies have proposed a specific immune response for OCI in comparison with chronic hepatitis C (CHC). Conclusions With a clinical history of approximately 11 years, occult HCV infection can be considered an occult type of CHC. Evidences suggest that considering OCI in these high-risk groups seems to be necessary. We suggest that alternative diagnostic tests should be applied and that there is a need for the participation of all countries to determine the epidemiology of this type of HCV infection. Additionally, evaluating OCI in blood transfusion centers and in patients who receive large amounts of blood and clotting factors, such as patients with hemophilia, should be performed in future projects. PMID:26734487

  16. Dusty Dwarfs Galaxies Occulting A Bright Background Spiral

    NASA Astrophysics Data System (ADS)

    Holwerda, Benne

    2017-08-01

    The role of dust in shaping the spectral energy distributions of low mass disk galaxies remains poorly understood. Recent results from the Herschel Space Observatory imply that dwarf galaxies contain large amounts of cool (T 20K) dust, coupled with very modest optical extinctions. These seemingly contradictory conclusions may be resolved if dwarfs harbor a variety of dust geometries, e.g., dust at larger galactocentric radii or in quiescent dark clumps. We propose HST observations of six truly occulting dwarf galaxies drawn from the Galaxy Zoo catalog of silhouetted galaxy pairs. Confirmed, true occulting dwarfs are rare as most low-mass disks in overlap are either close satellites or do not have a confirmed redshift. Dwarf occulters are the key to determining the spatial extent of dust, the small scale structure introduced by turbulence, and the prevailing dust attenuation law. The recent spectroscopic confirmation of bona-fide low mass occulting dwarfs offers an opportunity to map dust in these with HST. What is the role of dust in the SED of these dwarf disk galaxies? With shorter feedback scales, how does star-formation affect their morphology and dust composition, as revealed from their attenuation curve? The resolution of HST allows us to map the dust disks down to the fine scale structure of molecular clouds and multi-wavelength imaging maps the attenuation curve and hence dust composition in these disks. We therefore ask for 2 orbits on each of 6 dwarf galaxies in F275W, F475W, F606W, F814W and F125W to map dust from UV to NIR to constrain the attenuation curve.

  17. Three-dimensional graphdiyne as a topological nodal-line semimetal

    NASA Astrophysics Data System (ADS)

    Nomura, Takafumi; Habe, Tetsuro; Sakamoto, Ryota; Koshino, Mikito

    2018-05-01

    We study the electronic band structure of three-dimensional ABC-stacked (rhombohedral) graphdiyne, which is a new planar carbon allotrope recently fabricated. Using first-principles calculation, we show that the system is a nodal-line semimetal, in which the conduction band and valence band cross at a closed ring in the momentum space. We derive the minimum tight-binding model and the low-energy effective Hamiltonian in a 4 ×4 matrix form. The nodal line is protected by a nontrivial winding number, and it ensures the existence of the topological surface state in a finite-thickness slab. The Fermi surface of the doped system exhibits a peculiar, self-intersecting hourglass structure, which is quite different from the torus or pipe shape in the previously proposed nodal semimetals. Despite its simple configuration, three-dimensional graphdiyne offers unique electronic properties distinct from any other carbon allotropes.

  18. Estimation and evaluation of COSMIC radio occultation excess phase using undifferenced measurements

    NASA Astrophysics Data System (ADS)

    Xia, Pengfei; Ye, Shirong; Jiang, Kecai; Chen, Dezhong

    2017-05-01

    In the GPS radio occultation technique, the atmospheric excess phase (AEP) can be used to derive the refractivity, which is an important quantity in numerical weather prediction. The AEP is conventionally estimated based on GPS double-difference or single-difference techniques. These two techniques, however, rely on the reference data in the data processing, increasing the complexity of computation. In this study, an undifferenced (ND) processing strategy is proposed to estimate the AEP. To begin with, we use PANDA (Positioning and Navigation Data Analyst) software to perform the precise orbit determination (POD) for the purpose of acquiring the position and velocity of the mass centre of the COSMIC (The Constellation Observing System for Meteorology, Ionosphere and Climate) satellites and the corresponding receiver clock offset. The bending angles, refractivity and dry temperature profiles are derived from the estimated AEP using Radio Occultation Processing Package (ROPP) software. The ND method is validated by the COSMIC products in typical rising and setting occultation events. Results indicate that rms (root mean square) errors of relative refractivity differences between undifferenced and atmospheric profiles (atmPrf) provided by UCAR/CDAAC (University Corporation for Atmospheric Research/COSMIC Data Analysis and Archive Centre) are better than 4 and 3 % in rising and setting occultation events respectively. In addition, we also compare the relative refractivity bias between ND-derived methods and atmPrf profiles of globally distributed 200 COSMIC occultation events on 12 December 2013. The statistical results indicate that the average rms relative refractivity deviation between ND-derived and COSMIC profiles is better than 2 % in the rising occultation event and better than 1.7 % in the setting occultation event. Moreover, the observed COSMIC refractivity profiles from ND processing strategy are further validated using European Centre for Medium

  19. Long period nodal motion of sun synchronous orbits

    NASA Technical Reports Server (NTRS)

    Duck, K. I.

    1975-01-01

    An approximative model is formulated for assessing these perturbations that significantly affect long term modal motion of sun synchronous orbits. Computer simulations with several independent computer programs consider zonal and tesseral gravitational harmonics, third body gravitational disturbances induced by the sun and the moon, and atmospheric drag. A pendulum model consisting of evenzonal harmonics through order 4 and solar gravity dominated nodal motion approximation. This pendulum motion results from solar gravity inducing an inclination oscillation which couples into the nodal precession induced by the earth's oblateness. The pendulum model correlated well with simulations observed flight data.

  20. Prevalence of occult hepatitis C infection in chronic hemodialysis and kidney transplant patients.

    PubMed

    Baid-Agrawal, Seema; Schindler, Ralf; Reinke, Petra; Staedtler, Adrienne; Rimpler, Sunda; Malik, Barbara; Frei, Ulrich; Berg, Thomas

    2014-05-01

    Detection of hepatitis C virus (HCV) RNA in peripheral blood mononuclear cells (PBMC) and/or hepatocytes in absence of HCV RNA in serum, designated as 'occult HCV infection', has been a matter of controversy in recent years. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis (CHD) and kidney transplant (KTx) patients. We enrolled 417 CHD patients, 417 KTx recipients and 2 control groups - 25 anti-HCV (antibody against HCV)-positive and HCV RNA-positive patients with chronic hepatitis C, and 40 anti-HCV-, HCV RNA-, and HBsAg-negative healthy subjects. HCV RNA was tested in serum and PBMC using a sensitive commercial assay. In CHD patients, the prevalence of anti-HCV was 3.6% (15/417) and of positive serum HCV RNA 2.4% (10/417). HCV RNA was detected in PBMC in 1/407 (0.25%) HCV serum RNA-negative patients ("occult HCV infection"). In KTx recipients, prevalence of anti-HCV was 4.8% (20/417) and of positive serum HCV RNA 4.6% (19/417). Occult HCV infection was found in 2/398 (0.5%) serum HCV RNA-negative patients. On a mean longitudinal follow-up of 30months of the 3 patients with occult HCV infection, there was no clinical or virological evidence of HCV infection. The prevalence of occult HCV infection was very low in our CHD and KTx patients, and it did not appear to be clinically relevant. Further studies in geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  1. Surgical treatment of solitary brain metastases.

    PubMed

    Gates, Marilyn; Alsaidi, Mohammed; Kalkanis, Steven

    2012-01-01

    Brain metastases are the most common form of brain tumors and are diagnosed in about 40% of all patients with systemic malignancies. Although the percentage of solitary brain metastases has dropped in recent estimates from about 50-30% of all patients with brain metastases, this percentage still represents a significant number of patients, and the overall incidence of brain metastases is still on the rise. Historically, brain metastases carried a grim prognosis with a median survival of only a few weeks. The utilization of whole-brain radiation therapy (WBRT) and steroids improved the prognosis to few months. However, it was not until the advent of advanced surgical techniques in conjunction with other treatment modalities such as WBRT and stereotactic radiosurgery that patients became less likely to succumb to neurological complications. In the last few decades, surgical resection has evolved from a mere emergent palliative treatment to a standard treatment modality that has led to improved clinical outcomes in carefully selected patients with brain metastases. This positive contribution has been made possible by randomized clinical trials, advancement of surgical techniques and tools, imaging modalities, and better understanding of the pathophysiology and perioperative care. Copyright © 2012 S. Karger AG, Basel.

  2. A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'.

    PubMed

    Pescatori, M; Spyrou, M; Pulvirenti d'Urso, A

    2006-11-01

    Surgical treatment of constipation and obstructed defecation (OD) carries frequent recurrences, as OD is an 'iceberg syndrome' characterized by 'underwater rocks' or occult diseases which may affect the outcome of surgery. The aim of this study was to evaluate occult disorders in order to alert the clinician of these and minimize failures. One hundred consecutive constipated patients with OD symptoms, 81 female patients, median age 52 years, underwent perineal examination, proctoscopy, anorectal manometry, and anal/vaginal ultrasound. Anorectal physiology and imaging tests were also carried out when indicated, as well as psychological and urogynaecological consultation. Symptoms were graded using a modified 1-20 constipation score. Both evident (e.g. rectocele) and occult (e.g. anismus) diseases were prospectively evaluated using a novel 'iceberg diagram'. The type of treatment, whether conservative or surgical, was also recorded. Fifty-four (54%) patients had both mucosal prolapse and rectocele. All patients had at least two occult OD-related diseases, 66 patients had at least three: anxiety-depression, anismus and rectal hyposensation were the most frequent (66%, 44% and 33% respectively). The median constipation score was 11 (range 2-20), the median number of 'occult disorders' was 5 (range 2-8). Conservative treatment was carried out in most patients. Surgery was carried out in 14 (14%) patients. The novel 'iceberg diagram' allowed the adequate evaluation of OD-related occult diseases and better selection of patients for treatment. Most were managed conservatively, and only a minority were treated by surgery.

  3. A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'.

    PubMed

    Pescatori, M; Spyrou, M; Pulvirenti d'Urso, A

    2007-06-01

    Surgical treatment of constipation and obstructed defecation (OD) carries frequent recurrences, as OD is an 'iceberg syndrome' characterized by 'underwater rocks' or occult diseases which may affect the outcome of surgery. The aim of this study was to evaluate occult disorders, in order to alert the clinician of these and minimize failures. One hundred consecutive constipated patients with OD symptoms, 81 women, median age 52 years, underwent perineal examination, proctoscopy, anorectal manometry and anal/vaginal ultrasound (US). Anorectal physiology and imaging tests were also carried out when indicated, as well as psychological and urogynaecological consultations. Symptoms were graded using a modified 1-20 constipation score. Both evident (e.g. rectocele) and occult (e.g. anismus) diseases were prospectively evaluated using a novel 'iceberg diagram'. The type of treatment, whether conservative or surgical, was also recorded. Fifty-four (54%) patients had both mucosal prolapse and rectocele. All patients had at least two occult OD-related diseases, 66 patients had at least three of them: anxiety-depression, anismus and rectal hyposensation were the most frequent (66%, 44% and 33%, respectively). The median constipation score was 11 (range 2-20), the median number of 'occult disorders' was 5 (range 2-8). Conservative treatment was carried out in most cases. Surgery was carried out in 14 (14%) patients. The novel 'iceberg diagram' allowed the adequate evaluation of OD-related occult diseases and better selection of patients for treatment. Most were managed conservatively, and only a minority were treated by surgery.

  4. Occult head injury is common in children with concern for physical abuse.

    PubMed

    Boehnke, Mitchell; Mirsky, David; Stence, Nicholas; Stanley, Rachel M; Lindberg, Daniel M

    2018-04-13

    Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children <2 years old with concern for physical abuse. The American College of Radiology (ACR) recommends clinicians have a low threshold to obtain neuroimaging in these patients. Our aim was to determine the prevalence of occult head injury in a large patient cohort with suspected physical abuse using similar selection criteria from previous studies. Additionally, we evaluated proposed risk factors for associations with occult head injury. This was a retrospective, secondary analysis of data collected by an observational study of 20 U.S. child abuse teams that evaluated children who underwent subspecialty evaluation for concern of abuse. We evaluated children <2 years old and excluded those with abnormal mental status, bulging fontanelle, seizure, respiratory arrest, underlying neurological condition, focal neurological deficit or scalp injury. One thousand one hundred forty-three subjects met inclusion criteria and 62.5% (714) underwent neuroimaging with either head computed tomography or magnetic resonance imaging. We found an occult head injury prevalence of 19.7% (141). Subjects with emesis (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.8-6.8), macrocephaly (OR 8.5, 95% CI 3.7-20.2), and loss of consciousness (OR 5.1, 95% CI 1.2-22.9) had higher odds of occult head injury. Our results show a high prevalence of occult head injury in patients <2 years old with suspected physical abuse. Our data support the ACR recommendation that clinicians should have a low threshold to perform neuroimaging in patients <2 years of age.

  5. Topological nodal superconducting phases and topological phase transition in the hyperhoneycomb lattice

    NASA Astrophysics Data System (ADS)

    Bouhon, Adrien; Schmidt, Johann; Black-Schaffer, Annica M.

    2018-03-01

    We establish the topology of the spin-singlet superconducting states in the bare hyperhoneycomb lattice, and we derive analytically the full phase diagram using only symmetry and topology in combination with simple energy arguments. The phase diagram is dominated by two states preserving time-reversal symmetry. We find a line-nodal state dominating at low doping levels that is topologically nontrivial and exhibits surface Majorana flatbands, which we show perfectly match the bulk-boundary correspondence using the Berry phase approach. At higher doping levels, we find a fully gapped state with trivial topology. By analytically calculating the topological invariant of the nodal lines, we derive the critical point between the line-nodal and fully gapped states as a function of both pairing parameters and doping. We find that the line-nodal state is favored not only at lower doping levels but also if symmetry-allowed deformations of the lattice are present. Adding simple energy arguments, we establish that a fully gapped state with broken time-reversal symmetry likely appears covering the actual phase transition. We find this fully gapped state to be topologically trivial, while we find an additional point-nodal state at very low doing levels that also break time-reversal symmetry and has nontrivial topology with associated Fermi surface arcs. We eventually address the robustness of the phase diagram to generalized models also including adiabatic spin-orbit coupling, and we show how all but the point-nodal state are reasonably stable.

  6. Using the EXIST Active Shields for Earth Occultation Observations of X-Ray Sources

    NASA Technical Reports Server (NTRS)

    Wilson, Colleen A.; Fishman, Gerald; Hong, Jae-Sub; Gridlay, Jonathan; Krawczynski, Henric

    2005-01-01

    The EXIST active shields, now being planned for the main detectors of the coded aperture telescope, will have approximately 15 times the area of the BATSE detectors; and they will have a good geometry on the spacecraft for viewing both the leading and training Earth's limb for occultation observations. These occultation observations will complement the imaging observations of EXIST and can extend them to higher energies. Earth occultatio observations of the hard X-ray sky with BATSE on the Compton Gamma Ray Observatory developed and demonstrated the capabilities of large, flat, uncollimated detectors for this method. With BATSE, a catalog of 179 X-ray sources was monitored twice every spacecraft orbit for 9 years at energies above about 25 keV, resulting in 83 definite detections and 36 possible detections with 5-sigma detection sensitivities of 3.5-20 mcrab (20-430 keV) depending on the sky location. This catalog included four transients discovered with this technique and many variable objects (galactic and extragalactic). This poster will describe the Earth occultation technique, summarize the BATSE occultation observations, and compare the basic observational parameters of the occultation detector elements of BATSE and EXIST.

  7. Unilateral dampening of Bmp activity by nodal generates cardiac left-right asymmetry.

    PubMed

    Veerkamp, Justus; Rudolph, Franziska; Cseresnyes, Zoltan; Priller, Florian; Otten, Cécile; Renz, Marc; Schaefer, Liliana; Abdelilah-Seyfried, Salim

    2013-03-25

    Signaling by Nodal and Bmp is essential for cardiac laterality. How activities of these pathways translate into left-right asymmetric organ morphogenesis is largely unknown. We show that, in zebrafish, Nodal locally reduces Bmp activity on the left side of the cardiac field. This effect is mediated by the extracellular matrix enzyme Hyaluronan synthase 2, expression of which is induced by Nodal. Unilateral reduction of Bmp signaling results in lower expression of nonmuscle myosin II and higher cell motility on the left, driving asymmetric displacement of the entire cardiac field. In silico modeling shows that left-right differences in cell motility are sufficient to induce a robust, directional migration of cardiac tissue. Thus, the mechanism underlying the formation of cardiac left-right asymmetry involves Nodal modulating an antimotogenic Bmp activity. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Probing the Martian Atmosphere with MAVEN/IUVS Stellar Occultations

    NASA Astrophysics Data System (ADS)

    Gröller, H.; Yelle, R. V.; Koskinen, T.; Montmessin, F.; Lacombe, G.; Schneider, N. M.; Deighan, J.; Stewart, I. F.; Jain, S.; Chaffin, M.; Crismani, M. M. J.; Stiepen, A.; Lefèvre, F.; McClintock, B.; Clarke, J. T.; Holsclaw, G.; Mahaffy, P. R.; Bougher, S. W.; Jakosky, B. M.

    2015-12-01

    We present the first results of FUV and MUV stellar occultations taken with the Imaging UltraViolet Spectrometer (IUVS) onboard MAVEN. The FUV and MUV channels of the IUVS together cover the spectral range from 115 to 330 nm. The first two campaigns were executed during March 24 and March 26, 2015, and during May 17 and May 18, 2015, respectively. So far 13 occultations could be used to retrieve CO2 and O2 number densities in the altitude range between 100 and 150 km from the first occultation campaign. From the second occultation campaign number densities for CO2, O3, and aerosols were obtained between 20 and 100 km altitude. Temperature profiles for the same altitude ranges were calculated by applying the constraint of hydrostatic equilibrium to the CO2 densities. With a cadence of 2.6 s, including a 2.0 s integration time, the altitude resolution of the density and temperature profiles is between 1.5 and 4.5 km, depending on the geometry of the particular occultation. The retrieved density profiles of CO2 and O2 agree with previous measurements obtained by the Mars Express SPICAM instrument and by Viking 1 and 2. The corresponding O2 mixing ratios range from 1 to 5 x 10-3, also in agreement with previous observations. The temperatures that we retrieved agree with the models in the Mars Climate Database (MCD) between 10-2 and 10-4 Pa. At lower pressures, however, the measured temperatures are on average 70 K to 100 K cooler than the temperatures predicted by the MCD. This is because the model temperatures increase steadily with altitude above the mesopause whereas the observed temperatures decrease at pressures less than 3.5 x 10-5 Pa, reaching a minimum near 7 x 10-6 Pa. The large differences between the MCD and our results indicate that global models of thermal structure around the mesopause need to be revised.

  9. Management of Brain Metastases.

    PubMed

    Jeyapalan, Suriya A.; Batchelor, Tracy

    2004-07-01

    Advances in neurosurgery and the development of stereotactic radiosurgery have expanded treatment options available for patients with brain metastases. However, despite several randomized clinical trials and multiple uncontrolled studies, there is not a uniform consensus on the best treatment strategy for all patients with brain metastases. The heterogeneity of this patient population in terms of functional status, types of underlying cancers, status of systemic disease control, and number and location of brain metastases make such consensus difficult. Nevertheless, in certain situations, there is Class I evidence that supports one approach or another. The primary objectives in the management of this patient population include improved duration and quality of survival. Very few patients achieve long-term survival after the diagnosis of a brain metastasis.

  10. Observations with the GISMOS Airborne Radio Occultation System

    NASA Astrophysics Data System (ADS)

    Muradyan, Paytsar; Haase, Jennifer; Garrison, James; Lulich, Tyler; Xie, Feiqin

    2010-05-01

    The spatial sample density of temperature and moisture profiles derived from the current spaceborne GPS radio occultation (RO) constellation is limited by the number of occultation satellites in operation. With the current RO satellite configuration, only one RO profile per day is typically available in a 160,000 square kilometer area in the mid-latitude and tropics and slightly more in high latitudes. The airborne RO technique, which has the GPS receiver onboard an airplane, offers flexibility and much denser sampling for targeted observation within 400 km of the aircraft, and provides comparable high vertical resolution to that of the spaceborne case. With an airborne system, targeted measurements can be planned in an optimal geometry to study the accuracy of RO measurements in the lower troposphere where strong vertical gradients in moisture might lead to disruption of signal tracking. These dense measurements can also be used to test assimilation techniques of refractivity and lower tropospheric moisture derived from RO data. In February 2008, the GNSS Instrument System for Multistatic and Occultation Sensing (GISMOS), developed at Purdue University, was successfully deployed on the NSF HIAPER aircraft for series of research flights in the Gulf of Mexico coastal region to validate the airborne observing system. During this campaign, occultation observations were collected in conjunction with supplemental radiosonde and dropsonde soundings. RO signals were recorded using side-looking GPS antennas and dual frequency GPS receivers. However, these conventional phase-locked-loop GPS receivers cannot always track the signal in the lower troposphere, where there are rapid phase accelerations caused by highly variable moisture structures. To extend the observations deeper into the atmosphere, the raw signal from occulting satellites is recorded at 10MHz sampling interval by a GPS recording system (GRS). Open-loop (OL) tracking, which replaces the traditional GPS

  11. Influence of misalignments on the performance of externally occulted solar coronagraphs. Application to PROBA-3/ASPIICS

    NASA Astrophysics Data System (ADS)

    Shestov, S. V.; Zhukov, A. N.

    2018-05-01

    Context. The ASPIICS instrument is a novel externally occulted coronagraph that will be launched on board the PROBA-3 mission of the European Space Agency. The external occulter will be placed on one satellite 150 m ahead of the second satellite that will carry an optical instrument. During 6 h out of 19.38 h of orbit, the satellites will fly in a precise (accuracy around a few millimeters) formation, constituting a giant externally occulted coronagraph. The large distance between the external occulter and the primary objective will allow observations of the white-light solar corona starting from extremely low heights 1.1R⊙. Aims: We intend to analyze influence of shifts of the satellites and misalignments of optical elements on the ASPIICS performance in terms of diffracted light. Based on the quantitative influence of misalignments on diffracted light, we provide a recipe for choosing the size of the internal occulter (IO) to achieve a trade-off between the minimal height of observations and sustainability to possible misalignments. Methods: We considered different types of misalignments and analyzed their influence from optical and computational points of view. We implemented a numerical model of the diffracted light and its propagation through the optical system and computed intensities of diffracted light throughout the instrument. Our numerical approach is based on a model from the literature that considered the axisymmetrical case. Here we extend the model to include nonsymmetrical cases and possible misalignments. Results: The numerical computations fully confirm the main properties of the diffracted light that we obtained from semi-analytical consideration. We obtain that relative influences of various misalignments are significantly different. We show that the internal occulter with RIO = 1.694 mm = 1.1R⊙ is large enough to compensate possible misalignments expected to occur in PROBA-3/ASPIICS. Besides that we show that apodizing the edge of the

  12. Face Centered Cubic SnSe as a Z2 Trivial Dirac Nodal Line Material

    NASA Astrophysics Data System (ADS)

    Tateishi, Ikuma; Matsuura, Hiroyasu

    2018-07-01

    The presence of a Dirac nodal line in a time-reversal and inversion symmetric system is dictated by the Z2 index when spin-orbit interaction is absent. In a first principles calculation, we show that a Dirac nodal line can emerge in Z2 trivial material by calculating the band structure of SnSe in a face centered cubic lattice as an example. We qualitatively show that it becomes a topological crystalline insulator when spin-orbit interaction is taken into account. We clarify the origin of the Dirac nodal line by obtaining irreducible representations corresponding to bands and explain the triviality of the Z2 index. We construct an effective model representing the Dirac nodal line using the k · p method, and discuss the Berry phase and a surface state expected from the Dirac nodal line.

  13. Parapsychology on the couch: the psychology of occult belief in Germany, c. 1870-1939.

    PubMed

    Wolffram, Heather

    2006-01-01

    This article considers the attempts of academic psychologists and critical occultists in Germany during the late nineteenth and early twentieth centuries to construct a psychology of occult belief. While they claimed that the purpose of this new subdiscipline was to help evaluate the work of occult researchers, the emergence of a psychology of occult belief in Germany served primarily to pathologize parapsychology and its practitioners. Not to be outdone, however, parapsychologists argued that their adversaries suffered from a morbid inability to accept the reality of the paranormal. Unable to resolve through experimental means the dispute over who should be allowed to mold the public's understanding of the occult, both sides resorted to defaming their opponent. (c) 2006 Wiley Periodicals, Inc.

  14. Comparing different Ultraviolet Imaging Spectrograph (UVIS) occultation observations using modeling of water vapor jets

    NASA Astrophysics Data System (ADS)

    Portyankina, Ganna; Esposito, Larry W.; Hansen, Candice; Aye, Klaus-Michael

    2016-10-01

    Motivation: On March 11, 2016 the Cassini UVIS observed its 6th star occultation by Enceladus' plume. This observation was aimed to determine variability in the total gas flux from the Enceladus' southern polar region. The analysis of the received data suggests that the total gas flux is moderately increased comparing to the average gas flux observed by UVIS from 2005 to 2011 [1]. However, UVIS detected variability in individual jets. In particular, Baghdad 1 is more collimated in 2016 than in 2005, meaning its gas escapes at higher velocity.Model and fits: We use 3D DSMC model for water vapor jets to compare different UVIS occultation observations from 2005 to 2016. The model traces test articles from jets' sources [2] into space and results in coordinates and velocities for a set of test particles. We convert particle positions into the particle number density and integrate along UVIS line of sight (LoS) for each time step of the UVIS observation using precise observational geometry derived from SPICE [3]. We integrate all jets that are crossed by the LoS and perform constrained least-squares fit of resulting modeled opacities to the observed data to solved for relative strengths of jets. The geometry of each occultation is specific, for example, during solar occultation in 2010 UVIS LoS was almost parallel to tiger stripes, which made it possible to distinguish jets venting from different tiger stripes. In 2011 Eps Orionis occultation LoS was perpendicular to tiger stripes and thus many of the jets were geometrically overlapping. Solar occultation provided us with the largest inventory of active jets - our model fit detects at least 43 non-zero jet contributions. Stellar occultations generally have lower temporal resolution and observe only a sub-set of these jets: 2011 Eps Orionis needs minimum 25 non-zero jets to fit UVIS data. We will discuss different occultations and models fits, including the most recent Epsilon Orionis occultation of 2016.[1] Hansen et al

  15. VizieR Online Data Catalog: Outer satellites occultation predictions (Gomes-Junior+, 2016)

    NASA Astrophysics Data System (ADS)

    Gomes-Junior, A. R.; Assafin, M.; Beauvalet, L.; Desmars, J.; Vieira-Martins, R.; Camargo, J. I. B.; Morgado, B. E.; Braga-Ribas, F.

    2016-07-01

    Tables contain the day of the year and UTC central instant of the prediction; right ascension and declination of the occulted star - at the central instant of the occultation (corrected by proper motions); C/A: apparent geocentric distance between the satellite and the star (a.k.a. the distance between the shadow and the center of the Earth) at the moment of the geocentric closest approach, in arcseconds; P/A: the satellite position angle with respect to the occulted star at C/A, in degrees (zero at north of the star, increasing clockwise); v: relative velocity of event in km/s: positive = prograde, negative = retrograde; D: Geocentric distance to the occulting object in AU; R*: normalized UCAC4 magnitude in the R-band to a common shadow of 20km/s by the relationship R*=RUCAC4+2.5xlog(velocity/(20km/s)), the value 20km/s is typical of events around the opposition; long: east longitude of subplanet point in degrees, positive towards east, at the instant of the geocentric closest approach; LST: UT + long: local solar time at subplanet point, hh:mm; pmra and pmdec: proper motions in right ascension and declination, respectively (mas/year). For more detailed information about the definition and use of these stellar occultation geometric elements see Assafin et al. (2010, Cat. J/A+A/515/A32). (2 data files).

  16. Symmorphic Intersecting Nodal Rings in Semiconducting Layers

    NASA Astrophysics Data System (ADS)

    Gong, Cheng; Xie, Yuee; Chen, Yuanping; Kim, Heung-Sik; Vanderbilt, David

    2018-03-01

    The unique properties of topological semimetals have strongly driven efforts to seek for new topological phases and related materials. Here, we identify a critical condition for the existence of intersecting nodal rings (INRs) in symmorphic crystals, and further classify all possible kinds of INRs which can be obtained in the layered semiconductors with Amm2 and Cmmm space group symmetries. Several honeycomb structures are suggested to be topological INR semimetals, including layered and "hidden" layered structures. Transitions between the three types of INRs, named as α , β , and γ type, can be driven by external strains in these structures. The resulting surface states and Landau-level structures, more complicated than those resulting from a simple nodal loop, are also discussed.

  17. [Bone metastases pain in the elderly].

    PubMed

    Chouahnia, K; Luu, M; Baba-Hamed, N; Des Guetz, G

    2009-05-20

    Every year in Europe and in USA, more than 60% of new cases of cancer are diagnosed at the patient's of more than 65 years with a mortality of more than 70%. Pain, is a major symptom which often accompanies cancer. It is always painful and intolerable, notably when pain is linked to bone metastases to elderly patients often poly pathological. In 1/3 of cases pain is present at the time of diagnosis of cancer and in 2/3 of cases at the advanced diseases. The bone metastases occupy the third place after the pulmonary and liver metastases. They are in order of frequency linked in breast cancer, the kidney and the prostate cancer. Bone metastases are at the origin of the loss of the elderly autonomy, with for consequence an impairment of quality of life. Validated tools are at now available to assess this pain. The different treatments offered in bone metastases pain are: the chemotherapy, the surgery, radiotherapy, bisphosphonates and analgesic treatment.

  18. Imaging of brain metastases.

    PubMed

    Fink, Kathleen R; Fink, James R

    2013-01-01

    Imaging plays a key role in the diagnosis of central nervous system (CNS) metastasis. Imaging is used to detect metastases in patients with known malignancies and new neurological signs or symptoms, as well as to screen for CNS involvement in patients with known cancer. Computed tomography (CT) and magnetic resonance imaging (MRI) are the key imaging modalities used in the diagnosis of brain metastases. In difficult cases, such as newly diagnosed solitary enhancing brain lesions in patients without known malignancy, advanced imaging techniques including proton magnetic resonance spectroscopy (MRS), contrast enhanced magnetic resonance perfusion (MRP), diffusion weighted imaging (DWI), and diffusion tensor imaging (DTI) may aid in arriving at the correct diagnosis. This image-rich review discusses the imaging evaluation of patients with suspected intracranial involvement and malignancy, describes typical imaging findings of parenchymal brain metastasis on CT and MRI, and provides clues to specific histological diagnoses such as the presence of hemorrhage. Additionally, the role of advanced imaging techniques is reviewed, specifically in the context of differentiating metastasis from high-grade glioma and other solitary enhancing brain lesions. Extra-axial CNS involvement by metastases, including pachymeningeal and leptomeningeal metastases is also briefly reviewed.

  19. Defining occult injuries of the distal forearm and wrist in children.

    PubMed

    Elvey, Michael; Patel, S; Avisar, Erez; White, W J; Sorene, E

    2016-06-01

    The nonspecific terms "wrist sprain" and "suspected occult bony injury" are frequently documented as diagnoses in occult paediatric wrist injuries. To date, however, no one has accurately defined their true underlying pathology. The primary objective of this study was to identify the true pathoanatomy of occult acute paediatric wrist injuries. Our secondary objective was to compare our findings with existing adult data in order to determine any population differences that might be clinically relevant. We performed a single-centre retrospective case series evaluating MRI findings in acute paediatric wrist injuries presenting to the hand injury unit between 2011 and 2014. All patients underwent standardised radiographs of the wrist and, where clinically indicated, of the scaphoid. Where no bony anomaly was identified, MRI scanning was offered. Cohen's kappa coefficient was used to calculate the agreement between clinical and MRI diagnosis. 57 patients met the final inclusion criteria. Occult fractures and bony contusions comprised the majority of the pathologies, at 36.5 and 35.0 %, respectively. There were no cases of isolated soft-tissue injury. MRI effected management change in 35.1 % of cases. Paediatric wrists demonstrated differences in injury pattern and distribution when compared to an adult population. This study defines for the first time the true pathology of occult paediatric wrist injuries. The current definition of a wrist sprain was not applicable to a single case and therefore appears to be inappropriate for use in the paediatric population. A precise knowledge of the likely pathology facilitates accurate information delivery whilst reducing parental uncertainty and treatment variation.

  20. Painful cutaneous metastases from esophageal carcinoma.

    PubMed

    Stein, Ronnit Hamuy; Spencer, James M

    2002-10-01

    Cutaneous metastases, which are not included among the painful dermal tumors, are primarily asymptomatic and of variable clinical appearance. Although, to our knowledge, this case report of painful cutaneous metastases is only the fifth in the literature, physicians who discover a painful tumor perhaps now should consider cutaneous metastasis. In this report, we describe painful nodular scalp lesions related to esophageal adenocarcinoma, which rarely metastasizes to the skin.

  1. A predictive index of axillary nodal involvement in operable breast cancer.

    PubMed Central

    De Laurentiis, M.; Gallo, C.; De Placido, S.; Perrone, F.; Pettinato, G.; Petrella, G.; Carlomagno, C.; Panico, L.; Delrio, P.; Bianco, A. R.

    1996-01-01

    We investigated the association between pathological characteristics of primary breast cancer and degree of axillary nodal involvement and obtained a predictive index of the latter from the former. In 2076 cases, 17 histological features, including primary tumour and local invasion variables, were recorded. The whole sample was randomly split in a training (75% of cases) and a test sample. Simple and multiple correspondence analysis were used to select the variables to enter in a multinomial logit model to build an index predictive of the degree of nodal involvement. The response variable was axillary nodal status coded in four classes (N0, N1-3, N4-9, N > or = 10). The predictive index was then evaluated by testing goodness-of-fit and classification accuracy. Covariates significantly associated with nodal status were tumour size (P < 0.0001), tumour type (P < 0.0001), type of border (P = 0.048), multicentricity (P = 0.003), invasion of lymphatic and blood vessels (P < 0.0001) and nipple invasion (P = 0.006). Goodness-of-fit was validated by high concordance between observed and expected number of cases in each decile of predicted probability in both training and test samples. Classification accuracy analysis showed that true node-positive cases were well recognised (84.5%), but there was no clear distinction among the classes of node-positive cases. However, 10 year survival analysis showed a superimposible prognostic behaviour between predicted and observed nodal classes. Moreover, misclassified node-negative patients (i.e. those who are predicted positive) showed an outcome closer to patients with 1-3 metastatic nodes than to node-negative ones. In conclusion, the index cannot completely substitute for axillary node information, but it is a predictor of prognosis as accurate as nodal involvement and identifies a subgroup of node-negative patients with unfavourable prognosis. PMID:8630286

  2. Shape and Size of Patroclus and Menoetius from a Stellar Occultation

    NASA Astrophysics Data System (ADS)

    Buie, Marc W.; Olkin, Catherine B.; Merline, William J.; Timerson, Brad; Herald, Dave; Owen, William M.; Abramson, Harry B.; Abramson, Katherine J.; Breit, Derek C.; Caton, D. B.; Conard, Steve J.; Croom, Mark A.; Dunford, R. W.; Dunford, J. A.; Dunham, David W.; Ellington, Chad K.; Liu, Yanzhe; Maley, Paul D.; Olsen, Aart M.; Royer, Ronald; Scheck, Andrew E.; Sherrod, Clay; Sherrod, Lowell; Swift, Theodore J.; Taylor, Lawrence W.; Venable, Roger

    2014-11-01

    We will present results of a stellar occultation by the Jupiter Trojan asteroid, Patroclus and its nearly equal size moon, Menoetius. The occultation was observed widely across the United States on 2013 Oct 21 UT. Eleven sites out of 36 successfully recorded an occultation. Seven chords across Patroclus yielded a elliptical limb fit of 124.6 km by 98.2 km. There were six chords across Menoetius that yielded an elliptical limb fit of 117.2 km by 93.0 km. There were three sites that got chords on both objects. At the time of the occultation we measured a separation of 0.247 arcsec and a position angle for Menoetius of 265.7 deg measured eastward from J2000 North. More surprisingly, there were two sites that should have seen an occultation by Menoetius but instead never saw the star disappear. These two non-detections indicate the presence of a large void on the southern limb of the satellite. The observations are consistent with a large impact basin centered on the rotation pole. The depth of the projected crater profile is roughly 15 km, measured from the elliptical limb profile. The inferred diameter of the crater would be about 85 km. Combining this occultation data with previous lightcurve data, the axial ratios (ignoring the mass void) of both objects is 1.26:1.19:1 indicative of a mostly oblate ellipsoid with a slight asymmetry in its equatorial projection. These results are consistent with a fully tidally evolved system with the mass void or putative crater in a position consistent with principal axis rotation that is itself consistent with the largely oblate shape. Note: the location for IOTA listed in the affiliations is not correct (but was required to be entered) as there is no location for this global virtual organization. This research is funded, in part, by NSF AST-1212159.

  3. Risk of Ischemic and Hemorrhagic Strokes in Occult and Manifest Cancers.

    PubMed

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2018-06-04

    Manifest cancer is associated with increased risk of stroke. The risk of stroke in people with occult cancer in comparison to the risk in the background population without cancer has not been investigated. Smoking is a risk factor for both cancer and stroke, but the role of smoking for the risk of stroke in cancer has not been investigated. We identified all incident cases of cancer in Denmark 2003 to 2012 (n=264.376) from the Danish Cancer Registry. Each person with cancer was matched by age, sex, and income with 10 randomly selected persons without cancer at index date (n=2.571.260). Linking data to the Danish Stroke Registry, we studied risk of ischemic/hemorrhagic stroke the year before (occult cancer) and after cancer diagnosis was established in the Danish Stroke Registry (manifest cancer) and stratified into the 15 most common cancer types related (lung, colon, bladder, rectum, pancreas, kidney, stomach, and head and neck cancer) and unrelated (non-Hodgkin lymphoma, breast, prostate, melanoma, central nervous system, ovary and endometrial) to smoking. Risk of ischemic/hemorrhagic stroke was increased for both occult (relative risk, 1.75/2.00) and manifest cancers (relative risk, 1.30/1.41). For occult cancer, risk of ischemic stroke was increased for all of the smoking-related cancers, but among cancers unrelated to smoking, only lymphoma, central nervous system, and endometrial cancer were associated with increased risk of stroke; breast, prostate, melanoma, and ovarian cancers were not. For occult cancer, risk of hemorrhagic stroke was generally increased for smoking-related cancers while not for cancers unrelated to smoking. For manifest cancer, risk of ischemic and hemorrhagic stroke was generally increased for cancers related to smoking while not for cancers unrelated to smoking. Cancer, occult and manifest, is associated with increased risks for stroke. The increased risk is linked mainly to cancers related to smoking. © 2018 American Heart

  4. Reactivation of Embryonic Nodal Signaling is Associated with Tumor Progression and Promotes the Growth of Prostate Cancer Cells

    PubMed Central

    Lawrence, Mitchell G.; Margaryan, Naira V.; Loessner, Daniela; Collins, Angus; Kerr, Kris M.; Turner, Megan; Seftor, Elisabeth A.; Stephens, Carson R.; Lai, John; BioResource, APC; Postovit, Lynne-Marie; Clements, Judith A.; Hendrix, Mary J.C.

    2011-01-01

    Background Nodal is a member of the Transforming Growth Factor β (TGFβ) superfamily that directs embryonic patterning and promotes the plasticity and tumorigenicity of tumor cells, but its role in the prostate is unknown. The goal of this study was to characterize the expression and function of Nodal in prostate cancer and determine whether, like other TGFβ ligands, it modulates androgen receptor (AR) activity. Methods Nodal expression was investigated using immunohistochemistry of tissue microarrays and Western blots of prostate cell lines. The functional role of Nodal was examined using Matrigel and soft agar growth assays. Cross-talk between Nodal and AR signaling was assessed with luciferase reporter assays and expression of endogenous androgen regulated genes. Results Significantly increased Nodal expression was observed in cancer compared with benign prostate specimens. Nodal was only expressed by DU145 and PC3 cells. All cell lines expressed Nodal’s co-receptor, Cripto-1, but lacked Lefty, a critical negative regulator of Nodal signaling. Recombinant human Nodal triggered downstream Smad2 phosphorylation in DU145 and LNCaP cells, and stable transfection of pre-pro-Nodal enhanced the growth of LNCaP cells in Matrigel and soft agar. Finally, Nodal attenuated AR signaling, reducing the activity of a PSA promoter construct in luciferase assays and down-regulating the endogenous expression of androgen regulated genes. Conclusions An aberrant Nodal signaling pathway is re-expressed and functionally active in prostate cancer cells. PMID:21656830

  5. Electron densities in the ionosphere of Mars: A comparison of MARSIS and radio occultation measurements

    NASA Astrophysics Data System (ADS)

    Vogt, Marissa F.; Withers, Paul; Fallows, Kathryn; Flynn, Casey L.; Andrews, David J.; Duru, Firdevs; Morgan, David D.

    2016-10-01

    Radio occultation electron densities measurements from the Mariner 9 and Viking spacecraft, which orbited Mars in the 1970s, have recently become available in a digital format. These data are highly complementary to the radio occultation electron density profiles from Mars Global Surveyor, which were restricted in solar zenith angle and altitude. We have compiled data from the Mariner 9, Viking, and Mars Global Surveyor radio occultation experiments for comparison to electron density measurements made by Mars Advanced Radar for Subsurface and Ionosphere Sounding (MARSIS), the topside radar sounder on Mars Express, and MARSIS-based empirical density models. We find that the electron densities measured by radio occultation are in generally good agreement with the MARSIS data and model, especially near the altitude of the peak electron density but that the MARSIS data and model display a larger plasma scale height than the radio occultation profiles at altitudes between the peak density and 200 km. Consequently, the MARSIS-measured and model electron densities are consistently larger than radio occultation densities at altitudes 200-300 km. Finally, we have analyzed transitions in the topside ionosphere, at the boundary between the photochemically controlled and transport-controlled regions, and identified the average transition altitude, or altitude at which a change in scale height occurs. The average transition altitude is 200 km in the Mariner 9 and Viking radio occultation profiles and in profiles of the median MARSIS radar sounding electron densities.

  6. Brady's Geothermal Field Nodal Seismometers Metadata

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lesley Parker

    Metadata for the nodal seismometer array deployed at the POROTOMO's Natural Laboratory in Brady Hot Spring, Nevada during the March 2016 testing. Metadata includes location and timing for each instrument as well as file lists of data to be uploaded in a separate submission.

  7. Naturally Occurring Mutations in Large Surface Genes Related to Occult Infection of Hepatitis B Virus Genotype C

    PubMed Central

    Kim, Hong; Lee, Seoung-Ae; Kim, Dong-Won; Lee, Sueng-Hyun; Kim, Bum-Joon

    2013-01-01

    Molecular mechanisms related to occult hepatitis B virus (HBV) infection, particularly those based on genotype C infection, have rarely been determined thus far in the ongoing efforts to determine infection mechanisms. Therefore, we aim to elucidate the mutation patterns in the surface open reading frame (S ORF) underlying occult infections of HBV genotype C in the present study. Nested PCRs were applied to 624 HBV surface antigen (HBsAg) negative Korean subjects. Cloning and sequencing of the S ORF gene was applied to 41 occult cases and 40 control chronic carriers. Forty-one (6.6%) of the 624 Korean adults with HBsAg-negative serostatus were found to be positive for DNA according to nested PCR tests. Mutation frequencies in the three regions labeled here as preS1, preS2, and S were significantly higher in the occult subjects compared to the carriers in all cases. A total of two types of deletions, preS1 deletions in the start codon and preS2 deletions as well as nine types of point mutations were significantly implicated in the occult infection cases. Mutations within the “a” determinant region in HBsAg were found more frequently in the occult subjects than in the carriers. Mutations leading to premature termination of S ORF were found in 16 occult subjects (39.0%) but only in one subject from among the carriers (2.5%). In conclusion, our data suggest that preS deletions, the premature termination of S ORF, and “a” determinant mutations are associated with occult infections of HBV genotype C among a HBsAg-negative population. The novel mutation patterns related to occult infection introduced in the present study can help to broaden our understanding of HBV occult infections. PMID:23349904

  8. Role of Radiotherapy in the Treatment of Cervical Lymph Node Metastases From an Unknown Primary Site: Retrospective Analysis of 113 Patients

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beldi, Debora; Jereczek-Fossa, Barbara A.; University of Milan, Milan

    2007-11-15

    Purpose: The management of patients with cervical lymph-node metastases from unknown primary site (UPS) remains a matter of discussion. This study aimed to analyze the results and prognostic factors in a series of patients treated with radiotherapy. Methods and Materials: Data from 113 patients who presented with cervical lymph nodes metastases from UPS treated from 1980 to 2004 were reviewed. Eighty-seven patients (77.0%) were squamous cell carcinoma (SCC). Ninety-one patients were treated with curative and 22 with palliative intent. Fifty-nine of 113 patients (52.2%) received surgery followed by radiotherapy and 54 of 113 (47.8%) received radiotherapy alone. Radiotherapy was deliveredmore » to the neck and pharyngeal mucosa in 67 patients and to the ipsilateral or bilateral neck in 45 patients. Twenty-one patients (18.5%) also received chemotherapy. Results: The 5-year overall survival rates were 40.7% for the entire group and 46.6% for the SCC subgroup. The occurrence of the occult primary was observed in 23 of 113 patients (20.3%), 19 (82.6%) within the head and neck region. At multivariate analysis, treatment with curative intent and extensive irradiation of bilateral neck and pharyngeal mucosa were favorable prognostic factors for the whole series, and treatment with curative intent, extensive irradiation of bilateral neck and pharyngeal mucosa, and absence of extracapsular spread were favorable prognostic factors for the SCC subgroup. Conclusions: Patients with cervical lymph node metastases from UPS have a similar prognosis to those affected by other head and neck malignancies. Curative treatment strategies including neck dissection and extensive irradiation by three-dimensional conformal radiation therapy resulted in significantly better outcomes.« less

  9. Circulating Tumor Cells Predict Occult Metastatic Disease and Prognosis in Pancreatic Cancer.

    PubMed

    Court, Colin M; Ankeny, Jacob S; Sho, Shonan; Winograd, Paul; Hou, Shuang; Song, Min; Wainberg, Zev A; Girgis, Mark D; Graeber, Thomas G; Agopian, Vatche G; Tseng, Hsian-Rong; Tomlinson, James S

    2018-04-01

    Occult metastatic tumors, below imaging thresholds, are a limitation of staging systems that rely on cross-sectional imaging alone and are a cause of the routine understaging of pancreatic ductal adenocarcinomas (PDACs). We investigated circulating tumor cells (CTCs) as a preoperative predictor of occult metastatic disease and as a prognostic biomarker for PDAC patients. A total of 126 patients (100 with cancer, 26 with benign disease) were enrolled in our study and CTCs were identified and enumerated from 4 mL of venous blood using the microfluidic NanoVelcro assay. CTC enumeration was correlated with clinicopathologic variables and outcomes following both surgical and systemic therapies. CTCs were identified in 78% of PDAC patients and CTC counts correlated with increasing stage (ρ = 0.42, p < 0.001). Of the 53 patients taken for potentially curative surgery, 13 (24.5%) had occult metastatic disease intraoperatively. Patients with occult disease had significantly more CTCs than patients with local disease only (median 7 vs. 1 CTC, p < 0.0001). At a cut-off of three or more CTCs/4 mL, CTCs correctly identified patients with occult metastatic disease preoperatively (area under the receiver operating characteristic curve 0.82, 95% confidence interval (CI) 0.76-0.98, p < 0.0001). CTCs were a univariate predictor of recurrence-free survival following surgery [hazard ratio (HR) 2.36, 95% CI 1.17-4.78, p = 0.017], as well as an independent predictor of overall survival on multivariate analysis (HR 1.38, 95% CI 1.01-1.88, p = 0.040). CTCs show promise as a prognostic biomarker for PDAC patients at all stages of disease being treated both medically and surgically. Furthermore, CTCs demonstrate potential as a preoperative biomarker for identifying patients at high risk of occult metastatic disease.

  10. Lymph node density vs. the American Joint Committee on Cancer TNM nodal staging system in node-positive bladder cancer in patients undergoing extended or super-extended pelvic lymphadenectomy.

    PubMed

    Lee, Donghyun; Yoo, Sangjun; You, Dalsan; Hong, Bumsik; Cho, Yong Mee; Hong, Jun Hyuk; Kim, Choung-Soo; Ahn, Hanjonh; Ro, Jae Y; Jeong, In Gab

    2017-04-01

    We compared the prognostic value of the American Joint Committee on Cancer (AJCC) TNM nodal staging system with that of lymph node (LN) density in patients with LN-positive bladder cancer who received extended or super-extended pelvic lymphadenectomy. Of the 1,018 patients, who underwent radical cystectomy and pelvic lymphadenectomy between February 2005 and August 2014, 110 patients with LN metastases with extended (n = 68) or super-extended (n = 42) pelvic lymphadenectomy were included. All patients were staged using the 2002 (sixth edition) and 2010 (seventh edition) AJCC TNM staging systems. The association of several variables with recurrence-free survival (RFS) and overall survival (OS) was evaluated. The median number of total LNs removed was 29 (6-118) and the median LN density was 12.5% (1.6%-100%). RFS and OS were not significantly different between the 2002 (pN1-pM1) and 2010 (pN1-N3) AJCC TNM nodal staging systems (sixth edition: P = 0.512 and P = 0.519; seventh edition: P = 0.676 and P = 0.671, respectively). The 2-year RFS and OS rates according to the LN density quartiles were 58.5% and 76.9% in Q1, 39.1% and 70.8% in Q2, 28.8% and 50.1% in Q3, and 12.7% and 20.8% in Q4 (P = 0.001 and P = 0.001, respectively). Multivariate analysis adjusted for the 2010 AJCC TNM staging system showed that LN density was associated with a decreased OS (HR = 1.024; 95% CI: 1.010-1.039; P = 0.001). The nodal staging system (2002 or 2010) was not associated with the RFS and OS. LN density shows a better prognostic value than the AJCC TNM nodal staging system in patients with LN-positive bladder cancer receiving extended or super-extended pelvic lymphadenectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Future directions in treatment of brain metastases.

    PubMed

    Barani, Igor J; Larson, David A; Berger, Mitchel S

    2013-01-01

    Brain metastases affect up to 30% of patients with cancer. Management of brain metastases continues to evolve with ever increasing focus on cognitive preservation and quality of life. This manuscript reviews current state of brain metastases management and discusses various treatment controversies with focus on future clinical trials. Stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) are discussed in context of multiple (4+ brain metastases) as well as new approaches combining radiation and targeted agents. A brief discussion of modified WBRT approaches, including hippocampal-avoidance WBRT (HA-WBRT) is included as well as a section on recently presented results of Radiation Therapy Oncology Group (RTOG) 0614, a randomized, double-blind, placebo-controlled trial of menantine for prevention of neurocognitive injury after WBRT. A search of selected studies relevant to management of brain metastases was performed in PubMed as well as in various published meeting abstracts. This data was collated and analyzed in context of contemporary management and future clinical trial plans. This data is presented in tabular form and discussed extensively in the text. The published data demonstrate continued evolution of clinical trials and management strategies designed to minimize and/or prevent cognitive decline following radiation therapy management of brain metastases. Hippocampal avoidance whole-brain radiation therapy (HA-WBRT) and radiosurgery treatments for multiple brain metastases are discussed along with preliminary results of RTOG 0614, a trial of memantine therapy to prevent cognitive decline following WBRT. Trial results appear to support the use of memantine for prevention of cognitive decline. Different management strategies for multiple brain metastases (>4 brain metastases) are currently being evaluated in prospective clinical trials to minimize the likelihood of cognitive decline following WBRT.

  12. Persistence of RSV promotes proliferation and epithelial-mesenchymal transition of bronchial epithelial cells through Nodal signaling.

    PubMed

    Xiang, Zhao; Liang, Zhang; Yanfeng, Huang; Leitao, Kang

    2017-10-01

    Nodal may play an important role in the development of cancers. The present study was designed to determine the effects of Nodal induced by respiratory syncytial virus (RSV) infection on the occurrence and development of lung cancer and the underlying mechanisms. After verification of RSV infection by observation of cytopathic effect and indirect immunofluorescence, real-time PCR, Western blot and methylation assays were used to verify the influence of RSV on Nodal expression. Then, a Nodal overexpressed vector was constructed and the effects of Nodal on the proliferation and apoptosis of bronchial epithelial cells (BECs) and epithelial-mesenchymal transition (EMT) were assayed by flow cytometry and Western blot, respectively. Moreover, Lefty and pSmad2/3 were assayed by Western blot and Cyclin D1, CDK4, c-myc and Bcl-2 induced by Nodal overepression or RSV infection were also assayed by real-time PCR. The results showed that Nodal over expression and demethylation of the promoter were observed in BECs after RSV infection. Activation of Nodal promoted proliferation, colony formation and EMT and inhibited apoptosis of BECs. Nodal also promoted malignant change by promoting expression of cyclin D1 and related-dependent kinase and inhibiting apoptosis. Besides, RSV infection inhibited Lefty expression and promoted the activation of pSmad2/3. RSV also promoted Cyclin D1, CDK4, c-myc and Bcl-2 expression through the activation of pSmad2/3. Our data showed that persistence of RSV promoted the proliferation, epithelial-mesenchymal transition and expression of oncogenes through Nodal signaling, which may be associated with the occurrence and development of lung cancers.

  13. Brady's Geothermal Field - Map of DAS, Nodal, Vibroseis and Reftek Station Deployment

    DOE Data Explorer

    Kurt Feigl

    2016-10-15

    Map of DAS, nodal, vibroseis and Reftek stations during March 2016 deployment. The plot on the left has nodal stations labeled; the plot on the right has vibroseis observations labeled. Stations are shown in map-view using Brady's rotated X-Y coordinates with side plots denoting elevation with respect to the WGS84 ellipsoid. Blue circles denote vibroseis data, x symbols denote DAS (cyan for horizontal and magenta for vertical), black asterisks denote Reftek data, and red plus signs denote nodal data. This map can be found on UW-Madison's askja server at /PoroTomo/DATA/MAPS/Deployment_Stations.pdf

  14. Heparin as a pharmacologic intervention to induce positive scintiscan in occult gastrointestinal bleeding

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chaudhuri, T.K.; Brantly, M.

    1984-04-01

    The value of using heparin as a pharmacologic intervention to induce a positive scintiscan was studied in a patient with chronic occult gastrointestinal bleeding. When all standard diagnostic tests (upper and lower gastrointestinal series, upper and lower endoscopy, and conventional noninterventional Tc-99m RBC imaging) fail to detect and localize gastrointestinal bleeding in a patient who has definite clinical evidence (guaiac positive stool and dropping hemoglobin, hematocrit) of chronic occult gastrointestinal oozing, heparin may be used (with proper precaution) as a last resort to aid in the scintigraphic detection and localization of chronic occult gastrointestinal bleeding.

  15. Asteroid astrometry with Gaia: stellar occultations and beyond

    NASA Astrophysics Data System (ADS)

    Tanga, Paolo; Spoto, Federica; Hestroffer, Daniel; Altmann, Martin; Bouquillon, Sebastien; Desmars, Josselin

    2017-10-01

    The first data release of star astrometry by Gaia (Sept. 2016) has given an anticipation of the mission capabilities. By providing positions with uncertainties at the level of few milli-arcsec (mas) a new frame to calibrate ground-based observations has immediately become available, thus disclosing a new possibility of exploitation for archive data. We will discuss, in particular, the new role of stellar occulations.Successful observations of occultations have been used in the past to provide accurate shape and size of the targets and to calibrate other size determination methods. Now, a new possibility of exploitation exists, as occultation astrometry provides the possibility of measuring precise asteroid position, at the level of Gaia accuracy. This approach will have an increasing impact, also thanks to the much improved prediction accuracy that Gaia is going to provide, for smaller asteroids and fainter target stars.The scientific goals of improving asteroid astrometry are multiple. For instance, reaching sensitivity to Yarkovsky drift in the Main Belt might become possible, by occultation astrometry performed on smaller asteroids, thanks to future Gaia predictions.The second data release (April 2018) will also contain astrometry of asteroids observed directly by Gaia. The properties of this new data set, that will permit direct orbit improvement, will be illustrated.

  16. Titan's Upper Atmosphere from Cassini/UVIS Solar Occultations

    NASA Astrophysics Data System (ADS)

    Capalbo, Fernando J.; Bénilan, Yves; Yelle, Roger V.; Koskinen, Tommi T.

    2015-12-01

    Titan’s atmosphere is composed mainly of molecular nitrogen, methane being the principal trace gas. From the analysis of 8 solar occultations measured by the Extreme Ultraviolet channel of the Ultraviolet Imaging Spectrograph (UVIS) on board Cassini, we derived vertical profiles of N2 in the range 1100-1600 km and vertical profiles of CH4 in the range 850-1300 km. The correction of instrument effects and observational effects applied to the data are described. We present CH4 mole fractions, and average temperatures for the upper atmosphere obtained from the N2 profiles. The occultations correspond to different times and locations, and an analysis of variability of density and temperature is presented. The temperatures were analyzed as a function of geographical and temporal variables, without finding a clear correlation with any of them, although a trend of decreasing temperature toward the north pole was observed. The globally averaged temperature obtained is (150 ± 1) K. We compared our results from solar occultations with those derived from other UVIS observations, as well as studies performed with other instruments. The observational data we present confirm the atmospheric variability previously observed, add new information to the global picture of Titan’s upper atmosphere composition, variability, and dynamics, and provide new constraints to photochemical models.

  17. Brain metastasization of breast cancer.

    PubMed

    Custódio-Santos, Tânia; Videira, Mafalda; Brito, Maria Alexandra

    2017-08-01

    Central nervous system metastases have been reported in 15-25% of breast cancer patients, and the incidence is increasing. Moreover, the survival of these patients is generally poor, with reports of a 1-year survival rate of 20%. Therefore, a better knowledge about the determinants of brain metastasization is essential for the improvement of the clinical outcomes. Here, we summarize the current data about the metastatic cascade, ranging from the output of cancer cells from the primary tumour to their colonization in the brain, which involves the epithelial-mesenchymal transition, invasion of mammary tissue, intravasation into circulation, and homing into and extravasation towards the brain. The phenotypic change in malignant cells, and the importance of the microenvironment in the formation of brain metastases are also inspected. Finally, the importance of genetic and epigenetic changes, and the recently disclosed effects of microRNAs in brain metastasization of breast cancer are highlighted. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Recognizing nodal marginal zone lymphoma: recent advances and pitfalls. A systematic review

    PubMed Central

    van den Brand, Michiel; van Krieken, J. Han J.M.

    2013-01-01

    The diagnosis of nodal marginal zone lymphoma is one of the remaining problem areas in hematopathology. Because no established positive markers exist for this lymphoma, it is frequently a diagnosis of exclusion, making distinction from other low-grade B-cell lymphomas difficult or even impossible. This systematic review summarizes and discusses the current knowledge on nodal marginal zone lymphoma, including clinical features, epidemiology and etiology, histology, and cytogenetic and molecular features. In particular, recent advances in diagnostics and pathogenesis are discussed. New immunohistochemical markers have become available that could be used as positive markers for nodal marginal zone lymphoma. These markers could be used to ensure more homogeneous study groups in future research. Also, recent gene expression studies and studies describing specific gene mutations have provided clues to the pathogenesis of nodal marginal zone lymphoma, suggesting deregulation of the nuclear factor kappa B pathway. Nevertheless, nodal marginal zone lymphoma remains an enigmatic entity, requiring further study to define its pathogenesis to allow an accurate diagnosis and tailored treatment. However, recent data indicate that it is not related to splenic or extranodal lymphoma, and that it is also not related to lymphoplasmacytic lymphoma. Thus, even though the diagnosis is not always easy, it is clearly a separate entity. PMID:23813646

  19. Altered regional and circuit resting-state activity in patients with occult spastic diplegic cerebral palsy.

    PubMed

    Mu, Xuetao; Wang, Zhiqun; Nie, Binbin; Duan, Shaofeng; Ma, Qiaozhi; Dai, Guanghui; Wu, Chunnan; Dong, Yuru; Shan, Baoci; Ma, Lin

    2017-10-07

    Very few studies have been made to investigate functional activity changes in occult spastic diplegic cerebral palsy (SDCP). The purpose of this study was to analyze whole-brain resting state regional brain activity and functional connectivity (FC) changes in patients with SDCP. We examined 12 occult SDCP and 14 healthy control subjects using resting-state functional magnetic resonance imaging. The data were analyzed using Resting-State fMRI Data Analysis Toolkit (REST) software. The regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and whole brain FC of the motor cortex and thalamus were analyzed and compared between the occult SDCP and control groups. Compared with the control group, the occult SDCP group showed decreased ReHo regions, including the bilateral frontal, parietal, and temporal lobes, the cerebellum, right cingulate gyrus, and right lenticular nucleus, whereas an increased ReHo value was observed in the left precuneus, calcarine, fusiform gyrus, and right precuneus. Compared with the control group, no significant differences in ALFF were noted in the occult SDCP group. With the motor cortex as the region of interest, the occult SDCP group showed decreased connectivity regions in the bilateral fusiform and lingual gyrus, but increased connectivity regions in the contralateral precentral and postcentral gyrus, supplementary motor area, and the ipsilateral postcentral gyrus. With the thalamus being regarded as the region of interest, the occult SDCP group showed decreased connectivity regions in the bilateral basal ganglia, cingulate, and prefrontal cortex, but increased connectivity regions in the bilateral precentral gyrus, the contralateral cerebellum, and inferior temporal gyrus. Resting-state regional brain activities and FC changes in the patients with occult SDCP exhibited a special distribution pattern, which is consistent with the pathology of the disease. Copyright © 2017. Published by Elsevier B.V.

  20. Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece

    PubMed Central

    Mina, Paraskevi; Georgiadou, Sarah P; Rizos, Christos; Dalekos, George N; Rigopoulou, Eirini I

    2010-01-01

    AIM: To assess the hepatitis B virus (HBV)-DNA and the prevalence of occult HBV infection in end-stage renal failure (ESRF) patients from Central Greece. METHODS: Sera from 366 ESRF patients attending five out of six dialysis units from Central Greece were investigated for HBV-DNA by real-time polymerase chain reaction. Only serum samples with repeatedly detectable HBV-DNA were considered positive. IgG antibodies to hepatitis C virus (anti-HCV) were tested by a third generation enzyme linked immunosorbent assay (ELISA), while IgG antibodies to hepatitis E virus (anti-HEV) were tested by two commercially available ELISAs. RESULTS: HBV-DNA was detected in 15/366 patients (4.1%) and HBsAg in 20/366 (5.5%). The prevalence of occult HBV infection was 0.9% (3/346 HBsAg-negative patients). Occult HBV was not associated with a specific marker of HBV infection or anti-HCV or anti-HEV reactivity. There was no significant difference in HBV-DNA titres, demographic and biochemical features, between patients with occult HBV infection and those with HBsAg-positive chronic HBV infection. CONCLUSION: In central Greece, 4% of ESRF patients had detectable HBV-DNA, though in this setting, the prevalence of occult HBV seems to be very low (0.9%). PMID:20066742

  1. Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece.

    PubMed

    Mina, Paraskevi; Georgiadou, Sarah P; Rizos, Christos; Dalekos, George N; Rigopoulou, Eirini I

    2010-01-14

    To assess the hepatitis B virus (HBV)-DNA and the prevalence of occult HBV infection in end-stage renal failure (ESRF) patients from Central Greece. Sera from 366 ESRF patients attending five out of six dialysis units from Central Greece were investigated for HBV-DNA by real-time polymerase chain reaction. Only serum samples with repeatedly detectable HBV-DNA were considered positive. IgG antibodies to hepatitis C virus (anti-HCV) were tested by a third generation enzyme linked immunosorbent assay (ELISA), while IgG antibodies to hepatitis E virus (anti-HEV) were tested by two commercially available ELISAs. HBV-DNA was detected in 15/366 patients (4.1%) and HBsAg in 20/366 (5.5%). The prevalence of occult HBV infection was 0.9% (3/346 HBsAg-negative patients). Occult HBV was not associated with a specific marker of HBV infection or anti-HCV or anti-HEV reactivity. There was no significant difference in HBV-DNA titres, demographic and biochemical features, between patients with occult HBV infection and those with HBsAg-positive chronic HBV infection. In central Greece, 4% of ESRF patients had detectable HBV-DNA, though in this setting, the prevalence of occult HBV seems to be very low (0.9%).

  2. The Clinical Significance of Occult Gastrointestinal Primary Tumours in Metastatic Cancer: A Population Retrospective Cohort Study.

    PubMed

    Hannouf, Malek B; Winquist, Eric; Mahmud, Salaheddin M; Brackstone, Muriel; Sarma, Sisira; Rodrigues, George; Rogan, Peter K; Hoch, Jeffrey S; Zaric, Gregory S

    2018-01-01

    The purpose of this study was to estimate the incidence of occult gastrointestinal (GI) primary tumours in patients with metastatic cancer of uncertain primary origin and evaluate their influence on treatments and overall survival (OS). We used population heath data from Manitoba, Canada to identify all patients initially diagnosed with metastatic cancer between 2002 and 2011. We defined patients to have "occult" primary tumour if the primary was found at least 6 months after initial diagnosis. Otherwise, we considered primary tumours as "obvious." We used propensity-score methods to match each patient with occult GI tumour to four patients with obvious GI tumour on all known clinicopathologic features. We compared treatments and 2-year survival data between the two patient groups and assessed treatment effect on OS using Cox regression adjustment. Eighty-three patients had occult GI primary tumours, accounting for 17.6% of men and 14% of women with metastatic cancer of uncertain primary. A 1:4 matching created a matched group of 332 patients with obvious GI primary tumour. Occult cases compared to the matched group were less likely to receive surgical interventions and targeted biological therapy, and more likely to receive cytotoxic empiric chemotherapeutic agents. Having an occult GI tumour was associated with reduced OS and appeared to be a nonsignificant independent predictor of OS when adjusting for treatment differences. GI tumours are the most common occult primary tumours in men and the second most common in women. Patients with occult GI primary tumours are potentially being undertreated with available GI site-specific and targeted therapies.

  3. Potential role of combined FDG PET/CT & contrast enhancement MRI in a rectal carcinoma model with nodal metastases characterized by a poor FDG-avidity.

    PubMed

    Farace, Paolo; Conti, Giamaica; Merigo, Flavia; Tambalo, Stefano; Marzola, Pasquina; Sbarbati, Andrea; Quarta, Carmelo; D'Ambrosio, Daniela; Chondrogiannis, Sotirios; Nanni, Cristina; Rubello, Domenico

    2012-04-01

    To investigate the additional role of MRI contrast enhancement (CE) in the primary tumor and the FDG uptake at PET in the lymph-node metastases. A model of colorectal cancer induced by orthotopic HT-29 cells microinjection, producing pelvic lymph node metastases, was assessed using CE-MRI and FDG-PET. Histology and GLUT-1 immunohistochemistry were performed on primary tumors and iliac lymph nodes. Primary tumors were characterized by low FDG-uptake but high CE-MRI, particularly at tumor periphery. Undetectable FDG-uptake characterized the metastatic lymph-nodes. Histology revealed large stromal bundles at tumor periphery and a dense network of stromal fibers and neoplastic cells in the inner portion of the tumors. Both primary tumors and positive lymph nodes showed poor GLUT-1 staining. Our data support the complementary role of MRI-CE and FDG PET in some types of carcinomas characterized by abundant cancer-associated stroma and poor FDG avidity consequent to poor GLUT-1 transported. In these tumors FDG-PET alone may be not completely adequate to obtain an adequate tumor radiotherapy planning, and a combination with dual CE-MRI is strongly recommended. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. Do X-ray-occult fractures play a role in chronic pain following a whiplash injury?

    PubMed

    Hertzum-Larsen, Rasmus; Petersen, Henrik; Kasch, Helge; Bendix, Tom

    2014-08-01

    Whiplash trauma in motor vehicle accidents (MVA) may involve various painful soft tissue damages, but weeks/months later a minority of victims still suffers from various long-lasting and disabling symptoms, whiplash-associated disorders (WAD). The etiology is currently unknown, but X-ray-occult fractures may be one cause in some cases. The purpose of this prospective study was to examine the association between occult fractures, as seen on bone single photon emission computed tomography (SPECT), with neck-, head- and arm pain. An inception cohort of 107 patients presenting with acute whiplash symptoms following an MVA was invited to have a cervical SPECT shortly post injury and again 6 months later. Associations between occult fractures and pain levels at baseline, 6 and 12 months of follow-up were analyzed. Eighty-eight patients had baseline SPECT performed at median 15 days (range 3-28) post injury, but only 49 patients accepted to have the follow-up SPECT at 6 months. Abnormal SPECT, defined as minimum one area of focal uptake, was seen in 32 patients at baseline, reflecting an occult fracture. Occult fractures were not associated with pain levels, neither at baseline nor at follow-up. Occult fractures do not seem to play a role for development of chronic pain after whiplash.

  5. Occult infection related hepatitis B surface antigen variants showing lowered secretion capacity

    PubMed Central

    Kim, Hong; Lee, Seoung-Ae; Won, You-Sub; Lee, HyunJoo; Kim, Bum-Joon

    2015-01-01

    AIM: To elucidate the molecular mechanisms underlying hepatitis B virus (HBV) occult infection of genotype C. METHODS: A total of 10 types of hepatitis B surface antigen (HBsAg) variants from a Korean occult cohort were used. After a complete HBV genome plasmid mutated such that it does not express HBsAg and plasmid encoding, each HBsAg variant was transiently co-transfected into HuH-7 cells. The secretion capacity and intracellular expression of the HBV virions and HBsAgs in their respective variants were analyzed using real-time quantitative polymerase chain reaction assays and commercial HBsAg enzyme-linked immunosorbent assays, respectively. RESULTS: All variants exhibited lower levels of HBsAg secretion into the medium compared with the wild type. In particular, in eight of the ten variants, very low levels of HBsAg secretion that were similar to the negative control were detected. In contrast, most variants (9/10) exhibited normal virion secretion capacities comparable with, or even higher than, the wild type. This provided new insight into the intrinsic nature of occult HBV infection, which leads to HBsAg sero-negativeness but has horizontal infectivity. Furthermore, most variants generated higher reactive oxidative species production than the wild type. This finding provides potential links between occult HBV infection and liver disease progression. CONCLUSION: The presently obtained data indicate that deficiency in the secretion capacity of HBsAg variants may have a pivotal function in the occult infections of HBV genotype C. PMID:25684944

  6. Future directions in treatment of brain metastases

    PubMed Central

    Barani, Igor J.; Larson, David A.; Berger, Mitchel S.

    2013-01-01

    Background: Brain metastases affect up to 30% of patients with cancer. Management of brain metastases continues to evolve with ever increasing focus on cognitive preservation and quality of life. This manuscript reviews current state of brain metastases management and discusses various treatment controversies with focus on future clinical trials. Stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) are discussed in context of multiple (4+ brain metastases) as well as new approaches combining radiation and targeted agents. A brief discussion of modified WBRT approaches, including hippocampal-avoidance WBRT (HA-WBRT) is included as well as a section on recently presented results of Radiation Therapy Oncology Group (RTOG) 0614, a randomized, double-blind, placebo-controlled trial of menantine for prevention of neurocognitive injury after WBRT. Methods: A search of selected studies relevant to management of brain metastases was performed in PubMed as well as in various published meeting abstracts. This data was collated and analyzed in context of contemporary management and future clinical trial plans. This data is presented in tabular form and discussed extensively in the text. Results: The published data demonstrate continued evolution of clinical trials and management strategies designed to minimize and/or prevent cognitive decline following radiation therapy management of brain metastases. Hippocampal avoidance whole-brain radiation therapy (HA-WBRT) and radiosurgery treatments for multiple brain metastases are discussed along with preliminary results of RTOG 0614, a trial of memantine therapy to prevent cognitive decline following WBRT. Trial results appear to support the use of memantine for prevention of cognitive decline. Conclusions: Different management strategies for multiple brain metastases (>4 brain metastases) are currently being evaluated in prospective clinical trials to minimize the likelihood of cognitive decline following WBRT. PMID

  7. ASPIICS/PROBA-3 formation flying solar coronagraph: Stray light analysis and optimization of the occulter

    NASA Astrophysics Data System (ADS)

    Landini, F.; Mazzoli, A.; Venet, M.; Vivès, S.; Romoli, M.; Lamy, P.; Massone, G.

    2017-11-01

    The "Association de Satellites Pour l'Imagerie et l'Interferometrie de la Couronne Solaire", ASPIICS, selected by ESA for the PROBA-3 mission, heralds the next generation of coronagraph for solar research, exploiting formation flying to gain access to the inner corona under eclipse-like conditions for long periods of time. A detailed description of the ASPIICS instrument and of its scientific objectives can be found in [1]. ASPIICS is distributed on the two PROBA 3 spacecrafts (S/C) separated by 150 m. The coronagraph optical assembly is hosted by the "coronagraph S/C" protected from direct solar disk light by the occulting disk on the "occulter S/C". The most critical issue in the design of a solar coronagraph is the reduction of the stray light due to the diffraction and scattering of the solar disk light by the occulter, the aperture and the optics. In the present article, we deal with two of these issues: - The analysis of the stray light inside the telescope. - The optimization of the external occulter edge, in order to eliminate the Poisson spot behind the occulter and to lower the stray light level going through the entrance pupil of the telescope. This work was performed in the framework of the ESA STARTIGER program which took place at the Laboratoire d'Astrophysique de Marseille (LAM) during a 6-month period from September 2009 to March 2010. In general, it is a very complicated task to combine the above two stray light issues together in the simulation and design phase as it requires to consider the propagation inside the telescope of the light diffracted by the external occulter. Actually, the present literature only reports diffraction calculations performed for simple occulting systems (i.e., two disks and serrated disk). A more pragmatic approach, also driven by the tight schedule of the STARTIGER program, is to separate the two contributions, and perform two different stray light analyses. This paper is dedicated to the description of both analyses

  8. Stereotactic radiosurgery for multiple brain metastases

    NASA Astrophysics Data System (ADS)

    Lee, Anna; (Josh Yamada, Yoshiya

    2017-01-01

    Whole brain radiation therapy has been the traditional treatment of choice for patients with multiple brain metastases. Although stereotactic radiosurgery is widely accepted for the management to up to 4 brain metastases, its use is still controversial in cases of 5 or more brain metastases. Randomized trials have suggested that stereotactic radiosurgery alone is appropriate in up to 4 metastases without concomitant whole brain radiation. Level 1 evidence also suggests that withholding whole brain radiation may also reduce the impact of radiation on neurocognitive function and also may even offer a survival advantage. A recent analysis of a large multicentre prospective database has suggested that there are no differences in outcomes such as the likelihood of new metastasis or leptomeningeal disease in cases of 2-10 brain metastases, nor in overall survival. Hence in the era of prolonged survival with stage IV cancer, stereotactic radiosurgery is a reasonable alternative to whole brain radiation in order to minimize the impact of treatment upon quality of life without sacrificing overall survival.

  9. First Ionospheric Results From the MAVEN Radio Occultation Science Experiment (ROSE)

    NASA Astrophysics Data System (ADS)

    Withers, Paul; Felici, M.; Mendillo, M.; Moore, L.; Narvaez, C.; Vogt, M. F.; Jakosky, B. M.

    2018-05-01

    Radio occultation observations of the ionosphere of Mars can span the full vertical extent of the ionosphere, in contrast to in situ measurements that rarely sample the main region of the ionosphere. However, most existing radio occultation electron density profiles from Mars were acquired without clear context for the solar forcing or magnetospheric conditions, which presents challenges for the interpretation of these profiles. Here we present 48 ionospheric electron density profiles acquired by the Mars Atmosphere and Volatile EvolutioN mission (MAVEN) Radio Occultation Science Experiment (ROSE) from 5 July 2016 to 27 June 2017 at solar zenith angles of 54° to 101°. Latitude coverage is excellent, and comprehensive context for the interpretation of these profiles is provided by other MAVEN instruments. The profiles show a 9-km increase in ionospheric peak altitude in January 2017 that is associated with a lower atmospheric dust storm, variations in electron densities in the M1 layer that cannot be explained by variations in the solar soft X-ray flux, and topside electron densities that are larger in strongly magnetized regions than in weakly magnetized regions. MAVEN Radio Occultation Science Experiment electron density profiles are publicly available on the NASA Planetary Data System.

  10. RW Per - Nodal motion changes its amplitude by 1.4 mag

    NASA Technical Reports Server (NTRS)

    Schaefer, Bradley E.; Fried, Robert E.

    1991-01-01

    RW Per was found to have large secular changes in its eclipse amplitude. In blue light, for example, the amplitude was 3.2 mag in the early 1900s, 2.2 mag in the late 1960s, and 1.75 mag in 1990. Throughout this time, the brightness at maximum was constant in all colors. It is shown that the only possible explanation is nodal motion, where the inclination varies with a period of roughly 100,000 yr. The nodal motion is caused by a third star, for which the light curve, the colors, and the O - C curve already provide evidence. Thus, RW Per is only the fourth known star with large changes of eclipse amplitude and is only the second example of nodal motion.

  11. Repeated faecal occult blood testing is associated with decreased advanced colorectal cancer risk: A population-based study.

    PubMed

    James, Paul D; Rabeneck, Linda; Yun, Lingsong; Paszat, Lawrence; Baxter, Nancy N; Govindarajan, Anand; Antonova, Lilia; Tinmouth, Jill M

    2017-01-01

    Objective To evaluate the association between repeated faecal occult blood testing and advanced colorectal cancer risk at population level in Canada. Methods A retrospective cohort study of all Ontario residents aged 56-74 diagnosed with colorectal cancer from 1 April 2007 to 31 March 2010, identified using health administrative data. The primary outcome was stage IV colorectal cancer, and primary exposure was faecal occult blood testing use within five years prior to colorectal cancer diagnosis. Patients were categorized into four mutually exclusive groups based on their exposure to faecal occult blood testing in the five years prior to colorectal cancer diagnosis: none, pre-diagnostic, repeated, and sporadic. Logistic regression was utilized to adjust for confounders. Results Of 7753 patients (median age 66, interquartile range 61-70, 62% male) identified, 1694 (22%) presented with stage I, 2056 (27%) with stage II, 2428 (31%) with stage III, and 1575 (20%) with stage IV colorectal cancer. There were 4092 (53%) with no record of prior faecal occult blood testing, 1485 (19%) classified as pre-diagnostic, 1693 (22%) as sporadic, and 483 (6%) as repeated faecal occult blood testing. After adjusting for confounders, patients who had repeated faecal occult blood testing were significantly less likely to present with stage IV colorectal cancer at diagnosis (Odds ratio 0.46, 95% Confidence Interval 0.34-0.62) than those with no prior faecal occult blood testing. Conclusions Repeated faecal occult blood testing is associated with a decreased risk of advanced colorectal cancer. Our findings support the use of organized screening programmes that employ repeated faecal occult blood testing to improve colorectal cancer outcomes at population level.

  12. Stereotactic radiosurgery of brain metastases.

    PubMed

    Specht, Hanno M; Combs, Stephanie E

    2016-09-01

    Brain metastases are a common problem in solid malignancies and still represent a major cause of morbidity and mortality. With the ongoing improvement in systemic therapies, the expectations on the efficacy of brain metastases directed treatment options are growing. As local therapies against brain metastases continue to evolve, treatment patterns have shifted from a palliative "one-treatment-fits-all" towards an individualized, patient adapted approach. In this article we review the evidence for stereotactic radiation treatment based on the current literature. Stereotactic radiosurgery (SRS) as a local high precision approach for the primary treatment of asymptomatic brain metastases has gained wide acceptance. It leads to lasting tumor control with only minor side effects compared to whole brain radiotherapy, since there is only little dose delivered to the healthy brain. The same holds true for hypofractionated stereotactic radiotherapy (HFSRT) for large metastases or for lesions close to organs at risk (e.g. the brainstem). New treatment indications such as neoadjuvant SRS followed by surgical resection or postoperative local therapy to the resection cavity show promising data and are also highlighted in this manuscript. With the evolution of local treatment options, optimal patient selection becomes more and more crucial. This article aims to aid decision making by outlining prognostic factors, treatment techniques and indications and common dose prescriptions.

  13. Identification of occult tumors by whole-specimen mapping in solitary papillary thyroid carcinoma.

    PubMed

    Park, Seog Yun; Jung, Yuh-S; Ryu, Chang Hwan; Lee, Chang Yoon; Lee, You Jin; Lee, Eun Kyung; Kim, Seok-Ki; Kim, Tae Sung; Kim, Tae Hyun; Jang, Jeyun; Park, Daeyoon; Dong, Seung Myung; Kang, Jae-Goo; Lee, Jin Soo; Ryu, Junsun

    2015-08-01

    We undertook this study to estimate an accurate incidence and spread patterns of occult papillary thyroid carcinoma (PTC) in patients with a preoperative diagnosis of solitary PTC by using whole-specimen mapping of all specimens after a total thyroidectomy. Enrolled prospectively in this whole-thyroid mapping study are 82 consecutive patients who underwent a total thyroidectomy under a preoperative diagnosis of solitary PTC. All thyroidectomy specimens were serially sectioned in 2 mm thickness and whole-thyroid mapping was carried out for additional foci of occult PTC. The frequencies of occult lesions detected in the whole and contralateral lobe were determined, and clinicopathologic factors associated with multifocality were assessed. Whole-thyroid mapping revealed 66 occult PTC lesions missed by preoperative ultrasound in 37 (45.1%) of the 82 patients. The great majority (92.5%) of the occult PTC was smaller than 3 mm in size and 25 patients (30.5%) had contralateral lesions. We found that the male sex was an independent predictor of multifocality (odds ratio (OR), 3.00; 95% CI, 1.11-8.14), adjusting for preoperative findings. Analysis with pathologic parameters showed that the male sex (OR, 5.03; 95% CI, 1.68-15.08) and extrathyroidal extensions (OR, 3.03; 95% CI, 1.03-8.95) were associated with multifocal PTC. However, none of the clinicopathologic factors evaluated predicted contralateral PTC. Our study demonstrates the diagnostic limitations of ultrasound for the detection of multifocal PTC and the need to consider the possibility of occult lesions in the management of solitary PTC, especially in male patients. © 2015 Society for Endocrinology.

  14. The Regulus occultation light curve and the real atmosphere of Venus

    NASA Technical Reports Server (NTRS)

    Veverka, J.; Wasserman, L.

    1974-01-01

    An inversion of the light curve observed during the July 7, 1959, occultation of Regulus by Venus leads to the conclusion that the light curve cannot be reconciled with models of the Venus atmosphere based on spacecraft observations. The event occurred in daylight and, under the subsequently difficult observation conditions, it seems likely that the Regulus occultation light curve is marred by a systematic errors in spite of the competence of the observers involved.

  15. Winds and the occultation experiment. [for Venus and Mars atmospheric parameters

    NASA Technical Reports Server (NTRS)

    Gross, S. H.

    1974-01-01

    A spacecraft orbiting about another planet, such as Mars or Venus, may be used to obtain data about the pressure, density, and temperature fields over the planet from multiple occultations if the orbit precesses or retrogresses. Under certain conditions successive occultations will provide mean dynamic information such as wind speeds over the time and spacing intervals. It is shown that data concerning winds may be found by comparing refractivity information rather than pressure or temperature.

  16. External occulter laboratory demonstrator for the forthcoming formation flying coronagraphs.

    PubMed

    Landini, Federico; Vives, Sébastien; Venet, Mélanie; Romoli, Marco; Guillon, Christophe; Fineschi, Silvano

    2011-12-20

    The design and optimization of the external occulter geometry is one of the most discussed topics among solar coronagraph designers. To improve the performance of future coronagraphs and to stretch their inner fields of view toward the solar limb, the new concept of coronagraphs in formation flight has been introduced in the scientific debate. Solar coronagraphs in formation flight require several mechanical and technological constraints to be met, mainly due to the large dimension of the occulter and to the spacecraft's reciprocal alignment. The occulter edge requires special attention to minimize diffraction while being compatible with the handling and integrating of large delicate space components. Moreover, it is practically impossible to set up a full-scale model for laboratory tests. This article describes the design and laboratory tests on a demonstrator for a coronagraph to be operated in formation flight. The demonstrator is based on the principle of the linear edge, thus the presented results cannot be directly extrapolated to the case of the flying circular occulter. Nevertheless, we are able to confirm the results of other authors investigating on smaller coronagraphs and provide further information on the geometry and tolerances of the optimization system. The described work is one of the results of the ESA STARTIGER program on formation flying coronagraphs ["The STARTIGER's demonstrators: toward a new generation of formation flying solar coronagraphs," in 2010 International Conference on Space Optics (ICSO) (2010), paper 39].

  17. Detection of occult abscesses with /sup 111/In-labeled leukocytes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Martin, W.R.; Gurevich, N.; Goris, M.L.

    1979-07-01

    Clinicians are frequently faced with the problem of a patient in whom they suspect an occult abscess. In such a situation, there may be no clinical signs to localize the site of the abscess and often extensive investigations do not provide additional useful information. This report illustrates the efficacy of autologous leukocytes labeled with /sup 111/In oxine in detecting the site and extent of occult abscesses in two patients. The technique of in vitro lebeling of leukocytes is simple and has been mastered by all of our nuclear medicine technologists.

  18. Prediction of stellar occultations by distant solar system bodies in the Gaia era

    NASA Astrophysics Data System (ADS)

    Desmars, Josselin; Camargo, Julio; Sicardy, Bruno; Braga-Ribas, Felipe; Vieira-Martins, Roberto; Assafin, Marcelo; Bérard, Diane; Benedetti-Rossi, Gustavo

    2018-04-01

    Stellar occultations are a unique technique to access physical characteristics of distant solar system objects from the ground. They allow the measure of the size and the shape at kilometric level, the detection of tenuous atmospheres (few nanobars), and the investigation of close vicinity (satellites, rings) of Transneptunian objects and Centaurs. This technique is made successful thanks to accurate predictions of occultations. Accuracy of the predictions depends on the uncertainty in the position of the occulted star and the object's orbit. The Gaia stellar catalogue (Gaia Collaboration (2017)) now allows to get accurate astrometric stellar positions (to the mas level). The main uncertainty remains on the orbit. In this context, we now take advantage of the NIMA method (Desmars et al.(2015)) for the orbit determination and of the Gaia DR1 catalogue for the astrometry. In this document, we show how the orbit determination is improved by reducing current and some past observations with Gaia DR1. Moreover, we also use more than 45 past positive occultations observed in the 2009-2017 period to derive very accurate astrometric positions only depending on the position of the occulted stars (about few mas with Gaia DR1). We use the case of (10199) Chariklo as an illustration. The main limitation lies in the imprecision of the proper motions which is going to be solved by the Gaia DR2 release.

  19. Distribution of Cervical Lymph Node Metastases From Squamous Cell Carcinoma of the Oropharynx in the Era of Risk Stratification Using Human Papillomavirus and Smoking Status

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Amsbaugh, Mark J., E-mail: mjamsb01@louisville.edu; Yusuf, Mehran; Cash, Elizabeth

    Purpose/Objective(s): To investigate the factors contributing to the clinical presentation of oropharyngeal squamous cell carcinoma (OPSCC) in the era of risk stratification using human papilloma virus (HPV) and smoking status. Methods and Materials: All patients with OPSCC presenting to our institutional multidisciplinary clinic from January 2009 to June 2015 were reviewed from a prospective database. The patients were grouped as being at low risk, intermediate risk, and high risk in the manner described by Ang et al. Variance in clinical presentation was examined using χ{sup 2}, Kruskal-Wallis, Mann-Whitney, and logistic regression analyses. Results: The rates of HPV/p16 positivity (P<.001), never-smoking (P=.016),more » and cervical lymph node metastases (P=.023) were significantly higher for patients with OPSCC of the tonsil, base of tongue (BOT), or vallecula subsites when compared with pharyngeal wall or palate subsites. Low-risk patients with tonsil, base of tongue, or vallecula primary tumors presented with nodal stage N2a at a much higher than expected frequency (P=.007), and high-risk patients presented with tumor stage T4 at a much higher than expected frequency (P=.003). Patients with BOT primary tumors who were never-smokers were less likely to have clinically involved ipsilateral neck disease than were former smokers (odds ratio 1.8; P=.038). The distribution of cervical lymph node metastases was not associated with HPV/p16 positivity, risk group, or subsite. When these data were compared with those in historical series, no significant differences were seen in the patterns of cervical lymph node metastases for patients with OPSCC. Conclusions: For patients with OPSCC differences in HPV status, smoking history and anatomic subsite were associated with differences in clinical presentation but not with distribution of cervical lymph node metastases. Historical series describing the patterns of cervical lymph node metastases in patients with OPSCC

  20. Distribution of Cervical Lymph Node Metastases From Squamous Cell Carcinoma of the Oropharynx in the Era of Risk Stratification Using Human Papillomavirus and Smoking Status.

    PubMed

    Amsbaugh, Mark J; Yusuf, Mehran; Cash, Elizabeth; Silverman, Craig; Wilson, Elizabeth; Bumpous, Jeffrey; Potts, Kevin; Perez, Cesar; Bert, Robert; Redman, Rebecca; Dunlap, Neal

    2016-10-01

    To investigate the factors contributing to the clinical presentation of oropharyngeal squamous cell carcinoma (OPSCC) in the era of risk stratification using human papilloma virus (HPV) and smoking status. All patients with OPSCC presenting to our institutional multidisciplinary clinic from January 2009 to June 2015 were reviewed from a prospective database. The patients were grouped as being at low risk, intermediate risk, and high risk in the manner described by Ang et al. Variance in clinical presentation was examined using χ(2), Kruskal-Wallis, Mann-Whitney, and logistic regression analyses. The rates of HPV/p16 positivity (P<.001), never-smoking (P=.016), and cervical lymph node metastases (P=.023) were significantly higher for patients with OPSCC of the tonsil, base of tongue (BOT), or vallecula subsites when compared with pharyngeal wall or palate subsites. Low-risk patients with tonsil, base of tongue, or vallecula primary tumors presented with nodal stage N2a at a much higher than expected frequency (P=.007), and high-risk patients presented with tumor stage T4 at a much higher than expected frequency (P=.003). Patients with BOT primary tumors who were never-smokers were less likely to have clinically involved ipsilateral neck disease than were former smokers (odds ratio 1.8; P=.038). The distribution of cervical lymph node metastases was not associated with HPV/p16 positivity, risk group, or subsite. When these data were compared with those in historical series, no significant differences were seen in the patterns of cervical lymph node metastases for patients with OPSCC. For patients with OPSCC differences in HPV status, smoking history and anatomic subsite were associated with differences in clinical presentation but not with distribution of cervical lymph node metastases. Historical series describing the patterns of cervical lymph node metastases in patients with OPSCC remain clinically relevant. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. [Interventional radiology in bone metastases].

    PubMed

    Chiras, Jacques; Cormier, Evelyne; Baragan, Hector; Jean, Betty; Rose, Michèle

    2007-02-01

    Interventional radiology takes a large place in the treatment of bone metastases by numerous techniques, percutaneous or endovascular. Vertebroplasty appears actually as the most important technique for stabilisation of spine metastases as it induces satisfactory stabilisation of the vertebra and offer clear improvement of the quality of life. Due to the success of this technique cementoplasty of other bones, mainly pelvic girdle, largely develop. The heath due to the polymerisation of the cement induce carcinolytic effect but this effect is not as important as that can be created with radiofrequency destruction. This last technique appears actually as the most important development to destroy definitively some bone metastases and replace progressively alcoholic destruction of such lesions. Angiographic techniques appear more confidential but endovascular embolization is very useful to diminish the risk of surgical treatment of hyper vascular metastases. Chemoembolization is actually developped to associate the relief of pain induced by endovascular embolization and the carcinolytic effect obtained by local endovascular chemotherapy. All these techniques should develop largely during the next years and their efficacy and safety should improve largely by treating earlier the metastasis.

  2. Occult pneumothorax in trauma patients: should this be sought in the focused assessment with sonography for trauma examination?

    PubMed

    Tam, Michael M K

    2005-01-01

    At present, CT scan is the gold standard for detecting occult traumatic pneumothorax not apparent on supine chest X-ray radiograph. Recently there were suggestions to expand focused assessment with sonography for trauma (FAST) to include thoracic ultrasound for detecting pneumothorax. The aim of the present study is to determine the incidence of occult pneumothorax (as shown by CT) in the subgroup of trauma patients undergoing FAST. Review of all trauma patients with FAST done from 1 June 2001 to 31 October 2002. Incidence of occult pneumothorax as diagnosed by CT was determined. Patients were not counted as having true occult pneumothorax if they had chest drains inserted before arrival or imaging studies. Selected clinical findings were tested for association with occult pneumothorax. In total, 143 patients underwent FAST, of whom 137 (95.8%) had chest X-ray examination performed. Of the 137 patients 59 required CT abdomen and/or thorax. Occult pneumothorax was found in three patients (2.1%). A history of thorax and/or abdominal injury plus one or more of: (i) mechanisms potentially causing major trauma; (ii) abnormal chest examination; and (iii) chest X-ray radiograph abnormality in the absence of pneumothorax, was significantly associated with the presence of occult pneumothorax (P = 0.03, Fisher's exact test; sensitivity: 100%; specificity: 71%; likelihood ratio: 3.42). The incidence of occult pneumothorax in the subgroup of trauma patients undergoing FAST is low. It implies that routine screening for its presence by adding thoracic ultrasound to FAST is unnecessary. Identifying those at risk of occult pneumothorax for further investigation appeared feasible.

  3. Incidental Prophylactic Nodal Irradiation and Patterns of Nodal Relapse in Inoperable Early Stage NSCLC Patients Treated With SBRT: A Case-Matched Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lao, Louis; Department of Radiation Oncology, Auckland City Hospital, Auckland; Hope, Andrew J.

    2014-09-01

    Purpose: Reported rates of non-small cell lung cancer (NSCLC) nodal failure following stereotactic body radiation therapy (SBRT) are lower than those reported in the surgical series when matched for stage. We hypothesized that this effect was due to incidental prophylactic nodal irradiation. Methods and Materials: A prospectively collected group of medically inoperable early stage NSCLC patients from 2004 to 2010 was used to identify cases with nodal relapses. Controls were matched to cases, 2:1, controlling for tumor volume (ie, same or greater) and tumor location (ie, same lobe). Reference (normalized to equivalent dose for 2-Gy fractions [EQD2]) point doses atmore » the ipsilateral hilum and carina, demographic data, and clinical outcomes were extracted from the medical records. Univariate conditional logistical regression analyses were performed with variables of interest. Results: Cases and controls were well matched except for size. The controls, as expected, had larger gross tumor volumes (P=.02). The mean ipsilateral hilar doses were 9.6 Gy and 22.4 Gy for cases and controls, respectively (P=.014). The mean carinal doses were 7.0 Gy and 9.2 Gy, respectively (P=.13). Mediastinal nodal relapses, with and without ipsilateral hilar relapse, were associated with mean ipsilateral hilar doses of 3.6 Gy and 19.8 Gy, respectively (P=.01). The conditional density plot appears to demonstrate an inverse dose-effect relationship between ipsilateral hilar normalized total dose and risk of ipsilateral hilar relapse. Conclusions: Incidental hilar dose greater than 20 Gy is significantly associated with fewer ipsilateral hilar relapses in inoperable early stage NSCLC patients treated with SBRT.« less

  4. Results from the 2010 Feb 14 and July 4 Pluto Occultations

    NASA Astrophysics Data System (ADS)

    Young, Leslie; Sicardy, B.; Widemann, T.; Brucker, M. J.; Buie, M. W.; Fraser, B.; Van Heerden, H.; Howell, R. R.; Lonergan, K.; Olkin, C. B.; Reitsema, H. J.; Richter, A.; Sepersky, T.; Wasserman, L. H.; Young, E. F.

    2010-10-01

    The Portable High-speed Occultation Telescope (PHOT) group observed two occultations by Pluto in 2010. The first, of a I=9.3 magnitudue star on 2010 Feb 14, was organized by the Meudon occultation group, with the PHOT group as collaborators. For this bright but low-elevation event, we deployed to three sites in Europe: Obs. Haute Provence, France (0.8-m; L. Young, H. Reitsema), Leopold Figl, Austria (1.5-m; E. Young), and Apline Astrovillage, Lu, Switzerland (0.36-m; C. Olkin, L. Wasserman). We obtained a lightcurve at Lu under clear conditions, which will be combined with two other lightcurves from the Meudon group, from Sisteron and Pic du Midi, France. We observed the second Pluto occultation, of a I=13.2 star on 2010 July 4 UT, from four sites in South Africa: with our portable telescope near Upington (0.36-m; M. Buie, L. Wasserman), the Boyden telescope in Bloemfontein (1.5-m; L. Young, M. Brucker), the Innes telescope in Johannesburg (0.67-m; T. Sepersky, B. Fraser), and the telescope at Aloe Ridge north of Johannesburg (0.62-m; R. Howell, K. Lonergan, A. Richter). Upington was cloudy, Boyden had heavy scattered clouds, and Innes suffered from haze and telescope mechanical problems. A lightcurve was obtained from Aloe Ridge under clear conditions. Data was also obtained by Karl-Ludwig Bath & Thomas Sauer at Hakos, Namibia and by Berto Monard of ASSA near Pretoria, South Africa. The length of the Aloe Ridge chord suggests it is nearly central. These observations give us four contiguous years in which we observed one or more Pluto occultations, providing constraints on the seasonal evolution of Pluto's atmosphere. Thanks are due to Marcelo Assafin and Jim Elliot for sharing predictions prior to the July event. This work was supported, in part, by NASA PAST NNX08A062G.

  5. Skin metastases from lung cancer: a case report.

    PubMed

    Pajaziti, Laura; Hapçiu, Syzana Rexhepi; Dobruna, Shkendije; Hoxha, Naim; Kurshumliu, Fisnik; Pajaziti, Artina

    2015-04-11

    Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer. Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7(th) segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases. Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.

  6. Ultrasonography in diagnosing clinically occult groin hernia: systematic review and meta-analysis.

    PubMed

    Kwee, Robert M; Kwee, Thomas C

    2018-05-14

    To provide an updated systematic review on the performance of ultrasonography (US) in diagnosing clinically occult groin hernia. A systematic search was performed in MEDLINE and Embase. Methodological quality of included studies was assessed. Accuracy data of US in detecting clinically occult groin hernia were extracted. Positive predictive value (PPV) was pooled with a random effects model. For studies investigating the performance of US in hernia type classification (inguinal vs femoral), correctly classified proportion was assessed. Sixteen studies were included. In the two studies without verification bias, sensitivities were 29.4% [95% confidence interval (CI), 15.1-47.5%] and 90.9% (95% CI, 70.8-98.9%); specificities were 90.0% (95% CI, 80.5-95.9%) and 90.6% (95% CI, 83.0-95.6%). Verification bias or a variation of it (i.e. study limited to only subjects with definitive proof of disease status) was present in all other studies. Sensitivity, specificity, and negative predictive value (NPV) were not pooled. PPV ranged from 58.8 to 100%. Pooled PPV, based on data from ten studies with low risk of bias and no applicability concerns with respect to patient selection, was 85.6% (95% CI, 76.5-92.7%). Proportion of correctly classified hernias, based on data from four studies, ranged between 94.4% and 99.1%. Sensitivity, specificity and NPV of US in detecting clinically occult groin hernia cannot reliably be determined based on current evidence. Further studies are necessary. Accuracy may strongly depend on the examiner's skills. PPV is high. Inguinal and femoral hernias can reliably be differentiated by US. • Sensitivity, specificity and NPV of ultrasound in detecting clinically occult groin hernia cannot reliably be determined based on current evidence. • Accuracy may strongly depend on the examiner's skills. • PPV of US in detection of clinically occult groin hernia is high [pooled PPV of 85.6% (95% confidence interval, 76.5-92.7%)]. • US has very high

  7. Finding Terrestrial Planets Using External Occulters

    NASA Technical Reports Server (NTRS)

    Heap, Sara

    2007-01-01

    In order to identify a detected exoplanet as an Earth-like (habitable) planet, we must obtain its spectrum to verify that its atmosphere shows evidence of water vapor. We argue that a regular, optical telescope combined with a large occulter to block light from the star offers the most promising, cost-effective way to detect and characterize exoplanets.

  8. Technical Note: A Time-Dependent I(sub 0) Correction for Solar Occultation Instruments

    NASA Technical Reports Server (NTRS)

    Burton, Sharon P.; Thomason, Larry W.; Zawodny, Joseph M.

    2009-01-01

    Solar occultation has proven to be a reliable technique for the measurement of atmospheric constituents in the stratosphere. NASA's Stratospheric Aerosol and Gas Experiments (SAGE, SAGE II, and SAGE III) together have provided over 25 years of quality solar occultation data, a data record which has been an important resource for the scientific exploration of atmospheric composition and climate change. Herein, we describe an improvement to the processing of SAGE data that corrects for a previously uncorrected short-term timedependence in the calibration function. The variability relates to the apparent rotation of the scanning track with respect to the face of the sun due to the motion of the satellite. Correcting for this effect results in a decrease in the measurement noise in the Level 1 line-of-sight optical depth measurements of approximately 40% in the middle and upper stratospheric SAGE II and III where it has been applied. The technique is potentially useful for any scanning solar occultation instrument, and suggests further improvement for future occultation measurements if a full disk imaging system can be included.

  9. Software and hardware complex for observation of star occultations by asteroids

    NASA Astrophysics Data System (ADS)

    Karbovsky, V.; Kleshchonok, V.; Buromsky, M.

    2017-12-01

    The preparation to the program for observation of star occultations by asteroids on the AZT-2 telescope was started in 2016. A new method for registration of occultation with a CCD camera in the synchronous transfer mode was proposed and developed. The special program was written to control the CCD camera and record images during such observations. The speed of image transfer can vary within wide limits, which makes it possible to carry out observations in a wide range of stellar magnitudes. The telescope AZT-2 is used, which has the largest mirror diameter in Kiev (D = 0.7 m. F = 10.5 m). A 3-fold optical reducer was produced, which providing a field of view with a CCD camera Apogee Alta U47 10 arcminutes and the equivalent focal length of the telescope 3.2 meters. The results of test observations are presented. The program is implemented jointly by the Main Astronomical Observatory of the National Academy of Sciences of Ukraine and the Astronomical Observatory of the Taras Shevchenko National University of Kyiv. Regular observations of star occultation by asteroids are planned with the help of this complex. % Z https://occultations.org Kleshchonok,V.V.,Buromsky,M. I. 2005, Kinematics and Physics of Celestial Bodies, 21, 5, 405 Kleshchonok, V.V., Buromskii, N. I., Khat’ko,I.V.2008, Kinematics and Physics of Celestial Bodies, 24, 2, 114

  10. Occult Hepatitis B Virus Among the Patients With Abnormal Alanine Transaminase

    PubMed Central

    Makvandi, Manoochehr; Neisi, Niloofar; Khalafkhany, Davod; Makvandi, Kamyar; Hajiani, Eskandar; Shayesteh, Ali Akbar; Masjedi Zadeh, Abdolrahim; Sina, Amir Hosein; Hamidifard, Mojtaba; Rasti, Mojtaba; Aryan, Ehsan; Ahmadi, Kambiz; Yad Yad, Mohammad Jafar

    2014-01-01

    Background: The occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the sera or in the liver biopsy and the absence of hepatitis B surface antigen (HBsAg) by serological test. Objectives: The current study aimed to evaluate the occult HBV infection by polymerase chain reaction (PCR) and determine HBV genotyping among the patients with abnormal alanine transaminase (ALT) in Ahvaz city, Iran. Patients and Methods: The sera of 120 patients, 54 (45%) females and 66 (55%) males, with abnormal ALT 40-152 IU were collected. All the patients were negative for HBsAg for more than one year. The patients` sera were tested by PCR using primers specified for the S region of HBV. Then the positive PCR products were sequenced to determine HBV genotyping and phylogenic tree. Results: Of these 120 subjects, 12 (10%) patients including 6 (5%) males and 6 (5%) females were found positive for HBV DNA by PCR, which indicated the presence of occult HBV infection among these patients. The sequencing results revealed that genotype D was predominant with sub-genotyping D1 among OBI patients. Conclusions: Occult hepatitis B infection is remarkably prevalent in Ahvaz, Iran, and should be considered as a potential risk factor for the transmission of Hepatitis B Virus throughout the community by the carriers. PMID:25485052

  11. Metastases of breast cancer to a uterine leiomyoma.

    PubMed

    Ludovisi, Manuela; Moruzzi, Maria Cristina; Ferrandina, Gabriella; Scambia, Giovanni; Testa, Antonia Carla

    2017-09-19

    Metastases to the uterus occur very rarely, accounting for less than 10% of all cases of metastases involving the female genital tract; mammary and gastrointestinal carcinomas are the most frequent extragenital primary neoplasms metastasizing to the uterine corpus 1 . Very little data is available in the literature including 24 cases of breast cancer metastasized to a uterine leiomyoma 2 , as assessed at surgery (N = 16), and autoptic evaluation (n = 8). This article is protected by copyright. All rights reserved.

  12. Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation

    PubMed Central

    Mahmood, Ismail; Tawfeek, Zainab; El-Menyar, Ayman; Zarour, Ahmad; Afifi, Ibrahim; Kumar, Suresh; Latifi, Rifat; Al-Thani, Hassan

    2015-01-01

    Background. The management and outcomes of occult hemopneumothorax in blunt trauma patients who required mechanical ventilation are not well studied. We aimed to study patients with occult hemopneumothorax on mechanical ventilation who could be carefully managed without tube thoracostomy. Methods. Chest trauma patients with occult hemopneumothorax who were on mechanical ventilation were prospectively evaluated. The presence of hemopneumothorax was confirmed by CT scanning. Hospital length of stay, complications, and outcome were recorded. Results. A total of 56 chest trauma patients with occult hemopneumothorax who were on ventilatory support were included with a mean age of 36 ± 13 years. Hemopneumothorax was managed conservatively in 72% cases and 28% underwent tube thoracostomy as indicated. 29% of patients developed pneumonia, 16% had Acute Respiratory Distress Syndrome (ARDS), and 7% died. Thickness of hemothorax, duration of mechanical ventilation, and development of ARDS were significantly associated with tube thoracostomy in comparison to no-chest tube group. Conclusions. The majority of occult hemopneumothorax can be carefully managed without tube thoracostomy in patients who required positive pressure ventilation. Tube thoracotomy could be restricted to those who had evidence of increase in the size of the hemothorax or pneumothorax on follow-up chest radiographs or developed respiratory compromise. PMID:25785199

  13. The orphan receptor ALK7 and the Activin receptor ALK4 mediate signaling by Nodal proteins during vertebrate development.

    PubMed

    Reissmann, E; Jörnvall, H; Blokzijl, A; Andersson, O; Chang, C; Minchiotti, G; Persico, M G; Ibáñez, C F; Brivanlou, A H

    2001-08-01

    Nodal proteins have crucial roles in mesendoderm formation and left-right patterning during vertebrate development. The molecular mechanisms of signal transduction by Nodal and related ligands, however, are not fully understood. In this paper, we present biochemical and functional evidence that the orphan type I serine/threonine kinase receptor ALK7 acts as a receptor for mouse Nodal and Xenopus Nodal-related 1 (Xnr1). Receptor reconstitution experiments indicate that ALK7 collaborates with ActRIIB to confer responsiveness to Xnr1 and Nodal. Both receptors can independently bind Xnr1. In addition, Cripto, an extracellular protein genetically implicated in Nodal signaling, can independently interact with both Xnr1 and ALK7, and its expression greatly enhances the ability of ALK7 and ActRIIB to respond to Nodal ligands. The Activin receptor ALK4 is also able to mediate Nodal signaling but only in the presence of Cripto, with which it can also interact directly. A constitutively activated form of ALK7 mimics the mesendoderm-inducing activity of Xnr1 in Xenopus embryos, whereas a dominant-negative ALK7 specifically blocks the activities of Nodal and Xnr1 but has little effect on other related ligands. In contrast, a dominant-negative ALK4 blocks all mesoderm-inducing ligands tested, including Nodal, Xnr1, Xnr2, Xnr4, and Activin. In agreement with a role in Nodal signaling, ALK7 mRNA is localized to the ectodermal and organizer regions of Xenopus gastrula embryos and is expressed during early stages of mouse embryonic development. Therefore, our results indicate that both ALK4 and ALK7 can mediate signal transduction by Nodal proteins, although ALK7 appears to be a receptor more specifically dedicated to Nodal signaling.

  14. The orphan receptor ALK7 and the Activin receptor ALK4 mediate signaling by Nodal proteins during vertebrate development

    PubMed Central

    Reissmann, Eva; Jörnvall, Henrik; Blokzijl, Andries; Andersson, Olov; Chang, Chenbei; Minchiotti, Gabriella; Persico, M. Graziella; Ibáñez, Carlos F.; Brivanlou, Ali H.

    2001-01-01

    Nodal proteins have crucial roles in mesendoderm formation and left–right patterning during vertebrate development. The molecular mechanisms of signal transduction by Nodal and related ligands, however, are not fully understood. In this paper, we present biochemical and functional evidence that the orphan type I serine/threonine kinase receptor ALK7 acts as a receptor for mouse Nodal and Xenopus Nodal-related 1 (Xnr1). Receptor reconstitution experiments indicate that ALK7 collaborates with ActRIIB to confer responsiveness to Xnr1 and Nodal. Both receptors can independently bind Xnr1. In addition, Cripto, an extracellular protein genetically implicated in Nodal signaling, can independently interact with both Xnr1 and ALK7, and its expression greatly enhances the ability of ALK7 and ActRIIB to respond to Nodal ligands. The Activin receptor ALK4 is also able to mediate Nodal signaling but only in the presence of Cripto, with which it can also interact directly. A constitutively activated form of ALK7 mimics the mesendoderm-inducing activity of Xnr1 in Xenopus embryos, whereas a dominant-negative ALK7 specifically blocks the activities of Nodal and Xnr1 but has little effect on other related ligands. In contrast, a dominant-negative ALK4 blocks all mesoderm-inducing ligands tested, including Nodal, Xnr1, Xnr2, Xnr4, and Activin. In agreement with a role in Nodal signaling, ALK7 mRNA is localized to the ectodermal and organizer regions of Xenopus gastrula embryos and is expressed during early stages of mouse embryonic development. Therefore, our results indicate that both ALK4 and ALK7 can mediate signal transduction by Nodal proteins, although ALK7 appears to be a receptor more specifically dedicated to Nodal signaling. PMID:11485994

  15. Prognostic relevance of an epigenetic biomarker panel in sentinel lymph nodes from colon cancer patients.

    PubMed

    Lind, Guro E; Guriby, Marianne; Ahlquist, Terje; Hussain, Israr; Jeanmougin, Marine; Søreide, Kjetil; Kørner, Hartwig; Lothe, Ragnhild A; Nordgård, Oddmund

    2017-01-01

    Patients with early colorectal cancer (stages I-II) generally have a good prognosis, but a subgroup of 15-20% experiences relapse and eventually die of disease. Occult metastases have been suggested as a marker for increased risk of recurrence in patients with node-negative disease. Using a previously identified, highly accurate epigenetic biomarker panel for early detection of colorectal tumors, we aimed at evaluating the prognostic value of occult metastases in sentinel lymph nodes of colon cancer patients. The biomarker panel was analyzed by quantitative methylation-specific PCR in primary tumors and 783 sentinel lymph nodes from 201 patients. The panel status in sentinel lymph nodes showed a strong association with lymph node stage ( P  = 8.2E-17). Compared with routine lymph node diagnostics, the biomarker panel had a sensitivity of 79% (31/39). Interestingly, among 162 patients with negative lymph nodes from routine diagnostics, 13 (8%) were positive for the biomarker panel. Colon cancer patients with high sentinel lymph node methylation had an inferior prognosis (5-year overall survival P  = 3.0E-4; time to recurrence P  = 3.1E-4), although not significant. The same trend was observed in multivariate analyses ( P  = 1.4E-1 and P  = 6.7E-2, respectively). Occult sentinel lymph node metastases were not detected in early stage (I-II) colon cancer patients who experienced relapse. Colon cancer patients with high sentinel lymph node methylation of the analyzed epigenetic biomarker panel had an inferior prognosis, although not significant in multivariate analyses. Occult metastases in TNM stage II patients that experienced relapse were not detected.

  16. Germline BRCA mutations are associated with higher risk of nodal involvement, distant metastasis, and poor survival outcomes in prostate cancer.

    PubMed

    Castro, Elena; Goh, Chee; Olmos, David; Saunders, Ed; Leongamornlert, Daniel; Tymrakiewicz, Malgorzata; Mahmud, Nadiya; Dadaev, Tokhir; Govindasami, Koveela; Guy, Michelle; Sawyer, Emma; Wilkinson, Rosemary; Ardern-Jones, Audrey; Ellis, Steve; Frost, Debra; Peock, Susan; Evans, D Gareth; Tischkowitz, Marc; Cole, Trevor; Davidson, Rosemarie; Eccles, Diana; Brewer, Carole; Douglas, Fiona; Porteous, Mary E; Donaldson, Alan; Dorkins, Huw; Izatt, Louise; Cook, Jackie; Hodgson, Shirley; Kennedy, M John; Side, Lucy E; Eason, Jacqueline; Murray, Alex; Antoniou, Antonis C; Easton, Douglas F; Kote-Jarai, Zsofia; Eeles, Rosalind

    2013-05-10

    To analyze the baseline clinicopathologic characteristics of prostate tumors with germline BRCA1 and BRCA2 (BRCA1/2) mutations and the prognostic value of those mutations on prostate cancer (PCa) outcomes. This study analyzed the tumor features and outcomes of 2,019 patients with PCa (18 BRCA1 carriers, 61 BRCA2 carriers, and 1,940 noncarriers). The Kaplan-Meier method and Cox regression analysis were used to evaluate the associations between BRCA1/2 status and other PCa prognostic factors with overall survival (OS), cause-specific OS (CSS), CSS in localized PCa (CSS_M0), metastasis-free survival (MFS), and CSS from metastasis (CSS_M1). PCa with germline BRCA1/2 mutations were more frequently associated with Gleason ≥ 8 (P = .00003), T3/T4 stage (P = .003), nodal involvement (P = .00005), and metastases at diagnosis (P = .005) than PCa in noncarriers. CSS was significantly longer in noncarriers than in carriers (15.7 v 8.6 years, multivariable analyses [MVA] P = .015; hazard ratio [HR] = 1.8). For localized PCa, 5-year CSS and MFS were significantly higher in noncarriers (96% v 82%; MVA P = .01; HR = 2.6%; and 93% v 77%; MVA P = .009; HR = 2.7, respectively). Subgroup analyses confirmed the poor outcomes in BRCA2 patients, whereas the role of BRCA1 was not well defined due to the limited size and follow-up in this subgroup. Our results confirm that BRCA1/2 mutations confer a more aggressive PCa phenotype with a higher probability of nodal involvement and distant metastasis. BRCA mutations are associated with poor survival outcomes and this should be considered for tailoring clinical management of these patients.

  17. Role of Nodal-PITX2C signaling pathway in glucose-induced cardiomyocyte hypertrophy.

    PubMed

    Su, Dongmei; Jing, Sun; Guan, Lina; Li, Qian; Zhang, Huiling; Gao, Xiaobo; Ma, Xu

    2014-06-01

    Pathological cardiac hypertrophy is a major cause of morbidity and mortality in cardiovascular disease. Recent studies have shown that cardiomyocytes, in response to high glucose (HG) stimuli, undergo hypertrophic growth. While much work still needs to be done to elucidate this important mechanism of hypertrophy, previous works have showed that some pathways or genes play important roles in hypertrophy. In this study, we showed that sublethal concentrations of glucose (25 mmol/L) could induce cardiomyocyte hypertrophy with an increase in the cellular surface area and the upregulation of the atrial natriuretic peptide (ANP) gene, a hypertrophic marker. High glucose (HG) treatments resulted in the upregulation of the Nodal gene, which is under-expressed in cardiomyocytes. We also determined that the knockdown of the Nodal gene resisted HG-induced cardiomyocyte hypertrophy. The overexpression of Nodal was able to induce hypertrophy in cardiomyocytes, which was associated with the upregulation of the PITX2C gene. We also showed that increases in the PITX2C expression, in response to Nodal, were mediated by the Smad4 signaling pathway. This study is highly relevant to the understanding of the effects of the Nodal-PITX2C pathway on HG-induced cardiomyocyte hypertrophy, as well as the related molecular mechanisms.

  18. The Structure of Titan's Atmosphere from Cassini Radio Occultations

    NASA Technical Reports Server (NTRS)

    Schinder, Paul J.; Flasar, F. Michael; Marouf, Essam A.; French, Richard G.; McGhee, Colleen A.; Kliore, Arvydas J.; Rappaport, Nicole J.; Barbinis, Elias; Fleischman, Don; Anabtawi, Aseel

    2011-01-01

    We present results from the two radio occultations of the Cassini spacecraft by Titan in 2006, which probed mid-southern latitudes. Three of the ingress and egress soundings occurred within a narrow latitude range, 31.34 deg S near the surface, and the fourth at 52.8 deg S. Temperature - altitude profiles for all four occultation soundings are presented, and compared with the results of the Voyager 1 radio occultation (Lindal et al., 1983), the HASI instrument on the Huygens descent probe (Fulchignoni et al., 2005), and Cassini CIRS results (Flasar et al., 2005; Achterberg et al., 2008b). Sources of error in the retrieved temperature - altitude profiles are also discussed, and a major contribution is from spacecraft velocity errors in the reconstructed ephemeris. These can be reduced by using CIRS data at 300 km to make along-track adjustments of the spacecraft timing. The occultation soundings indicate that the temperatures just above the surface at 31-34 deg S are about 93 K, while that at 53 deg S is about 1 K colder. At the tropopause, the temperatures at the lower latitudes are all about 70 K, while the 53 deg S profile is again 1 K colder. The temperature lapse rate in the lowest 2 km for the two ingress (dawn) profiles at 31 and 33 deg S lie along a dry adiabat except within approximately 200m of the surface, where a small stable inversion occurs. This could be explained by turbulent mixing with low viscosity near the surface. The egress profile near 34 deg S shows a more complex structure in the lowest 2 km, while the egress profile at 53 deg S is more stable.

  19. The complete set of Cassini's UVIS occultation observations of Enceladus plume: model fits

    NASA Astrophysics Data System (ADS)

    Portyankina, G.; Esposito, L. W.; Hansen, C. J.

    2017-12-01

    Since the discovery in 2005, plume of Enceladus was observed by most of the instruments onboard Cassini spacecraft. Ultraviolet Imaging Spectrograph (UVIS) have observed Enceladus plume and collimated jets embedded in it in occultational geometry on 6 different occasions. We have constructed a 3D direct simulation Monte Carlo (DSMC) model for Enceladus jets and apply it to the analysis of the full set of UVIS occultation observations conducted during Cassini's mission from 2005 to 2017. The Monte Carlo model tracks test particles from their source at the surface into space. The initial positions of all test particles for a single jet are fixed to one of 100 jets sources identified by Porco et al. (2014). The initial three-dimensional velocity of each particle contains two components: a velocity Vz which is perpendicular to the surface, and a thermal velocity which is isotropic in the upward hemisphere. The direction and speed of the thermal velocity of each particle is chosen randomly but the ensemble moves isotropically at a speed which satisfies a Boltzmann distribution for a given temperature Tth. A range for reasonable Vz is then determined by requiring that modeled jet widths match the observed ones. Each model run results in a set of coordinates and velocities of a given set of test particles. These are converted to the test particle number densities and then integrated along LoS for each time step of the occultation observation. The geometry of the observation is calculated using SPICE. The overarching result of the simulation run is a test particle number density along LoS for each time point during the occultation observation for each of the jets separately. To fit the model to the data, we integrate all jets that are crossed by the LoS at each point during an observation. The relative strength of the jets must be determined to fit the observed UVIS curves. The results of the fits are sets of active jets for each occultation. Each UVIS occultation

  20. The role of epithelial-mesenchymal transition in squamous cell carcinoma of the oral cavity.

    PubMed

    Zidar, Nina; Boštjančič, Emanuela; Malgaj, Marija; Gale, Nina; Dovšak, Tadej; Didanovič, Vojko

    2018-02-01

    Epithelial-mesenchymal transition (EMT) has emerged as a possible mechanism of cancer metastasizing, but strong evidence for EMT involvement in human cancer is lacking. Our aim was to compare oral spindle cell carcinoma (SpCC) as an example of EMT with oral conventional squamous cell carcinoma (SCC) with and without nodal metastases to test the hypothesis that EMT contributes to metastasizing in oral SCC. Thirty cases of oral SCC with and without nodal metastasis and 15 cases of SpCC were included. Epithelial (cytokeratin, E-cadherin), mesenchymal (vimentin, N-cadherin), and stem cell markers (ALDH-1, CD44, Nanog, Sox-2) and transcription repressors (Snail, Slug, Twist) were analyzed immunohistochemically. We also analyzed the expression of microRNAs miR-141, miR-200 family, miR-205, and miR-429. SpCC exhibited loss of epithelial markers and expression of mesenchymal markers or coexpression of both up-regulation of transcription repressors and down-regulation of the investigated microRNAs. SCC showed only occasional focal expression of mesenchymal markers at the invasive front. No other differences were observed between SCC with and without nodal metastases except for a higher expression of ALDH-1 in SCC with metastases. Our results suggest that SpCC is an example of true EMT but do not support the hypothesis that EMT is involved in metastasizing of conventional SCC. Regarding oral SCC progression and metastasizing, we have been facing a shift from the initial enthusiasm for the EMT concept towards a more critical approach with "EMT-like" and "partial EMT" concepts. The real question, though, is, is there no EMT at all?

  1. Results of two multichord stellar occultations by dwarf planet (1) Ceres

    NASA Astrophysics Data System (ADS)

    Gomes-Júnior, A. R.; Giacchini, B. L.; Braga-Ribas, F.; Assafin, M.; Vieira-Martins, R.; Camargo, J. I. B.; Sicardy, B.; Timerson, B.; George, T.; Broughton, J.; Blank, T.; Benedetti-Rossi, G.; Brooks, J.; Dantowitz, R. F.; Dunham, D. W.; Dunham, J. B.; Ellington, C. K.; Emilio, M.; Herpich, F. R.; Jacques, C.; Maley, P. D.; Mehret, L.; Mello, A. J. T.; Milone, A. C.; Pimentel, E.; Schoenell, W.; Weber, N. S.

    2015-08-01

    We report the results of two multichord stellar occultations by the dwarf planet (1) Ceres that were observed from Brazil on 2010 August 17, and from the USA on 2013 October 25. Four positive detections were obtained for the 2010 occultation, and nine for the 2013 occultation. Elliptical models were adjusted to the observed chords to obtain Ceres' size and shape. Two limb-fitting solutions were studied for each event. The first one is a nominal solution with an indeterminate polar aspect angle. The second one was constrained by the pole coordinates as given by Drummond et al. Assuming a Maclaurin spheroid, we determine an equatorial diameter of 972 ± 6 km and an apparent oblateness of 0.08 ± 0.03 as our best solution. These results are compared to all available size and shape determinations for Ceres made so far, and shall be confirmed by the NASA's Dawn space mission.

  2. Clinical management of occult hemothorax: a prospective study of 81 patients.

    PubMed

    Mahmood, Ismail; Abdelrahman, Husham; Al-Hassani, Ammar; Nabir, Syed; Sebastian, Mark; Maull, Kimball

    2011-06-01

    Intrapleural blood detected by computed tomography scan, but not evident on plain chest radiograph, defines occult hemothorax. This study determined the role for tube thoracostomy. Hemothorax was quantified on computed tomography by measuring the deepest lamellar fluid stripe at the most dependent portion. Data were collected prospectively on demographics, injury mechanism/severity, chest injuries, mechanical ventilation, hospital length of stay, complications, and outcome. Indications for tube thoracostomy were recorded. Tube thoracostomy was avoided in 67 patients (83%). Indications for chest tube placement included progression of hemothorax (8), desaturation (4), and delayed hemothorax (2). Patients with intrapleural fluid thickness greater than 1.5 cm were 4 times more likely to require tube thoracostomy. Occult hemothorax can be managed successfully without tube thoracostomy in most cases. Mechanical ventilation is not an indication for chest tube placement. Accompanying occult pneumothorax may be expected in 50% of cases, but did not affect clinical management. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. CCR7 and CXCR4 Expression in Primary Head and Neck Squamous Cell Carcinomas and Nodal Metastases – a Clinical and Immunohistochemical Study

    PubMed Central

    Al-Jokhadar, Maya; Al-Mandily, Ahmad; Zaid, Khaled; Maalouf, Elie Azar

    2017-01-01

    Background: Squamous cell carcinomas (SCCs) are common head and neck malignancies demonstrating lymph node LN involvement. Recently chemokine receptor overxpression has been reported in many cancers. Of particular interest, CCR7 appears to be a strong mediator of LN metastases, while CXCR4 may mediate distant metastases. Any relations between their expression in primary HNSCCs and metastatic lymph nodes need to be clarified. Aims: To investigate CCR7 andCXCR4 expression in primary HNSCCs of all tumor sizes, clinical stages and histological grades, as well as involved lymph nodes, then make comparisons, also with control normal oral epithelium. Materials and Methods: The sample consisted of 60 formalin-fixed, paraffin-embedded specimens of primary HNSCCs, 77 others of metastasi-positive lymph nodes, and 10 of control normal oral epithelial tissues. Sections were conventionally stained with H&E and immunohistochemically with monoclonal anti-CCR7 and monoclonal anti-CXCR4 antibodies. Positive cells were counted under microscopic assessment in four fields (X40) per case. Results: There was no variation among primary HNSCC tumors staining positive for CCR7 and CXCR4 with tumor size of for CCR7 with lymph node involvement. However, a difference was noted between primary HNSCC tumors stained by CXCR4 with a single as compared to more numerous node involvement. CXCR4 appear to vary with the clinical stagebut no links were noted with histological grades. Staining for primary HNSCC tumors and metastatic lymph nodes correlated. PMID:28547946

  4. IRTF observations of the occultation of 28 Sgr by Saturn

    NASA Technical Reports Server (NTRS)

    Harrington, Joseph; Cooke, Maren L.; Forrest, William J.; Pipher, Judith L.; Dunham, Edward W.; Elliot, J. L.

    1993-01-01

    NASA's Mauna Kea IR Telescope Facility obtained an IR-imaging time series for the July 3, 1989 occultation of 28 Sgr by Saturn and its rings; the stellar signal is present in these images throughout the ring occultation event. These data are noted to vary systematically with respect to the Voyager data over large radius scales, perhaps due to stellar signal diffraction through the rings. The stellar diameter, which is projected to be about 20 km, placed most bending- and density-wave trains below measurable resolution. Masses and mean optical depths are presented for individual ring sections.

  5. Cassini UVIS solar occultations by Saturn's F ring and the detection of collision-produced micron-sized dust

    NASA Astrophysics Data System (ADS)

    Becker, Tracy M.; Colwell, Joshua E.; Esposito, Larry W.; Attree, Nicholas O.; Murray, Carl D.

    2018-05-01

    We present an analysis of eleven solar occultations by Saturn's F ring observed by the Ultraviolet Imaging Spectrograph (UVIS) on the Cassini spacecraft. In four of the solar occultations we detect an unambiguous signal from diffracted sunlight that adds to the direct solar signal just before or after the occultations occur. The strongest detection was a 10% increase over the direct signal that was enabled by the accidental misalignment of the instrument's pointing. We compare the UVIS data with images of the F ring obtained by the Cassini Imaging Science Subsystem (ISS) and find that in each instance of an unambiguous diffraction signature in the UVIS data, the ISS data shows that there was a recent disturbance in that region of the F ring. Similarly, the ISS images show a quiescent region of the F ring for all solar occultations in which no diffraction signature was detected. We therefore conclude that collisions in the F ring produce a population of small ring particles that can produce a detectable diffraction signal immediately interior or exterior to the F ring. The clearest example of this connection comes from the strong detection of diffracted light in the 2007 solar occultation, when the portion of the F ring that occulted the Sun had suffered a large collisional event, likely with S/2004 S 6, several months prior. This collision was observed in a series of ISS images (Murray et al., 2008). Our spectral analysis of the data shows no significant spectral features in the F ring, indicating that the particles must be at least 0.2 μm in radius. We apply a forward model of the solar occultations, accounting for the effects of diffracted light and the attenuated direct solar signal, to model the observed solar occultation light curves. These models constrain the optical depth, radial width, and particle size distribution of the F ring. We find that when the diffraction signature is present, we can best reproduce the occultation data using a particle population

  6. [Prevalence of occult hepatitis B virus infection and its phylogenetic features among mother-teenager pairs].

    PubMed

    Dong, Xiao-lian; Yao, Qing-qing; Wang, Xue-cai; Xu, Hai-tao; Wang, Xiao-li; Chen, Sheng-yu; Tang, Zhi-feng; Zheng, Ying-Jie

    2013-03-01

    Prevalence of occult hepatitis B virus (HBV) infection (OBI) was investigated in a paired mother-teenager population and HBV S gene variation including overt and occult HBV, was determined. A follow-up study based on an initial survey of 135 mother-teenager pairs was carried out through collection of questionnaires and blood samples HBsAg were detected by ELISA method, viral load by PCR amplification and HBV S gene by phylogenetic analysis. 102 pairs of subjects were followed-up. Blood samples from 94 mothers and 101 children were collected. OBI prevalence in mothers was 10.0% (6/60), significantly higher than 2.0% (2/101) in teenagers. Medians of viral load were 399.9 IU/ml and 247.6 IU/ml in overt and occult HBV strains, but without significant difference. 1 occult HBV strain belonged to genotype B with serotype adw while the other 7 were genotype C with serotype adr. 15 of the overt HBV strains belonged to genotype B with serotype adw and the other 8 were genotype C with serotype adr. Proportions of genotype-C strains were significantly higher in occult HBV strains than in overt HBV strains. OBI was seen in teenage-mother population.

  7. [Interventional radiology for bone metastases].

    PubMed

    Iannessi, Antoine; Garnon, Julien; Cormier, Évelyne; Clarencon, Frédéric; Chiras, Jacques

    2013-11-01

    The management of bone metastases requires a multidisciplinary staff to include systemic and local treatments like radiotherapy, surgery or interventional radiology (IR). Patients are often fragile. Imaging allows safe guidance to create "mini-invasive" procedures under adequate anesthesia. Patients' selection is important. If the goal is pain relief, cementoplasty provides a very effective bone consolidation and pain control. Simple and low-risk, vertebroplasty is the technique of choice in case of lytic bone metastases with spinal fracture risk or after failure of analgesic radiotherapy. If the medical project is curative, the tumor ablation procedures are realised through thermic or embolic techniques. After 60°C, the heat induces a coagulative necrose. Under -20°C, the cold leads to destroy the tissues. The major advantage of the cryotherapy is the predictibility of the ablation zone due to the well-visualized ice ball on perprocedural images. This technique is much more adapted to spare the nervous structures closed to the metastasis. The development of these new techniques of IR will treat bone metastases earlier, sometimes asymptomatic and thus improves the quality of life in patients with bone metastases.

  8. Interventional radiology in bone metastases.

    PubMed

    Chiras, J; Shotar, E; Cormier, E; Clarençon, F

    2017-11-01

    Interventional radiology plays a significant role in the treatment of bone metastases by various techniques, percutaneous or endovascular. Vertebroplasty is the most well-studied technique for stabilisation of spine metastases as it induces satisfactory stabilisation of the vertebra and offers clear improvement of the quality of life. Due to the success of this technique cementoplasty of other bones, mainly pelvic girdle, has been largely developed. The development of reinforced cementoplasty allows treatment of pre-fractural osteolysis of some long bones. The heat due to the polymerisation of the cement induces carcinolytic effect but this effect is not as important as that which results from radiofrequency destruction. This last technique appears currently as the most important development to definitively destroy bone metastases and is progressively replacing percutaneous alcoholic destruction of such lesions. Angiographic techniques, such as endovascular embolisation, can also be very useful to reduce the risk of surgical treatment of hyper vascular metastases. Chemoembolisation is currently developed to associate pain relief induced by Endovascular embolisation and the carcinolytic effect obtained by local endovascular chemotherapy. All these techniques should develop largely during the next years. © 2017 John Wiley & Sons Ltd.

  9. Role of surgery in brain metastases.

    PubMed

    Laghari, Altaf Ali; Ahmed, Syed Ijlal; Shamim, Muhammad Shahzad

    2017-08-01

    Brain metastases remain the commonest type of brain tumour, being four times more common than primary brain tumours. Although surgical intervention may be recommended for one of various reasons in the management of these tumours, including but not limited to conformation of diagnosis, relief of mass effect, improvement of neurological status and prolongation of survival, the guidelines for management of brain metastases remain largely subjective and therefore controversial. Herein the authors have attempted to review some of the existing evidence on role of surgery in the management of brain metastases and have presented their selected guidelines for the readers.

  10. [Results of conservative treatment in patients with occult pneumothorax].

    PubMed

    Llaquet Bayo, Heura; Montmany Vioque, Sandra; Rebasa, Pere; Navarro Soto, Salvador

    2016-04-01

    An occult pneumothorax is found in 2-15% trauma patients. Observation (without tube thoracostomy) in these patients presents still some controversies in the clinical practice. The objective of the study is to evaluate the efficacy and the adverse effects when observation is performed. A retrospective observational study was undertaken in our center (university hospital level II). Data was obtained from a database with prospective registration. A total of 1087 trauma patients admitted in the intensive care unit from 2006 to 2013 were included. In this period, 126 patients with occult pneumothorax were identified, 73 patients (58%) underwent immediate tube thoracostomy and 53 patients (42%) were observed. Nine patients (12%) failed observation and required tube thoracostomy for pneumothorax progression or hemothorax. No patient developed a tension pneumothorax or experienced another adverse event related to the absence of tube thoracostomy. Of the observed patients 16 were under positive pressure ventilation, in this group 3 patients (19%) failed observation. There were no differences in mortality, hospital length of stay or intensive care length of stay between the observed and non-observed group. Observation is a safe treatment in occult pneumothorax, even in pressure positive ventilated patients. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Near infrared photoimmunotherapy for lung metastases

    PubMed Central

    Sato, Kazuhide; Nagaya, Tadanobu; Mitsunaga, Makoto; Choyke, Peter L.; Kobayashi, Hisataka

    2015-01-01

    Lung metastases are a leading cause of cancer related deaths; nonetheless current treatments are limited. Near infrared photoimmunotherapy (NIR-PIT) is a new cancer treatment that combines the specificity of intravenously injected antibodies that target tumors with the toxicity induced by photosensitizers activated by NIR-light. Herein, we demonstrate the efficacy of NIR-PIT in a mouse model of lung metastases. Experiments were conducted with a HER2, luciferase and GFP expressing cell line (3T3/HER2-luc-GFP). An antibody-photosensitizer conjugate (APC) consisting of trastuzumab and a phthalocyanine dye, IRDye-700DX, was synthesized. In vitro NIR-PIT-induced cytotoxicity was light dose dependent. With 3D culture, repeated NIR-PIT could eradicate entire spheroids. In vivo anti-tumor effects of NIR-PIT included significant reductions in both tumor volume (p = 0.0141 vs. APC) and bioluminescence image (BLI) (p = 0.0086 vs. APC) in the flank model, and prolonged survival (p < 0.0001). BLI demonstrated a significant reduction in lung metastases volume (p = 0.0117 vs. APC). Multiple NIR-PIT doses significantly prolonged survival in the lung metastases model (p < 0.0001). These results suggested that NIR-PIT is a potential new therapy for the local control of lung metastases. PMID:26021765

  12. A nodal signaling pathway regulates the laterality of neuroanatomical asymmetries in the zebrafish forebrain.

    PubMed

    Concha, M L; Burdine, R D; Russell, C; Schier, A F; Wilson, S W

    2000-11-01

    Animals show behavioral asymmetries that are mediated by differences between the left and right sides of the brain. We report that the laterality of asymmetric development of the diencephalic habenular nuclei and the photoreceptive pineal complex is regulated by the Nodal signaling pathway and by midline tissue. Analysis of zebrafish embryos with compromised Nodal signaling reveals an early role for this pathway in the repression of asymmetrically expressed genes in the diencephalon. Later signaling mediated by the EGF-CFC protein One-eyed pinhead and the forkhead transcription factor Schmalspur is required to overcome this repression. When expression of Nodal pathway genes is either absent or symmetrical, neuroanatomical asymmetries are still established but are randomized. This indicates that Nodal signaling is not required for asymmetric development per se but is essential to determine the laterality of the asymmetry.

  13. A 2017 stellar occultation by Orcus/Vanth

    NASA Astrophysics Data System (ADS)

    Sickafoose, Amanda A.; Bosh, Amanda S.; Levine, Stephen; Zuluaga, Carlos A.; Genade, Anja; Schindler, Karsten; Lister, Tim; Person, Michael J.

    2017-10-01

    (90482) Orcus is a large trans-Neptunian object (TNO) of diameter ~900 km, located in the 3:2 orbital resonance with Neptune. This plutino has a satellite, Vanth, approximately 280 km in diameter. Vanth orbits roughly 9000 km from Orcus in a ~9.5-day period. This system is particularly interesting, as Orcus falls between the small, spectrally-bland TNOs and the large TNOs having spectra rich in volatile features, while Vanth might have resulted from either collision or capture.A stellar occultation by Orcus was predicted to occur on 07 March 2017. Observations were made from five sites: the 0.6-m Astronomical Telescope of the University of Stuttgart (ATUS) at Sierra Remote Observatories (SRO), California; Las Cumbres Observatory’s 1-m telescope (ELP) at McDonald Observatory, Fort Davis, Texas; NASA’s 3-m InfraRed Telescope Facility (IRTF) on Mauna Kea, Hawaii; the 4.1-m Southern Astrophysical Research telescope (SOAR) on Cerro Pachón, Chile; and the 0.6-m Southeastern Association for Research in Astronomy telescope (SARA-CT) at Cerro Tololo, Chile. High-speed, visible-wavelength images were taken at all sites, in addition to simultaneous K-band images at the IRTF. A solid-body occultation was observed at both ELP and the IRTF. Offset midtimes and incompatible light ratios suggest that two different stars were occulted by two different bodies, likely Orcus and Vanth. See Bosh et al. this conference for details of the astrometry for the event. Here, we present results from the observations, including light curves, size and albedo estimates, and upper limits on a possible atmosphere.

  14. [Prediction of occult carcinoma in contralateral nodules based on the ultrasonic features of unilateral papillary thyroid carcinoma].

    PubMed

    Yang, L M; Li, Q; Zhao, B W; Lyu, J G; Xu, H S; Xu, L L; Li, S Y; Gao, L; Zhu, J

    2017-04-07

    Objective: To investigate the occurrence of occult carcinoma in contralateral lobes based on the ultrasonic features of unilateral papillary thyroid carcinoma. Methods: The study included 202 consecutives cases of unilateral papillary thyroid carcinoma with benign nodules in the contralateral lobe identified by preoperative ultrasound or fine-needle aspiration from June 2014 to December 2015. All patients received total thyroidectomies, and with postoperative pathological examination they were divided into two groups, one including 60 cases with positive occult cancer and another one consisting of 142 cases with negative occult cancer. Univariate and multivariate analyses were performed to analyze the sonographic features of unilateral papillary thyroid carcinoma relevant to the occurrence of occult carcinoma in the contralateral nodules. Results: Univariate analysis indicated occult carcinoma in the contralateral lobes was associated with Hashimoto's thyroiditis(χ(2)=3.955, P =0.047), unclear border (χ(2)=4.375, P =0.036)and multifocality in the ipsilateral(χ(2)=7.375, P =0.007), but not with tumors maximum size, location, A/T, shape, internal structure, internal echo, acoustic halo, calcification, capsular invasion and blood flow signal in the lobe with carcinoma on another side. Multivariate analysis showed unclear border ( OR =2.727, P =0.010) and multifocality in the ipsilateral( OR =2.807, P =0.005)of carcinoma were independent predictive factor for contralateral occult PTC. Conclusions: Unclear border and multifocality of PTC in the ipsilateral were closely relevant to the occurrence of occult carcinoma in the contralateral nodules.

  15. Prognostic effect of isolated paraaortic nodal spread in endometrial cancer.

    PubMed

    Türkmen, Osman; Başaran, Derman; Karalok, Alper; Cömert Kimyon, Günsu; Taşçı, Tolga; Üreyen, Işın; Tulunay, Gökhan; Turan, Taner

    2018-03-28

    To evaluate the prognostic effect of isolated paraaortic lymph node metastasis in endometrial cancer (EC). This retrospective study included patients with FIGO 2009 stage IIIC2 disease due to isolated paraaortic lymph node metastasis (LNM). Patients with sarcomatous histology, synchronous gynecologic cancers and patients with concurrent pelvic lymph node metastases or patients that have intraabdominal tumor spread were excluded. Kaplan-Meier method was used for calculation of progression free survival (PFS) and overall survival. 1614 patients were operated for EC during study period.961 patients underwent lymph node dissection and 25 (2.6%) were found to have isolated LNM in paraaortic region and these constituted the study cohort.20 (80%) patients had endometrioid EC. Median number of retrieved lymph nodes from pelvic region and paraaortic region was 21.5 (range; 5-41) and 34.5 (range; 1-65), respectively. Median number of metastatic paraaortic nodes was 1 (range; 1-32).The median follow-up time was 15 months (range 5-94). 7 (28%) patients recurred after a median of 20 months (range, 3-99) from initial surgery. 3 patients recurred only in pelvis, one patient had upper abdominal spread and 3 had isolated extraabdominal recurrence.İnvolvement of uterine serosa, positive peritoneal cytology and presence of adnexal metastasis were significantly associated with diminished PFS (p<0.05). The presence of serosal involvement or adnexal involvement is as important as gross peritoneal spread and is related with poor survival in patients with isolated paraaortic nodal spread in EC. Chemotherapy should be the mainstay of treatment in this patient cohort which may eradicate systemic tumor spread.

  16. An approach to model reactor core nodalization for deterministic safety analysis

    NASA Astrophysics Data System (ADS)

    Salim, Mohd Faiz; Samsudin, Mohd Rafie; Mamat @ Ibrahim, Mohd Rizal; Roslan, Ridha; Sadri, Abd Aziz; Farid, Mohd Fairus Abd

    2016-01-01

    Adopting good nodalization strategy is essential to produce an accurate and high quality input model for Deterministic Safety Analysis (DSA) using System Thermal-Hydraulic (SYS-TH) computer code. The purpose of such analysis is to demonstrate the compliance against regulatory requirements and to verify the behavior of the reactor during normal and accident conditions as it was originally designed. Numerous studies in the past have been devoted to the development of the nodalization strategy for small research reactor (e.g. 250kW) up to the bigger research reactor (e.g. 30MW). As such, this paper aims to discuss the state-of-arts thermal hydraulics channel to be employed in the nodalization for RTP-TRIGA Research Reactor specifically for the reactor core. At present, the required thermal-hydraulic parameters for reactor core, such as core geometrical data (length, coolant flow area, hydraulic diameters, and axial power profile) and material properties (including the UZrH1.6, stainless steel clad, graphite reflector) have been collected, analyzed and consolidated in the Reference Database of RTP using standardized methodology, mainly derived from the available technical documentations. Based on the available information in the database, assumptions made on the nodalization approach and calculations performed will be discussed and presented. The development and identification of the thermal hydraulics channel for the reactor core will be implemented during the SYS-TH calculation using RELAP5-3D® computer code. This activity presented in this paper is part of the development of overall nodalization description for RTP-TRIGA Research Reactor under the IAEA Norwegian Extra-Budgetary Programme (NOKEBP) mentoring project on Expertise Development through the Analysis of Reactor Thermal-Hydraulics for Malaysia, denoted as EARTH-M.

  17. An approach to model reactor core nodalization for deterministic safety analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Salim, Mohd Faiz, E-mail: mohdfaizs@tnb.com.my; Samsudin, Mohd Rafie, E-mail: rafies@tnb.com.my; Mamat Ibrahim, Mohd Rizal, E-mail: m-rizal@nuclearmalaysia.gov.my

    Adopting good nodalization strategy is essential to produce an accurate and high quality input model for Deterministic Safety Analysis (DSA) using System Thermal-Hydraulic (SYS-TH) computer code. The purpose of such analysis is to demonstrate the compliance against regulatory requirements and to verify the behavior of the reactor during normal and accident conditions as it was originally designed. Numerous studies in the past have been devoted to the development of the nodalization strategy for small research reactor (e.g. 250kW) up to the bigger research reactor (e.g. 30MW). As such, this paper aims to discuss the state-of-arts thermal hydraulics channel to bemore » employed in the nodalization for RTP-TRIGA Research Reactor specifically for the reactor core. At present, the required thermal-hydraulic parameters for reactor core, such as core geometrical data (length, coolant flow area, hydraulic diameters, and axial power profile) and material properties (including the UZrH{sub 1.6}, stainless steel clad, graphite reflector) have been collected, analyzed and consolidated in the Reference Database of RTP using standardized methodology, mainly derived from the available technical documentations. Based on the available information in the database, assumptions made on the nodalization approach and calculations performed will be discussed and presented. The development and identification of the thermal hydraulics channel for the reactor core will be implemented during the SYS-TH calculation using RELAP5-3D{sup ®} computer code. This activity presented in this paper is part of the development of overall nodalization description for RTP-TRIGA Research Reactor under the IAEA Norwegian Extra-Budgetary Programme (NOKEBP) mentoring project on Expertise Development through the Analysis of Reactor Thermal-Hydraulics for Malaysia, denoted as EARTH-M.« less

  18. Prediction of occult hepatitis B virus infection in liver transplant donors through hepatitis B virus blood markers.

    PubMed

    Tandoi, Francesco; Caviglia, Gian Paolo; Pittaluga, Fabrizia; Abate, Maria Lorena; Smedile, Antonina; Romagnoli, Renato; Salizzoni, Mauro

    2014-11-01

    Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (p<0.0001). All anti-HBc-positive donors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBs<58 mIU/mL. In deceased donors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Gastroenteropancreatic Neuroendocrine Tumors with Liver Metastases in Korea: A Clinicopathological Analysis of 72 Cases in a Single Institute

    PubMed Central

    Shin, Yooju; Ha, Sang Yun; Hyeon, Jiyeon; Lee, Boram; Lee, Jeeyun; Jang, Kee-Taek; Kim, Kyoung-Mee; Park, Young Suk; Park, Cheol-Keun

    2015-01-01

    Purpose Management of gastroenteropancreatic (GEP) neuroendocrine tumors with liver metastases (NETLM) presents many clinical challenges. Assessment of the extent of disease and primary tumor site is crucial for management. In this study, we investigated the primary tumor sites and prognostic factors in GEP NETLM among Korean patients. Materials and Methods We reviewed the medical records of 72 Korean patients diagnosed with GEP NETLM between January 1999 and May 2013, focusing on their clinical and pathologic characteristics. Results The most frequently encountered primary tumor sites were the pancreas (n=25, 35%), stomach (n=8, 11%), gall bladder (n=4, 6%) and rectum (n=3, 4%). Twenty-five patients (35%) had occult primary tumor. Twelve patients (17%) had histological grade G1 tumors, 30 patients (42%) had G2 tumors, and 30 patients (42%) had G3 tumors. The mean follow-up period after histological confirmation of hepatic metastases was 11.30±2.44 months for G3 tumors, 19.67±4.09 months for G2 tumors, and 30.67±6.51 months for G1 tumors. Multivariate analyses revealed that an unknown primary tumor site (p=0.001) and higher histological grade (p < 0.001) were independent prognostic indicators for shorter overall survival (OS). Most long-term survivors (OS > 24 months) had received antitumor treatment. Conclusion The primary tumor site most frequently associated with GEP NETLM was the pancreas. Unknown primary tumor and higher histological grade were independent prognostic indicators for shorter OS. Patients identified as being at a risk of shorter OS should be followed up closely. PMID:25687852

  20. Structural insights into the interaction of a monoclonal antibody and Nodal peptides by STD-NMR spectroscopy.

    PubMed

    Calvanese, Luisa; Focà, Annalia; Sandomenico, Annamaria; Focà, Giuseppina; Caporale, Andrea; Doti, Nunzianna; Iaccarino, Emanuela; Leonardi, Antonio; D'Auria, Gabriella; Ruvo, Menotti; Falcigno, Lucia

    2017-12-15

    Nodal is a growth factor expressed during early embryonic development, but reactivated in several advanced-stage cancers. Targeting of Nodal signaling, which occurs via the binding to Cripto-1 co-receptor, results in inhibition of cell aggressiveness and reduced tumor growth. The Nodal binding region to Cripto-1 was identified and targeted with a high affinity monoclonal antibody (3D1). By STD-NMR technique, we investigated the interaction of Nodal fragments with 3D1 with the aim to elucidate at atomic level the interaction surface. Data indicate with high accuracy the antibody-antigen contact atoms and confirm the information previously obtained by immune-enzymatic methods. Main residues contacted by 3D1 are P46, V47, E49 and E50, which belong to the Nodal loop involved in the interaction with the co-receptor. Copyright © 2017 Elsevier Ltd. All rights reserved.