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Sample records for recurrence relations

  1. Recurrent Takotsubo Cardiomyopathy Related to Recurrent Thyrotoxicosis

    PubMed Central

    Patel, Keval; Griffing, George T.; Hauptman, Paul J.

    2016-01-01

    Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is characterized by acute left ventricular dysfunction caused by transient wall-motion abnormalities of the left ventricular apex and mid ventricle in the absence of obstructive coronary artery disease. Recurrent episodes are rare but have been reported, and several cases of takotsubo cardiomyopathy have been described in the presence of hyperthyroidism. We report the case of a 55-year-old woman who had recurrent takotsubo cardiomyopathy, documented by repeat coronary angiography and evaluations of left ventricular function, in the presence of recurrent hyperthyroidism related to Graves disease. After both episodes, the patient's left ventricular function returned to normal when her thyroid function normalized. These findings suggest a possible role of thyroid-hormone excess in the pathophysiology of some patients who have takotsubo cardiomyopathy. PMID:27127432

  2. Recurrent Takotsubo Cardiomyopathy Related to Recurrent Thyrotoxicosis.

    PubMed

    Patel, Keval; Griffing, George T; Hauptman, Paul J; Stolker, Joshua M

    2016-04-01

    Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is characterized by acute left ventricular dysfunction caused by transient wall-motion abnormalities of the left ventricular apex and mid ventricle in the absence of obstructive coronary artery disease. Recurrent episodes are rare but have been reported, and several cases of takotsubo cardiomyopathy have been described in the presence of hyperthyroidism. We report the case of a 55-year-old woman who had recurrent takotsubo cardiomyopathy, documented by repeat coronary angiography and evaluations of left ventricular function, in the presence of recurrent hyperthyroidism related to Graves disease. After both episodes, the patient's left ventricular function returned to normal when her thyroid function normalized. These findings suggest a possible role of thyroid-hormone excess in the pathophysiology of some patients who have takotsubo cardiomyopathy. PMID:27127432

  3. Recurrence relations of Kummer functions and Regge string scattering amplitudes

    NASA Astrophysics Data System (ADS)

    Lee, Jen-Chi; Mitsuka, Yoshihiro

    2013-04-01

    We discover an infinite number of recurrence relations among Regge string scattering amplitudes [11, 30] of different string states at arbitrary mass levels in the open bosonic string theory. As a result, all Regge string scattering amplitudes can be algebraically solved up to multiplicative factors. Instead of decoupling zero-norm states in the fixed angle regime, the calculation is based on recurrence relations and addition theorem of Kummer functions of the second kind. These recurrence relations among Regge string scattering amplitudes are dual to linear relations or symmetries among high-energy fixed angle string scattering amplitudes discovered previously.

  4. Relating movement recurrence and expressive timing patterns in music performances.

    PubMed

    Teixeira, Euler C F; Yehia, Hani C; Loureiro, Mauricio A

    2015-09-01

    In this study the movement patterns of ten expert musicians are quantitatively related to expressive timing patterns and the music structure during performances. The hypothesis is that ancillary gestures recurrently employed are closely related to expressive intentions, and that the expressive content imposed in key musical passages is thus reflected in the patterns of gestural recurrence. A movement and an audio analysis of 30 clarinet performances of a Brahms' excerpt are compared. Results show direct correlations between the recurrence pattern of clarinetists' ancillary movements and expressive bar duration manipulations employed by them, associated with melodic phrasing and harmonic transitions. PMID:26428815

  5. Relating movement recurrence and expressive timing patterns in music performances.

    PubMed

    Teixeira, Euler C F; Yehia, Hani C; Loureiro, Mauricio A

    2015-09-01

    In this study the movement patterns of ten expert musicians are quantitatively related to expressive timing patterns and the music structure during performances. The hypothesis is that ancillary gestures recurrently employed are closely related to expressive intentions, and that the expressive content imposed in key musical passages is thus reflected in the patterns of gestural recurrence. A movement and an audio analysis of 30 clarinet performances of a Brahms' excerpt are compared. Results show direct correlations between the recurrence pattern of clarinetists' ancillary movements and expressive bar duration manipulations employed by them, associated with melodic phrasing and harmonic transitions.

  6. The Recurrence Relations in Teaching Students of Informatics

    ERIC Educational Resources Information Center

    Bakoev, Valentin P.

    2010-01-01

    The topic "Recurrence relations" and its place in teaching students of Informatics is discussed in this paper. We represent many arguments about the importance, the necessity and the benefit of studying this subject by Informatics students. They are based on investigation of some fundamental books and textbooks on Discrete Mathematics,…

  7. Recurrent oculomotor neuritis related to autoimmune hypothyroidism. Case Report.

    PubMed

    Choi, Hye-Yeon; Rhee, Hak Young; Shin, Hae-Won

    2015-01-01

    Ophthalmopathy related to thyroid disease is due mainly to diffuse periorbital or eye muscle inflammation. It is more common in Grave's hyperthyroidism and rare in Hashimoto's hypothyroidism. Here we report a case of recurrent oculomotor nerve palsy associated with autoimmune hypothyroidism. Brain MRI revealed enhancement of the oculomotor nerves. Despite thyroid hormone replacement therapy, oculomotor nerve palsy recurred at the side contralateral to the initially involved nerve and the autoimmune antibody titer remained high. The symptom was responsive to high-dose steroid therapy. PMID:26454483

  8. Recurrence relations of higher spin BPST vertex operators for open strings

    NASA Astrophysics Data System (ADS)

    Fu, Chih-Hao; Lee, Jen-Chi; Tan, Chung-I.; Yang, Yi

    2013-08-01

    We calculate higher-spin Brower-Polchinski-Strassler-Tan (BPST) vertex operators for an open bosonic string and express these operators in terms of a Kummer function of the second kind. We derive an infinite number of recurrence relations among BPST vertex operators of different string states. These recurrence relations among BPST vertex operators lead to the recurrence relations among Regge string scattering amplitudes discovered recently.

  9. Consequences of recurrent gene flow from crops to wild relatives.

    PubMed

    Haygood, Ralph; Ives, Anthony R; Andow, David A

    2003-09-22

    Concern about gene flow from crops to wild relatives has become widespread with the increasing cultivation of transgenic crops. Possible consequences of such gene flow include genetic assimilation, wherein crop genes replace wild ones, and demographic swamping, wherein hybrids are less fertile than their wild parents, and wild populations shrink. Using mathematical models of a wild population recurrently receiving pollen from a genetically fixed crop, we find that the conditions for genetic assimilation are not stringent, and progress towards replacement can be fast, even for disfavoured crop genes. Demographic swamping and genetic drift relax the conditions for genetic assimilation and speed progress towards replacement. Genetic assimilation can involve thresholds and hysteresis, such that a small increase in immigration can lead to fixation of a disfavoured crop gene that had been maintained at a moderate frequency, even if the increase in immigration is cancelled before the gene fixes. Demographic swamping can give rise to 'migrational meltdown', such that a small increase in immigration can lead to not only fixation of a disfavoured crop gene but also drastic shrinkage of the wild population. These findings suggest that the spread of crop genes in wild populations should be monitored more closely. PMID:14561300

  10. Consequences of recurrent gene flow from crops to wild relatives.

    PubMed Central

    Haygood, Ralph; Ives, Anthony R; Andow, David A

    2003-01-01

    Concern about gene flow from crops to wild relatives has become widespread with the increasing cultivation of transgenic crops. Possible consequences of such gene flow include genetic assimilation, wherein crop genes replace wild ones, and demographic swamping, wherein hybrids are less fertile than their wild parents, and wild populations shrink. Using mathematical models of a wild population recurrently receiving pollen from a genetically fixed crop, we find that the conditions for genetic assimilation are not stringent, and progress towards replacement can be fast, even for disfavoured crop genes. Demographic swamping and genetic drift relax the conditions for genetic assimilation and speed progress towards replacement. Genetic assimilation can involve thresholds and hysteresis, such that a small increase in immigration can lead to fixation of a disfavoured crop gene that had been maintained at a moderate frequency, even if the increase in immigration is cancelled before the gene fixes. Demographic swamping can give rise to 'migrational meltdown', such that a small increase in immigration can lead to not only fixation of a disfavoured crop gene but also drastic shrinkage of the wild population. These findings suggest that the spread of crop genes in wild populations should be monitored more closely. PMID:14561300

  11. Consequences of recurrent gene flow from crops to wild relatives.

    PubMed

    Haygood, Ralph; Ives, Anthony R; Andow, David A

    2003-09-22

    Concern about gene flow from crops to wild relatives has become widespread with the increasing cultivation of transgenic crops. Possible consequences of such gene flow include genetic assimilation, wherein crop genes replace wild ones, and demographic swamping, wherein hybrids are less fertile than their wild parents, and wild populations shrink. Using mathematical models of a wild population recurrently receiving pollen from a genetically fixed crop, we find that the conditions for genetic assimilation are not stringent, and progress towards replacement can be fast, even for disfavoured crop genes. Demographic swamping and genetic drift relax the conditions for genetic assimilation and speed progress towards replacement. Genetic assimilation can involve thresholds and hysteresis, such that a small increase in immigration can lead to fixation of a disfavoured crop gene that had been maintained at a moderate frequency, even if the increase in immigration is cancelled before the gene fixes. Demographic swamping can give rise to 'migrational meltdown', such that a small increase in immigration can lead to not only fixation of a disfavoured crop gene but also drastic shrinkage of the wild population. These findings suggest that the spread of crop genes in wild populations should be monitored more closely.

  12. Breast cancer recurrence in relation to antidepressant use

    PubMed Central

    Chubak, Jessica; Bowles, Erin J.A.; Yu, Onchee; Buist, Diana S.M.; Fujii, Monica; Boudreau, Denise M.

    2016-01-01

    Purpose Women with breast cancer frequently use antidepressants; however, questions about the effect of these medications on breast cancer recurrence remain. Methods We identified 4216 women ≥18 years with an incident stage I or II breast cancer diagnosed between 1990–2008 in a mixed model healthcare delivery system linked to a cancer registry. Recurrences were ascertained from chart review. Medication exposures were extracted from electronic pharmacy records. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) to assess the association between antidepressant use and breast cancer recurrence and mortality. We also conducted analyses restricted to tamoxifen users. Results Antidepressants overall, tricyclic antidepressants, and selective serotonin reuptake inhibitors were not associated with risk of breast cancer recurrence or mortality. Women taking paroxetine only (adjusted HR: 1.66; 95% CI: 1.02, 2.71) and trazadone only (adjusted HR: 1.76; 95% CI: 1.06, 2.92), but not fluoxetine only (adjusted HR: 0.92; 95% CI: 0.55, 1.53), had higher recurrence risks than antidepressant non-users. There was some suggestion of an increased recurrence risk with concurrent paroxetine and tamoxifen use compared to users of tamoxifen only (adjusted HR: 1.49; 95% CI: 0.79, 2.83). Conclusions In general, antidepressants did not appear increase risk of breast cancer recurrence; though there were some suggested increases in risk that warrant further investigation in other datasets. Our results combined systematically and quantitatively with results from other studies may be useful for patients and providers making decisions about antidepressant use after breast cancer diagnosis. PMID:26518198

  13. Lifestyle and lifestyle-related comorbidities independently associated with colorectal adenoma recurrence in elderly Chinese people

    PubMed Central

    Saiken, Adake; Gu, Fang

    2016-01-01

    Objective The purpose of this study was to determine the lifestyle and lifestyle-related comorbidities independently associated with colorectal adenoma (CRA) recurrence in elderly Chinese people. Methods During the 5-year follow-up after the initial colonoscopy, participants aged >60 years with the diagnosis and removal of CRA underwent a complete surveillance colonoscopy, and 152 participants with CRA recurrence plus 152 participants free of recurrence were included in this analysis. Results Participants with CRA recurrence were more likely to consume less vegetables and fruits, and more red meats compared with the control group (P<0.05 for all). Lifestyle-related comorbidities, including hypertension and nonalcoholic fatty liver disease (NAFLD), were more common in participants with CRA recurrence than in the control group (P<0.05 for all). In the multivariate analysis, pack-years of smoking were independently associated with an increased CRA recurrence (odds ratio [OR]: 1.03; P<0.05). Eating less vegetables (OR: 099; P<0.05) and fruits (OR: 0.98; P<0.05) was identified as a statistically independent factor influencing CRA recurrence, as was eating more red meats (OR: 1.01; P<0.05). Hypertension was also found to be a factor independently associated with an increased CRA recurrence (OR: 2.44; P<0.05). NAFLD had an independent association, with an increased CRA recurrence (OR: 3.43; P<0.05). Conclusion Smoking cigarettes, high consumption of red meats, low intake of fruits and vegetables, and the presence of hypertension and NAFLD were independently associated with an increased CRA recurrence in elderly Chinese people. This conclusion helps elderly Chinese people to make effective behavioral changes, such as smoking cessation, substitution of fruits and vegetables for red meats, and timely treatment of hypertension and NAFLD, to reduce CRA recurrence and colorectal cancer risk. PMID:27382263

  14. Detecting event-related recurrences by symbolic analysis: applications to human language processing

    PubMed Central

    beim Graben, Peter; Hutt, Axel

    2015-01-01

    Quasi-stationarity is ubiquitous in complex dynamical systems. In brain dynamics, there is ample evidence that event-related potentials (ERPs) reflect such quasi-stationary states. In order to detect them from time series, several segmentation techniques have been proposed. In this study, we elaborate a recent approach for detecting quasi-stationary states as recurrence domains by means of recurrence analysis and subsequent symbolization methods. We address two pertinent problems of contemporary recurrence analysis: optimizing the size of recurrence neighbourhoods and identifying symbols from different realizations for sequence alignment. As possible solutions for these problems, we suggest a maximum entropy criterion and a Hausdorff clustering algorithm. The resulting recurrence domains for single-subject ERPs are obtained as partition cells reflecting quasi-stationary brain states. PMID:25548270

  15. Recurrence of choroidal neovascularisation after photodynamic therapy in patients with age‐related macular degeneration

    PubMed Central

    Potter, Michael J; Szabo, Shelagh M

    2007-01-01

    Aim To determine the incidence of recurrence of choroidal neovascularisation (CNV) 18 months after cessation of photodynamic therapy (PDT) with verteporfin monotherapy in patients with age‐related macular degeneration (AMD). Methods This was a prospective interventional cohort study. The sample consisted of 108 individuals with CNV secondary to AMD which was treated with PDT. Data on demographics, pre‐PDT and post‐PDT Early Treatment of Diabetic Retinopathy Study (ETDRS) acuity, pre‐PDT lesion size and composition were collected for each participant. All participants returned for fundus photographs and ETDRS acuity measurements 18 months after their final PDT, which were compared with the same measurements from the final treatment session to determine recurrence status. Recurrences were classified primarily on the basis of haemorrhage and increased lesion size. Results Recurrences were observed in 36 of 108 (33%) eyes. 23 of 36 (64%) recurrences were clinically meaningful. Of the explanatory variables considered, only final PDT acuity was significantly different between those that recurred (45.5 ETDRS letters) and those that did not (38.4 letters; p = 0.03). Conclusion CNV recurrences are common after PDT for AMD, occurring in 33% of eyes in this study. Visual acuity measured at the final PDT treatment visit may be a predictor of subsequent recurrence. PMID:17229805

  16. The leading term of the Plancherel-Rotach asymptotic formula for solutions of recurrence relations

    SciTech Connect

    Aptekarev, A I; Tulyakov, D N

    2014-12-31

    Recurrence relations generating Padé and Hermite-Padé polynomials are considered. Their coefficients increase with the index of the relation, but after dividing by an appropriate power of the scaling function they tend to a finite limit. As a result, after scaling the polynomials 'stabilize' for large indices; this type of asymptotic behaviour is called Plancherel-Rotach asymptotics. An explicit expression for the leading term of the asymptotic formula, which is valid outside sets containing the zeros of the polynomials, is obtained for wide classes of three- and four-term relations. For three-term recurrence relations this result generalizes a theorem Van Assche obtained for recurrence relations with 'regularly' growing coefficients. Bibliography: 19 titles.

  17. Explicit Relations of Physical Potentials Through Generalized Hypervirial and Kramers' Recurrence Relations

    NASA Astrophysics Data System (ADS)

    Sun, Guo-Hua; Dong, Shi-Hai

    2015-06-01

    Based on a Hamiltonian identity, we study one-dimensional generalized hypervirial theorem, Blanchard-like (non-diagonal case) and Kramers' (diagonal case) recurrence relations for arbitrary xκ which is independent of the central potential V(x). Some significant results in diagonal case are obtained for special κ in xκ (κ ≥ 2). In particular, we find the orthogonal relation = δn1n2 (κ = 0), = (En1 - En2)2 (κ = 1), En = + (κ = 2) and -4En + + 4 = 0 (κ = 3). The latter two formulas can be used directly to calculate the energy levels. We present useful explicit relations for some well known physical potentials without requiring the energy spectra of quantum system. Supported in part by Project 20150964-SIP-IPN, COFAA-IPN, Mexico

  18. Outburst-related period changes of recurrent nova CI aquilae

    SciTech Connect

    Wilson, R. E.; Honeycutt, R. K. E-mail: rewilson@ufl.edu

    2014-11-01

    Pre-outburst and post-outburst light curves and post-outburst eclipse timings are analyzed to measure any period (P) change related to nova CI Aql's outburst of early 2000 and a mean post-outburst dP/dt, which then lead to estimates of the accreting component's rate of mass (M) change and its overall outburst-related change of mass over roughly a decade of observations. We apply a recently developed procedure for unified analysis of three timing-related data types (light curves, radial velocities, and eclipse timings), although with only light curves and timings in this case. Fits to the data are reasonably good without need for a disk in the light-curve model, although the disk certainly exists and has an important role in our post-outburst mass flow computations. Initial experiments showed that, although there seems to be an accretion hot spot, it has essentially no effect on derived outburst-related ΔP or on post-outburst dP/dt. Use of atomic time (HJED) in place of HJD also has essentially nil effect on ΔP and dP/dt. We find ΔP consistently negative in various types of solutions, although at best only marginally significant statistically in any one experiment. Pre-outburst HJD {sub 0} and P results are given, as are post-outburst HJD {sub 0}, P, and dP/dt, with light curves and eclipse times as joint input, and also with only eclipse time input. Post-outburst dP/dt is negative at about 2.4σ. Explicit formulae for mass transfer rates and epoch-to-epoch mass change are developed and applied. A known offset in the magnitude zero point for 1991-1994 is corrected.

  19. Recurrence relation for the 6j-symbol of suq(2) as a symmetric eigenvalue problem

    NASA Astrophysics Data System (ADS)

    Khavkine, Igor

    2015-08-01

    A well-known recurrence relation for the 6j-symbol of the quantum group suq(2) is realized as a tridiagonal, symmetric eigenvalue problem. This formulation can be used to implement an efficient numerical evaluation algorithm, taking advantage of existing specialized numerical packages. For convenience, all formulas relevant for such an implementation are collected in Appendix A. This realization is a byproduct of an alternative proof of the recurrence relation, which generalizes a classical (q = 1) result of Schulten and Gordon and uses the diagrammatic spin network formalism of Temperley-Lieb recoupling theory to simplify intermediate calculations.

  20. Recurrence relations for orthogonal polynomials for PDEs in polar and cylindrical geometries.

    PubMed

    Richardson, Megan; Lambers, James V

    2016-01-01

    This paper introduces two families of orthogonal polynomials on the interval (-1,1), with weight function [Formula: see text]. The first family satisfies the boundary condition [Formula: see text], and the second one satisfies the boundary conditions [Formula: see text]. These boundary conditions arise naturally from PDEs defined on a disk with Dirichlet boundary conditions and the requirement of regularity in Cartesian coordinates. The families of orthogonal polynomials are obtained by orthogonalizing short linear combinations of Legendre polynomials that satisfy the same boundary conditions. Then, the three-term recurrence relations are derived. Finally, it is shown that from these recurrence relations, one can efficiently compute the corresponding recurrences for generalized Jacobi polynomials that satisfy the same boundary conditions. PMID:27652140

  1. The role of quantum recurrence in superconductivity, carbon nanotubes and related gauge symmetry breaking

    NASA Astrophysics Data System (ADS)

    Dolce, Donatello; Perali, Andrea

    2014-09-01

    Pure quantum phenomena are characterized by intrinsic recurrences in space and time. We use this intrinsic periodicity as a quantization condition to derive a heuristic description of the essential quantum phenomenology of superconductivity. The resulting description is based on fundamental quantum dynamics and geometrical considerations, rather than on microscopical characteristics of the superconducting materials. This allows us to investigate the related gauge symmetry breaking in terms of the competition between quantum recurrence and thermal noise. We also test the validity of this approach to describe the case of carbon nanotubes.

  2. Computational properties of three-term recurrence relations for Kummer functions

    NASA Astrophysics Data System (ADS)

    Deaño, Alfredo; Segura, Javier; Temme, Nico M.

    2010-01-01

    Several three-term recurrence relations for confluent hypergeometric functions are analyzed from a numerical point of view. Minimal and dominant solutions for complex values of the variable z are given, derived from asymptotic estimates of the Whittaker functions with large parameters. The Laguerre polynomials and the regular Coulomb wave functions are studied as particular cases, with numerical examples of their computation.

  3. Calculating the acidity constants of homologues and isomers of organic acids by means of recurrence relations

    NASA Astrophysics Data System (ADS)

    Zenkevich, I. G.

    2013-06-01

    It is noted that the p K a values of organic acids can be calculated using the unique recurrence relation p K a( n + 1) = ap K a( n) + b from the p K a values of other (usually the simplest and, consequently, better characterized) homologues of the same series. It is shown that this relation is valid within two taxonomic groups: insertion homologues of the ω-substituted acids X(CH2) n CO2H ( n ≥ 1) and isomers that differ in the position of substituents X in their alkyl fragments, k-X(C n H2 n )CO2H ( n ≥ 1, 1 ≤ k ≤ n + 1). It is concluded that this algorithm is a consequence of the unique mathematical properties of recurrence relations.

  4. Angiogenesis-associated sequence variants relative to breast cancer recurrence and survival

    PubMed Central

    Brock, Guy N.; VanCleave, Tiva T.; Benford, Marnita L.; Lavender, Nicole A.; Kruer, Traci L.; Wittliff, James L.

    2016-01-01

    Introduction Breast cancer (BrCA) risk stratification using clinico-pathological biomarkers helps improve disease prognosis prediction. However, disease recurrence rates remain unfavorable and individualized clinical management strategies are needed. Consequently, we evaluated the influence of 14 sequence variants detected in IL-10, TGF-β1, VEGF, and their associated receptors as effective predictors of BrCA clinical outcomes. Methods Tumor DNA samples collected from 441 BrCA patients were genotyped using TaqMan-PCR. Most selected targets alter cytokine serum/plasma levels or signaling pathways. Relationships between genetic profiles and recurrence as well as disease-related mortality were evaluated using cumulative incidence curves and competing risk regression models. Results The VEGF−2578 C allele was associated with a 1.3-to 1.6-fold increase in BrCA recurrence (HRtrend = 1.28; 95% CI = 0.96–1.72) and disease-related mortality (HRtrend = 1.56; 95% CI = 0.93–2.56). Although this marker was marginally significant relative to BrCA outcomes, there were substantial gains in the 5- and 8-year predictive accuracy compared to standard prognostic indicators. Among ER+/PR+ status patients, there was a significant impact of the VEGF−2578 CC genotype on disease recurrence and predictive accuracy. Conclusions Our findings suggest inheritance of the VEGF−2578 C allele could serve as an independent prognostic indicator of BrCA prognosis. The VEGF−2578 marker may have clinical implications among a subset of ER+/ PR+ patients with an aggressive phenotype. Because the VEGF−2578 C allele is linked to high VEGF expression, this cytokine is a potential prognostic and targeted clinical management tool. PMID:20571871

  5. Identification of recurrence-related genes by integrating microRNA and gene expression profiling of gastric cancer.

    PubMed

    Yan, Zhi; Xiong, Yimin; Xu, Weitian; Li, Min; Cheng, Yi; Chen, Fang; Ding, Shifang; Xu, Hualin; Zheng, Guorong

    2012-12-01

    We previously analyzed the microRNA (miRNA) expression pattern in gastric cancer with and without recurrence and obtained 17 differentially expressed miRNAs with potential to predict recurrence risk for GC patients. In the present study, we aimed to investigate recurrence-related genes which may be regulated by the differentially expressed miRNAs identified in our prior research. Three different miRNA target gene databases (miRanda, TargetScan and PicTar) were used for searching the potential genes regulated by miRNAs. A combination was performed between miRNA target genes and recurrence-related gene expression profiling. Three bioinformatics algorithms (PAM, SVM and RF) were used to feature recurrence-related gene selection. In addition, we validated the expression levels of the genes in GC patients using real-time PCR. A total of 3,263 genes were identified as potential targets of 17 miRNAs. We identified 2,736 differential expressed genes using the SAM method based on 22K oligo microarray data which included 7 recurrence and 4 without recurrence GC samples. Combining the target genes regulated by miRNAs and the differentially expressed genes between recurrence and non-recurrence groups, we identified 228 differential genes for further study. Finally, we identified HNRPA0 and PRDM4 as risk biomarkers of GC patients, which were regulated by hsa-miR‑194 and hsa-miR-373, respectively. Our data indicated that HNRPA0 and PRDM4 may be involved in the recurrence process of GC and have potential to act as new prognostic biomarkers in predicting recurrence risk for gastric cancer patients.

  6. Fast calculation of computer-generated hologram using run-length encoding based recurrence relation.

    PubMed

    Nishitsuji, Takashi; Shimobaba, Tomoyoshi; Kakue, Takashi; Ito, Tomoyoshi

    2015-04-20

    Computer-Generated Holograms (CGHs) can be generated by superimposing zoneplates. A zoneplate is a grating that can concentrate an incident light into a point. Since a zoneplate has a circular symmetry, we reported an algorithm that rapidly generates a zoneplate by drawing concentric circles using computer graphic techniques. However, random memory access was required in the algorithm and resulted in degradation of the computational efficiency. In this study, we propose a fast CGH generation algorithm without random memory access using run-length encoding (RLE) based recurrence relation. As a result, we succeeded in improving the calculation time by 88%, compared with that of the previous work.

  7. Recurrence relations for the Epstein-Hubbell integral and its generalized forms

    NASA Astrophysics Data System (ADS)

    Tezcan, Cevdet

    2005-04-01

    The generalized Epstein-Hubbell integral was recently considered by López and Ferreira (IMA J. Appl. Math. 67 (2002) 301) for values of the variable k close to its upper limit k=1. Here different forms of the generalized Epstein-Hubbell integral Λ( λ, γ, μ) ( α, β) ( ρ, δ, k) proposed by Kalla and Tuan (Comput. Math. Appl. 32 (1996) 49) are considered for values of the variable k=1. The numerical values of Sμ, Rμ and Pμ at k=1 are calculated by using the derived recurrence relations and are listed in tables.

  8. Acceleration of Electron Repulsion Integral Evaluation on Graphics Processing Units via Use of Recurrence Relations.

    PubMed

    Miao, Yipu; Merz, Kenneth M

    2013-02-12

    Electron repulsion integral (ERI) calculation on graphical processing units (GPUs) can significantly accelerate quantum chemical calculations. Herein, the ab initio self-consistent-field (SCF) calculation is implemented on GPUs using recurrence relations, which is one of the fastest ERI evaluation algorithms currently available. A direct-SCF scheme to assemble the Fock matrix efficiently is presented, wherein ERIs are evaluated on-the-fly to avoid CPU-GPU data transfer, a well-known architectural bottleneck in GPU specific computation. Realized speedups on GPUs reach 10-100 times relative to traditional CPU nodes, with accuracies of better than 1 × 10(-7) for systems with more than 4000 basis functions. PMID:26588740

  9. Aberrant expression of COT is related to recurrence of papillary thyroid cancer.

    PubMed

    Lee, Jandee; Jeong, Seonhyang; Park, Jae Hyun; Lee, Cho Rok; Ku, Cheol Ryong; Kang, Sang-Wook; Jeong, Jong Ju; Nam, Kee-Hyun; Shin, Dong Yeob; Lee, Eun Jig; Chung, Woong Youn; Jo, Young Suk

    2015-02-01

    Aberrant expression of Cancer Osaka Thyroid Oncogene mitogen-activated protein kinase kinase kinase 8 (COT) (MAP3K8) is a driver of resistance to B-RAF inhibition. However, the de novo expression and clinical implications of COT in papillary thyroid cancer (PTC) have not been investigated.The aim of this study is to investigate the expression of A-, B-, C-RAF, and COT in PTC (n = 167) and analyze the clinical implications of aberrant expression of these genes.Quantitative polymerase chain reaction (qPCR) and immunohistochemical staining (IHC) were performed on primary thyroid cancers. Expression of COT was compared with clinicopathological characteristics including recurrence-free survival. Datasets from public repository (NCBI) were subjected to Gene Set Enrichment Analysis (GSEA).qPCR data showed that the relative mRNA expression of A-, B-, C-RAF and COT of PTC were higher than normal tissues (all P < 0.01). In addition, the expression of COT mRNA in PTC showed positive correlation with A- (r = 0.4083, P < 0.001), B- (r = 0.2773, P = 0.0003), and C-RAF (r = 0.5954, P < 0.001). The mRNA expressions of A-, B,- and C-RAF were also correlated with each other (all P < 0.001). In IHC, the staining intensities of B-RAF and COT were higher in PTC than in normal tissue (P < 0.001). Interestingly, moderate-to-strong staining intensities of B-RAF and COT were more frequent in B-RAF-positive PTC (P < 0.001, P = 0.013, respectively). In addition, aberrant expression of COT was related to old age at initial diagnosis (P = 0.045) and higher recurrence rate (P = 0.025). In multivariate analysis, tumor recurrence was persistently associated with moderate-to-strong staining of COT after adjusting for age, sex, extrathyroidal extension, multifocality, T-stage, N-stage, TNM stage, and B-RAF mutation (odds ratio, 4.662; 95% confidence interval 1.066 - 21.609; P = 0.045). Moreover, moderate-to-strong COT expression in PTC

  10. Aberrant Expression of COT Is Related to Recurrence of Papillary Thyroid Cancer

    PubMed Central

    Lee, Jandee; Jeong, Seonhyang; Park, Jae Hyun; Lee, Cho Rok; Ku, Cheol Ryong; Kang, Sang-Wook; Jeong, Jong Ju; Nam, Kee-Hyun; Shin, Dong Yeob; Lee, Eun Jig; Chung, Woong Youn; Jo, Young Suk

    2015-01-01

    Abstract Aberrant expression of Cancer Osaka Thyroid Oncogene mitogen-activated protein kinase kinase kinase 8 (COT) (MAP3K8) is a driver of resistance to B-RAF inhibition. However, the de novo expression and clinical implications of COT in papillary thyroid cancer (PTC) have not been investigated. The aim of this study is to investigate the expression of A-, B-, C-RAF, and COT in PTC (n = 167) and analyze the clinical implications of aberrant expression of these genes. Quantitative polymerase chain reaction (qPCR) and immunohistochemical staining (IHC) were performed on primary thyroid cancers. Expression of COT was compared with clinicopathological characteristics including recurrence-free survival. Datasets from public repository (NCBI) were subjected to Gene Set Enrichment Analysis (GSEA). qPCR data showed that the relative mRNA expression of A-, B-, C-RAF and COT of PTC were higher than normal tissues (all P < 0.01). In addition, the expression of COT mRNA in PTC showed positive correlation with A- (r = 0.4083, P < 0.001), B- (r = 0.2773, P = 0.0003), and C-RAF (r = 0.5954, P < 0.001). The mRNA expressions of A-, B,- and C-RAF were also correlated with each other (all P < 0.001). In IHC, the staining intensities of B-RAF and COT were higher in PTC than in normal tissue (P < 0.001). Interestingly, moderate-to-strong staining intensities of B-RAF and COT were more frequent in B-RAFV600E-positive PTC (P < 0.001, P = 0.013, respectively). In addition, aberrant expression of COT was related to old age at initial diagnosis (P = 0.045) and higher recurrence rate (P = 0.025). In multivariate analysis, tumor recurrence was persistently associated with moderate-to-strong staining of COT after adjusting for age, sex, extrathyroidal extension, multifocality, T-stage, N-stage, TNM stage, and B-RAFV600E mutation (odds ratio, 4.662; 95% confidence interval 1.066 − 21.609; P = 0.045). Moreover, moderate

  11. Anti-viral therapy to reduce recurrence and improve survival in hepatitis B virus-related hepatocellular carcinoma

    PubMed Central

    Ishikawa, Toru

    2013-01-01

    Hepatocellular carcinoma (HCC) is the most common malignancy and the third leading cause of cancer death worldwide. Chronic infection with hepatitis B virus (HBV) and hepatitis C virus accounts for approximately 75%-80% of HCC cases worldwide. In particular, chronic HBV infection is a predominant risk factor for HCC in Asia and Africa. Hepatic resection and radiofrequency ablation are increasingly used for the curative treatment of HCC, and good local control can be achieved. However, the high rate of recurrence is a major obstacle to improving prognosis. A high viral load of HBV DNA is the most important correctable risk factor for recurrence. Furthermore, interferon and/or nucleotide analogues may decrease HBV DNA. Therefore, these drugs may decrease recurrence. In this article, treatment strategies for HBV-related HCC are described in order to reduce recurrence and improve survival. PMID:24379608

  12. Risk Factors and Post-Resection Independent Predictive Score for the Recurrence of Hepatitis B-Related Hepatocellular Carcinoma

    PubMed Central

    Poon, Ronnie Tung-Ping; Fong, Daniel Yee-Tak; Chui, Ada Hang-Wai; Seto, Wai-Kay; Fung, James Yan-Yue; Chan, Albert Chi-Yan; Yuen, John Chi-Hang; Tiu, Randal; Choi, Olivia; Lai, Ching-Lung; Yuen, Man-Fung

    2016-01-01

    Background Independent risk factors associated with hepatitis B (HBV)-related hepatocellular carcinoma (HCC) after resection remains unknown. An accurate risk score for HCC recurrence is lacking. Methods We prospectively followed up 200 patients who underwent liver resection for HBV-related HCC for at least 2 years. Demographic, biochemical, tumor, virological and anti-viral treatment factors were analyzed to identify independent risk factors associated with recurrence after resection and a risk score for HCC recurrence formulated. Results Two hundred patients (80% male) who underwent liver resection for HBV-related HCC were recruited. The median time of recurrence was 184 weeks (IQR 52–207 weeks) for the entire cohort and 100 patients (50%) developed HCC recurrence. Stepwise Cox regression analysis identified that one-month post resection HBV DNA >20,000 IU/mL (p = 0.019; relative risk (RR) 1.67; 95% confidence interval (C.I.): 1.09–2.57), the presence of lymphovascular permeation (p<0.001; RR 2.69; 95% C.I.: 1.75–4.12), microsatellite lesions (p<0.001; RR 2.86; 95% C.I.: 1.82–4.51), and AFP >100ng/mL before resection (p = 0.021; RR 1.63; 95% C.I.: 1.08–2.47) were independently associated with HCC recurrence. Antiviral treatment before resection (p = 0.024; RR 0.1; 95% C.I.: 0.01–0.74) was independently associated with reduced risk of HCC recurrence. A post-resection independent predictive score (PRIPS) was derived and validated with sensitivity of 75.3% and 60.6% and specificity of 55.7% and 79.2%, to predict the 1- and 3-year risks for the HCC recurrence respectively with the hazard ratio of 2.71 (95% C.I.: 2.12–3.48; p<0.001). The AUC for the 1- and 3-year prediction were 0.675 (95% C.I.: 0.6–0.78) and 0.746 (95% C.I.: 0.69–0.82) respectively. Conclusion Several tumor, virological and biochemical factors were associated with a higher cumulative risk of HCC recurrence after resection. PRIPS was derived for more accurate risk assessment

  13. Expression of Th1/Th2/Th3/Th17-related genes in recurrent aphthous ulcers.

    PubMed

    Lewkowicz, Natalia; Kur, Barbara; Kurnatowska, Anna; Tchorzewski, Henryk; Lewkowicz, Przemyslaw

    2011-10-01

    The pathogenesis of recurrent aphthous ulceration (RAU) is unknown, although an abnormal immune reaction appears to be involved. RAU may result from oral epithelium damage caused by T cell-mediated immune response. To improve understanding of the role of T cells in RAU, the present study analyzed. the expression of T cell-related genes in oral ulcers from patients with RAU, as well as in healthy non-keratinized oral mucosa from aphthae-free volunteers. Biopsies from RAU patients and healthy individuals were analyzed using Human Th1-Th2-Th3 RT(2) Profiler PCR Array and qRT-PCR that allowed to quantify the transcript levels of 86 genes related to T cell activation. We found that cells present in aphthous ulcers express a characteristic Th1-like gene profile. The majority of genes up-regulated in aphthous lesions such as IFN-γ, TNF, IL-15, IRF1, STAT-1 and STAT-4 were Th1-associated. Th2-realated genes were not overexpressed in RAU tissues, with the exception for CCR3. Th3- and Th17-related gene expression patterns were not demonstrated in RAU. These findings clearly reveal that aphthous ulcer formation is predominantly dependent on the activation of the Th1-type immune response.

  14. Relation of Temperature and Humidity to the Risk of Recurrent Gout Attacks

    PubMed Central

    Neogi, Tuhina; Chen, Clara; Niu, Jingbo; Chaisson, Christine; Hunter, David J.; Choi, Hyon; Zhang, Yuqing

    2014-01-01

    Gout attack risk may be affected by weather (e.g., because of volume depletion). We therefore examined the association of temperature and humidity with the risk of recurrent gout attacks by conducting an internet-based case-crossover study in the United States (in 2003–2010) among subjects with a diagnosis of gout who had 1 or more attacks during 1 year of follow-up. We examined the association of temperature and humidity over the prior 48 hours with the risk of gout attacks using a time-stratified approach and conditional logistic regression. Among 632 subjects with gout, there was a significant dose-response relationship between mean temperature in the prior 48 hours and the risk of subsequent gout attack (P = 0.01 for linear trend). Higher temperatures were associated with approximately 40% higher risk of gout attack compared with moderate temperatures. There was a reverse J-shaped relationship between mean relative humidity and the risk of gout attacks (P = 0.03 for quadratic trend). The combination of high temperature and low humidity had the greatest association (odds ratio = 2.04, 95% confidence interval: 1.26, 3.30) compared with moderate temperature and relative humidity. Thus, high ambient temperature and possibly extremes of humidity were associated with an increased risk of gout attack, despite the likelihood that individuals are often in climate-controlled indoor environments. PMID:24993733

  15. Development of efficient time-evolution method based on three-term recurrence relation

    SciTech Connect

    Akama, Tomoko Kobayashi, Osamu; Nanbu, Shinkoh

    2015-05-28

    The advantage of the real-time (RT) propagation method is a direct solution of the time-dependent Schrödinger equation which describes frequency properties as well as all dynamics of a molecular system composed of electrons and nuclei in quantum physics and chemistry. Its applications have been limited by computational feasibility, as the evaluation of the time-evolution operator is computationally demanding. In this article, a new efficient time-evolution method based on the three-term recurrence relation (3TRR) was proposed to reduce the time-consuming numerical procedure. The basic formula of this approach was derived by introducing a transformation of the operator using the arcsine function. Since this operator transformation causes transformation of time, we derived the relation between original and transformed time. The formula was adapted to assess the performance of the RT time-dependent Hartree-Fock (RT-TDHF) method and the time-dependent density functional theory. Compared to the commonly used fourth-order Runge-Kutta method, our new approach decreased computational time of the RT-TDHF calculation by about factor of four, showing the 3TRR formula to be an efficient time-evolution method for reducing computational cost.

  16. Relation of temperature and humidity to the risk of recurrent gout attacks.

    PubMed

    Neogi, Tuhina; Chen, Clara; Niu, Jingbo; Chaisson, Christine; Hunter, David J; Choi, Hyon; Zhang, Yuqing

    2014-08-15

    Gout attack risk may be affected by weather (e.g., because of volume depletion). We therefore examined the association of temperature and humidity with the risk of recurrent gout attacks by conducting an internet-based case-crossover study in the United States (in 2003-2010) among subjects with a diagnosis of gout who had 1 or more attacks during 1 year of follow-up. We examined the association of temperature and humidity over the prior 48 hours with the risk of gout attacks using a time-stratified approach and conditional logistic regression. Among 632 subjects with gout, there was a significant dose-response relationship between mean temperature in the prior 48 hours and the risk of subsequent gout attack (P = 0.01 for linear trend). Higher temperatures were associated with approximately 40% higher risk of gout attack compared with moderate temperatures. There was a reverse J-shaped relationship between mean relative humidity and the risk of gout attacks (P = 0.03 for quadratic trend). The combination of high temperature and low humidity had the greatest association (odds ratio = 2.04, 95% confidence interval: 1.26, 3.30) compared with moderate temperature and relative humidity. Thus, high ambient temperature and possibly extremes of humidity were associated with an increased risk of gout attack, despite the likelihood that individuals are often in climate-controlled indoor environments.

  17. The expression level of Rosa Terminal Flower 1 (RTFL1) is related with recurrent flowering in roses.

    PubMed

    Wang, Li-Na; Liu, Yun-Feng; Zhang, Yu-Man; Fang, Rong-Xiang; Liu, Qing-Lin

    2012-04-01

    We examined the relationship between the recurrent flowering character and the expression patterns of TERMINAL FLOWER 1 (TFL1) homologs in roses, using flower buds of Rosa multiflora, R. rugosa, R. chinensis, and six other rose species and nine rose cultivars. RTFL1 (Rosa TFL1) genes were amplified from rose genomic DNA using a combination of degenerate and gene-specific primers by thermal asymmetric interlaced-PCR and normal PCR, respectively. Their copy numbers in different species were determined by Southern blots. We used real-time PCR to analyze the expression patterns of RTFL1 genes at four developmental stages (pre-sprouting, young, mid-aged, and mature flower buds). Our results show that there are at least three RTFL1 homologs in roses; RTFL1a, RTFL1b, and RTFL1c. The sequences of the homologs were more similar among the same homolog in different species than among the different homologs in the same species. For RTFL1a, we detected two copies in R. multiflora, two copies in R. rugosa, and one copy in R. chinensis. For RTFL1c, we detected one copy in R. multiflora, two copies in R. rugosa, and three copies in R. chinensis. We detected only one copy of RTFL1b in R. chinensis. RTFL1c was expressed at high levels at all four flowering stages in R. multiflora and R. rugosa, which are non-recurrent flowering species, whereas it was barely detected in R. chinensis (a recurrent flowering species) at any stage. These results were further verified in six other non-recurrent flowering species and nine recurrent flowering cultivars. These results suggest that the recurrent flowering habit in roses results from lower expression of RTFL1c, which may be related to recurrent flowering character in roses.

  18. Accompanying coordinate expansion and recurrence relation method using a transfer relation scheme for electron repulsion integrals with high angular momenta and long contractions

    SciTech Connect

    Hayami, Masao; Seino, Junji; Nakai, Hiromi

    2015-05-28

    An efficient algorithm for the rapid evaluation of electron repulsion integrals is proposed. The present method, denoted by accompanying coordinate expansion and transferred recurrence relation (ACE-TRR), is constructed using a transfer relation scheme based on the accompanying coordinate expansion and recurrence relation method. Furthermore, the ACE-TRR algorithm is extended for the general-contraction basis sets. Numerical assessments clarify the efficiency of the ACE-TRR method for the systems including heavy elements, whose orbitals have long contractions and high angular momenta, such as f- and g-orbitals.

  19. Extension of accompanying coordinate expansion and recurrence relation method for general-contraction basis sets.

    PubMed

    Hayami, Masao; Seino, Junji; Nakai, Hiromi

    2014-07-30

    An algorithm of the accompanying coordinate expansion and recurrence relation (ACE-RR), which is used for the rapid evaluation of the electron repulsion integral (ERI), has been extended to the general-contraction (GC) scheme. The present algorithm, denoted by GC-ACE-RR, is designed for molecular calculations including heavy elements, whose orbitals consist of many primitive functions with and without higher angular momentum such as d- and f-orbitals. The performance of GC-ACE-RR was assessed for (ss|ss)-, (pp|pp)-, (dd|dd)-, and (ff|ff)-type ERIs in terms of contraction length and the number of GC orbitals. The present algorithm was found to reduce the central processing unit time compared with the ACE-RR algorithm, especially for higher angular momentum and highly contracted orbitals. Compared with HONDOPLUS and GAMESS program packages, GC-ACE-RR computations for ERIs of three-dimensional gold clusters Aun (n = 1, 2, …, 10, 15, 20, and 25) are more than 10 times faster. PMID:24889356

  20. Post-transplantation hepatocellular carcinoma recurrence: Patterns and relation between vascularity and differentiation degree

    PubMed Central

    Pecchi, Annarita; Besutti, Giulia; De Santis, Mario; Del Giovane, Cinzia; Nosseir, Sofia; Tarantino, Giuseppe; Di Benedetto, Fabrizio; Torricelli, Pietro

    2015-01-01

    AIM: To evaluate the relationship between hepatocellular carcinoma (HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence. METHODS: This retrospective study included 165 patients (143 men, 22 women; median age 56.8 years, range 28-70.4 years) transplanted for HCC who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying HCC imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about HCC differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent tumor were collected, classifying early and late recurrences based on timing (< or ≥ 2 years after transplantation) and intrahepatic, extrahepatic and both intrahepatic and extrahepatic recurrences based on location. All intrahepatic recurrences were classified as hypervascular or hypovascular and the differentiation degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the primary tumor and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the χ2 test. RESULTS: Of the 163 patients with imaging evidence of viable tumor, 156 (95.7%) had hypervascular and 7 (4.3%) hypovascular HCC. Among the 125 patients with evidence of viable tumor in the explanted liver, 19 (15.2%) had grade 1, 56 (44.8%) grade 2, 40 (32%) grade 3 and 4 (3.2%) grade 4 HCC, while the differentiation degree was not assessable for 6 patients (4.8%). A significant

  1. The association of idiopathic recurrent pregnancy loss with polymorphisms in hemostasis-related genes.

    PubMed

    Cao, Yunlei; Zhang, Zhaofeng; Xu, Jianhua; Yuan, Wei; Wang, Jian; Huang, Xianliang; Shen, Yueping; Du, Jing

    2013-11-10

    Recurrent pregnancy loss (RPL) is a complex, multifactorial condition. Inherited thrombophilia is the leading cause of thromboembolism and is associated with an increased risk of RPL. The aims of the current study were to investigate the effects of polymorphisms in hemostasis-related genes antithrombin (SERPINC1), thrombomodulin (THBD), tissue factor pathway inhibitor (TFPI), factor V, factor II and annexin A5 (ANXA5), involved in reproductive failure in 94 RPL cases with two or more consecutive pregnancy losses prior to 20weeks of pregnancy and 169 healthy controls who had at least one term delivery and no history of pregnancy loss. The genotypes of SERPINC1 G786A, THBD C1418T, TFPI T-33C, factor V G1628A, factor II A19911G and ANXA5 G76A were assayed by the Sequenom MassARRAY system. Genotype and allele frequencies for SERPINC1 (rs2227589), TFPI (rs8176592), factor V (rs6020), factor II (rs3136516) and ANXA5 (rs113588187) in cases and controls were similar. The distribution of THBD C1418T allele showed significant differences between RPL cases and healthy controls (odds ratio (OR): 1.58, 95%, confidence interval (CI): 1.05-2.39, P=0.027). In univariate logistic regression analyses, carriers of THBD 1418T allele (CT+TT) had an increased risk of RPL (OR: 1.83, 95%, CI: 1.10-3.06, P=0.020). This indicated that THBD 1418T allele was associated with increasing the risk of RPL. PMID:23954867

  2. Recurrent novae

    NASA Technical Reports Server (NTRS)

    Hack, Margherita; Selvelli, Pierluigi

    1993-01-01

    Recurrent novae seem to be a rather inhomogeneous group: T CrB is a binary with a M III companion; U Sco probably has a late dwarf as companion. Three are fast novae; two are slow novae. Some of them appear to have normal chemical composition; others may present He and CNO excess. Some present a mass-loss that is lower by two orders of magnitude than classical novae. However, our sample is too small for saying whether there are several classes of recurrent novae, which may be related to the various classes of classical novae, or whether the low mass-loss is a general property of the class or just a peculiarity of one member of the larger class of classical novae and recurrent novae.

  3. Recurrent seizures, mental retardation and extensive brain calcinosis related to delayed diagnosis of hypoparathyroidism in an adolescent boy.

    PubMed

    Eom, Tae-Hoon; Kim, Young-Hoon; Kim, Jung-Min

    2015-05-01

    Reports of adolescent patients presenting with intractable seizures and mental retardation secondary to idiopathic hypothyroidism are uncommon in the literature. In this case, we report a 17-year-old boy who developed recurrent seizures, mental retardation and extensive brain calcinosis related to delayed diagnosis of hypoparathyroidism. Hypoparathyroidism can be easily missed in children and adolescents, and may lead to irreversible neurologic sequelae. This case highlights the need to consider hypocalcemia in any patient with uncontrolled seizures.

  4. The Fermi-Pasta-Ulam recurrence and related phenomena for 1D shallow-water waves in a finite basin

    SciTech Connect

    Ruban, V. P.

    2012-02-15

    Different regimes of the Fermi-Pasta-Ulam (FPU) recurrence are simulated numerically for fully nonlinear 'one-dimensional' potential water waves in a finite-depth flume between two vertical walls. In such systems, the FPU recurrence is closely related to the dynamics of coherent structures approximately corresponding to solitons of the integrable Boussinesq system. A simplest periodic solution of the Boussinesq model, describing a single soliton between the walls, is presented in analytic form in terms of the elliptic Jacobi functions. In the numerical experiments, it is observed that depending on the number of solitons in the flume and their parameters, the FPU recurrence can occur in a simple or complicated manner, or be practically absent. For comparison, the nonlinear dynamics of potential water waves over nonuniform beds is simulated, with initial states taken in the form of several pairs of colliding solitons. With a mild-slope bed profile, a typical phenomenon in the course of evolution is the appearance of relatively high (rogue) waves, while for random, relatively short-correlated bed profiles it is either the appearance of tall waves or the formation of sharp crests at moderate-height waves.

  5. A Technique for Estimating Recurrence Intervals of Tropical Cyclone-Related High Winds in the Tropics: Results for Guam.

    NASA Astrophysics Data System (ADS)

    Rupp, John A.; Lander, Mark A.

    1996-05-01

    The authors develop a technique that applies models of the radial profile of the wind in tropical cyclones to historical best-track databases of tropical cyclones, in order to estimate the wind (at 1-h intervals) experienced at any selected tropical location for any or all of the historical tropical cyclones affecting the location. When these estimated winds are condensed into a time series of the highest annual tropical cyclone-related wind, extreme value analysis can be applied in order to calculate the recurrence intervals of extreme wind speeds.The island of Guam, located at a low latitude in the western North Pacific, was selected as a site for testing the technique. Guam has historical measurements of tropical cyclone-related wind, from which an independent estimate of the recurrence intervals of extreme wind speeds was obtained. In addition, wind traces during the passage of three major typhoons that affected Guam were used to assess the ability of the technique to reproduce an accurate hourly time series of the winds experienced during the passage of these typhoons.For Guam, the recurrence intervals calculated from the time series of wind yielded by the authors' technique closely match those computed from the wind measurements. The technique also reproduces a reasonable wind trace for the three major typhoons affecting Guam. Given its successful validation when applied to Guam, we believe that this technique can be used to make useful estimates of the recurrence intervals of tropical cyclone-related high wind speeds at any coastal tropical location where in situ wind measurements may he lacking, but where an historical best-track archive of tropical cyclone track and intensity exists.

  6. Significance of microRNA-related variants in susceptibility to recurrence of oropharyngeal cancer patients after definitive radiotherapy

    PubMed Central

    Sturgis, Erich M.; Cao, Xiaoli; Li, Yuncheng; Wei, Qingyi; Li, Guojun

    2016-01-01

    Common single nucleotide polymorphisms (SNPs) in miRNAs may affect miRNA functions and their target expression and thus may affect biological activities and cancer etiology as well as prognosis. Thus, we determined whether the 9 SNPs in microRNAs modify the risk of recurrence of squamous cell carcinoma of the oropharynx (SCCOP) in a cohort of 1008 patients. The log-rank test and multivariate Cox models were used to evaluate the associations. We found that the SNPs in the miRNA146, miRNA196, and Gemin3 were associated with a significantly reduced and increased risk of SCCOP recurrence after multivariate adjustment (aHR, 0.6, 95%CI, 0.4-0.9, aHR, 2.1, 95%CI, 1.6-2.8, and aHR, 0.6, 95%CI, 0.5-0.9, respectively). Furthermore, the similar effect of these 3 SNPs on SCCOP recurrence risk was found in HPV-positive SCCOP patients only. However, no significant associations were found for other SNPs. To evaluate the aggregate effects of these SNPs, we performed a combined risk genotype analysis. We found that, compared with the low-risk reference group with less than 4 risk genotypes, the medium-risk group with 4 or 5 risk genotypes exhibited a 1.7-fold (1.2-2.4) increased risk whereas the high-risk group with more than 5 risk genotypes exhibited a 3.0-fold (1.7-4.2) increased risk (Ptrend < 0.001). Such combined effects were particularly pronounced in HPV-positive SCCOP patients. Taken together, this is the first study with a large cohort of SCCOP patients showing that miRNA-related genetic variants may modify risk of SCCOP recurrence individually and jointly. Larger studies are needed to validate these results. PMID:27145460

  7. Effect of Recurrent Selection on Drought Tolerance and Related Morpho-Physiological Traits in Bread Wheat

    PubMed Central

    P, Ramya; Singh, Gyanendra Pratap; Jain, Neelu; Singh, Pradeep Kumar; Pandey, Manoj Kumar; Sharma, Kavita; Kumar, Arun; Harikrishna; Prabhu, Kumble Vinod

    2016-01-01

    Drought is one of the major abiotic stresses affecting wheat yield. A recurrent selection program was conducted to improve the drought tolerance and yield of bread wheat using drought tolerant advanced breeding lines from a drought tolerant x susceptible cross (HI 1500 x HUW 510). The parental lines were evaluated for yield, biomass and harvest index (HI) in addition to the drought adaptive traits like Canopy Temperature (CT), chlorophyll content and Normalized Difference Vegetative Index (NDVI). After three rounds of recurrent selection, the half sib progenies exhibited a marked reduction in CT, chlorophyll content and biomass; whereas improvement was noted for yield, HI and NDVI. Drought tolerance of the half-sib population appeared enhanced as indicated by drought indices and grain yield. Compared to base population, half-sibs showed better HI, grain filling and a significant (17.1%) increase in grain yield under water stress conditions. Cooler canopies and increased early vigour might have contributed to drought tolerance. A favourable combination of gibberellin sensitive and insensitive Rhtalleles was observed in the recombinant progenies. However, increased yield under water stress had a negative trade off in reduction of biomass. The study also identified potential lines with high yield and drought tolerance for subsequent varietal development for water limited areas. PMID:27300000

  8. A Novel Prioritization Method in Identifying Recurrent Venous Thromboembolism-Related Genes

    PubMed Central

    Xie, Ruiqiang; Chen, Binbin; Huang, Hao; Li, Yiran; He, Yuehan; Lv, Junjie; He, Weiming; Chen, Lina

    2016-01-01

    Identifying the genes involved in venous thromboembolism (VTE) recurrence is important not only for understanding the pathogenesis but also for discovering the therapeutic targets. We proposed a novel prioritization method called Function-Interaction-Pearson (FIP) by creating gene-disease similarity scores to prioritize candidate genes underling VTE. The scores were calculated by integrating and optimizing three types of resources including gene expression, gene ontology and protein-protein interaction. As a result, 124 out of top 200 prioritized candidate genes had been confirmed in literature, among which there were 34 antithrombotic drug targets. Compared with two well-known gene prioritization tools Endeavour and ToppNet, FIP was shown to have better performance. The approach provides a valuable alternative for drug targets discovery and disease therapy. PMID:27050193

  9. Immune-related pancreatitis secondary to nivolumab in a patient with recurrent lung adenocarcinoma: A case report.

    PubMed

    Ikeuchi, Kazuhiko; Okuma, Yusuke; Tabata, Taku

    2016-09-01

    Immune checkpoint inhibitor is a verified standard of care as a second-line chemotherapy for non-small cell lung cancer. Management of immune-related adverse effects (irAEs) is crucial for ensuring patient safety. However, less frequent irAEs may result in complications. Here, we report a patient with recurrent lung adenocarcinoma who was treated with nivolumab and developed immune-related pancreatitis. A 66-year-old Japanese female with recurrent lung adenocarcinoma and metastatic lymph nodes presented with anorexia, vomiting, and back pain on day 18 of two cycles of nivolumab. Laboratory data demonstrated a grade 3 elevation of serum amylase and lipase levels. Initially, no abnormality could be detected on computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), or the Gallium scan. The patient was treated with high-dose prednisone, resulting in gradual improvement of symptoms and laboratory data. A follow-up MRCP revealed a swollen pancreas and pancreatic inflammation. Immune-related pancreatitis is a rare type of nivolumab-induced irAE that shows no significant changes on radiologic imaging, except for a swollen pancreas on CT, and can be suppressed using high-dose prednisone. PMID:27565931

  10. Optical flickering of the recurrent nova RS Ophiuchi: amplitude-flux relation

    NASA Astrophysics Data System (ADS)

    Zamanov, R.; Latev, G.; Boeva, S.; Sokoloski, J. L.; Stoyanov, K.; Bachev, R.; Spassov, B.; Nikolov, G.; Golev, V.; Ibryamov, S.

    2015-07-01

    We report observations of the flickering variability of the symbiotic recurrent nova RS Oph at quiescence in five bands (UBVRI). We find evidence of a correlation between the peak-to-peak flickering amplitude (ΔF) and the average flux of the hot component (Fav). The correlation is highly significant, with a correlation coefficient of 0.85 and a p-value of ˜10-20. Combining the data from all wavebands, we find a dependence of the type Δ F ∝ F_{av}^k, with power-law index k = 1.02 ± 0.04 for the UBVRI flickering of RS Oph. Thus, the relationship between the amplitude of variability and the average flux of the hot component is consistent with linearity. The rms amplitude of flickering is on average 8 per cent (±2 per cent) of Fav. The detected correlation is similar to that found in accreting black holes/neutron stars and cataclysmic variables. The possible reasons are briefly discussed. The data are available upon request from the authors.

  11. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks

    PubMed Central

    Camcıoğlu, Burcu; Boşnak-Güçlü, Meral; Karadallı, Müşerrefe Nur; Akı, Şahika Zeynep; Türköz-Sucak, Gülsan

    2015-01-01

    Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS). Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS. PMID:26060589

  12. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks.

    PubMed

    Camcıoğlu, Burcu; Boşnak-Güçlü, Meral; Karadallı, Müşerrefe Nur; Akı, Şahika Zeynep; Türköz-Sucak, Gülsan

    2015-01-01

    Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS). Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS. PMID:26060589

  13. Analysis of recurrent laryngeal inspiratory discharges in relation to fast rhythms.

    PubMed

    Christakos, C N; Cohen, M I; Sica, A L; Huang, W X; See, W R; Barnhardt, R

    1994-09-01

    1. Inspiratory (I) activities of recurrent laryngeal (RL) motoneurons and efferent nerves were studied by autospectral, interval, and coherence analyses, with emphasis on fast rhythms of two types: medium-frequency oscillations (MFO, usual range 20-50 Hz for nerve autospectral peaks) and high-frequency oscillations (HFO, usual range 50-100 Hz). 2. In decerebrate, paralyzed, and artificially ventilated cats, recordings were taken from 27 isolated single RL fibers (14 cats) and 8 identified RL motoneurons in the medulla (6 cats), together with recordings of phrenic (PHR) and RL whole-nerve activities. In another 50 cats, RL and PHR nerve discharges were recorded simultaneously. 3. The autospectra of RL units showed prominent MFO peaks with frequencies close to that of the RL nerve MFO spectral peak, indicating presence of this type of fast rhythm in the units' discharges. Spectral analysis of RL unit activity in different segments of the I phase showed that the frequency of a unit's MFO was very close to the peak (maintained) firing rate of the unit during the portion of I analyzed. Thus a motoneuron's MFO spectral peak reflected its rhythmic discharge arising from the cell's refractoriness (and possibly with the rate changing in the course of I). 4. The coherences of motoneurons' MFOs to nerve MFOs were very low or 0, indicating that correlations between unitary MFOs of the RL population were rare and/or weak. 5. In those cats (19/20) that had discernible PHR nerve HFO autospectral peaks, about half of the recorded RL motoneurons (16/34) had HFO. For these motoneurons, the unit-nerve HFO coherences were substantial, indicating widespread correlations between unitary HFOs. 6. In a fraction of cats, coherence peaks in the MFO frequency range were observed between bilateral RL nerves, and between RL and PHR nerves, at frequencies that were subharmonics of the HFO frequency. 7. In light of theoretical considerations on the generation of aggregate rhythms from

  14. Autologous formalin-fixed tumor vaccine suppressed re-recurrence of HCV-related hepatocellular carcinoma following 29 unsuccessful treatments with extensive conventional therapy: a case report.

    PubMed

    Inui, Toshio; Ohno, Tadao

    2012-01-01

    Treatment of hepatocellular carcinoma (HCC) with autologous formalin-fixed tumor vaccine after primary resection has been shown to suppress the recurrence of hepatitis B virus-associated HCC, but the effect of this treatment on hepatitis C virus (HCV)-related disease has not yet been clarified. Here, we report a case of a patient with repeat recurrent HCC that was associated with HCV who had endured 29 episodes of HCC recurrence despite a variety of therapy using conventional methods. Finally, treatment with a single course of autologous formalin-fixed tumor vaccine resulted in suppression of potential further re-recurrence of HCC for more than 43 months without any additional treatment. PMID:22789008

  15. Magnetic Resonance Lymphography Findings in Patients With Biochemical Recurrence After Prostatectomy and the Relation With the Stephenson Nomogram

    SciTech Connect

    Meijer, Hanneke J.M.; Debats, Oscar A.; Roach, Mack; Span, Paul N.; Witjes, J. Alfred; Kaanders, Johannes H.A.M.; Lin, Emile N.J.Th. van; Barentsz, Jelle O.

    2012-12-01

    Purpose: To estimate the occurrence of positive lymph nodes on magnetic resonance lymphography (MRL) in patients with a prostate-specific antigen (PSA) recurrence after prostatectomy and to investigate the relation between score on the Stephenson nomogram and lymph node involvement on MRL. Methods and Materials: Sixty-five candidates for salvage radiation therapy were referred for an MRL to determine their lymph node status. Clinical and histopathologic features were recorded. For 49 patients, data were complete to calculate the Stephenson nomogram score. Receiver operating characteristic (ROC) analysis was performed to determine how well this nomogram related to the MRL result. Analysis was done for the whole group and separately for patients with a PSA <1.0 ng/mL to determine the situation in candidates for early salvage radiation therapy, and for patients without pathologic lymph nodes at initial lymph node dissection. Results: MRL detected positive lymph nodes in 47 patients. ROC analysis for the Stephenson nomogram yielded an area under the curve (AUC) of 0.78 (95% confidence interval, 0.61-0.93). Of 29 patients with a PSA <1.0 ng/mL, 18 had a positive MRL. Of 37 patients without lymph node involvement at initial lymph node dissection, 25 had a positive MRL. ROC analysis for the Stephenson nomogram showed AUCs of 0.84 and 0.74, respectively, for these latter groups. Conclusion: MRL detected positive lymph nodes in 72% of candidates for salvage radiation therapy, in 62% of candidates for early salvage radiation therapy, and in 68% of initially node-negative patients. The Stephenson nomogram showed a good correlation with the MRL result and may thus be useful for identifying patients with a PSA recurrence who are at high risk for lymph node involvement.

  16. Recurrent varicocele

    PubMed Central

    Rotker, Katherine; Sigman, Mark

    2016-01-01

    Varicocele recurrence is one of the most common complications associated with varicocele repair. A systematic review was performed to evaluate varicocele recurrence rates, anatomic causes of recurrence, and methods of management of recurrent varicoceles. The PubMed database was evaluated using keywords “recurrent” and “varicocele” as well as MESH criteria “recurrent” and “varicocele.” Articles were not included that were not in English, represented single case reports, focused solely on subclinical varicocele, or focused solely on a pediatric population (age <18). Rates of recurrence vary with the technique of varicocele repair from 0% to 35%. Anatomy of recurrence can be defined by venography. Management of varicocele recurrence can be surgical or via embolization. PMID:26806078

  17. Home-loving boreal hare mitochondria survived several invasions in Iberia: the relative roles of recurrent hybridisation and allele surfing.

    PubMed

    Melo-Ferreira, J; Farelo, L; Freitas, H; Suchentrunk, F; Boursot, P; Alves, P C

    2014-03-01

    Genetic introgression from a resident species into an invading close relative can result from repeated hybridisation along the invasion front and/or allele surfing on the expansion wave. Cases where the phenomenon is massive and systematic, such as for hares (genus Lepus) in Iberia, would be best explained by recurrent hybridisation but this is difficult to prove because the donor populations are generally extinct. In the Pyrenean foothills, Lepus europaeus presumably replaced Lepus granatensis recently and the present species border is parallel to the direction of invasion, so that populations of L. granatensis in the contact zone represent proxies of existing variation before the invasion. Among three pairs of populations sampled across this border, we find less differentiation of mitochondrial DNA (mtDNA) across than along it, as predicted under recurrent hybridisation at the invasion front. Using autosomal microsatellite loci and X- and Y-linked diagnostic loci, we show that admixture across the border is quasi-absent, making it unlikely that lack of interspecific mtDNA differentiation results from ongoing gene flow. Furthermore, we find that the local species ranges are climatically contrasted, making it also unlikely that ongoing ecology-driven movement of the contact account for mtDNA introgression. The lack of mtDNA differentiation across the boundary is mostly due to sharing of mtDNA from a boreal species currently extinct in Iberia (Lepus timidus) whose mitochondria have thus remained in place since the last deglaciation despite successive invasions by two other species. Home-loving mitochondria thus witness past species distribution rather than ongoing exchanges across stabilised contact zones.

  18. Familial recurrent hypersomnia: two siblings with Kleine-Levin syndrome and menstrual-related hypersomnia.

    PubMed

    Rocamora, Rodrigo; Gil-Nagel, Antonio; Franch, Oriol; Vela-Bueno, Antonio

    2010-11-01

    Kleine-Levin syndrome and menstrual-related hypersomnia are rare idiopathic sleep disorders occurring primarily in adolescence. They are characterized by intermittent periods of excessive sleepiness, cognitive disturbances, and behavioral abnormalities. In both, the etiology remains unknown but autoinmune, hormonal, infectious, and inflammatory mechanisms have been proposed. The authors describe, for the first time, the association of Kleine-Levin syndrome and menstrual-related hypersomnia in 2 adolescent siblings who shared the human leukocyte antigen (HLA) loci DQB1*0501. The same haplotype has been associated with sleepwalking and with rapid eye movement (REM) sleep behavior disorder. This gender differences in the manifestation of a probably genetic influenced sleep disorder suggests that hormonal mechanisms could be implicated in the phenotypical expression of this sleep disorder. The male sibling with Kleine-Levin syndrome was easily controlled with carbamazepine in low doses, but his sister could be only efficaciously treated with oral contraceptives. PMID:20404354

  19. Genetic variants within obesity-related genes are associated with tumor recurrence in patients with stages II/III colon cancer

    PubMed Central

    Sebio, Ana; Gerger, Armin; Matsusaka, Satoshi; Yang, Dongyun; Zhang, Wu; Stremitzer, Stefan; Stintizing, Sebastian; Sunakawa, Yu; Yamauchi, Shinichi; Ning, Yan; Fujimoto, Yoshiya; Ueno, Masashi; Lenz, Heinz-Josef

    2014-01-01

    Objective Obesity is an established risk factor for colorectal cancer (CRC) incidence and it is also linked to CRC recurrence and survival. Polymorphisms located in obesity-related genes are associated with increased risk of developing several cancer types including colorectal cancer. We evaluated whether SNPs in obesity-related genes may predict tumor recurrence in colon cancer patients. Methods Genotypes were obtained from germline DNA from 207 patients with stage II or III colon cancer at the Norris Comprehensive Cancer Center. Nine polymorphisms in eight obesity-related genes (PPAR, LEP, NFKB, CD36, DRG1, NGAL, REGIA and DSCR1) were evaluated. The primary endpoint of the study was 3-year recurrence rate. Positive associations were also tested in an independent Japanese cohort of 350 stage III CRC patients. Results In univariate analysis, for PPAR rs1801282, patients with a CC genotype had significantly lower recurrence probability (29± 4% standard error, SE) compared to patients with a CG genotype (48% ± 8% SE), HR: 1.77; 95%CI, 1.01-3.10; p=0.040. For DSCR1 rs6517239, patients with an AA genotype had higher recurrence probability than patients carrying at least one allele G (37% ± 4% SE vs 15% ± 6% SE), HR: 0.51, 95% CI, 0.27-0.94; p=0.027. This association was stronger in the patients bearing a left-sided tumor (HR: 0.34; 95%CI, 0.13-0.88; p=0.018). In the Japanese cohort no associations were found. Conclusion This hypothesis generating study suggests a potential influence of polymorphisms within obesity-related genes in the recurrence probability of colon cancer. These interesting results should be further evaluated. PMID:25379721

  20. Risk indicators for venous thrombosis in first-degree relatives of patients with recurrent venous thromboembolism in Chinese

    PubMed Central

    Zhao, Lianxing; Li, Chunsheng; Shao, Rui; Fang, Yingying

    2016-01-01

    Abstract Having encountered several subjects with venous thromboembolism (VTE) in 1 family in which 1 proband has recurrent VTE (rVTE), we aimed to assess the risk of VTE in first-degree relatives, especially the children of individuals with rVTE, and to investigate the association of endothelial nitric oxide synthase (eNOS) G894T polymorphism between Chinese persons with rVTE and their offspring. We collected information about family histories and blood samples from 126 individuals with rVTE who had presented to our institute from 2003 to 2014, and 126 population-based controls and the first-degree relatives of subjects in these 2 groups. We tested blood samples for heritable thrombophilia and calculated odds ratios (ORs) and kappa coefficients. First-degree relatives of individuals with rVTE patients had a statistically significant risk of developing VTE (OR 2.62, 95% confidence interval [CI] 1.61–4.26, P < 0.001). For siblings, the OR was 2.72 (95% CI 1.56–4.73, P < .001). Moreover, for each year that the patient was older, the OR was 0.98 (95% CI 0.97–0.99, P = 0.03). One (11.2%) of the 9 individuals who had the same eNOS G894T polymorphism as their probands had a history of VTE, whereas none of the 17 relatives without the same polymorphism had developed VTE. The associations between patients and their children were statistically significant for VTE (kappa = 0.23, P < 0.001) and for eNOS G894T (kappa = 0.03, P = 0.04). In this case-controlled study, we demonstrated a higher risk of VTE among first-degree relatives of individuals with rVTE, especially in siblings of younger subjects with rVTE. We also found that eNOS G894T polymorphism may be a predictor of VTE in offspring of individuals with rVTE. PMID:27741098

  1. Plasma Carotenoids and Tocopherols in Relation to Prostate-specific Antigen (PSA) Levels Among Men with Biochemical Recurrence of Prostate Cancer

    PubMed Central

    Antwi, Samuel; Steck, Susan E.; Zhang, Hongmei; Stumm, Lareissa; Zhang, Jiajia; Hurley, Thomas G.; Hebert, James R.

    2015-01-01

    Background Although men presenting with clinically localized prostate cancer (PrCA) often are treated with radical prostatectomy or radiation therapy with curative intent, about 25–40% develop biochemically recurrent PrCA within 5 years of treatment, which has no known cure. Studies suggest that carotenoid and tocopherol intake may be associated with PrCA risk and progression. We examined plasma carotenoid and tocopherol levels in relation to prostate-specific antigen (PSA) levels among men with PSA-defined biochemical recurrence of PrCA. Methods Data analyzed were from a 6-month diet, physical activity and stress-reduction intervention trial conducted in South Carolina among biochemically recurrent PrCA patients (n=39). Plasma carotenoids and tocopherol levels were measured using high-performance liquid chromatography (HPLC). Linear regression was used to estimate least-square means comparing PSA levels of men with high versus low carotenoid/tocopherol levels, adjusting for covariates. Results After adjusting for baseline PSA level, plasma cis-lutein/zeaxanthin level at 3 months was related inversely to PSA level at 3 months (P=0.0008), while α-tocopherol (P=0.01), β-cryptoxanthin (P=0.01), and all-trans-lycopene (P=0.004) levels at 3 months were related inversely to PSA levels at 6-months. Percent increase in α-tocopherol and trans-β-carotene levels from baseline to month 3 were associated with lower PSA levels at 3 and 6 months. Percent increase in β−cryptoxanthin, cislutein/zeaxanthin and all-trans-lycopene were associated with lower PSA levels at 6 months only. Conclusions Certain plasma carotenoids and tocopherols were related inversely to PSA levels at various timepoints, suggesting that greater intake of foods containing these micronutrients might be beneficial to men with PSA-defined PrCA recurrence. PMID:26165176

  2. eNOS3 Genetic Polymorphism Is Related to Post-Ablation Early Recurrence of Atrial Fibrillation

    PubMed Central

    Shim, Jaemin; Park, Jae Hyung; Lee, Ji-Young; Uhm, Jae-Sun; Joung, Boyoung; Lee, Moon-Hyoung; Ellinor, Patrick T.

    2015-01-01

    Purpose Previous studies have demonstrated an association between eNOS polymorphisms and atrial fibrillation (AF). We sought to determine whether eNOS polymorphisms are associated with AF recurrence after a radiofrequency catheter ablation (RFCA). Materials and Methods A total of 500 consecutive patients (56±11 years, 77% male) with paroxysmal (68%) or persistent (32%) AF who underwent RFCA and 500 age, gender-matched controls were genotyped for the eNOS3 single nucleotide polymorphism (rs1799983). AF recurrence was monitored according to 2012 ACC/AHA/ESC guidelines. Results The frequencies of the rs1799983 variant alleles (T) in the case and control group were not significantly different (OR 1.05, 95% CI 0.75-1.46, p=0.798). AF patients with rs1799983 variants were more likely to have coronary artery disease or stroke than those without genetic variant at this gene (31.0% vs. 17.3%, p=0.004). During mean 17 months follow-up, early recurrence of AF (ERAF; within 3 months) and clinical recurrence (CR) of AF were 31.8% and 24.8%, respectively. The rs1799983 variant was associated with higher risk of ERAF (OR 1.71, 95% CI 1.06-2.79, p=0.028), but not with CR. ERAF occurred earlier (11±16 days) in variant group than those without variant allele (20±25 days, p=0.016). A multiple logistic regression analysis showed that presence of the rs1799983 variant (OR 1.75, 95% CI 1.07-2.86, p=0.026) and persistent AF were independent predictors for ERAF after AF ablation. Conclusion The rs1799983 variant of the eNOS3 gene was associated with ERAF, but not with CR, after RFCA. eNOS3 gene variants may have a potential role for stratification of post-ablation management. PMID:26256966

  3. Recurrent Fever in Children

    PubMed Central

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-01-01

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time. PMID:27023528

  4. Interleukin-17 and leptin genes polymorphisms and their levels in relation to recurrent pregnancy loss in Egyptian females.

    PubMed

    Zidan, Haidy E; Rezk, Noha A; Alnemr, Amr Abd Almohsen; Moniem, Mohamed I Abdel

    2015-11-01

    Recurrent pregnancy loss (RPL) is a common problem during early gestation. The aim of our study was to investigate the association of IL-17 F( rs763780), IL-17 A (rs2275913), and leptin (2548 G/A) gene polymorphisms with RPL in obese and lean Egyptian females, and to find out whether these gene polymorphisms affect the women’s serum levels. One hundred and twenty patients with RPL and 120 fertile volunteers with no history of pregnancy loss were genotyped for leptin (2548 G/A), IL-17 A (rs2275913), and IL-17 F (rs763780) polymorphisms by RFLP. The serum level of IL-17 was measured by ELISA, while serum leptin level was measured by HPLC. We found that IL-17 F (rs763780) polymorphism was associated with a decreased risk of RPL in Egyptian females, and we also found that IL-17 A (rs2275913) and LEP (2548 G/A) SNP were associated with an increased risk of RPL. We also demonstrated that both the IL-17 and leptin levels were elevated in the women with RPL and in an obese subgroup within RPL in comparison to a lean one. PMID:26467330

  5. Temperature-plant pigment-optical relations in a recurrent offshore mesoscale eddy near Point Conception, California

    NASA Technical Reports Server (NTRS)

    Simpson, James J.; Pelaez, Jose; Haury, Loren R.; Wiesenhahn, David; Koblinsky, Chester J.

    1986-01-01

    The temperature-plant pigment-optical structure of a mesoscale anticyclonic eddy consistently found in shipboard surveys and satellite-sensed data several hundred kilometers southwest of Point Conception, CA, is described on three different time scales (100-day mesoscale, annual, and several-year). The satellite coastal zone color scanner (CZCS) ocean color imagery detected the near-surface chlorophyll structure of the eddy, but in situ optical and plant pigment data suggest that such imagery does not provide a good estimate of the integrated chlorophyll field of the eddy. The temperature and plant pigment boundaries of the eddy, as determined from two-dimensional gradients of advanced very high resolution radiometer (AVHRR) and CZCS imagery, do not coincide spatially. This and in situ temperature, plant pigment, and optical structure provide additional evidence that some eddy systems in the California Current are not isolated vortex systems but rather continuously entrain waters of nonlocal origin laterally into their upper layers. Within the California Current a ratio of AVHRR/CZCS data is useful for separating inshore from oceanic water masses and following their surface entrainment by offshore vortices. The historical 28-year California Cooperative Oceanic Fisheries Investigations data for the Point Conception region of the California Current and remotely sensed data over this region show that the Point Conception eddy is a recurrent feature in the offshore California Current. Moreover, the available data provide evidence that a large number of warm-core mesoscale eddies occur simultaneously in a transition zone between coastal and oceanic regimes, that these features recur at preferred locations within the transition zone, and that this family of eddies should impose a significant offshore boundary condition on the flow of the California Current.

  6. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis

    PubMed Central

    Ruderman, Michael A.; Wilson, Deirdra F.; Reid, Savanna

    2015-01-01

    Objective This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Background Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Methods Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Results Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05–4.17), drug violations (HR 2.44 95% CI: 2.00–2.98), non-violent violations (HR 2.14 95% CI: 1.73–2.64), violent and serious violations (HR 1.88 95% CI: 1.45–2.43), and technical violations (HR 1.86 95% CI: 1.37–2.53). Conclusions Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted. PMID:26492490

  7. Radiolabeled Monoclonal Antibody With or Without Peripheral Stem Cell Transplantation in Treating Children With Recurrent or Refractory Lymphoma

    ClinicalTrials.gov

    2013-01-16

    AIDS-related Peripheral/Systemic Lymphoma; AIDS-related Primary CNS Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma

  8. Heterogeneous recurrence monitoring and control of nonlinear stochastic processes

    SciTech Connect

    Yang, Hui Chen, Yun

    2014-03-15

    Recurrence is one of the most common phenomena in natural and engineering systems. Process monitoring of dynamic transitions in nonlinear and nonstationary systems is more concerned with aperiodic recurrences and recurrence variations. However, little has been done to investigate the heterogeneous recurrence variations and link with the objectives of process monitoring and anomaly detection. Notably, nonlinear recurrence methodologies are based on homogeneous recurrences, which treat all recurrence states in the same way as black dots, and non-recurrence is white in recurrence plots. Heterogeneous recurrences are more concerned about the variations of recurrence states in terms of state properties (e.g., values and relative locations) and the evolving dynamics (e.g., sequential state transitions). This paper presents a novel approach of heterogeneous recurrence analysis that utilizes a new fractal representation to delineate heterogeneous recurrence states in multiple scales, including the recurrences of both single states and multi-state sequences. Further, we developed a new set of heterogeneous recurrence quantifiers that are extracted from fractal representation in the transformed space. To that end, we integrated multivariate statistical control charts with heterogeneous recurrence analysis to simultaneously monitor two or more related quantifiers. Experimental results on nonlinear stochastic processes show that the proposed approach not only captures heterogeneous recurrence patterns in the fractal representation but also effectively monitors the changes in the dynamics of a complex system.

  9. Genome-wide analysis reveals recurrent structural abnormalities of TP63 and other p53-related genes in peripheral T-cell lymphomas

    PubMed Central

    Vasmatzis, George; Johnson, Sarah H.; Knudson, Ryan A.; Ketterling, Rhett P.; Braggio, Esteban; Fonseca, Rafael; Viswanatha, David S.; Law, Mark E.; Kip, N. Sertac; Özsan, Nazan; Grebe, Stefan K.; Frederick, Lori A.; Eckloff, Bruce W.; Thompson, E. Aubrey; Kadin, Marshall E.; Milosevic, Dragana; Porcher, Julie C.; Asmann, Yan W.; Smith, David I.; Kovtun, Irina V.; Ansell, Stephen M.; Dogan, Ahmet

    2012-01-01

    Peripheral T-cell lymphomas (PTCLs) are aggressive malignancies of mature T lymphocytes with 5-year overall survival rates of only ∼ 35%. Improvement in outcomes has been stymied by poor understanding of the genetics and molecular pathogenesis of PTCL, with a resulting paucity of molecular targets for therapy. We developed bioinformatic tools to identify chromosomal rearrangements using genome-wide, next-generation sequencing analysis of mate-pair DNA libraries and applied these tools to 16 PTCL patient tissue samples and 6 PTCL cell lines. Thirteen recurrent abnormalities were identified, of which 5 involved p53-related genes (TP53, TP63, CDKN2A, WWOX, and ANKRD11). Among these abnormalities were novel TP63 rearrangements encoding fusion proteins homologous to ΔNp63, a dominant-negative p63 isoform that inhibits the p53 pathway. TP63 rearrangements were seen in 11 (5.8%) of 190 PTCLs and were associated with inferior overall survival; they also were detected in 2 (1.2%) of 164 diffuse large B-cell lymphomas. As TP53 mutations are rare in PTCL compared with other malignancies, our findings suggest that a constellation of alternate genetic abnormalities may contribute to disruption of p53-associated tumor suppressor function in PTCL. PMID:22855598

  10. Recurrent aphthous stomatitis

    PubMed Central

    Preeti, L; Magesh, KT; Rajkumar, K; Karthik, Raghavendhar

    2011-01-01

    Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite their high prevalence, etiopathogenesis remains unclear. This review article summarizes the clinical presentation, diagnostic criteria, and recent trends in the management of recurrent apthous stomatitis. PMID:22144824

  11. Subperiostial recurrence of chondroblastoma.

    PubMed

    Reddy, Sumanth; Deavers, Michael; Lin, Patrick; Haygood, Tamara Miner

    2009-01-01

    We present a case of subperiosteal recurrence of chondroblastoma adjacent to the greater trochanter that was initially thought to represent septic arthritis of the hip in a 10-year-old girl. Soft-tissue recurrence of chondroblastoma is very rare, with fewer than ten cases reported in the literature. We demonstrate the recurrence on both CT and MRI. The MRI clearly demonstrates the soft-tissue recurrence and the associated inflammatory changes, with signal characteristics not unlike the primary tumor. PMID:27307836

  12. Intravenous Immunoglobulin Suppresses Abortion Relates to an Increase in the CD44bright NK Subset in Recurrent Pregnancy Loss Model Mice.

    PubMed

    Tanaka, Jun; Kitashoji, Akira; Fukunaga, Yuki; Kashihara, Junichi; Nakano, Atsushi; Kamizono, Akihito

    2016-08-01

    Recurrent pregnancy loss (RPL), which mostly is of unknown etiology (unexplained RPL, uRPL), is defined as three or more consecutive spontaneous abortions. Some women with uRPL display a higher fraction and cytotoxicity of natural killer (NK) cells in the periphery and endometrium. Therefore, some uRPL cases have been explained by autoimmune abnormalities. The efficacy of intravenous immunoglobulin (IVIg) for uRPL has been confirmed in several clinical trials; however, its mechanism remains unknown, mainly because the abortion mechanism remains to be elucidated. In the present study, we analyzed the mechanisms of both abortion and IVIg action using a uRPL mouse model in which abortion was induced by lipopolysaccharide injection. IVIg attenuated the abortion rate in the uRPL model mice. The suppressive effect of IVIg was maximized by high dose administration early after lipopolysaccharide injection. Specifically, we discovered the presence of two distinct uterine NK (uNK) subsets: CD44(bright) and CD44(mid) In uRPL model mice, we observed an increase in the number of CD44(bright) uNK cells, while the CD44(mid) uNK subset remained unchanged. Furthermore, when abortion was reduced by IVIg administration, the cell number of the CD44(bright) uNK subset did not increase, which might allow differentiating pathological from normal uNK cells based on CD44 expression. Based on these results, we propose not only an effective administration protocol of IVIg to the uRPL model mice, but also a novel mechanism of abortion related to the increase in the CD44(bright) subset and of IVIg, which suppresses the increase of the CD44(bright) subset.

  13. Recurrence Effects in the Parametric Spring Pendulum.

    ERIC Educational Resources Information Center

    Falk, Lars

    1978-01-01

    Gives a perturbation analysis to recurrence effects of the spring pendulum. The recurrence depends on two conservation laws which determine the motion in an intermediate region; oscillations outside this region are unstable and must return. Gives the relation to Fermi-Pasta-Ulam problem together with the explicit solution. (Author/GA)

  14. Management of recurrent miscarriage.

    PubMed

    Sugiura-Ogasawara, Mayumi; Ozaki, Yasuhiko; Suzumori, Nobuhiro

    2014-05-01

    Recurrent miscarriage is classically defined as three or more consecutive pregnancy losses. Many researchers have now revised this definition to two or more pregnancy losses because of the recent increase in the prevalence of childless couples. Established causes of recurrent miscarriage are antiphospholipid antibodies, uterine anomalies and abnormal chromosomes in either partner, particularly translocations. Antiphospholipid syndrome is the most important treatable cause of recurrent miscarriage. However, it is not yet established as to what kind of testing should be conducted in patients with recurrent pregnancy loss. Standardization of tests for antiphospholipid antibodies is needed. On the other hand, embryonic aneuploidy is the most frequent cause of recurrent miscarriage. Chromosome analysis of the embryo is important, because it has good predictive value for subsequent live birth. It is not necessary to give any medications for unexplained cases of recurrent miscarriage, and provision of psychological support may be the most important to encourage the couples to continue to conceive until a live birth results.

  15. [The recurrent multifocal pleomorphic adenoma].

    PubMed

    Vigili, M G; Sciarretta, F; Marzetti, A; Marzetti, F

    1993-01-01

    Pleomorphic adenoma (P.A.), the most common tumor of the salivary gland, demonstrates a peculiar clinicopathological behaviour for numerous reasons: the high recurrence rate following primary surgery (up to 50%), the appearance of malignancy (2-9%), the reported number of distant metastases histologically identical to the primary P.A. From among 71 cases of benign parotid tumors treated from Nov. 89 to Nov. 92 in the ENT Department of "Regina Elena", the National Cancer Institute in Rome, six particular cases showed multiple force of P.A. recurring after primary surgery performed from 3 to 32 years previously and are object of discussion in this study. All of these six cases had multiple recurrences, usually manifest as nodular clusters in the parotid area, while in three cases appeared as well a recurrence in the soft tissue of the neck, far removed from the parotid space, with no involvement of neck nodes as was revealed through histological examination following neck dissection. A hypothetical mechanism of diffusion is discussed. The Authors agree with the opinion which holds the surgeon's inability to successfully eradicate primary tumors responsible for the high frequency of recurrences. The surgical technique of "enucleation" is, in fact, inadequate in P.A. excision owing the high risk of mishandling or rupturing the tumor capsule with a consequent seeding of the tumor onto the surgical bed. Lateral lobectomy, with identification of the facial nerve, or total conservative parotidectomy (for deep lobe adenoma) are correct techniques in treating primary P.A.. The Authors also discuss management of recurrent P.A. in relation to facial nerve involvement. Preservation of the seventh nerve with eventual post-operative radiation should be considered an alternative to nerve sacrifice in selected cases of recurrent pleomorphic adenoma.

  16. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora.

    PubMed

    Xiao, Bingbing; Niu, Xiaoxi; Han, Na; Wang, Ben; Du, Pengcheng; Na, Risu; Chen, Chen; Liao, Qinping

    2016-06-02

    Bacterial vaginosis (BV) is a highly prevalent disease in women, and increases the risk of pelvic inflammatory disease. It has been given wide attention because of the high recurrence rate. Traditional diagnostic methods based on microscope providing limited information on the vaginal microbiota increase the difficulty in tracing the development of the disease in bacteria resistance condition. In this study, we used deep-sequencing technology to observe dynamic variation of the vaginal microbiota at three major time points during treatment, at D0 (before treatment), D7 (stop using the antibiotics) and D30 (the 30-day follow-up visit). Sixty-five patients with BV were enrolled (48 were cured and 17 were not cured), and their bacterial composition of the vaginal microbiota was compared. Interestingly, we identified 9 patients might be recurrence. We also introduced a new measurement point of D7, although its microbiota were significantly inhabited by antibiotic and hard to be observed by traditional method. The vaginal microbiota in deep-sequencing-view present a strong correlation to the final outcome. Thus, coupled with detailed individual bioinformatics analysis and deep-sequencing technology, we may illustrate a more accurate map of vaginal microbial to BV patients, which provide a new opportunity to reduce the rate of recurrence of BV.

  17. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora

    PubMed Central

    Xiao, Bingbing; Niu, Xiaoxi; Han, Na; Wang, Ben; Du, Pengcheng; Na, Risu; Chen, Chen; Liao, Qinping

    2016-01-01

    Bacterial vaginosis (BV) is a highly prevalent disease in women, and increases the risk of pelvic inflammatory disease. It has been given wide attention because of the high recurrence rate. Traditional diagnostic methods based on microscope providing limited information on the vaginal microbiota increase the difficulty in tracing the development of the disease in bacteria resistance condition. In this study, we used deep-sequencing technology to observe dynamic variation of the vaginal microbiota at three major time points during treatment, at D0 (before treatment), D7 (stop using the antibiotics) and D30 (the 30-day follow-up visit). Sixty-five patients with BV were enrolled (48 were cured and 17 were not cured), and their bacterial composition of the vaginal microbiota was compared. Interestingly, we identified 9 patients might be recurrence. We also introduced a new measurement point of D7, although its microbiota were significantly inhabited by antibiotic and hard to be observed by traditional method. The vaginal microbiota in deep-sequencing-view present a strong correlation to the final outcome. Thus, coupled with detailed individual bioinformatics analysis and deep-sequencing technology, we may illustrate a more accurate map of vaginal microbial to BV patients, which provide a new opportunity to reduce the rate of recurrence of BV. PMID:27253522

  18. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora.

    PubMed

    Xiao, Bingbing; Niu, Xiaoxi; Han, Na; Wang, Ben; Du, Pengcheng; Na, Risu; Chen, Chen; Liao, Qinping

    2016-01-01

    Bacterial vaginosis (BV) is a highly prevalent disease in women, and increases the risk of pelvic inflammatory disease. It has been given wide attention because of the high recurrence rate. Traditional diagnostic methods based on microscope providing limited information on the vaginal microbiota increase the difficulty in tracing the development of the disease in bacteria resistance condition. In this study, we used deep-sequencing technology to observe dynamic variation of the vaginal microbiota at three major time points during treatment, at D0 (before treatment), D7 (stop using the antibiotics) and D30 (the 30-day follow-up visit). Sixty-five patients with BV were enrolled (48 were cured and 17 were not cured), and their bacterial composition of the vaginal microbiota was compared. Interestingly, we identified 9 patients might be recurrence. We also introduced a new measurement point of D7, although its microbiota were significantly inhabited by antibiotic and hard to be observed by traditional method. The vaginal microbiota in deep-sequencing-view present a strong correlation to the final outcome. Thus, coupled with detailed individual bioinformatics analysis and deep-sequencing technology, we may illustrate a more accurate map of vaginal microbial to BV patients, which provide a new opportunity to reduce the rate of recurrence of BV. PMID:27253522

  19. Clinical and Histological Prognostic Factors in Axillary Node-Negative BreastCancer: Univariate and Multivariate Analysis with Relation to 5-Year Recurrence.

    PubMed

    Khanna; Tokuda; Shibuya; Tanaka; Sekine; Tajima; Osamura; Mitomi

    1995-04-30

    In the recent years several studies have shown that about 30% of cases with axillary node-nagative breast cancer suffer relapse of the disease. Our attempt was made to evaluate the most significant prognostic factors to predict this high risk group which may be benefited from adjuvant treatment. For this purpose, we selected 9 patients out of 80 cases of node-negative breast cancer who had been followed up at least for 5 years and had the recurrence of the disease. For comparison, 16 patients from the same group who did not have relapse were selected on a random basis. Histology, receptor status, AgNOR, DNA flow cytometry and various immunohistochemical parameters were compared between the groups with recurrence and that without recurrence. On univariate analysis, tumor size, immunohistochemical expressions of PCNA, MIB-1, c-erbB-2 and S-phase fraction were significantly different between the above two groups. By multivariate analysis, immunohistochemical c-erbB-2 expression (more than 50% of cancer cells) was an independent parameter. As a summary from our studies, c-erbB-2 immunohistochemical staining on paraffin sections might be the best independent prognostic factor in axillary node-negative breast cancers.

  20. Microchimerism in recurrent miscarriage.

    PubMed

    Gammill, Hilary S; Stephenson, Mary D; Aydelotte, Tessa M; Nelson, J Lee

    2014-11-01

    Maternal-fetal cell exchange during pregnancy results in acquisition of microchimerism, which can durably persist in both recipients. Naturally acquired microchimerism may impact maternal-fetal interaction in pregnancy. We conducted studies to ask whether microchimerism that a woman acquired from her own mother is detectable before or during pregnancy in women with recurrent miscarriage. Fetal microchimerism was also assayed. Women with primary idiopathic recurrent miscarriage (n=23) and controls (n=31) were studied. Genotyping was conducted for probands, their mothers and the fetus, a non-shared polymorphism identified and quantitative polymerase chain reaction performed to measure microchimerismin peripheral blood mononuclear cells. Preconception comparisons were made between recurrent miscarriage subjects and controls, using logistic regression and Wilcoxon rank sum. Longitudinal microchimerism in subsequent pregnancies of recurrent miscarriage subjects was described. There was a trend toward lower preconception detection of microchimerism in recurrent miscarriage versus controls, 6% vs. 19% (1/16 vs. 6/31, P=0.2). During pregnancy, 3/11 (27%) of recurrent miscarriage subjects who went on to have a birth had detection of microchimerism from their own mother, whereas neither of two subjects who went on to miscarry had detection (0/2). This initial data suggest that microchimerism from a woman's own mother, while detectable in women with recurrent miscarriage, may differ from controls and according to subsequent pregnancy outcome. Further studies are needed to determine the cell types, quantities and any potential functional role of microchimerism in recurrent miscarriage.

  1. Recurrent mixed tumor.

    PubMed

    Batsakis, J G

    1986-01-01

    Recurrence of benign neoplasms can usually be attributed to incomplete excision. Such is the case with benign mixed tumors of salivary glands. Certain histopathologic features of mixed tumors, however, appear to facilitate recurrences. These are: a predominantly myxoid composition, and transcapsular extension by the tumor. Multicentric origin is possible, but it must be regarded as a much lower order of probability.

  2. Recurrent malignant salivary gland neoplasms.

    PubMed

    Rodriguez-Bigas, M A; Sako, K; Razack, M S; Shedd, D P; Bakamjian, V Y; Castillo, N B; Rao, U

    1989-10-01

    Recurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty-three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re-emphasize the relative poor yield of attempts at retreatment of loco-regional recurrence of salivary gland tumors.

  3. Predictors of Recurrent AKI.

    PubMed

    Siew, Edward D; Parr, Sharidan K; Abdel-Kader, Khaled; Eden, Svetlana K; Peterson, Josh F; Bansal, Nisha; Hung, Adriana M; Fly, James; Speroff, Ted; Ikizler, T Alp; Matheny, Michael E

    2016-04-01

    Recurrent AKI is common among patients after hospitalized AKI and is associated with progressive CKD. In this study, we identified clinical risk factors for recurrent AKI present during index AKI hospitalizations that occurred between 2003 and 2010 using a regional Veterans Administration database in the United States. AKI was defined as a 0.3 mg/dl or 50% increase from a baseline creatinine measure. The primary outcome was hospitalization with recurrent AKI within 12 months of discharge from the index hospitalization. Time to recurrent AKI was examined using Cox regression analysis, and sensitivity analyses were performed using a competing risk approach. Among 11,683 qualifying AKI hospitalizations, 2954 patients (25%) were hospitalized with recurrent AKI within 12 months of discharge. Median time to recurrent AKI within 12 months was 64 (interquartile range 19-167) days. In addition to known demographic and comorbid risk factors for AKI, patients with longer AKI duration and those whose discharge diagnosis at index AKI hospitalization included congestive heart failure (primary diagnosis), decompensated advanced liver disease, cancer with or without chemotherapy, acute coronary syndrome, or volume depletion, were at highest risk for being hospitalized with recurrent AKI. Risk factors identified were similar when a competing risk model for death was applied. In conclusion, several inpatient conditions associated with AKI may increase the risk for recurrent AKI. These findings should facilitate risk stratification, guide appropriate patient referral after AKI, and help generate potential risk reduction strategies. Efforts to identify modifiable factors to prevent recurrent AKI in these patients are warranted.

  4. Recurrence of hallux valgus: a review.

    PubMed

    Raikin, Steven M; Miller, Adam G; Daniel, Joseph

    2014-06-01

    Recurrence of hallux valgus deformity can be a common complication after corrective surgery. The cause of recurrent hallux valgus is usually multifactorial, and includes patient-related factors such as preoperative anatomic predisposition, medical comorbidities, compliance with postcorrection instructions, and surgical factors such as choice of the appropriate procedure and technical competency. For a successful outcome, this cause must be ascertained preoperatively. Although the algorithm to determine which intervention should be used is not unlike that of primary hallux valgus surgery, operative correction of hallux valgus recurrence can be challenging. This article discusses these challenges, complications, causes, and techniques.

  5. Recurrent pregnancy loss.

    PubMed

    Rao, Kamini A; Pillai, Jyothi R

    2006-08-01

    Recurrent abortions are hisheartening to the couple and also to the treating clinicians. Miscarriage is the loss of pregnancy weighing 500 g or less. Recurrent miscarriage or habitual abortion is defined as three or more consective abortions. Important factors involved in recurrent early pregnancy loss are genetic factors, endocrine factors, anatomic factors, immunologic factors, infectious factors and environmental factors. The factors are described in a nutshell in the text. Any severe infection that leads to bacteraemia orviraemia can cause sporadic miscarriage. Congenital uterine abnormalities have been associated most often with second-trimestar pregnancy loss. As regarding management of recurrent pregnancy loss the clinician has limited options. The use of aspiration in low dose (75 mg) and heparin is beneficial in APS positive patients. Multivitamins and folic acid assume importance in thrombophilic disorders. Tender live care with regular antenatal check-ups go a great way in achieving live term pregnancy.

  6. Endocrinology of recurrent pregnancy loss.

    PubMed

    Arredondo, Francisco; Noble, Luis S

    2006-02-01

    Following implantation, the maintenance of the pregnancy is dependent on a multitude of endocrinological events that will eventually aid in the successful growth and development of the fetus. Although the great majority of pregnant women have no pre-existing endocrine abnormalities, a small number of women can have certain endocrine alterations that could potentially lead to recurrent pregnancy losses. It is estimated that approximately 8 to 12% of all pregnancy losses are the result of endocrine factors. During the preimplantation period, the uterus undergoes important developmental changes stimulated by estrogen, and more importantly, progesterone. Progesterone is essential for the successful implantation and maintenance of pregnancy. Therefore, disorders related to inadequate progesterone secretion by the corpus luteum are likely to affect the outcome of the pregnancy. Luteal phase deficiency, hyperprolactinemia, and polycystic ovarian syndrome are some examples. Several other endocrinological abnormalities such as thyroid disease, hypoparathyroidism, uncontrolled diabetes, and decreased ovarian reserve have been implicated as etiologic factors for recurrent pregnancy loss.

  7. Recurrent Dislocation of the Patella

    PubMed Central

    Benítez, Gustavo

    2015-01-01

    Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

  8. The Role of M1 and M2 Macrophages in Prostate Cancer in relation to Extracapsular Tumor Extension and Biochemical Recurrence after Radical Prostatectomy

    PubMed Central

    Lanciotti, M.; Masieri, L.; Raspollini, M. R.; Minervini, A.; Mari, A.; Comito, G.; Giannoni, E.; Carini, M.; Chiarugi, P.; Serni, S.

    2014-01-01

    Introduction. The aim of our work was to investigate the causal connection between M1 and M2 macrophage phenotypes occurrence and prostate cancer, their correlation with tumor extension (ECE), and biochemical recurrence (BR). Patient and Methods. Clinical and pathological data were prospectively gathered from 93 patients treated with radical prostatectomy. Correlations of commonly used variables were evaluated with uni- and multivariate analysis. The relationship between M1 and M2 occurrence and BR was also assessed with Kaplan-Meier survival analysis. Results. Above all in 63.4% there was a M2 prevalence. M1 occurred more frequently in OC disease, while M2 was more represented in ECE. At univariate analysis biopsy and pathologic GS and M2 were statistically correlated with ECE. Only pathologic GS and M2 confirmed to be correlated with ECE. According to macrophage density BCR free survival curves presented a statistically significant difference. When we stratified our population for M1 and M2,we did not find any statistical difference among curves. At univariate analysis GS, pTNM, and positive margins resulted to be significant predictors of BCR, while M1 and M2 did not achieve the statistical significance. At multivariate analysis, only GS and pathologic stage were independent predictors of BR. Conclusion. In our study patients with higher density of M count were associated with poor prognosis; M2 phenotype was significantly associated with ECE. PMID:24738060

  9. [Treatment of recurrent furunculosis].

    PubMed

    Engelhard, Esther A N; Spanjaard, Lodewijk; Stijnis, C Kees

    2013-01-01

    The management of recurrent furunculosis is difficult, and often disappointing. We present the case of a 23-year-old female patient suffering from recurrent furunculosis. The furunculosis persisted after treatment with mupirocin nasal ointment, chlorhexidine soap and instructions for washing clothes, towels and bed sheets for a period of 7 days. Treatment with low-dose clindamycin for three months ultimately proved successful. We propose a structural approach for recurrent furunculosis in which extensive history-taking is followed by appropriate tests. Before prescribing an oral antibiotic (preferably low-dose clindamycin or a macrolide for 3 months), the patient should use an antimicrobial nasal ointment and soap and follow hygienic instructions as mentioned above. Members of the household who also have signs of the infection should be treated. Hygienic education is an essential component of treatment. We believe that this approach will lead to a treatment that is more effective and efficient.

  10. Recurrent wheezing in children

    PubMed Central

    Piazza, Michele; Piacentini, Giorgio

    2016-01-01

    Recurrent wheezing have a significant morbidity and it’s estimated that about one third of school-age children manifest the symptom during the first 5 years of life. Proper identification of children at risk of developing asthma at school age may predict long-term outcomes and improve treatment and preventive approach, but the possibility to identify these children at preschool age remains limited. For many years authors focused their studies to identify early children with recurrent wheezing at risk to develop asthma at school age. Different phenotypes have been proposed for a more precise characterization and a personalized plan of treatment. The main criticism concerns the inability to define stable phenotypes with the risk of overestimating or underestimating the characteristics of symptoms in these children. The aim of this review is to report the recent developments on the diagnosis and treatment of recurrent paediatric wheezing. PMID:26835404

  11. [Treatment of recurrent furunculosis].

    PubMed

    Engelhard, Esther A N; Spanjaard, Lodewijk; Stijnis, C Kees

    2013-01-01

    The management of recurrent furunculosis is difficult, and often disappointing. We present the case of a 23-year-old female patient suffering from recurrent furunculosis. The furunculosis persisted after treatment with mupirocin nasal ointment, chlorhexidine soap and instructions for washing clothes, towels and bed sheets for a period of 7 days. Treatment with low-dose clindamycin for three months ultimately proved successful. We propose a structural approach for recurrent furunculosis in which extensive history-taking is followed by appropriate tests. Before prescribing an oral antibiotic (preferably low-dose clindamycin or a macrolide for 3 months), the patient should use an antimicrobial nasal ointment and soap and follow hygienic instructions as mentioned above. Members of the household who also have signs of the infection should be treated. Hygienic education is an essential component of treatment. We believe that this approach will lead to a treatment that is more effective and efficient. PMID:23369819

  12. Recurrent Wheezing in Infants

    PubMed Central

    Belhassen, Manon; De Blic, Jacques; Laforest, Laurent; Laigle, Valérie; Chanut-Vogel, Céline; Lamezec, Liliane; Brouard, Jacques; Fauroux, Brigitte; de Pouvourville, Gérard; Ginoux, Marine; Van Ganse, Eric

    2016-01-01

    Abstract Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data. Infants aged from 6 to 24 months, receiving ≥2 dispensations of respiratory drugs within 3 months, and presenting a marker of poor control (index date), were selected. During the 6 months after index date, MRU was described in the cohort and among 3 subgroups with more severe RW, defined as ≥4 dispensations of respiratory drugs, ≥3 dispensations of oral corticosteroids (OCS), or ≥1 hospitalization for respiratory symptoms. A total of 115,489 infants had RW, corresponding to 8.2% of subjects in this age group. During follow-up, 68.7% of infants received inhaled corticosteroids, but only 1.8 U (unit) were dispensed over 6 months, suggesting discontinuous use. Control was mostly inadequate: 61.7% of subjects received OCS, 80.2% antibiotics, and 71.2% short-acting beta-agonists, and medical/paramedical visits were numerous, particularly for physiotherapy. Severe RW concerned 39.0% of the cohort; 32.8% and 11.7% of infants had repeated use of respiratory drugs and OCS, respectively, and 5.5% were hospitalized for respiratory symptoms. In this real-life nation-wide study, RW was common and infants had poor control and high MRU. Interventions are needed to support adequate use of controller therapy, and to improve medical care. PMID:27082618

  13. Recurrent pregnancy loss.

    PubMed

    Hatasaka, H H; Varner, M W

    1994-12-01

    Recurrent pregnancy loss is a frustrating clinical dilemma for both patients and physicians because, in most cases, causes are nebulous and few treatments with proven benefit can be offered. Involved, expensive tests have frequently been proposed and their use has often filtered into clinical practice before their utility has been firmly demonstrated. Proposed causes of recurrent pregnancy loss include genetic and environmental etiologies, infectious agents, maternal congenital and acquired anatomic abnormalities, and immunologic and endocrinologic dysfunction. Appropriate management relies upon a realistic understanding of the often substantial limitations of currently available therapies.

  14. Tackling a Recurrent Pinealoblastoma

    PubMed Central

    Palled, Siddanna; Kalavagunta, Sruthi; Beerappa Gowda, Jaipal; Umesh, Kavita; Aal, Mahalaxmi; Abdul Razack, Tanvir pasha Chitraduraga; Gowda, Veerabhadre; Viswanath, Lokesh

    2014-01-01

    Pineoblastomas are rare, malignant, pineal region lesions that account for <0.1% of all intracranial tumors and can metastasize along the neuroaxis. Pineoblastomas are more common in children than in adults and adults account for <10% of patients. The management of pinealoblastoma is multimodality approach, surgery followed with radiation and chemotherapy. In view of aggressive nature few centres use high dose chemotherapy with autologus stem cell transplant in newly diagnosed cases but in recurrent setting the literature is very sparse. The present case represents the management of pinealoblastoma in the recurrent setting with reirradiation and adjuvant carmustine chemotherapy wherein the management guidelines are not definitive. PMID:25210636

  15. Recurrent Aphthous Stomatitis

    PubMed Central

    Akintoye, Sunday O.; Greenberg, Martin S.

    2014-01-01

    Recurrent Aphthous Stomatitis (RAS) is the most common ulcerative disease affecting the oral mucosa. It occurs mostly in healthy individuals and has atypical clinical presentation in immunocompromised individuals. The etiology of RAS is still unknown, but several local, systemic, immunologic, genetic, allergic, nutritional, and microbial factors, as well as immunosuppressive drugs, have been proposed as causative agents. Clinical management of RAS is based on severity of symptoms, frequency, size and number of lesions using topical and systemic therapies. The goals of therapy are to decrease pain and ulcer size, promote healing and decrease frequency of recurrence. PMID:24655523

  16. Recurrent infective endocarditis.

    PubMed Central

    Lossos, I. S.; Oren, R.

    1993-01-01

    Infective endocarditis is a serious disease associated with high mortality. Patients surviving recurrent bouts of infective endocarditis are reported infrequently. We report on a non-drug abuser patient who experienced seven episodes of infective endocarditis--the largest number reported to our knowledge in a single non-drug abuser patient. PMID:8290417

  17. Lung Cancer Indicators Recurrence

    Cancer.gov

    This study describes prognostic factors for lung cancer spread and recurrence, as well as subsequent risk of death from the disease. The investigators observed that regardless of cancer stage, grade, or type of lung cancer, patients in the study were more

  18. On Solving Linear Recurrences

    ERIC Educational Resources Information Center

    Dobbs, David E.

    2013-01-01

    A direct method is given for solving first-order linear recurrences with constant coefficients. The limiting value of that solution is studied as "n to infinity." This classroom note could serve as enrichment material for the typical introductory course on discrete mathematics that follows a calculus course.

  19. Recurrent Corneal Erosion

    MedlinePlus

    ... to apply a tight patch that restricts eye movement at night and upon waking so there is less likelihood of recurrence. If these rather simple procedures are not successful, the eye care professional may re-scrape the area to create a more irregular abrasion followed by ...

  20. Prognostic factors for hepatocellular carcinoma recurrence.

    PubMed

    Colecchia, Antonio; Schiumerini, Ramona; Cucchetti, Alessandro; Cescon, Matteo; Taddia, Martina; Marasco, Giovanni; Festi, Davide

    2014-05-28

    The recurrence of hepatocellular carcinoma, the sixth most common neoplasm and the third leading cause of cancer-related mortality worldwide, represents an important clinical problem, since it may occur after both surgical and medical treatment. The recurrence rate involves 2 phases: an early phase and a late phase. The early phase usually occurs within 2 years after resection; it is mainly related to local invasion and intrahepatic metastases and, therefore, to the intrinsic biology of the tumor. On the other hand, the late phase occurs more than 2 years after surgery and is mainly related to de novo tumor formation as a consequence of the carcinogenic cirrhotic environment. Since recent studies have reported that early and late recurrences may have different risk factors, it is clinically important to recognize these factors in the individual patient as soon as possible. The aim of this review was, therefore, to identify predicting factors for the recurrence of hepatocellular carcinoma, by means of invasive and non-invasive methods, according to the different therapeutic strategies available. In particular the role of emerging techniques (e.g., transient elastography) and biological features of hepatocellular carcinoma in predicting recurrence have been discussed. In particular, invasive methods were differentiated from non-invasive ones for research purposes, taking into consideration the emerging role of the genetic signature of hepatocellular carcinoma in order to better allocate treatment strategies and surveillance follow-up in patients with this type of tumor.

  1. Recurrent Infections May Signal Immunodeficiencies

    MedlinePlus

    ... Search AAAAI Breadcrumb navigation Home ▸ Conditions & Treatments ▸ Library ▸ Primary Immunodeficiency Disease Library ▸ Recurrent Infections May Signal Immunodeficiencies Share | Recurrent Infections May Signal Immunodeficiencies This article has been reviewed by Thanai Pongdee, MD, FAAAAI ...

  2. Innovative approaches to recurrent training

    NASA Technical Reports Server (NTRS)

    Noon, H.; Murphy, M.

    1984-01-01

    Innovative approaches to recurrent training for regional airline aircrews are explored. Guidelines for recurrent training programs which include in corporation of cockpit resource management are discussed. B.W.

  3. Recurrent Education: Trends and Issues.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

    The document, consisting of three parts, focuses on recurrent education and the need for more effective deployment of educational resources within member countries of the Organization for Economic Cooperation and Development. The first section discusses the rationale for recurrent education. Recurrent education presents an educational opportunity…

  4. Prevention of recurrent nephrolithiasis.

    PubMed

    Goldfarb, D S; Coe, F L

    1999-11-15

    The first episode of nephrolithiasis provides an opportunity to advise patients about measures for preventing future stones. Low fluid intake and excessive intake of protein, salt and oxalate are important modifiable risk factors for kidney stones. Calcium restriction is not useful and may potentiate osteoporosis. Diseases such as hyperparathyroidism, sarcoidosis and renal tubular acidosis should be considered in patients with nephrolithiasis. A 24-hour urine collection with measurement of the important analytes is usually reserved for use in patients with recurrent stone formation. In these patients, the major urinary risk factors include hypercalciuria, hyperoxaluria, hypocitraturia and hyperuricosuria. Effective preventive and treatment measures include thiazide therapy to lower the urinary calcium level, citrate supplementation to increase the urinary citrate level and, sometimes, allopurinol therapy to lower uric acid excretion. Uric acid stones are most often treated with citrate supplementation. Data now support the cost-effectiveness of evaluation and treatment of patients with recurrent stones. PMID:10593318

  5. Prophylactic treatment with melatonin before recurrent neonatal seizures: Effects on long-term neurobehavioral changes and the underlying expression of metabolism-related genes in rat hippocampus and cerebral cortex.

    PubMed

    Ni, Hong; Sun, Qi; Tian, Tian; Feng, Xing; Sun, Bao-liang

    2015-06-01

    Although it has been suggested that the protective effect of melatonin against seizure-induced neurotoxicity involves inhibition of neuronal lipid peroxidation, current data concerning the exact molecular mechanism are still limited. This study was undertaken to investigate the changes in neurobehavioral, cognitive and lipid metabolism-related gene expressions in both hippocampus and cerebral cortex of rats subjected to recurrent neonatal seizures, and the effects of melatonin treatment before seizure (55mg/kg, 1mg/ml). 6-day-old (P6) SD rats were randomly divided into four groups of control (CONT, the same below), melatonin treated control (Mel), recurrent neonatal seizure (RS) and melatonin and RS combination treatment (Mel+RS). Neurological behavioral parameters of brain damage (plane righting reflex, negative geotaxis reaction reflex, Cliff avoidance reflex, forelimb suspension reflex) were observed on P31. Morris water maze test was performed during P29-P35. Then the protein levels of ACAT1, Cathepsin-E and Ca(2+)/calmodulin-dependent protein kinase II (CAMK II) in hippocampus and cerebral cortex were detected by western blot method. As expected, RS group showed a significant delay or reduce of the four reflexes, as well as bad performance in the Morris water maze test. Flurothyl-induced neurobehavioral toxicology was blocked by pre-treatment with melatonin. In parallel with these behavioral changes, gene expression by western blot method demonstrated that rats pretreated with melatonin (Mel+RS) showed a significant down-regulated expression of ACAT-1, Cathepsin-E and up-regulated CAMK II in hippocampus and cerebral cortex when compared with RS group. Our findings provide support for ACAT-1/Cathepsin-E as well as CaMK II being potential targets for the treatment of neonatal seizure-induced brain damage by melatonin.

  6. Recurrent respiratory tract infections in paediatric patients.

    PubMed

    Bellanti, J A

    1997-01-01

    Paediatric respiratory tract infections are one of the most common reasons for physician visits and hospitalisation, and are associated with significant morbidity and mortality. The role of physicians and other healthcare professionals has expanded from merely treating disease to implementing measures aimed at health maintenance and disease prevention. Therefore, children with recurrent respiratory tract infections represent a great challenge for the paediatrician, from both therapeutic and preventive standpoints. The paediatrician must first determine whether these recurrent infections are because of host-derived factors or are the result of increased environmental exposure. Host-derived factors may be nonimmunological or related to host immunodeficiency. The leading cause of recurrent respiratory tract infections throughout the world is increased environmental exposure in children attending nursery school or daycare centres. Acute otitis media in children is of particular concern because of its high incidence, frequent recurrence, and serious long term sequelae, e.g. hearing loss. The socioeconomic impact of these recurrent infections is staggering, and there remains much scope for devising methods for their treatment and prevention. Recent approaches have included the encouragement of breastfeeding, the use of intravenous immunoglobulin and respiratory syncytical virus immune globulin, as well as methods of stimulating immunity, such as ribosomal immunotherapy. PMID:9378072

  7. Microarray analysis of potential genes in the pathogenesis of recurrent oral ulcer

    PubMed Central

    Han, Jingying; He, Zhiwei; Li, Kun; Hou, Lu

    2015-01-01

    Recurrent oral ulcer seriously threatens patients’ daily life and health. This study investigated potential genes and pathways that participate in the pathogenesis of recurrent oral ulcer by high throughput bioinformatic analysis. RT-PCR and Western blot were applied to further verify screened interleukins effect. Recurrent oral ulcer related genes were collected from websites and papers, and further found out from Human Genome 280 6.0 microarray data. Each pathway of recurrent oral ulcer related genes were got through chip hybridization. RT-PCR was applied to test four recurrent oral ulcer related genes to verify the microarray data. Data transformation, scatter plot, clustering analysis, and expression pattern analysis were used to analyze recurrent oral ulcer related gene expression changes. Recurrent oral ulcer gene microarray was successfully established. Microarray showed that 551 genes involved in recurrent oral ulcer activity and 196 genes were recurrent oral ulcer related genes. Of them, 76 genes up-regulated, 62 genes down-regulated, and 58 genes up-/down-regulated. Total expression level up-regulated 752 times (60%) and down-regulated 485 times (40%). IL-2 plays an important role in the occurrence, development and recurrence of recurrent oral ulcer on the mRNA and protein levels. Gene microarray can be used to analyze potential genes and pathways in recurrent oral ulcer. IL-2 may be involved in the pathogenesis of recurrent oral ulcer. PMID:26722428

  8. Microarray analysis of potential genes in the pathogenesis of recurrent oral ulcer.

    PubMed

    Han, Jingying; He, Zhiwei; Li, Kun; Hou, Lu

    2015-01-01

    Recurrent oral ulcer seriously threatens patients' daily life and health. This study investigated potential genes and pathways that participate in the pathogenesis of recurrent oral ulcer by high throughput bioinformatic analysis. RT-PCR and Western blot were applied to further verify screened interleukins effect. Recurrent oral ulcer related genes were collected from websites and papers, and further found out from Human Genome 280 6.0 microarray data. Each pathway of recurrent oral ulcer related genes were got through chip hybridization. RT-PCR was applied to test four recurrent oral ulcer related genes to verify the microarray data. Data transformation, scatter plot, clustering analysis, and expression pattern analysis were used to analyze recurrent oral ulcer related gene expression changes. Recurrent oral ulcer gene microarray was successfully established. Microarray showed that 551 genes involved in recurrent oral ulcer activity and 196 genes were recurrent oral ulcer related genes. Of them, 76 genes up-regulated, 62 genes down-regulated, and 58 genes up-/down-regulated. Total expression level up-regulated 752 times (60%) and down-regulated 485 times (40%). IL-2 plays an important role in the occurrence, development and recurrence of recurrent oral ulcer on the mRNA and protein levels. Gene microarray can be used to analyze potential genes and pathways in recurrent oral ulcer. IL-2 may be involved in the pathogenesis of recurrent oral ulcer.

  9. Surgical management of primary and recurrent melanoma.

    PubMed

    Farma, Jeffrey M; Kulkarni, Nandini; Hsu, Cary

    2015-04-01

    Melanoma accounts for less than 2% of skin cancer cases but causes most skin cancer-related deaths. Surgery continues to be the cornerstone of treatment of melanoma and surgical principles are guided by data derived from clinical research. This article examines the evolution of surgical techniques for the diagnosis and treatment of primary and locally recurrent melanoma.

  10. The recurrence sequence via the Fibonacci groups

    NASA Astrophysics Data System (ADS)

    Aküzüm, Yeşim; Deveci, Ömür

    2016-04-01

    This work develops properties of the recurrence sequence defined by the aid of the relation matrix of the Fibonacci groups. The study of this sequence modulo m yields cyclic groups and semigroups from generating matrix. Finally, we extend the sequence defined to groups and then, we obtain its period in the Fibonacci groups.

  11. Recurrent Hypothenar Hammer Syndrome: A Case Report.

    PubMed

    Adams, Nicholas S; Ford, Ronald D

    2016-10-01

    Hypothenar hammer syndrome (HHS) is a rare cause of digital ischemia and pain caused from repetitive trauma to the palm. Often related to occupational practices, thrombosis and embolization can occur. Treatment is often surgical and involves excision with or without reconstruction. We describe a 55 year-old, male pipe fitter previously diagnosed and treated for HHS with excision and repair using a reversed interpositional vein graft in the mid-1980's. He continued to work in the profession, which he regularly used his palm as a hammer and returned approximately 30 years later with recurrent symptoms of cold intolerance and pain. Angiography confirmed occlusion of the ulnar artery with emboli present distally. The patient was again treated with excision and reconstruction. HHS is an uncommon cause of digital ischemia. Its recurrence is even more rare. To our knowledge, this is the first described case of diagnosed and treated recurrent HHS. PMID:27595964

  12. Divergent clonal selection dominates medulloblastoma at recurrence.

    PubMed

    Morrissy, A Sorana; Garzia, Livia; Shih, David J H; Zuyderduyn, Scott; Huang, Xi; Skowron, Patryk; Remke, Marc; Cavalli, Florence M G; Ramaswamy, Vijay; Lindsay, Patricia E; Jelveh, Salomeh; Donovan, Laura K; Wang, Xin; Luu, Betty; Zayne, Kory; Li, Yisu; Mayoh, Chelsea; Thiessen, Nina; Mercier, Eloi; Mungall, Karen L; Ma, Yusanne; Tse, Kane; Zeng, Thomas; Shumansky, Karey; Roth, Andrew J L; Shah, Sohrab; Farooq, Hamza; Kijima, Noriyuki; Holgado, Borja L; Lee, John J Y; Matan-Lithwick, Stuart; Liu, Jessica; Mack, Stephen C; Manno, Alex; Michealraj, K A; Nor, Carolina; Peacock, John; Qin, Lei; Reimand, Juri; Rolider, Adi; Thompson, Yuan Y; Wu, Xiaochong; Pugh, Trevor; Ally, Adrian; Bilenky, Mikhail; Butterfield, Yaron S N; Carlsen, Rebecca; Cheng, Young; Chuah, Eric; Corbett, Richard D; Dhalla, Noreen; He, An; Lee, Darlene; Li, Haiyan I; Long, William; Mayo, Michael; Plettner, Patrick; Qian, Jenny Q; Schein, Jacqueline E; Tam, Angela; Wong, Tina; Birol, Inanc; Zhao, Yongjun; Faria, Claudia C; Pimentel, José; Nunes, Sofia; Shalaby, Tarek; Grotzer, Michael; Pollack, Ian F; Hamilton, Ronald L; Li, Xiao-Nan; Bendel, Anne E; Fults, Daniel W; Walter, Andrew W; Kumabe, Toshihiro; Tominaga, Teiji; Collins, V Peter; Cho, Yoon-Jae; Hoffman, Caitlin; Lyden, David; Wisoff, Jeffrey H; Garvin, James H; Stearns, Duncan S; Massimi, Luca; Schüller, Ulrich; Sterba, Jaroslav; Zitterbart, Karel; Puget, Stephanie; Ayrault, Olivier; Dunn, Sandra E; Tirapelli, Daniela P C; Carlotti, Carlos G; Wheeler, Helen; Hallahan, Andrew R; Ingram, Wendy; MacDonald, Tobey J; Olson, Jeffrey J; Van Meir, Erwin G; Lee, Ji-Yeoun; Wang, Kyu-Chang; Kim, Seung-Ki; Cho, Byung-Kyu; Pietsch, Torsten; Fleischhack, Gudrun; Tippelt, Stephan; Ra, Young Shin; Bailey, Simon; Lindsey, Janet C; Clifford, Steven C; Eberhart, Charles G; Cooper, Michael K; Packer, Roger J; Massimino, Maura; Garre, Maria Luisa; Bartels, Ute; Tabori, Uri; Hawkins, Cynthia E; Dirks, Peter; Bouffet, Eric; Rutka, James T; Wechsler-Reya, Robert J; Weiss, William A; Collier, Lara S; Dupuy, Adam J; Korshunov, Andrey; Jones, David T W; Kool, Marcel; Northcott, Paul A; Pfister, Stefan M; Largaespada, David A; Mungall, Andrew J; Moore, Richard A; Jabado, Nada; Bader, Gary D; Jones, Steven J M; Malkin, David; Marra, Marco A; Taylor, Michael D

    2016-01-21

    The development of targeted anti-cancer therapies through the study of cancer genomes is intended to increase survival rates and decrease treatment-related toxicity. We treated a transposon-driven, functional genomic mouse model of medulloblastoma with 'humanized' in vivo therapy (microneurosurgical tumour resection followed by multi-fractionated, image-guided radiotherapy). Genetic events in recurrent murine medulloblastoma exhibit a very poor overlap with those in matched murine diagnostic samples (<5%). Whole-genome sequencing of 33 pairs of human diagnostic and post-therapy medulloblastomas demonstrated substantial genetic divergence of the dominant clone after therapy (<12% diagnostic events were retained at recurrence). In both mice and humans, the dominant clone at recurrence arose through clonal selection of a pre-existing minor clone present at diagnosis. Targeted therapy is unlikely to be effective in the absence of the target, therefore our results offer a simple, proximal, and remediable explanation for the failure of prior clinical trials of targeted therapy.

  13. Recurrent Miller Fisher syndrome.

    PubMed

    Madhavan, S; Geetha; Bhargavan, P V

    2004-07-01

    Miller Fisher syndrome (MFS) is a variant of Guillan Barre syndrome characterized by the triad of ophthalmoplegia, ataxia and areflexia. Recurrences are exceptional with Miller Fisher syndrome. We are reporting a case with two episodes of MFS within two years. Initially he presented with partial ophthalmoplegia, ataxia. Second episode was characterized by full-blown presentation characterized by ataxia, areflexia and ophthalmoplegia. CSF analysis was typical during both episodes. Nerve conduction velocity study was fairly within normal limits. MRI of brain was within normal limits. He responded to symptomatic measures initially, then to steroids in the second episode. We are reporting the case due to its rarity.

  14. Recurrent respiratory papillomatosis.

    PubMed

    Venkatesan, Naren N; Pine, Harold S; Underbrink, Michael P

    2012-06-01

    Recurrent respiratory papillomatosis (RRP) is a rare, benign disease with no known cure. RRP is caused by infection of the upper aerodigestive tract with the human papillomavirus (HPV). Passage through the birth canal is thought to be the initial transmission event, but infection may occur in utero. HPV vaccines have helped to provide protection from cervical cancer; however, their role in the prevention of RRP is undetermined. Clinical presentation of initial symptoms of RRP may be subtle. RRP course varies, and current management focuses on surgical debulking of papillomatous lesions with or without concurrent adjuvant therapy. PMID:22588043

  15. Recurrent renal giant leiomyosarcoma.

    PubMed

    Öziş, Salih Erpulat; Gülpınar, Kamil; Şahlı, Zafer; Konak, Baha Burak; Keskin, Mete; Özdemir, Süleyman; Ataoğlu, Ömür

    2016-01-01

    Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1-2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50-60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion's pathology from low-grade to a high-grade tumor. PMID:27436926

  16. Recurrence theorems: A unified account

    SciTech Connect

    Wallace, David

    2015-02-15

    I discuss classical and quantum recurrence theorems in a unified manner, treating both as generalisations of the fact that a system with a finite state space only has so many places to go. Along the way, I prove versions of the recurrence theorem applicable to dynamics on linear and metric spaces and make some comments about applications of the classical recurrence theorem in the foundations of statistical mechanics.

  17. Psychosocial adjustment to recurrent cancer.

    PubMed

    Mahon, S M; Cella, D F; Donovan, M I

    1990-01-01

    This descriptive study of the perceptions and needs of people with recurrent malignancies asks three questions: How do patients describe the meaning of a recurrence of cancer? Do individuals perceive the diagnosis of recurrence and the initial diagnosis of cancer differently? What are the key psychosocial problems associated with recurrent cancer? The theoretical framework was based on Lazarus and Folkman's theory of stress, appraisal, and coping. Subjects completed the Impact of Event Scale (IES), the Psychosocial Adjustment to Illness Scale--Self-Report (PAIS), and a semistructured qualitative interview. The interview elicited perceptions of the event of recurrence and differences between the diagnosis of recurrence and the initial diagnosis. The convenience sample included 40 patients diagnosed with recurrent cancer within the last 30 days. Many subjects (78%) reported that the recurrence was more upsetting than the initial diagnosis. Scores on both the IES and the PAIS were high when compared to normative samples of patients with cancer suggesting that this sample of patients experienced a lot of psychological distress as well as problems at home, work, and in their social lives. These concerns often were unknown to caregivers. Although more research is needed, the authors propose that, with more accurate assessment, more effective intervention could be implemented and the quality of life improved for patients with recurrent cancer.

  18. Abemaciclib in Children With DIPG or Recurrent/Refractory Solid Tumors

    ClinicalTrials.gov

    2016-04-12

    Diffuse Intrinsic Pontine Glioma; Brain Tumor, Recurrent; Solid Tumor, Recurrent; Neuroblastoma, Recurrent, Refractory; Ewing Sarcoma, Recurrent, Refractory; Rhabdomyosarcoma, Recurrent, Refractory; Osteosarcoma, Recurrent, Refractory; Rhabdoid Tumor, Recurrent, Refractory

  19. Recurrent ovarian cancer.

    PubMed

    Pujade-Lauraine, E; Combe, P

    2016-04-01

    Recurrence still occurs in a majority of patients with advanced ovarian cancer. However, progress in the management has allowed a significant prolongation of survival for relapsing disease. These last years, the field of interest has moved from chemotherapy to targeted therapy which is dominated by anti-angiogenic and anti-PARP agents. It is assumed that platinum-free interval will not remain the main prognostic and predictive criterion in the future, and will be replaced by a multi-factorial approach. This trend for personalization of therapy has highlighted important neglected fields for clinical research such as multi-line (≥3) relapse, frail patients including elderly and symptomatic and supportive measures. PMID:27141075

  20. Recurrent vulvovaginal candidiasis.

    PubMed

    Sobel, Jack D

    2016-01-01

    Recurrent vulvovaginal candidiasis (RVVC) is a common cause of significant morbidity in women in all strata of society affecting millions of women worldwide. Previously, RVVC occurrence was limited by onset of menopause but the widespread use of hormone replacement therapy has extended the at-risk period. Candida albicans remains the dominant species responsible for RVVC, however optimal management of RVVC requires species determination and effective treatment measures are best if species-specific. Considerable progress has been made in understanding risk factors that determine susceptibility to RVVC, particularly genetic factors, as well as new insights into normal vaginal defense immune mechanisms and their aberrations in RVVC. While effective control of RVVC is achievable with the use of fluconazole maintenance suppressive therapy, cure of RVVC remains elusive especially in this era of fluconazole drug resistance. Vaccine development remains a critical challenge and need.

  1. Re-irradiation alternatives for recurrent high-grade glioma

    PubMed Central

    Dong, Yuanli; Fu, Chengrui; Guan, Hui; Zhang, Tianyi; Zhang, Zicheng; Zhou, Tao; Li, Baosheng

    2016-01-01

    Despite advances in the fields of surgery, chemotherapy and radiotherapy, the prognosis for high-grade glioma (HGG) remains unsatisfactory. The majority of HGG patients experience disease recurrence. To date, no standard treatments have been established for recurrent HGG. Repeat surgery and chemotherapy demonstrate moderate efficacy. As recurrent lesions are usually located within the previously irradiated field, a second course of irradiation was once considered controversial, as it was considered to exhibit unsatisfactory efficacy and radiation-related toxicities. However, an increasing number of studies have indicated that re-irradiation may present an efficacious treatment for recurrent HGG. Re-irradiation may be delivered via conventionally fractionated stereotactic radiotherapy, hypofractionated stereotactic radiation therapy, stereotactic radiosurgery and brachytherapy techniques. In the present review, the current literature regarding re-irradiation treatment for recurrent HGG is summarized with regard to survival outcome and side effects. PMID:27703519

  2. The content of recurrent dreams in young adolescents.

    PubMed

    Gauchat, Aline; Séguin, Jean R; McSween-Cadieux, Esther; Zadra, Antonio

    2015-12-01

    Studies on children's recurrent dreams have been largely anecdotal and based on adults' recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future research. PMID:26366465

  3. The content of recurrent dreams in young adolescents.

    PubMed

    Gauchat, Aline; Séguin, Jean R; McSween-Cadieux, Esther; Zadra, Antonio

    2015-12-01

    Studies on children's recurrent dreams have been largely anecdotal and based on adults' recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future research.

  4. The content of recurrent dreams in young adolescents

    PubMed Central

    Gauchat, Aline; Séguin, Jean R.; McSween-Cadieux, Esther; Zadra, Antonio

    2015-01-01

    Studies on children’s recurrent dreams have been largely anecdotal and based on adults’ recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15 years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future research. PMID:26366465

  5. Distinct recurrent versus afferent dynamics in cortical visual processing.

    PubMed

    Reinhold, Kimberly; Lien, Anthony D; Scanziani, Massimo

    2015-12-01

    How intracortical recurrent circuits in mammalian sensory cortex influence dynamics of sensory representation is not understood. Previous methods could not distinguish the relative contributions of recurrent circuits and thalamic afferents to cortical dynamics. We accomplish this by optogenetically manipulating thalamus and cortex. Over the initial 40 ms of visual stimulation, excitation from recurrent circuits in visual cortex progressively increased to exceed direct thalamocortical excitation. Even when recurrent excitation exceeded thalamic excitation, upon silencing thalamus, sensory-evoked activity in cortex decayed rapidly, with a time constant of 10 ms, which is similar to a neuron's integration time window. In awake mice, this cortical decay function predicted the time-locking of cortical activity to thalamic input at frequencies <15 Hz and attenuation of the cortical response to higher frequencies. Under anesthesia, depression at thalamocortical synapses disrupted the fidelity of sensory transmission. Thus, we determine dynamics intrinsic to cortical recurrent circuits that transform afferent input in time.

  6. Recurrence prediction in oral cancers: a serum Raman spectroscopy study.

    PubMed

    Sahu, Aditi; Nandakumar, Nikhila; Sawant, Sharada; Krishna, C Murali

    2015-04-01

    High mortality rates associated with oral cancers can be primarily attributed to the failure of current histological procedures in predicting recurrence. Identifying recurrence related factors can lead to improved prognosis, optimized treatment and enhanced overall outcomes. Serum Raman spectroscopy has previously shown potential in the diagnosis of cancers, such as head and neck, cervix, breast, oral cancers, and also in predicting treatment response. In the present study, serum was collected from 22 oral cancer subjects [with recurrence (n = 10) and no-recurrence (n = 12)] before and after surgery and spectra were acquired using a Raman microprobe coupled with a 40× objective. Spectral acquisition parameters were as follows: λex = 785 nm, laser power = 30 mW, integration time: 12 s and averages: 3. Data was analyzed in a patient-wise approach using unsupervised PCA and supervised PC-LDA, followed by LOOCV. PCA and PC-LDA findings suggest that recurrent and non-recurrent cases cannot be classified in before surgery serum samples; an average classification efficiency of ∼78% was obtained in after-surgery samples. Mean and difference spectra and PCA loadings indicate that DNA and protein markers may be potential spectral markers for recurrence. RS of post surgery serum samples may have the potential to predict the probability of recurrence in clinics, after prospective large-scale validation.

  7. Recurrence plots and recurrence quantification analysis of human motion data

    NASA Astrophysics Data System (ADS)

    Josiński, Henryk; Michalczuk, Agnieszka; Świtoński, Adam; Szczesna, Agnieszka; Wojciechowski, Konrad

    2016-06-01

    The authors present exemplary application of recurrence plots, cross recurrence plots and recurrence quantification analysis for the purpose of exploration of experimental time series describing selected aspects of human motion. Time series were extracted from treadmill gait sequences which were recorded in the Human Motion Laboratory (HML) of the Polish-Japanese Academy of Information Technology in Bytom, Poland by means of the Vicon system. Analysis was focused on the time series representing movements of hip, knee, ankle and wrist joints in the sagittal plane.

  8. Recurrence Quantification of Fractal Structures

    PubMed Central

    Webber, Charles L.

    2012-01-01

    By definition, fractal structures possess recurrent patterns. At different levels repeating patterns can be visualized at higher magnifications. The purpose of this chapter is threefold. First, general characteristics of dynamical systems are addressed from a theoretical mathematical perspective. Second, qualitative and quantitative recurrence analyses are reviewed in brief, but the reader is directed to other sources for explicit details. Third, example mathematical systems that generate strange attractors are explicitly defined, giving the reader the ability to reproduce the rich dynamics of continuous chaotic flows or discrete chaotic iterations. The challenge is then posited for the reader to study for themselves the recurrent structuring of these different dynamics. With a firm appreciation of the power of recurrence analysis, the reader will be prepared to turn their sights on real-world systems (physiological, psychological, mechanical, etc.). PMID:23060808

  9. [Annexins and recurrent pregnancy loss].

    PubMed

    Udry, Sebastián; Aranda, Federico; Latino, Omar; Larrañaga, Gabriela de

    2013-01-01

    Recurrent Pregnancy Loss (RPL) affects public health and directly compromises the quality of life of hundreds of women, with a detrimental effect on their physical and mental health. Approximately 50% of RPL are not associated to any of the currently known etiology and will be considered idiopathic. Recently, it has been demonstrated that the expression of annexin 5 (ANXA5), a protein found on the trophoblastic surface, plays a fundamental role in the development of pregnancy due to its immunomodulator and anticoagulant function at the placentary level. Some genetic haplotypes of ANXA5 are associated to alterations in the expression of this gene, such as haplotype M2 which is associated to a decrease in the expression of ANXA5. The presence of this haplotype is related to the following conditions occurring during pregnancy: RPL, foetal intrauterine growth restriction, low child weight at birth, preeclampsia and maternal pulmonary thromboembolism. This review describes the structure, function and genetic expression of ANXA5, as well as its possible implication in RPL. PMID:24152411

  10. The recurrent carpal tunnel syndrome.

    PubMed

    Kern, B C; Brock, M; Rudolph, K H; Logemann, H

    1993-01-01

    Sixteen out of 720 patients with carpal tunnel syndrome who had undergone surgery since 1979 were reoperated for a "recurrence" (2.2%). Twelve of these patients had been originally operated on in our department. Thus, our own recurrence rate is 1.7%. Three patients deteriorated following surgery, 6 had an unsatisfactory improvement, and in 7 the symptoms recurred after initial improvement. Eight of the reoperated patients had a predisposing disease (terminal renal insufficiency, insulin-dependent diabetes mellitus, acromegaly). In 10 of the 16 cases the initial operation had been carried out by surgeons in the first three years of training. Reoperation revealed incomplete splitting of the transverse carpal ligament in 10 cases, compression of the median nerve by the scar in 4, injury of the muscular branch in 1, and an anatomical variant as cause of incomplete decompression in 1 patient. "Recurrences" after carpal tunnel surgery are predominantly due to inadequacies of the first procedure. A remarkable number of patients (50%) has predisposing diseases. Interfascicular or epineural neurolysis and complete exposure and neurolysis of the median nerve and its branches is necessary only in cases of recurrence. Their omission at the first surgery does not result in an increased recurrence rate. Our observations indicate that the number of operations for recurrent carpal tunnel syndrome can probably be reduced when the first operation is performed with care and experience. Patients with carpal tunnel syndrome secondary to a systemic disease are particularly at risk.

  11. Recurrent miscarriage: causes, evaluation and management.

    PubMed

    Garrido-Gimenez, Carmen; Alijotas-Reig, Jaume

    2015-03-01

    Recurrent miscarriage is frustrating for the physician and a heartbreaking experience for the patient. Approximately 5% of couples trying to conceive have two consecutive miscarriages. Despite a thorough study of patients, the aetiology of this common obstetric complication is unknown in 50% of cases. Known causes include abnormal chromosomes, endocrinological disorders and uterine abnormalities. Although antiphospholipid antibodies have been demonstrated in miscarriages, the role played by alloimmune mechanisms remains unclear. New immunological approaches such as natural killer cells, regulatory T cells, tumour necrosis factor α, cell-derived microparticles, leptin, certain glycoproteins and cytokines should be considered. The management of thyroid diseases and immunological disorders is continuously evolving. Several genetic diagnostic procedures such as parental karyotyping and preimplantation genetic screening should probably not be used routinely. Antiphopholipid syndrome and some recurrent miscarriage-related endocrinological disorders can be effectively treated. Finally, new therapeutic approaches and the pleiotropic effects of old ones have led to improved fetal-maternal outcomes.

  12. Recurrent events and the exploding Cox model

    PubMed Central

    Gjessing, Håkon K.; Røysland, Kjetil; Pena, Edsel A.; Aalen, Odd O.

    2014-01-01

    Counting process models have played an important role in survival and event history analysis for more than 30 years. Nevertheless, almost all models that are being used have a very simple structure. Analyzing recurrent events invites the application of more complex models with dynamic covariates. We discuss how to define valid models in such a setting. One has to check carefully that a suggested model is well defined as a stochastic process. We give conditions for this to hold. Some detailed discussion is presented in relation to a Cox type model, where the exponential structure combined with feedback lead to an exploding model. In general, counting process models with dynamic covariates can be formulated to avoid explosions. In particular, models with a linear feedback structure do not explode, making them useful tools in general modeling of recurrent events. PMID:20625827

  13. Parallel first-order linear recurrence solver

    SciTech Connect

    Meyer, G.G.L.; Podrazik, L.

    1987-04-01

    In this paper the authors present a parallel procedure for the solution of first-order linear recurrence systems of size N when the number or processors rho is small in relation to N. They show that when 1 < rho/sup 2/ less than or equal to N, a first-order linear recurrence system of size N can be solved in 5(N - 1)(rho + 1) steps on a p processor SIMD machine and at most 5(N - 1/2)/(rho + 3/2) steps on a p processor MIMD machine. As a special case, they show that their approach precisely achieves the lower bound 2(N - 1)/(rho + 1) for solving the parallel prefix problem on a p processor machine.

  14. Patterns and Timing of Recurrence After Temozolomide-Based Chemoradiation for Glioblastoma

    SciTech Connect

    Milano, Michael T.; Okunieff, Paul; Donatello, Rosemary S.; Mohile, Nimish A.; Sul, Joohee; Walter, Kevin A.; Korones, David N.

    2010-11-15

    Purpose: To determine recurrence patterns of glioblastoma treated with temozolomide-based chemoradiation. Methods: Pretreatment and serial posttreatment magnetic resonance imaging scans of 54 patients were retrospectively evaluated. Central recurrence (i.e., local progression) and the development of new (i.e., interval appearance of discrete enhancing lesion) in-field, marginal, and distant recurrences were assessed, with the pattern of recurrence of individual lesions defined relative to the 95% isodose line (D{sub 95}). Distant recurrences were defined as lesions completely outside D{sub 95}, marginal recurrences crossed D{sub 95}, and in-field recurrences were completely inside D{sub 95}. Results: At a median follow-up of 17 months, 39 of 54 (72%) patients developed recurrent glioblastoma. Among these 39 patients, central recurrence occurred in 80% (at a median of 7 months from diagnosis); new in-field recurrence developed in 33% (at a median of 14 months); marginal recurrences developed in 15% (at a median of 18 months); and distant recurrences developed in 20% (at a median of 11 months). The actuarial rates of central, new in-field, marginal, distant, and any new recurrences at 1-year were 46%, 15%, 3%, 14%, and 25% respectively, whereas at 2 years, the rates were 68%, 60%, 32%, 28%, and 66%, reflecting an increasing probability of new lesions developing at later time points. Ten patients developed subependymal recurrences, of whom 7 developed multiple subependymal lesions. Conclusions: Whereas central recurrence of glioblastoma treated with radiation and temozolomide predominates and persists over time, new in-field, marginal, and distant recurrences commonly develop, particularly at later time points in patients with longer survival.

  15. [Recurrent spontaneous abortions].

    PubMed

    Salat-Baroux, J

    1988-01-01

    The process of fertilization in humans, is remarkably inefficient. Spontaneous abortion is estimated to be between 15 and 20% of all clinical pregnancies, and the early spontaneous abortion rate is closer to 30-50% of fertilized ova. Not all authors agree on the definition of "recurrent spontaneous abortion" (RSA), so the frequency of repeated pregnancy wastage is difficult to determine; from empirically derived data, it has been estimated to range between 0.4 and 0.8%. Because of the various etiologies of RSA, their association in determining an abortive event, it is difficult to evaluate their exact incidence. Moreover, their is no prospective study on this subject, so it is advisable to distinguish between the admitted causes, the likely factors, and the etiologies to be evaluated. In the first group, the congenital or acquired müllerian anomalies (especially the septate uterus), represent about 25% of the RSA, but a lot of problems concerning the physiopathology are still debated, even if the rate of pregnancies after surgery ranges around 50% in certain series. On the other hand, the genetic factors, identified especially with the banding technique, are undeniable: however, although the rate of chromosomal aberrations in the offspring (Monosomy X, Trisony 16, Triploidy) is very high (50 to 60% of spontaneous abortions in the first trimester of pregnancy), when couples with usual abortions are subjected to karyotypic analysis, genetic anomalies (especially translocations) are been noted in only 6.2% of the women and 2.6% of the men. In the second group, the infective factors (chlamydiae, toxoplasma and mycoplasma) are difficult to analyse since the serology is not sufficient without a real proof of an endometrial colonization. Among the endocrinological causes, the classical luteal phase deficiency remains a subject of controversy (estimated between 3 and 30%) not only for the establishment of the diagnosis, but also for the efficiency of progesterone

  16. The use of a sternothyroid muscle flap to prevent the re-recurrence of a recurrent tracheoesophageal fistula found 10 years after the primary repair.

    PubMed

    Takayasu, Hajime; Masumoto, Kouji; Ishikawa, Miki; Sasaki, Takato; Ono, Kentaro

    2016-12-01

    Recurrent tracheoesophageal fistula (TEF) is still difficult to diagnose and repair. In almost all cases, recurrence appears relatively soon after the primary surgery. We herein describe a case of recurrent TEF that appeared 10 years after the primary repair. At 2 years of age, the patient suffered from mental retardation due to encephalitis and developed a hiatus hernia with gastro-esophageal reflux. He underwent the repair of a hiatus hernia and fundoplication at 3 years of age. However, the hiatus hernia recurred 6 months after the operation. The patient suffered from recurrent pneumonia for 6 years after the appearance of the recurrent hiatus hernia. At 9 years of age, he was hospitalized frequently due to recurrent severe pneumonia. After admission at 9 years of age, an endoscopic study under general anesthesia was performed and revealed subglottic stenosis and a dilated esophagus with a recurrent hiatus hernia. Tracheotomy or laryngotracheal separation was first planned in order to improve his upper airway and facilitate the safer repair of the recurrent hiatus hernia. After laryngotracheal separation, the patient still suffered from severe pneumonia. In addition, a small volume of nutritional supplement was aspirated from the tracheostomy. Thus, recurrent TEF was suspected. Tests using dye under both esophagoscopy and bronchoscopy confirmed recurrent TEF. The fistula recurred in the cervical area because of the elevation of the esophagus due to the recurrent hiatus hernia. The fistula was surgically closed, with a sternothyroid muscle flap to prevent re-recurrence. At 4 months after this operation, the recurrent hiatus hernia was repaired. Thereafter, the patient's respiratory symptoms showed a dramatic improvement. The patient is now doing well and free from further recurrences of TEF and hiatus hernia at 2 years after the final operation. PMID:27589983

  17. Potential Interest in Circulating miR-BART17-5p As a Post-Treatment Biomarker for Prediction of Recurrence in Epstein-Barr Virus-Related Nasopharyngeal Carcinoma

    PubMed Central

    Hirai, Nobuyuki; Wakisaka, Naohiro; Kondo, Satoru; Aga, Mitsuharu; Moriyama-Kita, Makiko; Ueno, Takayoshi; Nakanishi, Yosuke; Endo, Kazuhira; Sugimoto, Hisashi; Murono, Shigeyuki; Sato, Hiroshi; Yoshizaki, Tomokazu

    2016-01-01

    Objectives Epstein-Barr virus (EBV)-related micoRNAs (miRNAs), BamHI-A rightward transcripts (BART)-miRNAs, are released in a stable form from viable cells, which are abundant in patients with EBV-positive nasopharyngeal carcinoma (NPC). We estimated copy numbers of circulating miR-BART2-5p, miR-BART17-5p, and miR-BART18-5p as well as BamHI-W DNA as biomarkers. Materials and Methods Serums from 31 EBV-positive (confirmed by in situ hybridization for EBV-encoded small RNAs) NPC patients and 40 non-NPC controls were analyzed. Among the 31 NPC patients, serums at the initial diagnosis and three months after treatment were obtained from 20 patients, and serums only at three months after treatment were obtained from 11 patients. Results The sensitivity/specificity of circulating BamHI-W DNA, miR-BART2-5p, miR-BART17-5p, and miR-BART18-5p for the diagnosis of NPC before treatment were 100 / 100, 85 / 85, 60 / 95, and 25 / 100%, respectively. For BamHI-W DNA, NPC patients with stage IV disease had significantly higher copy numbers than those with I-III. Copy numbers decreased significantly post-treatment. In contrast, copy numbers of the three BART-miRNAs showed no significant correlation with the clinical stage at diagnosis or any significant post-treatment change. After treatment, BamHI-W DNA and miR-BART17-5p were detected in 5 and 6 cases out of 11 patients with recurrent or residual tumors, respectively. However, BamHI-W DNA and miR-BART17-5p were absent in all 20 patients without relapse or residual tumors. Conclusion The copy number of circulating BamHI-W DNA is a more useful biomarker for the initial diagnosis of NPC than the three BART-miRNAs examined. Post-treatment detection of miR-BART17-5p is a potential biomarker of a poor prognosis. PMID:27684719

  18. Recurrence of sickness absence due to common mental disorders

    PubMed Central

    Bültmann, Ute; Roelen, Corné A. M.; Hoedeman, Rob; van der Klink, Jac J. L.; Groothoff, Johan W.

    2010-01-01

    Purpose Common mental disorders (CMDs) are an important cause of work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. This study examines the recurrence risk of sickness absence due to CMDs. Methods A cohort of 9,904 employees with a sickness absence due to CMDs, working in the Dutch Post or Telecommunication company, was studied over a 7-year period. Recurrence was defined as the start of at least one new episode of sickness absence with CMDs after complete return to work for at least 28 days. The recurrence density (RD) of sickness absence with CMDs was calculated per 1,000 person-years. Results Of the 9,904 employees with a first absence due to CMDs 1,925 (19%) had a recurrence, 90% of recurrences occurred within 3 years. The RD of sickness absence due to CMDs was 84.5 employees per 1,000 person-years (95% CI = 80.7–88.3). The RD of sickness absence due to CMDs was similar in women and in men. In men, depressive symptoms were related to higher recurrence of sickness absence due to CMDs than distress symptoms and adjustment disorders. In women, no difference by diagnostic category was found. Conclusions Employees with a previous episode of sickness absence with CMDs are at increased risk of recurrent sickness absence with CMDs. Relapse prevention consultations are recommended for a period of 3 years after return to work. PMID:20449605

  19. The recurrence rate of stones following ESWL.

    PubMed

    Köhrmann, K U; Rassweiler, J; Alken, P

    1993-01-01

    With extracorporeal shockwave lithotripsy (ESWL) stone fragmentation and the potential creation of residual stones has become an integral part of the treatment strategy. Therefore true recurrence, regrowth and pseudo-recurrence determine the rate of new stone formation. In unselected series the overall recurrence rate after ESWL varies between 6% after 1 year and 20% after 4 years. The comparison between the recurrence rate after ESWL and the natural recurrence rate reveals that the results of ESWL are better than expected. Lithotripsy has no special effect on true stone recurrence, and even pseudo-recurrence is of minor clinical significance.

  20. Divergent clonal selection dominates medulloblastoma at recurrence.

    PubMed

    Morrissy, A Sorana; Garzia, Livia; Shih, David J H; Zuyderduyn, Scott; Huang, Xi; Skowron, Patryk; Remke, Marc; Cavalli, Florence M G; Ramaswamy, Vijay; Lindsay, Patricia E; Jelveh, Salomeh; Donovan, Laura K; Wang, Xin; Luu, Betty; Zayne, Kory; Li, Yisu; Mayoh, Chelsea; Thiessen, Nina; Mercier, Eloi; Mungall, Karen L; Ma, Yusanne; Tse, Kane; Zeng, Thomas; Shumansky, Karey; Roth, Andrew J L; Shah, Sohrab; Farooq, Hamza; Kijima, Noriyuki; Holgado, Borja L; Lee, John J Y; Matan-Lithwick, Stuart; Liu, Jessica; Mack, Stephen C; Manno, Alex; Michealraj, K A; Nor, Carolina; Peacock, John; Qin, Lei; Reimand, Juri; Rolider, Adi; Thompson, Yuan Y; Wu, Xiaochong; Pugh, Trevor; Ally, Adrian; Bilenky, Mikhail; Butterfield, Yaron S N; Carlsen, Rebecca; Cheng, Young; Chuah, Eric; Corbett, Richard D; Dhalla, Noreen; He, An; Lee, Darlene; Li, Haiyan I; Long, William; Mayo, Michael; Plettner, Patrick; Qian, Jenny Q; Schein, Jacqueline E; Tam, Angela; Wong, Tina; Birol, Inanc; Zhao, Yongjun; Faria, Claudia C; Pimentel, José; Nunes, Sofia; Shalaby, Tarek; Grotzer, Michael; Pollack, Ian F; Hamilton, Ronald L; Li, Xiao-Nan; Bendel, Anne E; Fults, Daniel W; Walter, Andrew W; Kumabe, Toshihiro; Tominaga, Teiji; Collins, V Peter; Cho, Yoon-Jae; Hoffman, Caitlin; Lyden, David; Wisoff, Jeffrey H; Garvin, James H; Stearns, Duncan S; Massimi, Luca; Schüller, Ulrich; Sterba, Jaroslav; Zitterbart, Karel; Puget, Stephanie; Ayrault, Olivier; Dunn, Sandra E; Tirapelli, Daniela P C; Carlotti, Carlos G; Wheeler, Helen; Hallahan, Andrew R; Ingram, Wendy; MacDonald, Tobey J; Olson, Jeffrey J; Van Meir, Erwin G; Lee, Ji-Yeoun; Wang, Kyu-Chang; Kim, Seung-Ki; Cho, Byung-Kyu; Pietsch, Torsten; Fleischhack, Gudrun; Tippelt, Stephan; Ra, Young Shin; Bailey, Simon; Lindsey, Janet C; Clifford, Steven C; Eberhart, Charles G; Cooper, Michael K; Packer, Roger J; Massimino, Maura; Garre, Maria Luisa; Bartels, Ute; Tabori, Uri; Hawkins, Cynthia E; Dirks, Peter; Bouffet, Eric; Rutka, James T; Wechsler-Reya, Robert J; Weiss, William A; Collier, Lara S; Dupuy, Adam J; Korshunov, Andrey; Jones, David T W; Kool, Marcel; Northcott, Paul A; Pfister, Stefan M; Largaespada, David A; Mungall, Andrew J; Moore, Richard A; Jabado, Nada; Bader, Gary D; Jones, Steven J M; Malkin, David; Marra, Marco A; Taylor, Michael D

    2016-01-21

    The development of targeted anti-cancer therapies through the study of cancer genomes is intended to increase survival rates and decrease treatment-related toxicity. We treated a transposon-driven, functional genomic mouse model of medulloblastoma with 'humanized' in vivo therapy (microneurosurgical tumour resection followed by multi-fractionated, image-guided radiotherapy). Genetic events in recurrent murine medulloblastoma exhibit a very poor overlap with those in matched murine diagnostic samples (<5%). Whole-genome sequencing of 33 pairs of human diagnostic and post-therapy medulloblastomas demonstrated substantial genetic divergence of the dominant clone after therapy (<12% diagnostic events were retained at recurrence). In both mice and humans, the dominant clone at recurrence arose through clonal selection of a pre-existing minor clone present at diagnosis. Targeted therapy is unlikely to be effective in the absence of the target, therefore our results offer a simple, proximal, and remediable explanation for the failure of prior clinical trials of targeted therapy. PMID:26760213

  1. Divergent clonal selection dominates medulloblastoma at recurrence

    PubMed Central

    Morrissy, A. Sorana; Garzia, Livia; Shih, David J. H.; Zuyderduyn, Scott; Huang, Xi; Skowron, Patryk; Remke, Marc; Cavalli, Florence M. G.; Ramaswamy, Vijay; Lindsay, Patricia E.; Jelveh, Salomeh; Donovan, Laura K.; Wang, Xin; Luu, Betty; Zayne, Kory; Li, Yisu; Mayoh, Chelsea; Thiessen, Nina; Mercier, Eloi; Mungall, Karen L.; Ma, Yusanne; Tse, Kane; Zeng, Thomas; Shumansky, Karey; Roth, Andrew J. L.; Shah, Sohrab; Farooq, Hamza; Kijima, Noriyuki; Holgado, Borja L.; Lee, John J. Y.; Matan-Lithwick, Stuart; Liu, Jessica; Mack, Stephen C.; Manno, Alex; Michealraj, K. A.; Nor, Carolina; Peacock, John; Qin, Lei; Reimand, Juri; Rolider, Adi; Thompson, Yuan Y.; Wu, Xiaochong; Pugh, Trevor; Ally, Adrian; Bilenky, Mikhail; Butterfield, Yaron S. N.; Carlsen, Rebecca; Cheng, Young; Chuah, Eric; Corbett, Richard D.; Dhalla, Noreen; He, An; Lee, Darlene; Li, Haiyan I.; Long, William; Mayo, Michael; Plettner, Patrick; Qian, Jenny Q.; Schein, Jacqueline E.; Tam, Angela; Wong, Tina; Birol, Inanc; Zhao, Yongjun; Faria, Claudia C.; Pimentel, José; Nunes, Sofia; Shalaby, Tarek; Grotzer, Michael; Pollack, Ian F.; Hamilton, Ronald L.; Li, Xiao-Nan; Bendel, Anne E.; Fults, Daniel W.; Walter, Andrew W.; Kumabe, Toshihiro; Tominaga, Teiji; Collins, V. Peter; Cho, Yoon-Jae; Hoffman, Caitlin; Lyden, David; Wisoff, Jeffrey H.; Garvin, James H.; Stearns, Duncan S.; Massimi, Luca; Schüller, Ulrich; Sterba, Jaroslav; Zitterbart, Karel; Puget, Stephanie; Ayrault, Olivier; Dunn, Sandra E.; Tirapelli, Daniela P. C.; Carlotti, Carlos G.; Wheeler, Helen; Hallahan, Andrew R.; Ingram, Wendy; MacDonald, Tobey J.; Olson, Jeffrey J.; Van Meir, Erwin G.; Lee, Ji-Yeoun; Wang, Kyu-Chang; Kim, Seung-Ki; Cho, Byung-Kyu; Pietsch, Torsten; Fleischhack, Gudrun; Tippelt, Stephan; Ra, Young Shin; Bailey, Simon; Lindsey, Janet C.; Clifford, Steven C.; Eberhart, Charles G.; Cooper, Michael K.; Packer, Roger J.; Massimino, Maura; Garre, Maria Luisa; Bartels, Ute; Tabori, Uri; Hawkins, Cynthia E.; Dirks, Peter; Bouffet, Eric; Rutka, James T.; Wechsler-Reya, Robert J.; Weiss, William A.; Collier, Lara S.; Dupuy, Adam J.; Korshunov, Andrey; Jones, David T. W.; Kool, Marcel; Northcott, Paul A.; Pfister, Stefan M.; Largaespada, David A.; Mungall, Andrew J.; Moore, Richard A.; Jabado, Nada; Bader, Gary D.; Jones, Steven J. M.; Malkin, David; Marra, Marco A.; Taylor, Michael D.

    2016-01-01

    The development of targeted anti-cancer therapies through the study of cancer genomes is intended to increase survival rates and decrease treatment-related toxicity. We treated a transposon–driven, functional genomic mouse model of medulloblastoma with ‘humanized’ in vivo therapy (microneurosurgical tumour resection followed by multi-fractionated, image-guided radiotherapy). Genetic events in recurrent murine medulloblastoma exhibit a very poor overlap with those in matched murine diagnostic samples (<5%). Whole-genome sequencing of 33 pairs of human diagnostic and post-therapy medulloblastomas demonstrated substantial genetic divergence of the dominant clone after therapy (<12% diagnostic events were retained at recurrence). In both mice and humans, the dominant clone at recurrence arose through clonal selection of a pre-existing minor clone present at diagnosis. Targeted therapy is unlikely to be effective in the absence of the target, therefore our results offer a simple, proximal, and remediable explanation for the failure of prior clinical trials of targeted therapy. PMID:26760213

  2. Systematic review on the recurrence of postoperative nausea and vomiting after a first episode in the recovery room – implications for the treatment of PONV and related clinical trials

    PubMed Central

    Eberhart, Leopold HJ; Frank, Silke; Lange, Henning; Morin, Astrid M; Scherag, André; Wulf, Hinnerk; Kranke, Peter

    2006-01-01

    Background Despite the presence of a plethora of publications on the prevention of postoperative nausea and vomiting (PONV) only little is known how to treat established symptoms. Besides the high effort of performing these efficacy trials (much more patients must give their consent than are actually included in a study) and ethical concerns, little is known about the rate of re-occurring PONV/vomiting after placebo. As a consequence investigators will have difficulties defining a clinically relevant effect for the new treatment which is crucial for any planning. A quantitative systematic review was performed in order to provide more reliable estimates of the incidence of re-occurring PONV/vomiting after placebo and to help investigators defining a clinically relevant treatment effect. Methods A systematic search of the literature was performed using an extended search strategy of a previous review. Data on the recurrence of PONV (any nausea or emetic symptom) and vomiting (retching or vomiting) was extracted from published reports treating PONV with placebo and unpublished results from two observational trials where no treatment was given. A nonlinear random effects model was used to calculate estimates of the recurrence of symptoms and their 95%-confidence intervals (95%-CI). Results A total of 29 trials (including the unpublished data) were eligible for the calculations. Depending on the length of observation after administering placebo or no treatment the recurrence rate of PONV was between 65% (95%-CI: 53%...75%) and 84% (95%-CI: 73%...91%) and that of vomiting was between 65% (95%-CI: 44%...81%) and 78% (95%-CI: 59%...90%). Conclusion Almost all trials showed a considerable and consistently high rate of recurrence of emetic symptoms after placebo highlighting the need for a consequent antiemetic treatment. Future (placebo) controlled efficacy trials may use the presented empirical estimates for defining clinically relevant effects and for statistical power

  3. Recurrence of hepatitis C after liver transplantation

    PubMed Central

    Vinaixa, Carmen; Rubín, Angel; Aguilera, Victoria; Berenguer, Marina

    2013-01-01

    Recurrence of hepatitis C virus (HCV) infection following liver transplantation is a major source of morbidity and mortality. The natural history of hepatitis C in the transplant setting is shortened. Overall, one third of HCV-infected recipients have developed allograft cirrhosis due to HCV recurrence by the 5th-7th year post-transplantation. The most significant variables which determine disease progression are the use of organs from old donors, the use of an inadequate immunosuppression (too low, inducing treatment rejection episodes, too potent or too rapidly changing), and the presence of comorbid conditions that also impact the quality of the graft (biliary complications, metabolic syndrome). The only factor consistently shown to modify the natural history of recurrent disease is antiviral therapy. A sustained viral response, achieved by one third of those treated with dual therapy, is associated with improved histology, reduced liver-related complications and increased survival. Variables associated with enhanced viral response with dual therapy include an adequate genetic background (IL28B C/C of both donor and recipient), good treatment adherence (full doses of ribavirin, treatment duration), lack of graft cirrhosis at baseline, and viral genotype non-1. Data with triple therapy are encouraging. Response rates of about 60% at end-of-therapy have been described. Drug-drug interactions with calcineurin inhibitors are present but easily manageable with strict trough levels monitoring. Side effects are frequent and severe, particularly anemia, infections and acute renal insufficiency. In the future new oral antivirals will likely prevent viral reinfection. In this review, we will cover the most significant but also controversial aspects regarding recurrent HCV infection, including the natural history, retransplantation, antiviral therapy, and outcome in HIV-HCV patients. PMID:24714603

  4. Nonfunctioning giant pituitary adenomas: Invasiveness and recurrence

    PubMed Central

    Landeiro, José Alberto; Fonseca, Elissa Oliveira; Monnerat, Andrea Lima Cruz; Taboada, Giselle Fernandes; Cabral, Gustavo Augusto Porto Sereno; Antunes, Felippe

    2015-01-01

    Background: We report our surgical series of 35 patients with giant nonfunctioning pituitary adenomas (GNFPA). We analyzed the rule of Ki-67 antigen expression in predicting recurrence. Methods: Thirty-five patients were operated between 2000 and 2010. Suprassellar extension of the tumors were classified according to Hardy and Mohr based on magnetic resonance (MR) studies. Pituitary endocrine function and MR scans were assessed preoperatively and at 1, 6, and 12 months postoperatively. Immunohistochemical studies were based in regard to the expression of the proliferative Ki-67 index and the hormonal receptor for luteinizing hormone, follicle stimulating hormone, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, and prolactin. Tumors specimens were obtained from 35 patients with GNFPA. Endoscopic transsphenoidal surgery was the approach of choice. Results: Thirty-five patients were submitted to 49 surgeries, 44 (89.8%) were transsphenoidal and 5 (10.2%) were transcranial. The most frequent preoperative complaints were visual acuity impairment and visual field defect in 25 (71.2%) and 23 (65.7%) cases, respectively. Improvement of visual acuitiy and visual field deficit after surgery was seen in 20 (80%) and 17 (73.9%) patients, respectively. Endocrinological deficits were encountered in 20 patients (57.1%). After surgery, 18 patients (51.4%) required hormonal replacement. Three patients had visual symptoms related to pituitary apoplexy and recovered after surgery. The Ki-67 labeling index (LI) ranged from <1% to 4.8%. The rate of recurrence in tumors with Ki-67 <3% was 7.7% (2 patients), Ki-67 >3% was present in 5 patients and the recurrence committed 3 patients. Conclusion: In our series, regardless the improvement of visual function and compressing symptoms, 5 patients with expression of Ki-67 LI more than 3% experienced a recurrence. PMID:26674325

  5. RECURRENT NOVAE IN M31

    SciTech Connect

    Shafter, A. W.; Henze, M.; Rector, T. A.; Schweizer, F.; Hornoch, K.; Orio, M.; Pietsch, W.; Darnley, M. J.; Williams, S. C.; Bode, M. F.; Bryan, J.

    2015-02-01

    The reported positions of 964 suspected nova eruptions in M31 recorded through the end of calendar year 2013 have been compared in order to identify recurrent nova (RN) candidates. To pass the initial screen and qualify as a RN candidate, two or more eruptions were required to be coincident within 0.′1, although this criterion was relaxed to 0.′15 for novae discovered on early photographic patrols. A total of 118 eruptions from 51 potential RN systems satisfied the screening criterion. To determine what fraction of these novae are indeed recurrent, the original plates and published images of the relevant eruptions have been carefully compared. This procedure has resulted in the elimination of 27 of the 51 progenitor candidates (61 eruptions) from further consideration as RNe, with another 8 systems (17 eruptions) deemed unlikely to be recurrent. Of the remaining 16 systems, 12 candidates (32 eruptions) were judged to be RNe, with an additional 4 systems (8 eruptions) being possibly recurrent. It is estimated that ∼4% of the nova eruptions seen in M31 over the past century are associated with RNe. A Monte Carlo analysis shows that the discovery efficiency for RNe may be as low as 10% that for novae in general, suggesting that as many as one in three nova eruptions observed in M31 arise from progenitor systems having recurrence times ≲100 yr. For plausible system parameters, it appears unlikely that RNe can provide a significant channel for the production of Type Ia supernovae.

  6. Shortest recurrence periods of novae

    SciTech Connect

    Kato, Mariko; Saio, Hideyuki; Hachisu, Izumi; Nomoto, Ken'ichi

    2014-10-01

    Stimulated by the recent discovery of the 1 yr recurrence period nova M31N 2008-12a, we examined the shortest recurrence periods of hydrogen shell flashes on mass-accreting white dwarfs (WDs). We discuss the mechanism that yields a finite minimum recurrence period for a given WD mass. Calculating the unstable flashes for various WD masses and mass accretion rates, we identified a shortest recurrence period of about two months for a non-rotating 1.38 M {sub ☉} WD with a mass accretion rate of 3.6 × 10{sup –7} M {sub ☉} yr{sup –1}. A 1 yr recurrence period is realized for very massive (≳ 1.3 M {sub ☉}) WDs with very high accretion rates (≳ 1.5 × 10{sup –7} M {sub ☉} yr{sup –1}). We revised our stability limit of hydrogen shell burning, which will be useful for binary evolution calculations toward Type Ia supernovae.

  7. Treatment of recurrent vulvovaginal candidiasis.

    PubMed

    Ringdahl, E N

    2000-06-01

    Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year or at least three episodes unrelated to antibiotic therapy occur within one year. Although greater than 50 percent of women more than 25 years of age develop vulvovaginal candidiasis at some time, fewer than 5 percent of these women experience recurrences. Clinical evaluation of recurrent episodes is essential. Patients who self-diagnose may miss other causes or concurrent infections. Known etiologies of recurrent vulvovaginal candidiasis include treatment-resistant Candida species other than Candida albicans, frequent antibiotic therapy, contraceptive use, compromise of the immune system, sexual activity and hyperglycemia. If microscopic examination of vaginal secretions in a potassium hydroxide preparation is negative but clinical suspicion is high, fungal cultures should be obtained. After the acute episode has been treated, subsequent prophylaxis (maintenance therapy) is important. Because many patients experience recurrences once prophylaxis is discontinued, long-term therapy may be warranted. Patients are more likely to comply when antifungal therapy is administered orally, but oral treatment carries a greater potential for systemic toxicity and drug interactions.

  8. [Pediatric clubfoot : Treatment of recurrence].

    PubMed

    Radler, C; Mindler, G T

    2016-10-01

    Over the last 10 years the Ponseti method has become established as the gold standard for initial treatment of clubfeet nearly worldwide. Nevertheless, there are considerable fluctuations regarding the authenticity and quality in the application of the Ponseti method. Especially the efforts to ensure and promote compliance with the foot abduction brace and subsequently the recurrence rate show great variation. As a result, we are still faced with a significant number of recurrent or residual clubfeet. In recent years it has been shown in high-volume clinics that even these can almost always be successfully treated with recasting and with minor interventions, such as anterior tibial tendon transfer and lengthening of the Achilles tendon. More invasive surgical procedures are only very rarely indicated and are reserved for severe recurrence in previously surgically treated and secondary clubfeet. PMID:27577568

  9. Recurrent abdominal pain during childhood.

    PubMed Central

    Scott, R. B.

    1994-01-01

    Recurrent abdominal pain is a common presenting complaint among children. A thorough history and physical examination and limited laboratory investigation should enable a physician to make a positive diagnosis of "functional" recurrent abdominal pain in 90% to 95% of cases; an organic cause is identified in only 5% to 10%. The care and thoroughness of the history and physical examination establish the physician's credibility; explaining the clinical basis for the diagnosis and educating the child and parents on what is known about the condition reassures the parents. PMID:8199511

  10. Lapatinib in Treating Young Patients With Recurrent or Refractory Central Nervous System Tumors

    ClinicalTrials.gov

    2014-05-07

    Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Ependymoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Oligodendroglioma

  11. Prognostic factors in recurrent glioblastoma patients treated with bevacizumab.

    PubMed

    Schaub, Christina; Tichy, Julia; Schäfer, Niklas; Franz, Kea; Mack, Frederic; Mittelbronn, Michel; Kebir, Sied; Thiepold, Anna-Luisa; Waha, Andreas; Filmann, Natalie; Banat, Mohammed; Fimmers, Rolf; Steinbach, Joachim P; Herrlinger, Ulrich; Rieger, Johannes; Glas, Martin; Bähr, Oliver

    2016-08-01

    The value of bevacizumab (BEV) in recurrent glioblastoma is unclear. Imaging parameters and progression-free survival (PFS) are problematic endpoints. Few data exist on clinical factors influencing overall survival (OS) in unselected patients with recurrent glioblastoma exposed to BEV. We retrospectively analyzed 174 patients with recurrent glioblastoma treated with BEV at two German brain tumor centers. We evaluated general patient characteristics, MGMT status, pretreatment, concomitant oncologic treatment and overall survival. Karnofsky performance score, number of prior chemotherapies, number of prior recurrences and combined treatment with irinotecan (IRI) were significantly associated with OS in univariate analysis. We did not find differences in OS related to sex, age, histology, MGMT status, prior surgical treatment or number of prior radiotherapies. Combined treatment with IRI and higher KPS both remained significantly associated with prolonged survival in multivariate analysis, but patients receiving IRI co-treatment had less advanced disease. Grouping into clinically relevant categories revealed an OS of 16.9 months from start of BEV in patients with first recurrence and KPS ≥ 80 % (n = 25). In contrast, in patients with second recurrence and KPS < 80 %, OS was 3.6 months (n = 27). Our observational data support an early use of BEV in patients with good performance status. The benefit of co-treatment with IRI in our cohort seems to be the result of biased patient recruitment. PMID:27193554

  12. Research on recurrent pregnancy complications: a clinician's perspective.

    PubMed

    Smulian, John C

    2007-07-01

    Research on recurrent pregnancy complications is essential to help clinicians provide appropriate counselling and guide the management of patients with a history of adverse pregnancy outcomes. However, recurrence research is complex, in both its execution and interpretation. The paucity of appropriate data sets accessible for study of recurrent pregnancy outcomes presents significant challenges in performing recurrence research. This is further compounded by the different perspectives on recurrence between epidemiologists and clinicians. The interpretation of risk, whether it is absolute risk, relative risk or population-attributable fraction, underlies the often opposing perspectives of researchers and clinicians. Because clinicians acutely feel the need to provide appropriate counselling and management strategies when there has been a previous pregnancy complication, it is necessary that all those involved in research and care for these women work together to address gaps in our knowledge for recurrent pregnancy outcomes. In this way, we can develop a better understanding of disease processes, counsel patients better, design management plans and, ultimately, achieve better outcomes for our patients.

  13. [Radiodiagnosis of recurrences of lymphogranulomatosis].

    PubMed

    Mendeleev, I M; Miasnikov, A A; Balashov, A T; Polezhaev, Iu N

    1988-01-01

    The authors discuss the role and place of chest x-ray tomography, scintigraphy with 67Ga-citrate, ultrasonic investigation, angiography, angioscintigraphy, computed tomography, scintigraphy of the liver and bones in the diagnosis of recurrences of Hodgkin's disease and in control of a progress of disease. Indications for a successive use of one or the other method have been defined.

  14. Onychomycosis: Strategies to Minimize Recurrence.

    PubMed

    Gupta, Aditya K; Elewski, Boni E; Rosen, Ted; Caldwell, Bryan; Pariser, David M; Kircik, Leon H; Bhatia, Neal; Tosti, Antonella

    2016-03-01

    Recurrence (relapse or re-infection) in onychomycosis is common, occurring in 10% to 53% of patients. However, data on prevalence is limited as few clinical studies follow patients beyond 12 months. It has been suggested that recurrence after continuous terbinafine treatment may be less common than with intermittent or continuous itraconazole therapy, probably due to the fungicidal activity of terbinafine, although these differences tended not to be significant. Relapse rates also increase with time, peaking at month 36. Although a number of factors have been suggested to play a role in recurrence, only the co-existence of diabetes has been shown to have a significant impact. Data with topical therapy is sparse; a small study showed amorolfine prophylaxis may delay recurrence. High concentrations of efinaconazole have been reported in the nail two weeks' post-treatment suggesting twice monthly prophylaxis with topical treatments may be a realistic option, and may be an important consideration in diabetic patients with onychomycosis. Data suggest that prophylaxis may need to be continued for up to three years for optimal effect. Treating tinea pedis and any immediate family members is also critical. Other preventative strategies include avoiding communal areas where infection can spread (such as swimming pools), and decontaminating footwear. PMID:26954312

  15. Recurrent Processing during Object Recognition

    PubMed Central

    O’Reilly, Randall C.; Wyatte, Dean; Herd, Seth; Mingus, Brian; Jilk, David J.

    2013-01-01

    How does the brain learn to recognize objects visually, and perform this difficult feat robustly in the face of many sources of ambiguity and variability? We present a computational model based on the biology of the relevant visual pathways that learns to reliably recognize 100 different object categories in the face of naturally occurring variability in location, rotation, size, and lighting. The model exhibits robustness to highly ambiguous, partially occluded inputs. Both the unified, biologically plausible learning mechanism and the robustness to occlusion derive from the role that recurrent connectivity and recurrent processing mechanisms play in the model. Furthermore, this interaction of recurrent connectivity and learning predicts that high-level visual representations should be shaped by error signals from nearby, associated brain areas over the course of visual learning. Consistent with this prediction, we show how semantic knowledge about object categories changes the nature of their learned visual representations, as well as how this representational shift supports the mapping between perceptual and conceptual knowledge. Altogether, these findings support the potential importance of ongoing recurrent processing throughout the brain’s visual system and suggest ways in which object recognition can be understood in terms of interactions within and between processes over time. PMID:23554596

  16. Recurrent Education. A Resource Guide.

    ERIC Educational Resources Information Center

    Rochte, Newton C.

    To assist both practitioner and reader to find answers to questions on the theory and practice of recurrent education, this resource guide compiles 715 abstracts of relevant articles, books, and monographs, from many countries. Descriptors and identifiers, used in computer searches to identify the materials, are arranged alphabetically in the…

  17. [Recurrent erysipelas and cellulitis: management].

    PubMed

    Zürcher, Sven; Trellu, Laurence Toutous

    2015-04-01

    Erysipelas and infectious cellulitis are skin infections that develop following the entry of bacteria through gaps in the skin. The most common complication is recurrence. Control of predisposing factors remains essential to prevent it. Prophylactic antibiotics are sometimes prescribed, but this approach is based on small studies and expert opinion. This article reflects the current state of knowledge and the standard of care.

  18. Genetics Home Reference: recurrent hydatidiform mole

    MedlinePlus

    ... Rashid Y, Sheridan E, Bonthron DT. Genetic and epigenetic analysis of recurrent hydatidiform mole. Hum Mutat. 2009 ... on PubMed Nguyen NM, Slim R. Genetics and Epigenetics of Recurrent Hydatidiform Moles: Basic Science and Genetic ...

  19. 14 CFR 91.1107 - Recurrent training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Recurrent training. 91.1107 Section 91.1107... Management § 91.1107 Recurrent training. (a) Each program manager must ensure that each crewmember receives recurrent training and is adequately trained and currently proficient for the type aircraft and...

  20. 14 CFR 121.427 - Recurrent training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Recurrent training. 121.427 Section 121.427..., FLAG, AND SUPPLEMENTAL OPERATIONS Training Program § 121.427 Recurrent training. (a) Recurrent training must ensure that each crew member or dispatcher is adequately trained and currently proficient...

  1. 14 CFR 135.351 - Recurrent training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Recurrent training. 135.351 Section 135.351... AND ON DEMAND OPERATIONS AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Training § 135.351 Recurrent training. (a) Each certificate holder must ensure that each crewmember receives recurrent...

  2. Balanced feedforward inhibition and dominant recurrent inhibition in olfactory cortex.

    PubMed

    Large, Adam M; Vogler, Nathan W; Mielo, Samantha; Oswald, Anne-Marie M

    2016-02-23

    Throughout the brain, the recruitment of feedforward and recurrent inhibition shapes neural responses. However, disentangling the relative contributions of these often-overlapping cortical circuits is challenging. The piriform cortex provides an ideal system to address this issue because the interneurons responsible for feedforward and recurrent inhibition are anatomically segregated in layer (L) 1 and L2/3 respectively. Here we use a combination of optical and electrical activation of interneurons to profile the inhibitory input received by three classes of principal excitatory neuron in the anterior piriform cortex. In all classes, we find that L1 interneurons provide weaker inhibition than L2/3 interneurons. Nonetheless, feedforward inhibitory strength covaries with the amount of afferent excitation received by each class of principal neuron. In contrast, intracortical stimulation of L2/3 evokes strong inhibition that dominates recurrent excitation in all classes. Finally, we find that the relative contributions of feedforward and recurrent pathways differ between principal neuron classes. Specifically, L2 neurons receive more reliable afferent drive and less overall inhibition than L3 neurons. Alternatively, L3 neurons receive substantially more intracortical inhibition. These three features--balanced afferent drive, dominant recurrent inhibition, and differential recruitment by afferent vs. intracortical circuits, dependent on cell class--suggest mechanisms for olfactory processing that may extend to other sensory cortices.

  3. Intraoperative radiation therapy in recurrent ovarian cancer

    SciTech Connect

    Yap, O.W. Stephanie . E-mail: stbeast@stanford.edu; Kapp, Daniel S.; Teng, Nelson N.H.; Husain, Amreen

    2005-11-15

    Purpose: To evaluate disease outcomes and complications in patients with recurrent ovarian cancer treated with cytoreductive surgery and intraoperative radiation therapy (IORT). Methods and Materials: A retrospective study of 24 consecutive patients with ovarian carcinoma who underwent secondary cytoreduction and intraoperative radiation therapy at our institution between 1994 and 2002 was conducted. After optimal cytoreductive surgery, IORT was delivered with orthovoltage X-rays (200 kVp) using individually sized and beveled cone applications. Outcomes measures were local control of disease, progression-free interval, overall survival, and treatment-related complications. Results: Of these 24 patients, 22 were available for follow-up analysis. Additional treatment at the time of and after IORT included whole abdominopelvic radiation, 9; pelvic or locoregional radiation, 5; chemotherapy, 6; and no adjuvant treatment, 2. IORT doses ranged from 9-14 Gy (median, 12 Gy). The anatomic sites treated were pelvis (sidewalls, vaginal cuff, presacral area, anterior pubis), para-aortic and paracaval lymph node beds, inguinal region, or porta hepatitis. At a median follow-up of 24 months, 5 patients remain free of disease, whereas 17 patients have recurred, of whom 4 are alive with disease and 13 died from disease. Five patients recurred within the radiation fields for a locoregional relapse rate of 32% and 12 patients recurred at distant sites with a median time to recurrence of 13.7 months. Five-year overall survival was 22% with a median survival of 26 months from time of IORT. Nine patients (41%) experienced Grade 3 toxicities from their treatments. Conclusion: In carefully selected patients with locally recurrent ovarian cancer, combined IORT and tumor reductive surgery is reasonably tolerated and may contribute to achieving local control and disease palliation.

  4. Training recurrent networks by Evolino.

    PubMed

    Schmidhuber, Jürgen; Wierstra, Daan; Gagliolo, Matteo; Gomez, Faustino

    2007-03-01

    In recent years, gradient-based LSTM recurrent neural networks (RNNs) solved many previously RNN-unlearnable tasks. Sometimes, however, gradient information is of little use for training RNNs, due to numerous local minima. For such cases, we present a novel method: EVOlution of systems with LINear Outputs (Evolino). Evolino evolves weights to the nonlinear, hidden nodes of RNNs while computing optimal linear mappings from hidden state to output, using methods such as pseudo-inverse-based linear regression. If we instead use quadratic programming to maximize the margin, we obtain the first evolutionary recurrent support vector machines. We show that Evolino-based LSTM can solve tasks that Echo State nets (Jaeger, 2004a) cannot and achieves higher accuracy in certain continuous function generation tasks than conventional gradient descent RNNs, including gradient-based LSTM.

  5. Clopidogrel-Induced Recurrent Polyarthritis

    PubMed Central

    Harburger, Joseph; Stallings, Gary; Agrawal, Nikhil; Garg, Jalaj

    2013-01-01

    Clopidogrel is an oral thienopyridine and together with aspirin is a component of dual antiplatelet therapy for the prevention of stent thrombosis after intracoronary stent placement. The common adverse effects from its use are an increased risk of bleeding, neutropenia, and rash. Arthralgia and backache are also known to occur with its use. There have been case reports linking arthritis with the use of clopidogrel. We describe the case of a 64-year-old man who reported symptoms of fever and joint pains following initiation of therapy with clopidogrel. Acute-phase reactants were elevated. Laboratory and radiologic testing were unremarkable. Incidentally, he reported experiencing a similar arthritis after he received a loading dose of clopidogrel prior to a diagnostic coronary angiography in the past. The symptoms improved dramatically on discontinuation of clopidogrel. There was no recurrence of symptoms with prasugrel. This describes possibly the second incidence of recurrent arthritis with clopidogrel therapy. PMID:26425581

  6. Training recurrent networks by Evolino.

    PubMed

    Schmidhuber, Jürgen; Wierstra, Daan; Gagliolo, Matteo; Gomez, Faustino

    2007-03-01

    In recent years, gradient-based LSTM recurrent neural networks (RNNs) solved many previously RNN-unlearnable tasks. Sometimes, however, gradient information is of little use for training RNNs, due to numerous local minima. For such cases, we present a novel method: EVOlution of systems with LINear Outputs (Evolino). Evolino evolves weights to the nonlinear, hidden nodes of RNNs while computing optimal linear mappings from hidden state to output, using methods such as pseudo-inverse-based linear regression. If we instead use quadratic programming to maximize the margin, we obtain the first evolutionary recurrent support vector machines. We show that Evolino-based LSTM can solve tasks that Echo State nets (Jaeger, 2004a) cannot and achieves higher accuracy in certain continuous function generation tasks than conventional gradient descent RNNs, including gradient-based LSTM. PMID:17298232

  7. [Belated recurrence of anaphylactic reaction].

    PubMed

    Schelske, Christa

    2012-01-30

    Anaphylaxis is a serious allergic reaction, and the incidence is increasing. A biphasic anaphylactic reaction with recurrent symptoms after a long period without any symptoms is described. Guidelines recommend adrenalin as first line treatment, but some patients are only treated with glucocorticoids and antihistamines. The importance of correct treatment with adrenalin, instructions in correct self administration with adrenalin after admission, and examination for allergies is underlined.

  8. Origin of Tumor Recurrence After Intensity Modulated Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma

    SciTech Connect

    Raktoe, Sawan A.S.; Dehnad, Homan; Raaijmakers, Cornelis P.J.; Braunius, Weibel; Terhaard, Chris H.J.

    2013-01-01

    Purpose: To model locoregional recurrences of oropharyngeal squamous cell carcinomas (OSCC) treated with primary intensity modulated radiation therapy (IMRT) in order to find the origins from which recurrences grow and relate their location to original target volume borders. Methods and Materials: This was a retrospective analysis of OSCC treated with primary IMRT between January 2002 and December 2009. Locoregional recurrence volumes were delineated on diagnostic scans and coregistered rigidly with treatment planning computed tomography scans. Each recurrence was analyzed with two methods. First, overlapping volumes of a recurrence and original target were measured ('volumetric approach') and assessed as 'in-field', 'marginal', or 'out-field'. Then, the center of mass (COM) of a recurrence volume was assumed as the origin from where a recurrence expanded, the COM location was compared with original target volume borders and assessed as 'in-field', 'marginal', or 'out-field'. Results: One hundred thirty-one OSCC were assessed. For all patients alive at the end of follow-up, the mean follow-up time was 40 months (range, 12-83 months); 2 patients were lost to follow-up. The locoregional recurrence rate was 27%. Of all recurrences, 51% were local, 23% were regional, and 26% had both local and regional recurrences. Of all recurrences, 74% had imaging available for assessment. Regarding volumetric analysis of local recurrences, 15% were in-field gross tumor volume (GTV), and 65% were in-field clinical tumor volume (CTV). Using the COM approach, we found that 70% of local recurrences were in-field GTV and 90% were in-field CTV. Of the regional recurrences, 25% were volumetrically in-field GTV, and using the COM approach, we found 54% were in-field GTV. The COM of local out-field CTV recurrences were maximally 16 mm outside CTV borders, whereas for regional recurrences, this was 17 mm. Conclusions: The COM model is practical and specific for recurrence assessment. Most

  9. Recurrent Benign Salivary Gland Neoplasms.

    PubMed

    Witt, Robert Lee; Nicolai, Piero

    2016-01-01

    The most important causes of recurrence of benign pleomorphic adenoma are enucleation with intraoperative spillage and incomplete tumor excision in association with characteristic histologic findings for the lesion (incomplete pseudocapsule and the presence of pseudopodia). Most recurrent pleomorphic adenomas (RPAs) are multinodular. MRI is the imaging method of choice for their assessment. Nerve integrity monitoring may reduce morbidity of RPA surgery. Although treatment of RPA must be individualized, total parotidectomy is generally recommended given the multicentricity of the lesions. However, surgery alone may be inadequate for controlling RPA over the long term. There is growing evidence from retrospective series that postoperative radiotherapy results in significantly better local control. A high percentage of RPAs are incurable. All patients should therefore be informed about the possibility of needing multiple treatment procedures, with possible impairment of facial nerve function, and radiation therapy for RPA. Reappearance of Warthin tumor is a metachronous occurrence of a new focus or residual incomplete excision of all primary multicentric foci of Warthin tumor. Selected cases can be observed. Conservative surgical management can include partial superficial parotidectomy or extracapsular dissection. Not uncommonly, other major and minor salivary gland neoplasms, including myoepithelioma, basal cell adenoma, oncocytoma, canalicular adenoma, cystadenoma, and ductal papilloma, follow an indolent course after surgical resection, with rare cases of recurrence.

  10. Erlotinib and Temozolomide in Treating Young Patients With Recurrent or Refractory Solid Tumors

    ClinicalTrials.gov

    2013-06-04

    Previously Treated Childhood Rhabdomyosarcoma; Recurrent Childhood Brain Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Medulloblastoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent Osteosarcoma

  11. Stress Reduction in Improving Quality of Life in Patients With Recurrent Gynecologic or Breast Cancer

    ClinicalTrials.gov

    2015-10-08

    Anxiety Disorder; Depression; Fatigue; Leydig Cell Tumor; Ovarian Sarcoma; Ovarian Stromal Cancer; Pain; Peritoneal Carcinomatosis; Pseudomyxoma Peritonei; Recurrent Breast Cancer; Recurrent Cervical Cancer; Recurrent Endometrial Carcinoma; Recurrent Fallopian Tube Cancer; Recurrent Gestational Trophoblastic Tumor; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Primary Peritoneal Cavity Cancer; Recurrent Uterine Sarcoma; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer

  12. Obatoclax and Bortezomib in Treating Patients With Aggressive Relapsed or Recurrent Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2015-12-03

    Adult Non-Hodgkin Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma

  13. Anatomic factors associated with recurrent pregnancy loss.

    PubMed

    Propst, A M; Hill, J A

    2000-01-01

    Anatomic uterine defects appear to predispose women to reproductive difficulties, including first- and second-trimester pregnancy losses, higher rates of preterm labor and birth, and abnormal fetal presentation. These anatomic abnormalities can be classified as congenital, including müllerian and diethylstilbestrol-related abnormalities, or acquired, such as intrauterine adhesions or leiomyomata. In women with three or more consecutive spontaneous abortions who underwent hysterosalpingography or hysteroscopic examination of their uteri, mullerian anomalies have been found in 8 to 10%. Women with mullerian anomalies may be predisposed to recurrent pregnancy loss because of inadequate vascularity to the developing embryo and placenta, reduced intraluminal volume, or cervical incompetence. The reproductive history of most women with a müllerian anomaly is poor, especially for women with a uterine septum, the most common mullerian anomaly. Recurrent pregnancy losses resulting from a uterine septum, bicornuate uterus, intrauterine adhesions, and fibroids are amenable to surgical correction. Women with müllerian anomaly and a history of second-trimester pregnancy losses may benefit from a prophylactic cervical cerclage.

  14. Risk Factors for Recurrent Lumbar Disc Herniation

    PubMed Central

    Huang, Weimin; Han, Zhiwei; Liu, Jiang; Yu, Lili; Yu, Xiuchun

    2016-01-01

    Abstract Recurrent lumbar disc herniation (rLDH) is a common complication following primary discectomy. This systematic review aimed to investigate the current evidence on risk factors for rLDH. Cohort or case-control studies addressing risk factors for rLDH were identified by search in Pubmed (Medline), Embase, Web of Science, and Cochrane library from inception to June 2015. Relevant results were pooled to give overall estimates if possible. Heterogeneity among studies was examined and publication bias was also assessed. A total of 17 studies were included in this systematic review. Risk factors that had significant relation with rLDH were smoking (OR 1.99, 95% CI 1.53–2.58), disc protrusion (OR 1.79, 95% CI 1.15–2.79), and diabetes (OR 1.19, 95% CI 1.06–1.32). Gender, BMI, occupational work, level, and side of herniation did not correlate with rLDH significantly. Based on current evidence, smoking, disc protrusion, and diabetes were predictors for rLDH. Patients with these risk factors should be paid more attention for prevention of recurrence after primary surgery. More evidence provided by high-quality observational studies is still needed to further investigate risk factors for rLDH. PMID:26765413

  15. Nitrergic Mechanisms for Management of Recurrent Priapism

    PubMed Central

    Anele, Uzoma A.; Burnett, Arthur L.

    2015-01-01

    Introduction Priapism is a condition involving prolonged penile erection unrelated to sexual interest or desire. The ischemic type, including its recurrent variant, is often associated with both physical and psychological complications. As such, management is of critical importance. Ideal therapies for recurrent priapism should address its underlying pathophysiology. Aim To review the available literature on priapism management approaches particularly related to nitrergic mechanisms. Methods A literature review of the pathophysiology and management of priapism was performed using PubMed. Main Outcome Measure Publications pertaining to mechanisms of the molecular pathophysiology of priapism. Results Nitrergic mechanisms are characterized as major players in the molecular pathophysiology of priapism. PDE5 inhibitors represent an available therapeutic option with demonstrated ability in attenuating these underlying nitrergic derangements. Several additional signaling pathways have been found to play a role in the molecular pathophysiology of priapism and have also been associated with these nitrergic mechanisms. Conclusion An increasing understanding of the molecular pathophysiology of priapism has led to the discovery of new potential targets. Several mechanism-based therapeutic approaches may become available in the future. PMID:26478814

  16. The causes of recurrent geomagnetic storms

    NASA Technical Reports Server (NTRS)

    Burlaga, L. F.; Lepping, R. P.

    1976-01-01

    The causes of recurrent geomagnetic activity were studied by analyzing interplanetary magnetic field and plasma data from earth-orbiting spacecraft in the interval from November 1973 to February 1974. This interval included the start of two long sequences of geomagnetic activity and two corresponding corotating interplanetary streams. In general, the geomagnetic activity was related to an electric field which was due to two factors: (1) the ordered, mesoscale pattern of the stream itself, and (2) random, smaller-scale fluctuations in the southward component of the interplanetary magnetic field Bz. The geomagnetic activity in each recurrent sequence consisted of two successive stages. The first stage was usually the most intense, and it occurred during the passage of the interaction region at the front of a stream. These large amplitudes of Bz were primarily produced in the interplanetary medium by compression of ambient fluctuations as the stream steepened in transit to 1 A.U. The second stage of geomagnetic activity immediately following the first was associated with the highest speeds in the stream.

  17. Magnetic resonance analysis of malignant transformation in recurrent glioma

    PubMed Central

    Jalbert, Llewellyn E.; Neill, Evan; Phillips, Joanna J.; Lupo, Janine M.; Olson, Marram P.; Molinaro, Annette M.; Berger, Mitchel S.; Chang, Susan M.; Nelson, Sarah J.

    2016-01-01

    Background Patients with low-grade glioma (LGG) have a relatively long survival, and a balance is often struck between treating the tumor and impacting quality of life. While lesions may remain stable for many years, they may also undergo malignant transformation (MT) at the time of recurrence and require more aggressive intervention. Here we report on a state-of-the-art multiparametric MRI study of patients with recurrent LGG. Methods One hundred and eleven patients previously diagnosed with LGG were scanned at either 1.5 T or 3 T MR at the time of recurrence. Volumetric and intensity parameters were estimated from anatomic, diffusion, perfusion, and metabolic MR data. Direct comparisons of histopathological markers from image-guided tissue samples with metrics derived from the corresponding locations on the in vivo images were made. A bioinformatics approach was applied to visualize and interpret these results, which included imaging heatmaps and network analysis. Multivariate linear-regression modeling was utilized for predicting transformation. Results Many advanced imaging parameters were found to be significantly different for patients with tumors that had undergone MT versus those that had not. Imaging metrics calculated at the tissue sample locations highlighted the distinct biological significance of the imaging and the heterogeneity present in recurrent LGG, while multivariate modeling yielded a 76.04% accuracy in predicting MT. Conclusions The acquisition and quantitative analysis of such multiparametric MR data may ultimately allow for improved clinical assessment and treatment stratification for patients with recurrent LGG. PMID:26911151

  18. Cognitive Adaptation Theory and Breast Cancer Recurrence: Are There Limits?

    ERIC Educational Resources Information Center

    Tomich, Patricia L.; Helgeson, Vicki S.

    2006-01-01

    Relations of the components of cognitive adaptation theory (self-esteem, optimism, control) to quality of life and benefit finding were examined for 70 women (91% Caucasian) diagnosed with Stage I, II, or III breast cancer over 5 years ago. Half of these women experienced a recurrence within the 5 years; the other half remained disease free. Women…

  19. Genetic segregation analysis of early-onset recurrent unipolar depression.

    PubMed Central

    Marazita, M L; Neiswanger, K; Cooper, M; Zubenko, G S; Giles, D E; Frank, E; Kupfer, D J; Kaplan, B B

    1997-01-01

    Major depression is a relatively common psychiatric disorder that can be quite debilitating. Family, twin, and adoption studies indicate that unipolar depression has both genetic and environmental components. Early age at onset and recurrent episodes in the proband each increase the familiarity of the illness. To investigate the potential genetic underpinnings of the disease, we have performed a complex segregation analysis on 832 individuals from 50 multigenerational families ascertained through a proband with early-onset recurrent unipolar major depression. The analysis was conducted by use of regressive models, to test a variety of hypotheses to explain the familial aggregation of recurrent unipolar depression. Analyses were conducted under two alternative definitions of affection status for the relatives of probands: (1) "narrow," in which relatives were assumed to be affected only if they were diagnosed with recurrent unipolar depression; and (2) "broad," in which relatives were assumed to be affected if diagnosed with any major affective illness. Under the narrow-definition assumption, the model that best explains these family data is a transmitted (although non-Mendelian) recessive major effect with significant residual parental effects on affection status. Under the broad-definition assumption, the best-fitting model is a Mendelian codominant major locus with significant residual parental and spousal effects. PMID:9399885

  20. Recurrent sinus pauses: an atypical presentation of temporal lobe epilepsy.

    PubMed

    Amor, Martin Miguel; Eltawansy, Sherif Ali; Osofsky, Jeffrey; Holland, Neil

    2014-01-01

    Autonomic dysfunction related to seizures may give rise to a broad spectrum of cardiovascular abnormalities. Among these, ictal bradycardia and conduction delays may be encountered. Failure to recognize these abnormalities may contribute to sudden, unexplained death in epilepsy patients. We report a case of a Haitian female with temporal lobe epilepsy associated with recurrent sinus pauses.

  1. Synthesis of recurrent neural networks for dynamical system simulation.

    PubMed

    Trischler, Adam P; D'Eleuterio, Gabriele M T

    2016-08-01

    We review several of the most widely used techniques for training recurrent neural networks to approximate dynamical systems, then describe a novel algorithm for this task. The algorithm is based on an earlier theoretical result that guarantees the quality of the network approximation. We show that a feedforward neural network can be trained on the vector-field representation of a given dynamical system using backpropagation, then recast it as a recurrent network that replicates the original system's dynamics. After detailing this algorithm and its relation to earlier approaches, we present numerical examples that demonstrate its capabilities. One of the distinguishing features of our approach is that both the original dynamical systems and the recurrent networks that simulate them operate in continuous time.

  2. Order patterns recurrence plots in the analysis of ERP data

    PubMed Central

    Marwan, Norbert; Kurths, Jürgen

    2007-01-01

    Recurrence quantification analysis (RQA) is an established tool for data analysis in various behavioural sciences. In this article we present a refined notion of RQA based on order patterns. The use of order patterns is commonplace in time series analysis. Exploiting this concept in combination with recurrence plots (RP) and their quantification (RQA) allows for advances in contemporary EEG research, specifically in the analysis of event related potentials (ERP), as the method is known to be robust against non-stationary data. The use of order patterns recurrence plots (OPRPs) on EEG data recorded during a language processing experiment exemplifies the potentials of the method. We could show that the application of RQA to ERP data allows for a considerable reduction of the number of trials required in ERP research while still maintaining statistical validity. PMID:19003502

  3. Recurrent pleomorphic adenoma of the palate in a child.

    PubMed

    Shaaban, H; Bruce, J; Davenport, P J

    2001-04-01

    A rare case of recurrent pleomorphic adenoma of the palate in a 9-year-old boy is presented. Pleomorphic adenoma is relatively rare in children compared with its incidence in adults. However, it is the most common benign epithelial tumour of the salivary glands. The majority of pleomorphic adenomata in children occur in the major salivary glands, mainly the parotid gland. Pleomorphic adenomata of the minor salivary glands are rare in children and mainly occur in the palatal glands. Of the few cases of pleomorphic adenoma of the palate reported in children, only one case showed recurrence of the tumour after primary excision. We present the second case of recurrent pleomorphic adenoma of the palate in a child.

  4. Detection of Recurrent Fluorescence Photons

    NASA Astrophysics Data System (ADS)

    Ebara, Yuta; Furukawa, Takeshi; Matsumoto, Jun; Tanuma, Hajime; Azuma, Toshiyuki; Shiromaru, Haruo; Hansen, Klavs

    2016-09-01

    We have detected visible photons emitted from the thermally populated electronic excited state, namely recurrent fluorescence (RF), of C6- stored in an electrostatic ion storage ring. Clear evidence is provided to distinguish RF from normal fluorescence, based on the temporal profile of detected photons synchronized with the revolution of C6- in the ring, for which the time scale is far longer than the lifetime of the intact photoexcited state. The relaxation (cooling) process via RF is likely to be commonplace for isolated molecular systems and crucial to the stabilization of molecules in interstellar environments.

  5. Recurrent corneal erosion: clinical features.

    PubMed

    Hope-Ross, M W; Chell, P B; Kervick, G N; McDonnell, P J

    1994-01-01

    The clinical features of a group of 30 patients with recalcitrant recurrent corneal erosions (i.e. those who failed to respond to conventional therapy) were evaluated. Associated ocular and facial abnormalities were documented. Meibomian gland dysfunction was present in all patients as manifest by dropout and inspissation of the meibomian glands, reduced tear film break-up time and debris in the tear film. Dropout of meibomian glands was present in 25 (83%) patients and was maximum in the medial half of the lid in 21 (84%) of these 25 patients. Tear film break-up time was reduced in all patients, being instant in 7 (23%), between 1 and 5 seconds in 22 (74%) and between 10 and 15 seconds in 1 (3%) patient. Superficial corneal abnormalities were present in 28 (93%) patients as manifest by maps, dots and fingerprints. Facial abnormalities such as telangiectasia, rhinophyma and acne rosacea were present in 22 (73%) patients. The findings of our study suggest an association between recalcitrant recurrent corneal erosions and meibomian gland dysfunction.

  6. Medical treatment of recurrent meningiomas.

    PubMed

    Chamberlain, Marc C; Barnholtz-Sloan, Jill S

    2011-10-01

    Meningiomas are the second most common primary brain tumor and are primarily treated with surgery (with or without embolization) and radiotherapy. Increasingly today, meningiomas undergo multiple resections and two radiotherapy treatments (either stereotactic or conventional external beam) before consideration for hormonal, chemotherapy or targeted therapy. The failure of hormonal and cytotoxic chemotherapy in the treatment of recurrent meningioma and increasing understanding of potential molecular targets in meningioma has resulted in multiple studies utilizing single-agent targeted therapy directed at biologically relevant signaling pathways, such as somatostatin (Sandostatin(®) LAR, SOM230c), PDGF (imatinib), EGF (erlotinib) and VEGF (sunitinib and vatalanib). Early results using a targeted approach have been modest at best and are often associated with significant toxicity. Consequently and at present, the brain tumor guidelines recognize only three medical therapies for inoperable and radiation-refractory meningiomas: hydroxyurea, IFN-α and Sandostatin LAR, a somatostatin analogue. Clearly, there remains an unmet need in neuro-oncology with respect to the medical treatment of recurrent meningiomas. PMID:21955199

  7. Differential equations, associators, and recurrences for amplitudes

    NASA Astrophysics Data System (ADS)

    Puhlfürst, Georg; Stieberger, Stephan

    2016-01-01

    We provide new methods to straightforwardly obtain compact and analytic expressions for ɛ-expansions of functions appearing in both field and string theory amplitudes. An algebraic method is presented to explicitly solve for recurrence relations connecting different ɛ-orders of a power series solution in ɛ of a differential equation. This strategy generalizes the usual iteration by Picard's method. Our tools are demonstrated for generalized hypergeometric functions. Furthermore, we match the ɛ-expansion of specific generalized hypergeometric functions with the underlying Drinfeld associator with proper Lie algebra and monodromy representations. We also apply our tools for computing ɛ-expansions for solutions to generic first-order Fuchsian equations (Schlesinger system). Finally, we set up our methods to systematically get compact and explicit α‧-expansions of tree-level superstring amplitudes to any order in α‧.

  8. Widespread Recurrent Evolution of Genomic Features

    PubMed Central

    Maeso, Ignacio; Roy, Scott William; Irimia, Manuel

    2012-01-01

    The recent explosion of genome sequences from all major phylogenetic groups has unveiled an unexpected wealth of cases of recurrent evolution of strikingly similar genomic features in different lineages. Here, we review the diverse known types of recurrent evolution in eukaryotic genomes, with a special focus on metazoans, ranging from reductive genome evolution to origins of splice-leader trans-splicing, from tandem exon duplications to gene family expansions. We first propose a general classification scheme for evolutionary recurrence at the genomic level, based on the type of driving force—mutation or selection—and the environmental and genomic circumstances underlying these forces. We then discuss various cases of recurrent genomic evolution under this scheme. Finally, we provide a broader context for repeated genomic evolution, including the unique relationship of genomic recurrence with the genotype–phenotype map, and the ways in which the study of recurrent genomic evolution can be used to understand fundamental evolutionary processes. PMID:22417916

  9. [Recurrent urological cancer--diagnose and treatment].

    PubMed

    Takeshima, H; Akaza, H

    1998-02-01

    Clinical efforts to spare bladder function even in the case of muscle invasive recurrent bladder cancer is taking. Early detection of recurrence is essential for bladder sparing, and both urinary NMP22 and BTA are thought to have potency to detect recurrence of bladder cancer earlier than urinary cytology. Intravesical administration of BCG for superficial bladder cancer and intraarterial injection of chemoagents (Methotrexate and Cisplatin) with radiation for muscle invasive bladder cancer are thought to play important roles in sparing the bladder. Early detection of recurrent prostate cancer is becoming easier by ultrasensitive PSA assay. Though the value of early detection of recurrence is not proven since the benefits of early hormonal treatment have not yet been established, that should be a good indicator to evaluate new and coming treatments and play a important role to develop an effective treatment for recurrent prostate cancer.

  10. Recurrence quantification analysis of chimera states

    NASA Astrophysics Data System (ADS)

    Santos, M. S.; Szezech, J. D.; Batista, A. M.; Caldas, I. L.; Viana, R. L.; Lopes, S. R.

    2015-10-01

    Chimera states, characterised by coexistence of coherence and incoherence in coupled dynamical systems, have been found in various physical systems, such as mechanical oscillator networks and Josephson-junction arrays. We used recurrence plots to provide graphical representations of recurrent patterns and identify chimera states. Moreover, we show that recurrence plots can be used as a diagnostic of chimera states and also to identify the chimera collapse.

  11. Recurrence of spinal schwannoma: Is it preventable?

    PubMed Central

    Senapati, Satya B.; Mishra, Sudhansu S.; Dhir, Manmath K.; Patnaik, Ashis; Panigrahi, Souvagya

    2016-01-01

    Spinal schwannomas account for about 25% of primary intradural spinal cord tumors in adult. The prognosis for spinal schwannomas is excellent in most cases. Complete resection is curative. However following subtotal removal, recurrence develops after several years. We describe a case of recurrent spinal schwannoma who had been operated twice before for same disease. The possible cause of recurrence and difficulties in reoperation are discussed.

  12. Quantum recurrences: probe to study quantum chaos

    PubMed

    Saif

    2000-11-01

    We study the phase space of periodically modulated gravitational cavity by means of quantum recurrence phenomena. We report that the quantum recurrences serve as a tool to connect phase space of the driven system with a spectrum in the quantum domain. With the help of quantum recurrences we investigate the quasienergy spectrum of the system for a certain fixed modulation strength. In addition, we study transition of spectrum from discrete to continuum as a function of modulation strength. PMID:11101963

  13. Recurrence of spinal schwannoma: Is it preventable?

    PubMed Central

    Senapati, Satya B.; Mishra, Sudhansu S.; Dhir, Manmath K.; Patnaik, Ashis; Panigrahi, Souvagya

    2016-01-01

    Spinal schwannomas account for about 25% of primary intradural spinal cord tumors in adult. The prognosis for spinal schwannomas is excellent in most cases. Complete resection is curative. However following subtotal removal, recurrence develops after several years. We describe a case of recurrent spinal schwannoma who had been operated twice before for same disease. The possible cause of recurrence and difficulties in reoperation are discussed. PMID:27695564

  14. Asymmetry of recurrent dynamics as a function of postural stance.

    PubMed

    King, Adam C; Wang, Zheng; Newell, Karl M

    2012-08-01

    This experiment was setup to investigate the deterministic and stochastic properties of the recurrent dynamics of the center of pressure trajectories of each leg (COP(left) and COP(right)) and whole-body (COP(net)) as a function of different foot positions in postural stance (side-by-side, staggered, and tandem standing) and the availability of visual information. The foot position of postural stance can induce degrees of asymmetry of postural instabilities as well as load on each leg that it was hypothesized would influence the deterministic and stochastic properties of COP fluctuations of each leg and of COP(net). Young adults performed two 60 s trials of quiet standing at each posture-vision condition. The availability of visual information increased COP path length, but had no effect on the recurrent dynamics of COP trajectories. Recurrence quantification analysis showed that recurrence, determinism, and entropy were dependent on the direction (AP/ML) of COP motion and foot position during postural stances. The degree of asymmetry between the left and right leg COP dynamics differed across all postural stances and COP(net) dynamics were more similar to those of the more loaded leg. The cross-recurrence quantification analysis also revealed asymmetries in the coordination coupling of AP/ML under each leg; although, these differences were markedly reduced in tandem postures. The findings support the postulation that the asymmetry generated through mechanical constraints (foot position and load) is related to asymmetrical recurrent dynamics of the individual leg and COP(net) based on the degree of postural instability.

  15. Palbociclib Isethionate in Treating Younger Patients With Recurrent, Progressive, or Refractory Central Nervous System Tumors

    ClinicalTrials.gov

    2016-10-19

    Childhood Choroid Plexus Tumor; Childhood Ependymoblastoma; Childhood Grade III Meningioma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Medulloepithelioma; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor

  16. Differences in risk factors for recurrent versus incident preterm delivery.

    PubMed

    Grantz, Katherine L; Hinkle, Stefanie N; Mendola, Pauline; Sjaarda, Lindsey A; Leishear, Kira; Albert, Paul S

    2015-07-15

    Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002-2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with multiplicative interactions between each preterm risk factor and prior preterm delivery status to explore whether risk factors varied between incident and recurrent preterm delivery at <37 weeks. Fewer second pregnancy factors were associated with recurrent preterm delivery, including alcohol, thyroid disease, and depression. Smoking was associated with increased risk for incident (relative risk (RR) = 1.95, 95% confidence interval (CI): 1.53, 2.49) but not recurrent (RR = 1.09, 95% CI: 0.71, 1.19) preterm delivery, whereas alcohol was associated with an increased risk for recurrent (RR = 2.38, 95% CI: 1.53, 3.71) but not incident (RR = 0.98, 95% CI: 0.67, 1.43; Pinteraction = 0.02 and <0.01) preterm delivery, respectively. Prior term delivery did not necessarily confer protection from known second pregnancy preterm delivery risk factors. In the setting of a prior preterm delivery, many risk factors did not persist. Prior preterm delivery history is important when assessing subsequent preterm delivery risk factors. PMID:26033931

  17. Differences in risk factors for recurrent versus incident preterm delivery.

    PubMed

    Grantz, Katherine L; Hinkle, Stefanie N; Mendola, Pauline; Sjaarda, Lindsey A; Leishear, Kira; Albert, Paul S

    2015-07-15

    Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002-2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with multiplicative interactions between each preterm risk factor and prior preterm delivery status to explore whether risk factors varied between incident and recurrent preterm delivery at <37 weeks. Fewer second pregnancy factors were associated with recurrent preterm delivery, including alcohol, thyroid disease, and depression. Smoking was associated with increased risk for incident (relative risk (RR) = 1.95, 95% confidence interval (CI): 1.53, 2.49) but not recurrent (RR = 1.09, 95% CI: 0.71, 1.19) preterm delivery, whereas alcohol was associated with an increased risk for recurrent (RR = 2.38, 95% CI: 1.53, 3.71) but not incident (RR = 0.98, 95% CI: 0.67, 1.43; Pinteraction = 0.02 and <0.01) preterm delivery, respectively. Prior term delivery did not necessarily confer protection from known second pregnancy preterm delivery risk factors. In the setting of a prior preterm delivery, many risk factors did not persist. Prior preterm delivery history is important when assessing subsequent preterm delivery risk factors.

  18. Differences in Risk Factors for Recurrent Versus Incident Preterm Delivery

    PubMed Central

    Grantz, Katherine L.; Hinkle, Stefanie N.; Mendola, Pauline; Sjaarda, Lindsey A.; Leishear, Kira; Albert, Paul S.

    2015-01-01

    Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002–2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with multiplicative interactions between each preterm risk factor and prior preterm delivery status to explore whether risk factors varied between incident and recurrent preterm delivery at <37 weeks. Fewer second pregnancy factors were associated with recurrent preterm delivery, including alcohol, thyroid disease, and depression. Smoking was associated with increased risk for incident (relative risk (RR) = 1.95, 95% confidence interval (CI): 1.53, 2.49) but not recurrent (RR = 1.09, 95% CI: 0.71, 1.19) preterm delivery, whereas alcohol was associated with an increased risk for recurrent (RR = 2.38, 95% CI: 1.53, 3.71) but not incident (RR = 0.98, 95% CI: 0.67, 1.43; Pinteraction = 0.02 and <0.01) preterm delivery, respectively. Prior term delivery did not necessarily confer protection from known second pregnancy preterm delivery risk factors. In the setting of a prior preterm delivery, many risk factors did not persist. Prior preterm delivery history is important when assessing subsequent preterm delivery risk factors. PMID:26033931

  19. A Brownian model for recurrent earthquakes

    USGS Publications Warehouse

    Matthews, M.V.; Ellsworth, W.L.; Reasenberg, P.A.

    2002-01-01

    We construct a probability model for rupture times on a recurrent earthquake source. Adding Brownian perturbations to steady tectonic loading produces a stochastic load-state process. Rupture is assumed to occur when this process reaches a critical-failure threshold. An earthquake relaxes the load state to a characteristic ground level and begins a new failure cycle. The load-state process is a Brownian relaxation oscillator. Intervals between events have a Brownian passage-time distribution that may serve as a temporal model for time-dependent, long-term seismic forecasting. This distribution has the following noteworthy properties: (1) the probability of immediate rerupture is zero; (2) the hazard rate increases steadily from zero at t = 0 to a finite maximum near the mean recurrence time and then decreases asymptotically to a quasi-stationary level, in which the conditional probability of an event becomes time independent; and (3) the quasi-stationary failure rate is greater than, equal to, or less than the mean failure rate because the coefficient of variation is less than, equal to, or greater than 1/???2 ??? 0.707. In addition, the model provides expressions for the hazard rate and probability of rupture on faults for which only a bound can be placed on the time of the last rupture. The Brownian relaxation oscillator provides a connection between observable event times and a formal state variable that reflects the macromechanics of stress and strain accumulation. Analysis of this process reveals that the quasi-stationary distance to failure has a gamma distribution, and residual life has a related exponential distribution. It also enables calculation of "interaction" effects due to external perturbations to the state, such as stress-transfer effects from earthquakes outside the target source. The influence of interaction effects on recurrence times is transient and strongly dependent on when in the loading cycle step pertubations occur. Transient effects may

  20. Poincare Recurrences and Topological Diversity

    NASA Astrophysics Data System (ADS)

    Kleban, M.; Porrati, M.; Rabadan, R.

    2004-10-01

    Finite entropy thermal systems undergo Poincaré recurrences. In the context of field theory, this implies that at finite temperature, timelike two-point functions will be quasi-periodic. In this note we attempt to reproduce this behavior using the AdS/CFT correspondence by studying the correlator of a massive scalar field in the bulk. We evaluate the correlator by summing over all the SL(2,Bbb Z) images of the BTZ spacetime. We show that all the terms in this sum receive large corrections after at certain critical time, and that the result, even if convergent, is not quasi-periodic. We present several arguments indicating that the periodicity will be very difficult to recover without an exact re-summation, and discuss several toy models which illustrate this. Finally, we consider the consequences for the information paradox.

  1. Recurrent Glioblastoma: Where we stand

    PubMed Central

    Roy, Sanjoy; Lahiri, Debarshi; Maji, Tapas; Biswas, Jaydip

    2015-01-01

    Current first-line treatment regimens combine surgical resection and chemoradiation for Glioblastoma that provides a slight increase in overall survival. Age on its own should not be used as an exclusion criterion of glioblastoma multiforme (GBM) treatment, but performance should be factored heavily into the decision-making process for treatment planning. Despite aggressive initial treatment, most patients develop recurrent diseases which can be treated with re-resection, systemic treatment with targeted agents or cytotoxic chemotherapy, reirradiation, or radiosurgery. Research into novel therapies is investigating alternative temozolomide regimens, convection-enhanced delivery, immunotherapy, gene therapy, antiangiogenic agents, poly ADP ribose polymerase inhibitors, or cancer stem cell signaling pathways. Given the aggressive and resilient nature of GBM, continued efforts to better understand GBM pathophysiology are required to discover novel targets for future therapy. PMID:26981507

  2. Recurrent pregnancy loss and obesity.

    PubMed

    Sugiura-Ogasawara, Mayumi

    2015-05-01

    Recurrent pregnancy loss (RPL) was defined as two or more miscarriages. Antiphospholipid syndrome, uterine anomalies, and parental chromosomal abnormalities, particularly translocation and abnormal embryonic karyotype, are identifiable causes of RPL. Obesity may increase the risk of sporadic miscarriage in pregnancies conceived spontaneously. Obesity with body mass index (BMI)>30 kg/m2 is an independent risk factor for further miscarriage with odds ratio 1.7-3.5 in patients with early RPL. Obesity is associated with euploid miscarriage. Unexplained RPL with euploid embryo might be a common disease caused by both polymorphisms of multiple susceptibility genes and lifestyle factors such as women's age, obesity, and smoking. Patients with a history of RPL were found to have a higher risk of cardiovascular disease, celiac disease, gastric ulcer, gastritis, and atopic dermatitis. No study has examined the effect of weight loss on the prevention of further miscarriage in patients with RPL.

  3. Thrombophilia and Recurrent Pregnancy Loss

    PubMed Central

    Abu-Heija, Adel

    2014-01-01

    The association between thrombophilia and recurrent pregnancy loss (RPL) has become an undisputed fact. Thorombophilia creates a hypercoaguable state which leads to arterial and/or venous thrombosis at the site of implantation or in the placental blood vessels. Anticoagulants are an effective treatment against RPL in women with acquired thrombophilia due to antiphospholipid syndrome. The results of the use of anticoagulants for treating RPL in women with inherited thrombophilia (IT) are encouraging, but recently four major multicentre studies have shown that fetal outcomes (determined by live birth rates) may not be as favourable as previously suggested. Although the reported side-effects for anticoagulants are rare and usually reversible, the current recommendation is not to use anticoagulants in women with RPL and IT, or for those with unexplained losses. This review examines the strength of the association between thrombophilia and RPL and whether the use of anticoagulants can improve fetal outcomes. PMID:24516750

  4. Recurrence of neuroleptic malignant syndrome.

    PubMed

    González-Blanco, Leticia; García-Prada, Hilario; Santamarina, Susana; Jiménez-Treviño, Luis; Bobes, Julio

    2013-01-01

    Neuroleptic malignant syndrome (NMS) is a rare idiosyncratic reaction associated with the use of neuroleptics that has an incidence of 0.02 to 3% among patients taking these drugs. This is a very serious complication with a mortality rate that reaches 10-20%. It is therefore very important to have high clinical suspicion and use appropriate criteria to objectify this clinical picture early, stopping the medication causing the picture and to avoid the subsequent complications as much as possible that would be responsible for both its mortality and sequels. We present that case of an 81-year old woman who was admitted to the Psychiatric Hospitalization Unit (PHU) for a depressive episode with psychotic symptoms who developed a neuroleptic malignant syndrome (NMS) when Haloperidol was introduced. After its suspension and subsequent clinical recovery, antipsychotic treatment with Risperidone was reintroduced and she suffered a recurrence of NMS. Finally, significant improvement was achieved with several sessions of electroshock therapy (EST).

  5. Recurrent Excitation in Neocortical Circuits

    NASA Astrophysics Data System (ADS)

    Douglas, Rodney J.; Koch, Christof; Mahowald, Misha; Martin, Kevan A. C.; Suarez, Humbert H.

    1995-08-01

    The majority of synapses in the mammalian cortex originate from cortical neurons. Indeed, the largest input to cortical cells comes from neighboring excitatory cells. However, most models of cortical development and processing do not reflect the anatomy and physiology of feedback excitation and are restricted to serial feedforward excitation. This report describes how populations of neurons in cat visual cortex can use excitatory feedback, characterized as an effective "network conductance," to amplify their feedforward input signals and demonstrates how neuronal discharge can be kept proportional to stimulus strength despite strong, recurrent connections that threaten to cause runaway excitation. These principles are incorporated into models of cortical direction and orientation selectivity that emphasize the basic design principles of cortical architectures.

  6. Chemoradiotherapy response in recurrent rectal cancer

    PubMed Central

    Yu, Stanley K T; Bhangu, Aneel; Tait, Diana M; Tekkis, Paris; Wotherspoon, Andrew; Brown, Gina

    2014-01-01

    The efficacy of response to preoperative chemoradiotherapy (CRT) in recurrent versus primary rectal cancer has not been investigated. We compared radiological downsizing between primary and recurrent rectal cancers following CRT and determined the optimal size reduction threshold for response validated by survival outcomes. The proportional change in tumor length for primary and recurrent rectal cancers following CRT was compared using the independent sample t-test. Overall survival (OS) was calculated using the Kaplan–Meier product limit method and differences between survival for tumor size reduction thresholds of 30% (response evaluation criteria in solid tumors [RECIST]), 40%, and 50% after CRT in primary and recurrent rectal cancer groups. A total of 385 patients undergoing CRT were analyzed, 99 with recurrent rectal cancer and 286 with primary rectal cancer. The mean proportional reduction in maximum craniocaudal length was significantly higher for primary rectal tumors (33%) compared with recurrent rectal cancer (11%) (P < 0.01). There was no difference in OS for either primary or recurrent rectal cancer when ≤30% or ≤40% definitions were used. However, for both primary and recurrent tumors, significant differences in median 3-year OS were observed when a RECIST cut-off of 50% was used. OS was 99% versus 77% in primary and 100% versus 42% in recurrent rectal cancer (P = 0.002 and P = 0.03, respectively). Only patients that demonstrated >50% size reduction showed a survival benefit. Recurrent rectal cancer appears radioresistant compared with primary tumors for tumor size after CRT. Further investigation into improving/intensifying chemotherapy and radiotherapy for locally recurrent rectal cancer is justified. PMID:24403010

  7. Local and global approaches to the problem of Poincaré recurrences. Applications in nonlinear dynamics

    NASA Astrophysics Data System (ADS)

    Anishchenko, V. S.; Boev, Ya. I.; Semenova, N. I.; Strelkova, G. I.

    2015-07-01

    We review rigorous and numerical results on the statistics of Poincaré recurrences which are related to the modern development of the Poincaré recurrence problem. We analyze and describe the rigorous results which are achieved both in the classical (local) approach and in the recently developed global approach. These results are illustrated by numerical simulation data for simple chaotic and ergodic systems. It is shown that the basic theoretical laws can be applied to noisy systems if the probability measure is ergodic and stationary. Poincaré recurrences are studied numerically in nonautonomous systems. Statistical characteristics of recurrences are analyzed in the framework of the global approach for the cases of positive and zero topological entropy. We show that for the positive entropy, there is a relationship between the Afraimovich-Pesin dimension, Lyapunov exponents and the Kolmogorov-Sinai entropy either without and in the presence of external noise. The case of zero topological entropy is exemplified by numerical results for the Poincare recurrence statistics in the circle map. We show and prove that the dependence of minimal recurrence times on the return region size demonstrates universal properties for the golden and the silver ratio. The behavior of Poincaré recurrences is analyzed at the critical point of Feigenbaum attractor birth. We explore Poincaré recurrences for an ergodic set which is generated in the stroboscopic section of a nonautonomous oscillator and is similar to a circle shift. Based on the obtained results we show how the Poincaré recurrence statistics can be applied for solving a number of nonlinear dynamics issues. We propose and illustrate alternative methods for diagnosing effects of external and mutual synchronization of chaotic systems in the context of the local and global approaches. The properties of the recurrence time probability density can be used to detect the stochastic resonance phenomenon. We also discuss how

  8. Uncertainty in recurrence rates of large magnitude events due to short historic catalogs

    NASA Astrophysics Data System (ADS)

    Mohammed, Tariq; Atkinson, Gail M.; Assatourians, Karen

    2014-07-01

    Seismic hazard analysis requires knowledge of the recurrence rates of large magnitude earthquakes that drive the hazard at low probabilities of interest for seismic design. Earthquake recurrence is usually determined through studies of the historic earthquake catalogue for a given region. Reliable historic catalogues generally span time periods of 100-200 years in North America, while large magnitude events (M ≥ 7) have recurrence rates on the order of hundreds or thousands of years in many areas, resulting in large uncertainty in recurrence rates for large events. Using Monte Carlo techniques and assuming typical recurrence parameters, we simulate earthquake catalogues that span long periods of time. We then split these catalogues into smaller catalogues spanning 100-200 years that mimic the length of historic catalogues. For each of these simulated "historic" catalogues, a recurrence rate for large magnitude events is determined. By comparing recurrence rates from one historic-length catalogue to another, we quantify the uncertainty associated with determining recurrence rates from short historic catalogues. The use of simulations to explore the uncertainty (rather than analytical solutions) allows us flexibility to consider issues such as the relative contributions of aleatory versus epistemic uncertainty, and the influence of fitting method, as well as lending insight into extreme-event statistics. The uncertainty in recurrence rates of large (M > 7) events is about a factor of two in regions of high seismicity, due to the shortness of historic catalogues. This uncertainty increases greatly with decreasing seismic activity. Uncertainty is dependent on the length of the catalogue as well as the fitting method used (least squares vs. maximum likelihood). Examination of 90th percentile recurrence rates reveals that epistemic uncertainty in the true parameters may cause recurrence rates determined from historic catalogues to be uncertain by a factor greater than

  9. Oxaliplatin in Treating Young Patients With Recurrent Solid Tumors That Have Not Responded to Previous Treatment

    ClinicalTrials.gov

    2013-06-04

    Childhood Central Nervous System Germ Cell Tumor; Childhood Extragonadal Germ Cell Tumor; Childhood Hepatoblastoma; Childhood Hepatocellular Carcinoma; Childhood High-grade Cerebral Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Malignant Ovarian Germ Cell Tumor; Childhood Malignant Testicular Germ Cell Tumor; Childhood Teratoma; Recurrent Adrenocortical Carcinoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Liver Cancer; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Colon Cancer; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Nasopharyngeal Cancer; Recurrent Neuroblastoma; Recurrent Osteosarcoma; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer

  10. Treatment for recurrent medulloblastoma with intrathecal liposomal cytarabine and systemic metronomic combination therapy.

    PubMed

    Nygaard, Randi; Kivivuori, Sanna-Maria

    2012-03-01

    The prognosis of recurrent medulloblastoma is dismal, with a median survival of less than 1 year. Our patient was initially diagnosed with high-risk medulloblastoma when he was 14 years old. He had a recurrence 18 months after the end of therapy. Recurrence treatment consisted of 13 intrathecal applications of liposomal cytarabine over an 18-month period, and oral metronomic antiangiogenic therapy with thalidomide, celecoxib, and etoposide. Side effects from the intrathecal treatment were most likely related to arachnoiditis despite prolonged prophylaxis with steroids. He also developed partial hearing loss. Neutropenia was the main side effect of the metronomic therapy. He remains alive, with a good quality of life and without evidence of disease 34 months from the start of recurrence therapy. This combination of local antineoplastic and systemic antiangiogenic therapy seems to be promising for recurrent medulloblastoma. However, more patients and standardized protocols are needed to verify the benefit of this combination therapy and to define the correct duration of treatment.

  11. [Prophylactic effect of UFT in combination with intravesical chemotherapy on the recurrence of superficial bladder tumor].

    PubMed

    Yoshida, O; Kakehi, Y; Nishio, Y; Tomoyoshi, T; Konami, T; Usui, T; Igawa, M; Takenaka, I; Fujita, K

    1992-12-01

    The influence of N1-(2-tetrahydrofuryl)-5-fluorouracil plus uracil (UFT) on the recurrence of superficial bladder tumors was evaluated in a randomized clinical study. Group A (n = 196) underwent transurethral resection (TUR) and the intravesical chemoprophylaxis, while group B (n = 193) received 400 mg per a day of UFT orally for 6 months in addition to the instillation therapy. These adjuvant therapy was started one week after TUR. Consequently, 30 patients in group B showed UFT-related toxicity and administration of UFT was discontinued in 10 of them. In addition, 87 patients in group B did not complete the 6-month course of UFT administration. Comparison of 2-year actuarial non-recurrence curves revealed no significant difference between groups A and B. However, UFT seemed to have a favorable prophylactic effect when recurrence rates were compared among those patients with recurrent tumors (generalized Wilcoxon: p = 0.1277), and those with recurrent multiple tumors (p = 0.0847).

  12. Dietary Lignan and Proanthocyanidin Consumption and Colorectal Adenoma Recurrence in the Polyp Prevention Trial

    PubMed Central

    Bobe, Gerd; Murphy, Gwen; Albert, Paul S.; Sansbury, Leah B.; Lanza, Elaine; Schatzkin, Arthur; Cross, Amanda J.

    2011-01-01

    Lignans and proanthocyanidins are plant polyphenols that have shown protective properties against colorectal neoplasms in some human studies. Using logistic regression, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) to prospectively evaluate the association between lignan and proanthocyanidin intake, estimated from databases linked to a food frequency questionnaire, and adenoma recurrence in 1,859 participants of the Polyp Prevention Trial. Overall, individual or total lignans or proanthocyanidins were not associated with colorectal adenoma recurrence. However, in sex-specific analyses, total lignan intake was positively associated with any adenoma recurrence in women (highest versus lowest lignan intake quartile OR = 2.07, 95% CI: 1.22-3.52, P trend = 0.004) but not in men (P interaction = 0.04). To conclude, dietary lignan and proanthocyanidin consumption was not generally related to colorectal adenoma recurrence; however, high lignan intake may increase the risk of adenoma recurrence in women. PMID:21618513

  13. Late breast recurrence after lumpectomy and irradiation

    SciTech Connect

    Kurtz, J.M.; Spitalier, J.M.; Amalric, R.

    1983-08-01

    For 276 patients with early breast cancer followed from 10 to 21 years after lumpectomy and radiotherapy, the recurrence rate in the treated breast was 15.6%, and 7.2% developed contralateral breast cancer. Only 63% of breast recurrences occurred within 5 years, and the remainder were late failures, with 5 of the 43 recurrences observed after 10 years. The proportion of failures occurring late was greater for T/sub 1/ than for T/sub 2/ tumors (53% vs 25%). Twenty-six percent of early recurrences were inoperable, and an adverse impact of early recurrence on 10-year survival was clearly demonstrable. Late recurrences were all operable and did not appear to be associated with decreased survival. Only 16 of the 36 patients (44%) with operable breast recurrence ever developed metastatic disease, and 5 year survival following salvage therapy was 62%. Although the treated breast remains at continuous cancer risk even beyond 5 years, the prognosis of late recurrence appears quite similar to that of contralateral breast cancer.

  14. 28 CFR 51.14 - Recurrent practices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Recurrent practices. 51.14 Section 51.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED General Provisions § 51.14 Recurrent practices. Where a jurisdiction implements a practice...

  15. Lesson Learned from (some) Recurrent Novae

    NASA Astrophysics Data System (ADS)

    Mason, E.; Walter, F. M.

    2014-12-01

    In this talk we present early decline and nebular spectra of the recurrent novae YY Dor and nova LMC 2009. These and a few other recurrent novae of the same type, share similar spectral characteristics and evolution. We will discuss those common features critically suggesting same white dwarf progenitor and post outburst phases for all of them.

  16. 14 CFR 121.427 - Recurrent training.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... required by §§ 121.421(b) and 121.422(b), respectively. (4) Approved recurrent CRM training. For flight... operational flight training (LOFT) session. The recurrent CRM training requirement does not apply until a person has completed the applicable initial CRM training required by §§ 121.419, 121.421, or 121.422....

  17. Local Recurrence After Uveal Melanoma Proton Beam Therapy: Recurrence Types and Prognostic Consequences

    SciTech Connect

    Caujolle, Jean-Pierre; Paoli, Vincent; Chamorey, Emmanuel; Maschi, Celia; Baillif, Stéphanie; Herault, Joël; Gastaud, Pierre; Hannoun-Levi, Jean Michel

    2013-04-01

    Purpose: To study the prognosis of the different types of uveal melanoma recurrences treated by proton beam therapy (PBT). Methods and Materials: This retrospective study analyzed 61 cases of uveal melanoma local recurrences on a total of 1102 patients treated by PBT between June 1991 and December 2010. Survival rates have been determined by using Kaplan-Meier curves. Prognostic factors have been evaluated by using log-rank test or Cox model. Results: Our local recurrence rate was 6.1% at 5 years. These recurrences were divided into 25 patients with marginal recurrences, 18 global recurrences, 12 distant recurrences, and 6 extrascleral extensions. Five factors have been identified as statistically significant risk factors of local recurrence in the univariate analysis: large tumoral diameter, small tumoral volume, low ratio of tumoral volume over eyeball volume, iris root involvement, and safety margin inferior to 1 mm. In the local recurrence-free population, the overall survival rate was 68.7% at 10 years and the specific survival rate was 83.6% at 10 years. In the local recurrence population, the overall survival rate was 43.1% at 10 years and the specific survival rate was 55% at 10 years. The multivariate analysis of death risk factors has shown a better prognosis for marginal recurrences. Conclusion: Survival rate of marginal recurrences is superior to that of the other recurrences. The type of recurrence is a clinical prognostic value to take into account. The influence of local recurrence retreatment by proton beam therapy should be evaluated by novel studies.

  18. High activity iodine 125 endocurietherapy for recurrent skull base tumors

    SciTech Connect

    Kumar, P.P.; Good, R.R.; Leibrock, L.G.; Mawk, J.R.; Yonkers, A.J.; Ogren, F.P.

    1988-04-15

    Experience with endocurietherapy of skull base tumors is reviewed. We present our cases of recurrent pituitary hemangiopericytoma, radiation-induced recurrent meningioma, recurrent clival chordoma, recurrent nasopharyngeal cancer involving the cavernous sinus, and recurrent parotid carcinoma of the skull base which were all successfully retreated with high-activity 125-iodine (I-125) permanent implantation.76 references.

  19. Interstitial Photodynamic Therapy in Treating Patients With Recurrent Head and Neck Cancer

    ClinicalTrials.gov

    2016-10-20

    Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Tongue Carcinoma

  20. Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors

    PubMed Central

    Ansa, Benjamin; Yoo, Wonsuk; Whitehead, Mary; Coughlin, Steven; Smith, Selina

    2015-01-01

    A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs). Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%), lack of physical activity (48.7%), and a high fat diet (63.2%) are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5%) agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9%) believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M2 reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M2 (p = 0.06); nearly all of the women (99.2%) answered “yes” to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05). These results provide information about AA BCSs’ beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity. PMID:26703650

  1. Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors.

    PubMed

    Ansa, Benjamin; Yoo, Wonsuk; Whitehead, Mary; Coughlin, Steven; Smith, Selina

    2016-01-01

    A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs). Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%), lack of physical activity (48.7%), and a high fat diet (63.2%) are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5%) agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9%) believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M² reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M² (p = 0.06); nearly all of the women (99.2%) answered "yes" to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05). These results provide information about AA BCSs' beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity. PMID:26703650

  2. Bone and Metabolic Markers in Women With Recurrent Calcium Stones

    PubMed Central

    Arrabal-Martin, Miguel; Arias-Santiago, Salvador

    2013-01-01

    Purpose The target of our work was to study several biochemical parameters in phospho-calcic and bone metabolism in blood and urine and the bone mineral density of women with recurrent calcium nephrolithiasis. Materials and Methods We conducted a cross-sectional study with a control group of 85 women divided into 3 groups: group 1 consisted of 25 women without a history of nephrolithiasis, group 2 consisted of 35 women with only one episode of calcium nephrolithiasis, and group 3 consisted of 25 women with a history of recurrent calcium nephrolithiasis. Blood and urine biochemical study was performed, including markers related to lithiasis, and a bone mineral density study was done by use of bone densitometry. Results Patients in group 3 showed statistically significantly elevated calciuria (15.4 mg/dL), fasting calcium/creatinine ratio (0.14), and 24-hour calcium/creatinine ratio (0.21) compared with groups 1 and 2. Moreover, this group of women with recurrent calcium nephrolithiasis had significantly elevated values of beta-crosslaps, a bone resorption marker, compared with groups 1 and 2 (p=0.000) and showed more bone mineral density loss than did these groups. Conclusions Recurrent calcium nephrolithiasis in women has a significant association with bone mineral density loss and with values of calciuria, both fasting and 24-hour. PMID:23526577

  3. Optimization of Individualized Dynamic Treatment Regimes for Recurrent Diseases

    PubMed Central

    Huang, Xuelin; Ning, Jing; Wahed, Abdus S.

    2014-01-01

    Patients with cancer or other recurrent diseases may undergo a long process of initial treatment, disease recurrences and salvage treatments. It is important to optimize the multi-stage treatment sequence in this process to maximally prolong patients’ survival. Comparing disease-free survival for each treatment stage over-penalizes disease recurrences but under-penalizes treatment-related mortalities. Moreover, treatment regimes used in practice are dynamic, i.e., the choice of next treatment depends on a patient’s responses to previous therapies. In this article, using accelerated failure time models, we develop a method to optimize such dynamic treatment regimes (DTRs). This method utilizes all the longitudinal data collected during the multi-stage process of disease recurrences and treatments, and identifies the optimal DTR for each individual patient by maximizing his/her expected overall survival. The application of this method is illustrated using data from a study of acute myeloid leukemia. The optimal treatment strategies for different patient subgroups are identified. PMID:24510534

  4. Evidence-based management of recurrent miscarriages

    PubMed Central

    Jeve, Yadava B.; Davies, William

    2014-01-01

    Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

  5. Physician consultation in young children with recurrent pain—a population-based study

    PubMed Central

    Wager, J; Zernikow, B

    2015-01-01

    Background. Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain. Methods. The present study analyzes data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study comprising n = 2,149 children (3–10 years old) with recurrent pain to find robust predictors. We used multiple logistic regressions to investigate age, gender, socio-economic status (SES), migration background, pain intensity, pain frequency, pain-related disability, mental health problems, and health-related quality of life (HRQL) as predictors for visiting a doctor due to pain. Results. Overall, young girls with high pain-related disability, intensity, frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life and mental health problems were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize. Conclusions. Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization. PMID:25945310

  6. Twenty four hour pulse pressure predicts long term recurrence in acute stroke patients

    PubMed Central

    Tsivgoulis, G; Spengos, K; Zakopoulos, N; Manios, E; Xinos, K; Vassilopoulos, D; Vemmos, K

    2005-01-01

    Objectives: The impact of different blood pressure (BP) components during the acute stage of stroke on the risk of recurrent stroke is controversial. The present study aimed to investigate by 24 hour BP monitoring a possible association between acute BP values and long term recurrence. Methods: A total of 339 consecutive patients with first ever acute stroke underwent 24 hour BP monitoring within 24 hours of ictus. Known stroke risk factors and clinical findings on admission were documented. Patients given antihypertensive medication during BP monitoring were excluded. The outcome of interest during the one year follow up was recurrent stroke. The Cox proportional hazard model was used to analyse association of casual and 24 hour BP recordings with one year recurrence after adjusting for stroke risk factors, baseline clinical characteristics, and secondary prevention therapies. Results: The cumulative one year recurrence rate was 9.2% (95% CI 5.9% to 12.3%). Multivariate Cox regression analyses revealed age, diabetes mellitus, and 24 hour pulse pressure (PP) as the only significant predictors for stroke recurrence. The relative risk for one year recurrence associated with every 10 mm Hg increase in 24 hour PP was 1.323 (95% CI 1.019 to 1.718, p = 0.036). Higher casual PP levels were significantly related to an increased risk of one year recurrence on univariate analysis, but not in the multivariate Cox regression model. Conclusions: Elevated 24 hour PP levels in patients with acute stroke are independently associated with higher risk of long term recurrence. Further research is required to investigate whether the risk of recurrent stroke can be reduced to a greater extent by decreasing the pulsatile component of BP in patients with acute stroke. PMID:16170077

  7. Alisertib in Treating Young Patients With Recurrent or Refractory Solid Tumors or Leukemia

    ClinicalTrials.gov

    2016-07-20

    Hepatoblastoma; Previously Treated Childhood Rhabdomyosarcoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Kidney Neoplasm; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent Osteosarcoma

  8. Dasatinib in Treating Patients With Recurrent or Persistent Ovarian, Fallopian Tube, Endometrial or Peritoneal Cancer

    ClinicalTrials.gov

    2016-11-02

    Endometrial Clear Cell Adenocarcinoma; Estrogen Receptor Negative; Ovarian Clear Cell Cystadenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma

  9. Ultraviolet spectroscopy of the recurrent nova U Scorpii during outburst

    NASA Technical Reports Server (NTRS)

    Williams, R. E.; Sparks, W. M.; Gallagher, J. S.; Ney, E. P.; Starrfield, S. G.; Truran, J. W.

    1981-01-01

    Observations of the recurrent nova U Sco during the 1979 outburst are presented, and the spectral evolution is found to differ from that of other recurrent novas. Spectra are dominated by emission lines, and the strong forbidden-line emission characteristic is conspicuously absent. A method to determine masses of nova shells is outlined, and an analysis of the emission lines shows an enrichment in N relative to C and O, and that the nova ejecta are rich in He relative to H. Optical spectra of U Sco obtained following its return to quiescence show predominantly He II emission lines, which suggests an enrichment of the preoutburst gas in He, and thus the presence of a highly evolved companion.

  10. A Feynman integral and its recurrences and associators

    NASA Astrophysics Data System (ADS)

    Puhlfürst, Georg; Stieberger, Stephan

    2016-05-01

    We determine closed and compact expressions for the ɛ-expansion of certain Gaussian hypergeometric functions expanded around half-integer values by explicitly solving for their recurrence relations. This ɛ-expansion is identified with the normalized solution of the underlying Fuchs system of four regular singular points. We compute its regularized zeta series (giving rise to two independent associators) whose ratio gives the ɛ-expansion at a specific value. Furthermore, we use the well known one-loop massive bubble integral as an example to demonstrate how to obtain all-order ɛ-expansions for Feynman integrals and how to construct representations for Feynman integrals in terms of generalized hypergeometric functions. We use the method of differential equations in combination with the recently established general solution for recurrence relations with non-commutative coefficients.

  11. Chlamydia trachomatis infection in "sine causa" recurrent abortion.

    PubMed

    Olliaro, P; Regazzetti, A; Gorini, G; Milano, F; Marchetti, A; Rondanelli, E G

    One hundred and one women suffering from "sine causa" recurrent abortion were screened for Chlamydia trachomatis (C.T.) infection by using direct examination, cultural and serological procedures. In this series, C.T. infection did not appear to be related to increased risk of recurrent abortion. The culture-positive and serology-positive rates (14.85% and 34.65%, respectively) did not differ from other unselected populations. Neither time from last abortion nor type of abortion were significantly related to C.T. infection. Nonetheless, the women who underwent examination within one year from last abortion and had a culture-positive partner as well, were more likely to present with a C.T.-positive culture.

  12. Urban legends: recurrent aphthous stomatitis.

    PubMed

    Baccaglini, L; Lalla, R V; Bruce, A J; Sartori-Valinotti, J C; Latortue, M C; Carrozzo, M; Rogers, R S

    2011-11-01

    Recurrent aphthous stomatitis (RAS) is the most common idiopathic intraoral ulcerative disease in the USA. Aphthae typically occur in apparently healthy individuals, although an association with certain systemic diseases has been reported. Despite the unclear etiopathogenesis, new drug trials are continuously conducted in an attempt to reduce pain and dysfunction. We investigated four controversial topics: (1) Is complex aphthosis a mild form of Behçet's disease (BD)? (2) Is periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome a distinct medical entity? (3) Is RAS associated with other systemic diseases [e.g., celiac disease (CD) and B12 deficiency]? (4) Are there any new RAS treatments? Results from extensive literature searches, including a systematic review of RAS trials, suggested the following: (1) Complex aphthosis is not a mild form of BD in North America or Western Europe; (2) Diagnostic criteria for PFAPA have low specificity and the characteristics of the oral ulcers warrant further studies; (3) Oral ulcers may be associated with CD; however, these ulcers may not be RAS; RAS is rarely associated with B12 deficiency; nevertheless, B12 treatment may be beneficial, via mechanisms that warrant further study; (4) Thirty-three controlled trials published in the past 6 years reported some effectiveness, although potential for bias was high.

  13. Recurrent seizures after lidocaine ingestion

    PubMed Central

    Aminiahidashti, Hamed; Laali, Abolghasem; Nosrati, Nazanin; Jahani, Fatemeh

    2015-01-01

    Lidocaine has a concentration-dependent effect on seizures. Concentrations above 15 μg/mL frequently result in seizures in laboratory animals and human. We report a case of central nervous system (CNS) lidocaine toxicity and recurrent seizure after erroneous ingestion of lidocaine solution. A 4-year-old boy presented to the Emergency Department of Imam Hospital of Sari in December 2013 due to tonic-clonic generalized seizures approximately 30 min ago. 3 h before seizure, his mother gave him 2 spoons (amount 20–25 cc) lidocaine hydrochloride 2% solution instead of pediatric gripe by mistake. Seizure with generalized tonic-clonic occurred 3 times in home. Neurological examination was essentially unremarkable except for the depressed level of consciousness. Personal and medical history was unremarkable. There was no evidence of intracranial ischemic or hemorrhagic lesions in computed tomography scan. There were no further seizures, the condition of the patient remained stable, and he was discharged 2 days after admission. The use of viscous lidocaine may result in cardiovascular and CNS toxicity, particularly in children. Conservative management is the best option for treatment of lidocaine induced seizure. PMID:25709968

  14. Recurrent seizures after lidocaine ingestion.

    PubMed

    Aminiahidashti, Hamed; Laali, Abolghasem; Nosrati, Nazanin; Jahani, Fatemeh

    2015-01-01

    Lidocaine has a concentration-dependent effect on seizures. Concentrations above 15 μg/mL frequently result in seizures in laboratory animals and human. We report a case of central nervous system (CNS) lidocaine toxicity and recurrent seizure after erroneous ingestion of lidocaine solution. A 4-year-old boy presented to the Emergency Department of Imam Hospital of Sari in December 2013 due to tonic-clonic generalized seizures approximately 30 min ago. 3 h before seizure, his mother gave him 2 spoons (amount 20-25 cc) lidocaine hydrochloride 2% solution instead of pediatric gripe by mistake. Seizure with generalized tonic-clonic occurred 3 times in home. Neurological examination was essentially unremarkable except for the depressed level of consciousness. Personal and medical history was unremarkable. There was no evidence of intracranial ischemic or hemorrhagic lesions in computed tomography scan. There were no further seizures, the condition of the patient remained stable, and he was discharged 2 days after admission. The use of viscous lidocaine may result in cardiovascular and CNS toxicity, particularly in children. Conservative management is the best option for treatment of lidocaine induced seizure. PMID:25709968

  15. Tea and Recurrent Clostridium difficile Infection

    PubMed Central

    Starley, Brad; Galagan, Jack Carl; Yabes, Joseph Michael; Evans, Sara

    2016-01-01

    Background and Aims. Studies have shown effects of diet on gut microbiota. We aimed to identify foods associated with recurrent Clostridium difficile infection (CDI). Methods. In this cross-sectional survey, consecutive patients diagnosed with CDI were identified by electronic medical records. Colitis symptoms and positive Clostridium difficile assay were confirmed. Health-care onset-health-care facility associated CDI was excluded. Food surveys were mailed to 411 patients. Survey responses served as the primary outcome measure. Spearman's rank correlation identified risk factors for CDI recurrence. Results. Surveys were returned by 68 patients. Nineteen patients experienced CDI recurrence. Compared to patients without CDI recurrence, patients with CDI recurrence had more antibiotics prescribed preceding their infection (p = 0.003). Greater numbers of the latter also listed tea (p = 0.002), coffee (p = 0.013), and eggs (p = 0.013), on their 24-hour food recall. Logistic regression identified tea as the only food risk factor for CDI recurrence (adjusted OR: 5.71; 95% CI: 1.26–25.89). Conclusion. The present results indicate a possible association between tea and CDI recurrence. Additional studies are needed to characterize and confirm this association. PMID:27651790

  16. Tea and Recurrent Clostridium difficile Infection.

    PubMed

    Oman Evans Ii, Martin; Starley, Brad; Galagan, Jack Carl; Yabes, Joseph Michael; Evans, Sara; Salama, Joseph John

    2016-01-01

    Background and Aims. Studies have shown effects of diet on gut microbiota. We aimed to identify foods associated with recurrent Clostridium difficile infection (CDI). Methods. In this cross-sectional survey, consecutive patients diagnosed with CDI were identified by electronic medical records. Colitis symptoms and positive Clostridium difficile assay were confirmed. Health-care onset-health-care facility associated CDI was excluded. Food surveys were mailed to 411 patients. Survey responses served as the primary outcome measure. Spearman's rank correlation identified risk factors for CDI recurrence. Results. Surveys were returned by 68 patients. Nineteen patients experienced CDI recurrence. Compared to patients without CDI recurrence, patients with CDI recurrence had more antibiotics prescribed preceding their infection (p = 0.003). Greater numbers of the latter also listed tea (p = 0.002), coffee (p = 0.013), and eggs (p = 0.013), on their 24-hour food recall. Logistic regression identified tea as the only food risk factor for CDI recurrence (adjusted OR: 5.71; 95% CI: 1.26-25.89). Conclusion. The present results indicate a possible association between tea and CDI recurrence. Additional studies are needed to characterize and confirm this association.

  17. Tea and Recurrent Clostridium difficile Infection.

    PubMed

    Oman Evans Ii, Martin; Starley, Brad; Galagan, Jack Carl; Yabes, Joseph Michael; Evans, Sara; Salama, Joseph John

    2016-01-01

    Background and Aims. Studies have shown effects of diet on gut microbiota. We aimed to identify foods associated with recurrent Clostridium difficile infection (CDI). Methods. In this cross-sectional survey, consecutive patients diagnosed with CDI were identified by electronic medical records. Colitis symptoms and positive Clostridium difficile assay were confirmed. Health-care onset-health-care facility associated CDI was excluded. Food surveys were mailed to 411 patients. Survey responses served as the primary outcome measure. Spearman's rank correlation identified risk factors for CDI recurrence. Results. Surveys were returned by 68 patients. Nineteen patients experienced CDI recurrence. Compared to patients without CDI recurrence, patients with CDI recurrence had more antibiotics prescribed preceding their infection (p = 0.003). Greater numbers of the latter also listed tea (p = 0.002), coffee (p = 0.013), and eggs (p = 0.013), on their 24-hour food recall. Logistic regression identified tea as the only food risk factor for CDI recurrence (adjusted OR: 5.71; 95% CI: 1.26-25.89). Conclusion. The present results indicate a possible association between tea and CDI recurrence. Additional studies are needed to characterize and confirm this association. PMID:27651790

  18. Tea and Recurrent Clostridium difficile Infection

    PubMed Central

    Starley, Brad; Galagan, Jack Carl; Yabes, Joseph Michael; Evans, Sara

    2016-01-01

    Background and Aims. Studies have shown effects of diet on gut microbiota. We aimed to identify foods associated with recurrent Clostridium difficile infection (CDI). Methods. In this cross-sectional survey, consecutive patients diagnosed with CDI were identified by electronic medical records. Colitis symptoms and positive Clostridium difficile assay were confirmed. Health-care onset-health-care facility associated CDI was excluded. Food surveys were mailed to 411 patients. Survey responses served as the primary outcome measure. Spearman's rank correlation identified risk factors for CDI recurrence. Results. Surveys were returned by 68 patients. Nineteen patients experienced CDI recurrence. Compared to patients without CDI recurrence, patients with CDI recurrence had more antibiotics prescribed preceding their infection (p = 0.003). Greater numbers of the latter also listed tea (p = 0.002), coffee (p = 0.013), and eggs (p = 0.013), on their 24-hour food recall. Logistic regression identified tea as the only food risk factor for CDI recurrence (adjusted OR: 5.71; 95% CI: 1.26–25.89). Conclusion. The present results indicate a possible association between tea and CDI recurrence. Additional studies are needed to characterize and confirm this association.

  19. Extraneural Metastases of Glioblastoma without Simultaneous Central Nervous System Recurrence

    PubMed Central

    Kim, Wonki; Yoo, Heon; Shin, Sang Hoon; Gwak, Ho Shin

    2014-01-01

    Glioblastoma multiforme (GBM) is well known as the most common malignant primary brain tumor. It could easily spread into the adjacent or distant brain tissue by infiltration, direct extension and cerebro-spinal fluid dissemination. The extranueural metastatic spread of GBM is relatively rare but it could have more progressive disease course. We report a 39-year-old man who had multiple bone metastases and malignant pleural effusion of the GBM without primary site recurrence. PMID:25408938

  20. Electrogram Morphology Recurrence Patterns during Atrial Fibrillation

    PubMed Central

    Ng, Jason; Gordon, David; Passman, Rod S.; Knight, Bradley P.; Arora, Rishi; Goldberger, Jeffrey J.

    2014-01-01

    Background Traditional mapping of atrial fibrillation (AF) is limited by changing electrogram morphologies and variable cycle lengths. Objective We tested the hypothesis that morphology recurrence plot analysis would identify sites of stable and repeatable electrogram morphology patterns. Methods AF electrograms recorded from left atrial (LA) and right atrial (RA) sites in 19 patients (10 male, 59±10 years old) prior to AF ablation were analyzed. Morphology recurrence plots for each electrogram recording were created by cross-correlation of each automatically detected activation with every other activation in the recording. A recurrence percentage, the percentage of the most common morphology, and the mean cycle length of activations with the most common morphology (CLR) were computed. Results The morphology recurrence plots commonly showed checkerboard patterns of alternating high and low cross correlation values indicating periodic recurrences in morphologies. The mean recurrence percentage for all sites and all patients was 38±25%. The highest recurrence percentage per patient averaged 83±17%. The highest recurrence percentage was located in the RA in 5 patients and in the LA in 14 patients. Patients with sites of shortest CLR in the LA and RA had ablation failure rates of 25% and 100%, respectively (HR=4.95; p=0.05). Conclusions A new technique to characterize electrogram morphology recurrence demonstrated that there is a distribution of sites with high and low repeatability of electrogram morphologies. Sites with rapid activation of highly repetitive morphology patterns may be critical to sustaining AF. Further testing of this approach to map and ablate AF sources is warranted. PMID:25101485

  1. Predictive Factor of Local Recurrence after Balloon-Occluded TACE with Miriplatin (MPT) in Hepatocellular Carcinoma

    PubMed Central

    Ishikawa, Toru; Abe, Satoshi; Inoue, Ryousuke; Sugano, Tomoyuki; Watanabe, Yuhsuke; Iwanaga, Akito; Seki, Keiichi; Honma, Terasu; Nemoto, Takeo; Takeda, Keiko; Yoshida, Toshiaki

    2014-01-01

    Background Miriplatin (MPT) is a novel platinum complex used in TACE that shows promise for the treatment of hepatocellular carcinoma (HCC). However, rapid washout has been reported in some cases. Therefore, various methods of administration with MPT have been attempted to increase its therapeutic efficacy. One hopeful method is balloon-occluded TACE (B-TACE), but the therapeutic efficacy of B-TACE with MPT has not been evaluated. Aim To investigate the treatment outcomes and factors involved in local recurrence after B-TACE with MPT in HCC. Methods This study included 51 patients (55 nodules) with HCC lesions equal or less than 5 cm in diameter who underwent B-TACE with MPT between January 2012 and June 2013. Local recurrence after B-TACE with MPT and factors associated with local recurrence were evaluated. Results The overall local recurrence rate was 11.1% at 6 months and 26.2% at 12 months. The local recurrence rate did differ significantly depending on CT values immediately after B-TACE with MPT. Multivariate analysis also showed that the CT value after B-TACE with MPT was the only factor related to local recurrence after B-TACE. Conclusions B-TACE with MPT achieves relatively good local control of HCC. The plain CT value immediately after B-TACE with MPT is a predictive factor for local recurrence. In patients with unsatisfactory CT values, locoregional therapy or additional treatment is required. PMID:25047920

  2. Validation study of genes with hypermethylated promoter regions associated with prostate cancer recurrence

    PubMed Central

    Stott-Miller, Marni; Zhao, Shanshan; Wright, Jonathan L.; Kolb, Suzanne; Bibikova, Marina; Klotzle, Brandy; Ostrander, Elaine A.; Fan, Jian-Bing; Feng, Ziding; Stanford, Janet L.

    2014-01-01

    Background One challenge in prostate cancer (PCa) is distinguishing indolent from aggressive disease at diagnosis. DNA promoter hypermethylation is a frequent epigenetic event in PCa, but few studies of DNA methylation in relation to features of more aggressive tumors or PCa recurrence have been completed. Methods We used the Infinium® HumanMethylation450 BeadChip to assess DNA methylation in tumor tissue from 407 patients with clinically localized PCa who underwent radical prostatectomy. Recurrence status was determined by follow-up patient surveys, medical record review, and linkage with the SEER registry. The methylation status of 14 genes for which promoter hypermethylation was previously correlated with advanced disease or biochemical recurrence was evaluated. Average methylation level for promoter region CpGs in patients who recurred compared to those with no evidence of recurrence was analyzed. For two genes with differential methylation, time to recurrence was examined. Results During an average follow-up of 11.7 years, 104 (26%) patients recurred. Significant promoter hypermethylation in at least 50% of CpG sites in two genes, ABHD9 and HOXD3, was found in tumors from patients who recurred compared to those without recurrence. Evidence was strongest for HOXD3 (lowest P = 9.46x10−6), with higher average methylation across promoter region CpGs associated with reduced recurrence-free survival (P = 2×10−4). DNA methylation profiles did not differ by recurrence status for the other genes. Conclusions These results validate the association between promoter hypermethylation of ADHB9 and HOXD3 and PCa recurrence. Impact Tumor DNA methylation profiling may help distinguish PCa patients at higher risk for disease recurrence. PMID:24718283

  3. Analysis of Recurrence Management in Patients Who Underwent Nonsurgical Treatment for Acute Appendicitis.

    PubMed

    Liang, Tsung-Jung; Liu, Shiuh-Inn; Tsai, Chung-Yu; Kang, Chi-Hsiang; Huang, Wei-Chun; Chang, Hong-Tai; Chen, I-Shu

    2016-03-01

    The recurrence rate for acute appendicitis treated nonoperatively varies between studies. Few studies have adequately evaluated the management of these patients when appendicitis recurs. We aimed to explore the recurrence rate and management of patients with acute appendicitis that were first treated nonoperatively.We identified patients in the Taiwan National Health Insurance Research Database who were hospitalized due to acute appendicitis for the first time between 2000 and 2010 and received nonsurgical treatment. The recurrence and its management were recorded. Data were analyzed to access the risk factors for recurrence and factors that influenced the management of recurrent appendicitis.Among the 239,821 patients hospitalized with acute appendicitis for the first time, 12,235 (5.1%) patients were managed nonoperatively. Of these, 864 (7.1%) had a recurrence during a median follow-up of 6.5 years. Appendectomy was performed by an open and laparoscopic approach in 483 (55.9%) and 258 (29.9%) patients, respectively. The remaining 123 (14.2%) patients were again treated nonsurgically. Recurrence was independently associated with young age, male sex, percutaneous abscess drainage, and medical center admission by multivariable analysis. In addition, age <18, a (CCI) <2, medical center admission, and a longer time to recurrence were correlated with using laparoscopy to treat recurrence. Neither type of appendicitis, percutaneous abscess drainage, nor length of first time hospital stay had an influence on the selection of surgical approach.In conclusion, a laparoscopic appendectomy can be performed in recurrent appendicitis cases, and its application may not be related to previous appendicitis severity.

  4. Complex partial status epilepticus: a recurrent problem.

    PubMed Central

    Cockerell, O C; Walker, M C; Sander, J W; Shorvon, S D

    1994-01-01

    Twenty patients with complex partial status epilepticus were identified retrospectively from a specialist neurology hospital. Seventeen patients experienced recurrent episodes of complex partial status epilepticus, often occurring at regular intervals, usually over many years, and while being treated with effective anti-epileptic drugs. No unifying cause for the recurrences, and no common epilepsy aetiologies, were identified. In spite of the frequency of recurrence and length of history, none of the patients showed any marked evidence of cognitive or neurological deterioration. Complex partial status epilepticus is more common than is generally recognised, should be differentiated from other forms of non-convulsive status, and is often difficult to treat. PMID:8021671

  5. Recurrent cutaneous jellyfish eruptions without envenomation.

    PubMed

    Månsson, T; Randle, H W; Mandojana, R M; Calton, G J; Burnett, J W

    1985-01-01

    Three patients exhibiting recurrent cutaneous eruptions induced by contact with jellyfish tentacles are presented. The recurrent eruptions appeared several days after the primary exposure without contact with any offending coelenterate. The principal species involved include Pelagia noctiluca, Physalia physalis and probably Lychnorhiza lucerna. These three cases, combined with an earlier similar report of recurrent lesions induced by Physalia physalis suggest that this phenomenon may be widespread. In two of the three cases, the secondary eruption was more severe than that occurring after the primary envenomation. PMID:2578711

  6. Recurrent stroke: what have we learnt?

    PubMed

    Rabia, K; Khoo, Em

    2007-01-01

    Stroke is the third leading cause of death, a major cause of disability in adults, and is frequently more disabling than fatal. With a decline in mortality from initial cerebral infarction and an increase in the life expectancy of the population, the number of patients with recurrent stroke and ensuing cardiovascular events will become greater. Thus it is important to find out those patients at high risk of stroke recurrence. This case report illustrates the process of recurrent stroke and the resulting disabilities and morbidities in a 42-year- old man. The role of integrated stroke rehabilitation programme is described. PMID:25606084

  7. Assessment of risk for recurrent diverticulitis: a proposal of risk score for complicated recurrence.

    PubMed

    Sallinen, Ville; Mali, Juha; Leppäniemi, Ari; Mentula, Panu

    2015-02-01

    Recurrence of acute diverticulitis is common, and--especially complicated recurrence--causes significant morbidity. To prevent recurrence, selected patients have been offered prophylactic sigmoid resection. However, as there is no tool to predict whose diverticulitis will recur and, in particular, who will have complicated recurrence, the indications for sigmoid resections have been variable. The objective of this study was to identify risk factors predicting recurrence of acute diverticulitis. This is a retrospective cohort study of patients presenting with computed tomography-confirmed acute diverticulitis and treated nonresectionally during 2006 to 2010. Risk factors for recurrence were identified using uni- and multivariate Cox regression. A total of 512 patients were included. History of diverticulitis was an independent risk factor predicting uncomplicated recurrence of diverticulitis (1-2 earlier diverticulitis HR 1.6, 3 or more--HR 3.2). History of diverticulitis (HR 3.3), abscess (HR 6.2), and corticosteroid medication (HR 16.1) were independent risk factors for complicated recurrence. Based on regression coefficients, risk scoring was created: 1 point for history of diverticulitis, 2 points for abscess, and 3 points for corticosteroid medication. The risk score was unable to predict uncomplicated recurrence (AUC 0.48), but was able to predict complicated recurrence (AUC 0.80). Patients were further divided into low-risk (0-2 points) and high-risk (>2 points) groups. Low-risk and high-risk groups had 3% and 43% 5-year complicated recurrence rates, respectively. Risk for complicated recurrence of acute diverticulitis can be assessed using risk scoring. The risk for uncomplicated recurrence increases along with increasing number of previous diverticulitis.

  8. Discontinuities in recurrent neural networks.

    PubMed

    Gavaldá, R; Siegelmann, H T

    1999-04-01

    This article studies the computational power of various discontinuous real computational models that are based on the classical analog recurrent neural network (ARNN). This ARNN consists of finite number of neurons; each neuron computes a polynomial net function and a sigmoid-like continuous activation function. We introduce arithmetic networks as ARNN augmented with a few simple discontinuous (e.g., threshold or zero test) neurons. We argue that even with weights restricted to polynomial time computable reals, arithmetic networks are able to compute arbitrarily complex recursive functions. We identify many types of neural networks that are at least as powerful as arithmetic nets, some of which are not in fact discontinuous, but they boost other arithmetic operations in the net function (e.g., neurons that can use divisions and polynomial net functions inside sigmoid-like continuous activation functions). These arithmetic networks are equivalent to the Blum-Shub-Smale model, when the latter is restricted to a bounded number of registers. With respect to implementation on digital computers, we show that arithmetic networks with rational weights can be simulated with exponential precision, but even with polynomial-time computable real weights, arithmetic networks are not subject to any fixed precision bounds. This is in contrast with the ARNN that are known to demand precision that is linear in the computation time. When nontrivial periodic functions (e.g., fractional part, sine, tangent) are added to arithmetic networks, the resulting networks are computationally equivalent to a massively parallel machine. Thus, these highly discontinuous networks can solve the presumably intractable class of PSPACE-complete problems in polynomial time.

  9. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study

    PubMed Central

    Moreira, Bruno S.; Sampaio, Rosana F.; Kirkwood, Renata N.

    2015-01-01

    BACKGROUND: Falling is a common but devastating and costly problem of aging. There is no consensus in the literature on whether the spatial and temporal gait parameters could identify elderly people at risk of recurrent falls. OBJECTIVE: To determine whether spatiotemporal gait parameters could predict recurrent falls in elderly women. METHOD: One hundred and forty-eight elderly women (65-85 years) participated in this study. Seven spatiotemporal gait parameters were collected with the GAITRite(r) system. Falls were recorded prospectively during 12 months through biweekly phone contacts. Elderly women who reported two or more falls throughout the follow-up period were considered as recurrent fallers. Principal component analysis (PCA) and discriminant analysis followed by biplot graph interpretation were applied to the gait parameters. RESULTS: After 12 months, 23 elderly women fell twice or more and comprised the recurrent fallers group and 110 with one or no falls comprised the non-recurrent fallers group. PCA resulted in three components that explained 88.3% of data variance. Discriminant analysis showed that none of the components could significantly discriminate the groups. However, visual inspection of the biplot showed a trend towards group separation in relation to gait velocity and stance time. PC1 represented gait rhythm and showed that recurrent fallers tend to walk with lower velocity and cadence and increased stance time in relation to non-recurrent fallers. CONCLUSIONS: The analyzed spatiotemporal gait parameters failed to predict recurrent falls in this sample. The PCA-biplot technique highlighted important trends or red flags that should be considered when evaluating recurrent falls in elderly females. PMID:25714603

  10. Recurrences of transient synovitis of the hip.

    PubMed Central

    Illingworth, C M

    1983-01-01

    Thirty six children with transient synovitis of the hip had a total of 80 recurrences, 69 of them personally observed, and 11 described by the mother. No features distinguished the initial attack of those who had a recurrence from that of the 18 children who have not so far had a recurrence. We analysed the total of 126 episodes. In 72 there was evidence of an associated infection from the history, clinical signs, and a raised antistreptolysin O titre or isolation of a pathogen from a throat swab. The prognosis is difficult to assess because the symptoms, signs, and special investigations are not specific. Recurrences can occur after many years without symptoms. PMID:6614977

  11. Treatment modalities in recurrent miscarriages without diagnosis.

    PubMed

    Whitley, Kari A; Ural, Serdar H

    2014-07-01

    Recurrent miscarriage is defined as the loss of three consecutive pregnancies before 20 weeks' gestational age. Patients are referred to subspecialists such as reproductive endocrinology or maternal fetal medicine to exclude the most common causes of recurrent miscarriage including autoimmune disorders, structural uterine pathology, metabolic derangements, hematologic conditions, and chromosomal abnormalities. Unfortunately, this extensive list of conditions accounts for less than 50% of patients affected by recurrent miscarriage, leaving the remaining 50% without answers. Multiple treatment modalities, including supplementation with progesterone, human chorionic gonadotropin, aspirin with and without heparin, and immune modulators have been tested for this large percentage of patients with very few answers. In fact, the only successful intervention addressed in the literature consists of supportive care at a dedicated recurrent miscarriage clinic. Without large randomized clinical trials, there is no evidence to support the use of supplemental medications in this patient population.

  12. Recurrent amyloid tumor of the parotid gland.

    PubMed

    Vavrina, J; Müller, W; Gebbers, J O

    1995-01-01

    A case of an organ-limited amyloid tumor of the left parotid gland is described with a history of recurrence. A slowly growing parotid mass was the only symptom. After 5.5 years following local excision, the patient was readmitted with a slowly growing recurrence in the superficial lobe of the previously treated gland. Lateral parotidectomy was performed with wide excision of the infiltrated tissue and preservation of the facial nerve. Primary amyloidosis of the AL type was confirmed with immunohistochemical studies revealing staining for lambda but not kappa light chains of immunoglobulins. There has been no clinical or laboratory evidence of systemic amyloidosis or recurrence after 2 years. To the best of our knowledge, this is the first report of a recurrent amyloid tumor of the parotid gland.

  13. Poincaré recurrences of DNA sequences

    NASA Astrophysics Data System (ADS)

    Frahm, K. M.; Shepelyansky, D. L.

    2012-01-01

    We analyze the statistical properties of Poincaré recurrences of Homo sapiens, mammalian, and other DNA sequences taken from the Ensembl Genome data base with up to 15 billion base pairs. We show that the probability of Poincaré recurrences decays in an algebraic way with the Poincaré exponent β≈4 even if the oscillatory dependence is well pronounced. The correlations between recurrences decay with an exponent ν≈0.6 that leads to an anomalous superdiffusive walk. However, for Homo sapiens sequences, with the largest available statistics, the diffusion coefficient converges to a finite value on distances larger than one million base pairs. We argue that the approach based on Poncaré recurrences determines new proximity features between different species and sheds a new light on their evolution history.

  14. Zermelo, Boltzmann, and the recurrence paradox

    NASA Astrophysics Data System (ADS)

    Steckline, Vincent S.

    1983-10-01

    The papers exchanged by Ludwig Boltzmann and Ernst Zermelo concerning the recurrence paradox are summarized. The historical context of the paradox, Zermelo's proof of the paradox, his opinions of its consequences, Boltzmann's reply, and the ensuing discussion are described.

  15. [Recurrent intestinal ischemia due to factor VIII].

    PubMed

    Castellanos Monedero, Jesús Javier; Legaz Huidobro, María Luisa; Galindo Andugar, María Angeles; Rodríguez Pérez, Alvaro; Mantrana del Valle, José María

    2008-01-01

    Intestinal ischemia is difficult to diagnose and can be caused by several etiologic processes. We report the case of a female patient with recurrent bowel ischemia due to small vessel thrombosis, which is caused by factor VIII, a procoagulant factor.

  16. Risk factors and treatment for recurrent vulvar squamous cell carcinoma.

    PubMed

    Nooij, L S; Brand, F A M; Gaarenstroom, K N; Creutzberg, C L; de Hullu, J A; van Poelgeest, M I E

    2016-10-01

    Recurrent disease occurs in 12-37% of patients with vulvar squamous cell carcinoma (VSCC). Decisions about treatment of recurrent VSCC mainly depend on the location of the recurrence and previous treatment, resulting in individualized and consensus-based approaches. Most recurrences (40-80%) occur within 2 years after initial treatment. Currently, wide local excision is the treatment of choice for local recurrences. Isolated local recurrence of VSCC has a good prognosis, with reported 5-year survival rates of up to 60%. Groin recurrences and distant recurrences are less common and have an extremely poor prognosis. For groin recurrences, surgery with or without (chemo) radiotherapy is a treatment option, depending on prior treatment. For distant recurrences, there are only palliative treatment options. In this review, we give an overview of the available literature and discuss epidemiology, risk factors, and prognostic factors for the different types of recurrent VSCC and we describe treatment options and clinical outcome. PMID:27637349

  17. Risk of Recurrence in Laryngeal Cancer

    PubMed Central

    Sørum Falk, Ragnhild; Folkvard Evensen, Jan; Boysen, Morten; Brøndbo, Kjell

    2016-01-01

    A cohort study was undertaken to analyze the risk of recurrence among 1616 patients with primary squamous cell carcinoma of the larynx from 1983 to 2010 at a single, tertiary academic center in Oslo, Norway. The cohort was followed from the date of diagnosis to September 2011. Competing risk regression analysis assessed the association between various risk factors and the risk of recurrence, where death was considered a competing event. Recurrence was observed in 368 patients (23%) during the study period. The majority (71%) of recurrences involved the location of the primary tumor. The overall risk of recurrence during the first three years after initiating treatment was 20.5%. Increased risk of recurrence was observed in patients with supraglottic cancer, younger patients, those with T2–T3 tumors and in patients treated in the earlier part of the study period. Significant factors for recurrence in glottic carcinomas were age, treatment in the earlier part of the study and T-status, whereas age was a significant factor in supraglottic cancer. N-status appeared less significant. In conclusion, follow-up of laryngeal squamous cell carcinoma should place particular emphasis on the site of the primary tumor, younger patients, cases of supraglottic cancer and T2-T4 primary tumors, especially during the first three years after treatment. More studies are needed to assess the impact of surgical versus non-surgical treatment, and eventually the significance of recurrence, for disease-specific and overall survival in cases of advanced laryngeal squamous cell carcinoma. PMID:27716797

  18. Percutaneous cholecystolithotomy: is gall stone recurrence inevitable?

    PubMed Central

    Donald, J J; Cheslyn-Curtis, S; Gillams, A R; Russell, R C; Lees, W R

    1994-01-01

    Using radiological interventional techniques the gall bladder can be cleared of stones with a high success rate. As with any treatment option that leaves the gall bladder in situ there is an accompanying risk of stone recurrence, which is currently unknown for the radiological method. One hundred patients were studied prospectively to determine the recurrence rate of stones and clinical outcome after successful percutaneous cholecystolithotomy. Follow up included both clinical assessment and ultrasound examination at 3, 6, and 12 months and then annual intervals thereafter. The overall stone recurrence rate was 31% at a mean follow up of 26 months (range, 3-50 months). By actuarial life table analysis, the cumulative proportion of gall stone recurrence was 7, 19, 28, 35, and 44% at 6, 12, 24, 36, and 48 months respectively. Of the 31 patients with recurrent stones; 17 remain asymptomatic, seven have experienced biliary colic, two abdominal pain, three non-specific upper gastrointestinal symptoms, and two jaundice secondary to common duct stones. Thirteen of the stone free patients have remained symptomatic; six with abdominal pain and seven with nonspecific upper gastrointestinal symptoms. Eight patients have subsequently had a cholecystectomy. No significant difference was found between the sex of the patient or the number of stones before treatment and the stone recurrence rates. The cumulative stone recurrence rate was significantly less in the 56 patients who received adjuvant chemolitholysis (p < 0.05). These data show that stone recurrence after successful percutaneous cholecystolithotomy occurs in the minority, and is usually asymptomatic. It is concluded that the technique remains justified in the management of selected patients with gall stones. PMID:8200568

  19. Persistent and Recurrent Clostridium difficile Colitis

    PubMed Central

    Cole, Shola A.; Stahl, Thomas J.

    2015-01-01

    Clostridium difficile infection (CDI) is the most frequent cause of nosocomial diarrhea. It has become a significant dilemma in the treatment of patients, and causes increasing morbidity that, in extreme cases, may result in death. Persistent and recurrent disease hamper attempts at eradication of this infection. Escalating levels of treatment and novel therapeutics are being utilized and developed to treat CDI. Further trials are warranted to definitively determine what protocols can be used to treat persistent and recurrent disease. PMID:26034401

  20. Recurrent congenital heart block in neonatal lupus.

    PubMed

    Escobar, Maria C; Gómez-Puerta, José A; Albert, Dimpna; Ferrer, Queralt; Girona, Josep

    2007-07-01

    Congenital heart block (CHB) is the main complication of neonatal lupus (NL) and is strongly associated with the presence of anti-SSA/Ro and anti-SSB/La antibodies. The recurrence of CHB in subsequent pregnancies in mothers with these antibodies is uncommon, occurring in approximately 15% of cases. We describe here a case of recurrent CHB in a previously asymptomatic mother with Sjögren syndrome and discuss the current strategies for the prevention and treatment of CHB in NL.

  1. Multivariate linear recurrences and power series division

    PubMed Central

    Hauser, Herwig; Koutschan, Christoph

    2012-01-01

    Bousquet-Mélou and Petkovšek investigated the generating functions of multivariate linear recurrences with constant coefficients. We will give a reinterpretation of their results by means of division theorems for formal power series, which clarifies the structural background and provides short, conceptual proofs. In addition, extending the division to the context of differential operators, the case of recurrences with polynomial coefficients can be treated in an analogous way. PMID:23482936

  2. Spinal Recurrence From Intracranial Germinoma: Risk Factors and Treatment Outcome for Spinal Recurrence

    SciTech Connect

    Ogawa, Kazuhiko Yoshii, Yoshihiko; Shikama, Naoto; Nakamura, Katsumasa; Uno, Takashi; Onishi, Hiroshi; Itami, Jun; Shioyama, Yoshiyuki; Iraha, Shiro; Hyodo, Akio; Toita, Takafumi; Kakinohana, Yasumasa; Tamaki, Wakana; Ito, Hisao; Murayama, Sadayuki

    2008-12-01

    Purpose: To analyze retrospectively the risk factors of spinal recurrence in patients with intracranial germinoma and clinical outcomes of patients who developed spinal recurrence. Methods and Materials: Between 1980 and 2007, 165 patients with no evidence of spinal metastases at diagnosis were treated with cranial radiotherapy without spinal irradiation. The median follow-up in all 165 patients was 61.2 months (range, 1.2-260.1 months). Results: After the initial treatment, 15 patients (9.1%) developed spinal recurrences. Multivariate analysis revealed that large intracranial disease ({>=}4 cm) and multifocal intracranial disease were independent risk factors for spinal recurrence. Radiation field, total radiation dose, and the use of chemotherapy did not affect the occurrence of spinal recurrences. Of the 15 patients who experienced spinal recurrence, the 3-year actuarial overall survival and disease-free survival (DFS) rates from the beginning of salvage treatments were 65% and 57%, respectively. In the analysis, presence of intracranial recurrence and salvage treatment modality (radiotherapy with chemotherapy vs. radiotherapy alone) had a statistically significant impact on DFS. The 3-year DFS rate in patients with no intracranial recurrence and treated with both spinal radiotherapy and chemotherapy was 100%, whereas only 17% in patients with intracranial recurrence or treated with radiotherapy alone (p = 0.001). Conclusion: Large intracranial disease and multifocal intracranial disease were risk factors for spinal recurrence in patients with intracranial germinoma with no evidence of spinal metastases at diagnosis. For patients who developed spinal recurrence alone, salvage treatment combined with spinal radiotherapy and chemotherapy was effective in controlling the recurrent disease.

  3. Recurrent perinatal loss: a case study.

    PubMed

    Kavanaugh, K; Robertson, P A

    1999-01-01

    To date, investigators have not demonstrated a clear relationship between a parent's history of prior perinatal losses and intensity of grief response following a subsequent perinatal loss. Examining this relationship for low-income, African-American parents is important because they are a vulnerable population due to the high incidence of perinatal mortality in Blacks and their other life stressors that can impact on grief response and caring needs. The purpose of this case study was to examine the impact of recurrent perinatal loss on a low-income African-American parent. The research design for this study was case report, using interview data collected from a mother who had recently experienced her fourth perinatal loss, which occurred at twenty-five weeks of gestation. Transcripts from two open-ended interviews were analyzed. The theoretical framework used to guide analysis of this case study was Lazarus and Folkman's stress and coping theory. Results demonstrated that the prior perinatal losses did not appear as critical components of the way the mother responded to her most recent loss. Instead, perception of the care she received from healthcare providers and how that care related to her experiences with her one living child who was born at the same gestational age was an important determinant in how she responded to her loss. The results of this case study demonstrate the importance assessing a person's perception of their experience and those factors which contribute to the way they respond.

  4. Generalization Through the Recurrent Interaction of Episodic Memories

    PubMed Central

    Kumaran, Dharshan; McClelland, James L.

    2012-01-01

    In this article, we present a perspective on the role of the hippocampal system in generalization, instantiated in a computational model called REMERGE (recurrency and episodic memory results in generalization). We expose a fundamental, but neglected, tension between prevailing computational theories that emphasize the function of the hippocampus in pattern separation (Marr, 1971; McClelland, McNaughton, & O'Reilly, 1995), and empirical support for its role in generalization and flexible relational memory (Cohen & Eichenbaum, 1993; Eichenbaum, 1999). Our account provides a means by which to resolve this conflict, by demonstrating that the basic representational scheme envisioned by complementary learning systems theory (McClelland et al., 1995), which relies upon orthogonalized codes in the hippocampus, is compatible with efficient generalization—as long as there is recurrence rather than unidirectional flow within the hippocampal circuit or, more widely, between the hippocampus and neocortex. We propose that recurrent similarity computation, a process that facilitates the discovery of higher-order relationships between a set of related experiences, expands the scope of classical exemplar-based models of memory (e.g., Nosofsky, 1984) and allows the hippocampus to support generalization through interactions that unfold within a dynamically created memory space. PMID:22775499

  5. Aggressive Recurrence of Primary Hepatic Epithelioid Haemangioendothelioma after Liver Transplantation

    PubMed Central

    Abdoh, Qusay A.; Abaalkhail, Faisal A.; Al Sebayel, Mohammed; Al-Hussaini, Hussa F.; Helmy, Hazem; Almansour, Mohamad; Elsiesy, Hussien A.

    2016-01-01

    HEHE is a rare neoplasm of vascular origin that occurs in the liver; UNOS reported a favorable outcome after liver transplantation in 110 patients with 1-year and 5-year survival of 80% and 64%. Case Report. A 40-year-old lady presented with a three-month history of right upper abdominal pain with nausea, vomiting, and significant loss of weight associated with scleral icterus and progressive abdominal distension. Examination revealed jaundice, hepatomegaly, and ascites. Serum bilirubin was 26.5 mg/dL and ALP was 552 CT. Abdomen and pelvis showed diffuse infiltrative neoplastic process of the liver with a mass effect and stretching of the hepatic and portal veins, in addition to bile duct dilatation. Viral hepatitis markers were negative and serum alpha fetoprotein was within reference range. Liver biopsy was consistent with HEHE, with positive endothelial markers (CD31, CD34, and factor VIII-related antigen). She underwent living related liver transplantation on June 2013 and was discharged after 20 days with normal liver enzymes. Four months later, she presented with diffuse disease recurrence. Liver biopsy confirmed disease recurrence; she received supportive treatment and unfortunately she died 2 weeks later. Conclusion. HEHE can have rapid and aggressive recurrence after liver transplantation. PMID:27446853

  6. Aggressive Recurrence of Primary Hepatic Epithelioid Haemangioendothelioma after Liver Transplantation.

    PubMed

    Abdoh, Qusay A; Alnajjar, Asma M; Abaalkhail, Faisal A; Al Sebayel, Mohammed; Al-Hussaini, Hussa F; Al-Hamoudi, Waleed K; Helmy, Hazem; Almansour, Mohamad; Elsiesy, Hussien A

    2016-01-01

    HEHE is a rare neoplasm of vascular origin that occurs in the liver; UNOS reported a favorable outcome after liver transplantation in 110 patients with 1-year and 5-year survival of 80% and 64%. Case Report. A 40-year-old lady presented with a three-month history of right upper abdominal pain with nausea, vomiting, and significant loss of weight associated with scleral icterus and progressive abdominal distension. Examination revealed jaundice, hepatomegaly, and ascites. Serum bilirubin was 26.5 mg/dL and ALP was 552 CT. Abdomen and pelvis showed diffuse infiltrative neoplastic process of the liver with a mass effect and stretching of the hepatic and portal veins, in addition to bile duct dilatation. Viral hepatitis markers were negative and serum alpha fetoprotein was within reference range. Liver biopsy was consistent with HEHE, with positive endothelial markers (CD31, CD34, and factor VIII-related antigen). She underwent living related liver transplantation on June 2013 and was discharged after 20 days with normal liver enzymes. Four months later, she presented with diffuse disease recurrence. Liver biopsy confirmed disease recurrence; she received supportive treatment and unfortunately she died 2 weeks later. Conclusion. HEHE can have rapid and aggressive recurrence after liver transplantation. PMID:27446853

  7. FSGS Recurrence in Adults after Renal Transplantation

    PubMed Central

    Rudnicki, Michael

    2016-01-01

    Recurrence of focal segmental glomerulosclerosis (FSGS) in the allograft occurs in 30–50% of patients, and it is associated with poor renal allograft survival. Major risk factors for recurrence are younger age at diagnosis, rapid progression to end-stage renal disease, white race, and the loss of previous allografts due to recurrence. Recent data support the hypothesis that circulating permeability factors play a crucial role in podocyte injury and progression of FSGS. Due to lack of controlled trials, the management of recurrent FSGS is inconsistent and highly empirical. Prophylactic and perioperative treatment with plasmapheresis and high-dose (intravenous) cyclosporine represent the main cornerstones of immunosuppressive therapy. In recent years, therapy with rituximab has shown promising results. Despite evidence of activation of the renin-angiotensin system (RAS) in recurrent FSGS and its association with progression, only limited data exist on the renoprotective role of RAS blockade in this setting. Further well designed studies are needed on pathogenesis risk factors and therapeutical options in FSGS and its recurrence after transplantation. PMID:27144163

  8. Current treatment options for recurrent nasopharyngeal cancer

    PubMed Central

    Suárez, Carlos; Rodrigo, Juan P.; Rinaldo, Alessandra; Langendijk, Johannes A.; Shaha, Ashok R.

    2010-01-01

    Loco-regional control rate of nasopharyngeal carcinoma (NPC) has improved significantly in the past decade. However, local recurrence still represents a major cause of mortality and morbidity in advanced stages, and management of local failure remains a challenging issue in NPC. The best salvage treatment for local recurrent NPC remains to be determined. The options include brachytherapy, external radiotherapy, stereotactic radiosurgery, and nasopharyngectomy, either alone or in different combinations. In this article we will discuss the different options for salvage of locally recurrent NPC. Retreatment of locally recurrent NPC using radiotherapy, alone or in combination with other treatment modalities, as well as surgery, can result in long-term local control and survival in a substantial proportion of patients. For small-volume recurrent tumors (T1–T2) treated with external radiotherapy, brachytherapy or stereotactic radiosurgery, comparable results to those obtained with surgery have been reported. In contrast, treatment results of advanced-stage locally recurrent NPC are generally more satisfactory with surgery (with or without postoperative radiotherapy) than with reirradiation. PMID:20865269

  9. Recurrent largngeal nerve paralysis: a laryngographic and computed tomographic study

    SciTech Connect

    Agha, F.P.

    1983-07-01

    Vocal cord paralysis is a relatively common entity, usually resulting from a pathologic process of the vagus nerve or its recurrent larynegeal branch. It is rarely caused by intralargngeal lesions. Four teen patients with recurrent laryngeal nerve paralysis (RLNP) were evaluated by laryngography, computed tomography (CT), or both. In the evaluation of the paramedian cord, CT was limited in its ability to differentiate between tumor or RLNP as the cause of the fixed cord, but it yielded more information than laryngography on the structural abnormalities of the larynx and pre-epiglottic and paralaryngeal spaces. Laryngography revealed distinct features of RLNP and is the procedure of choice for evaluation of functional abnormalities of the larynx until further experience with faster CT scanners and dynamic scanning of the larynx is gained.

  10. Medical prevention of recurrent acute otitis media: an updated overview.

    PubMed

    Marchisio, Paola; Nazzari, Erica; Torretta, Sara; Esposito, Susanna; Principi, Nicola

    2014-05-01

    Acute otitis media (AOM) is one of the most common pediatric diseases; almost all children experience at least one episode, and a third have two or more episodes in the first three years of life. The disease burden of AOM has important medical, social and economic effects. AOM requires considerable financial assistance due to needing at least one doctor visit and a prescription for antipyretics and/or antibiotics. AOM is also associated with high indirect costs, which are mostly related to lost days of work for one parent. Moreover, due to its acute symptoms and frequent recurrences, AOM considerably impacts both the child and family's quality of life. AOM prevention, particularly recurrent AOM (rAOM), is a primary goal of pediatric practice. In this paper, we review current evidence regarding the efficacy of medical treatments and vaccines for preventing rAOM and suggest the best approaches for AOM-prone children. PMID:24678887

  11. A recurrent dynamic model for correspondence-based face recognition.

    PubMed

    Wolfrum, Philipp; Wolff, Christian; Lücke, Jörg; von der Malsburg, Christoph

    2008-01-01

    Our aim here is to create a fully neural, functionally competitive, and correspondence-based model for invariant face recognition. By recurrently integrating information about feature similarities, spatial feature relations, and facial structure stored in memory, the system evaluates face identity ("what"-information) and face position ("where"-information) using explicit representations for both. The network consists of three functional layers of processing, (1) an input layer for image representation, (2) a middle layer for recurrent information integration, and (3) a gallery layer for memory storage. Each layer consists of cortical columns as functional building blocks that are modeled in accordance with recent experimental findings. In numerical simulations we apply the system to standard benchmark databases for face recognition. We find that recognition rates of our biologically inspired approach lie in the same range as recognition rates of recent and purely functionally motivated systems. PMID:19146266

  12. Fourth Recurrence of Cardiac Myxoma in a Patient with the Carney Complex.

    PubMed

    Kwon, O Young; Kim, Gun Jik; Jang, Woo Sung; Lee, Young Ok; Cho, Jun Yong; Lee, Jong Tae

    2016-04-01

    Although cardiac myxoma is the most commonly encountered benign cardiac tumor in cardiac surgery practice, recurrent cardiac myxoma is very rare, is most commonly related to the Carney complex, and usually requires multiple cardiac operations with specific requirements in terms of perioperative management. In this report, we describe a patient who experienced the fourth recurrence of cardiac myxoma and review the diagnostic criteria of the Carney complex. This is the first report of such a case in Korea. PMID:27066435

  13. Fourth Recurrence of Cardiac Myxoma in a Patient with the Carney Complex

    PubMed Central

    Kwon, O Young; Kim, Gun Jik; Jang, Woo Sung; Lee, Young Ok; Cho, Jun Yong; Lee, Jong Tae

    2016-01-01

    Although cardiac myxoma is the most commonly encountered benign cardiac tumor in cardiac surgery practice, recurrent cardiac myxoma is very rare, is most commonly related to the Carney complex, and usually requires multiple cardiac operations with specific requirements in terms of perioperative management. In this report, we describe a patient who experienced the fourth recurrence of cardiac myxoma and review the diagnostic criteria of the Carney complex. This is the first report of such a case in Korea. PMID:27066435

  14. Effect of Recurrent Otitis Media on Language Profile in Children with Fragile X Syndrome

    PubMed Central

    Badran, Hatem Soliman; Abulnasr, Khairy M.; Abd El Hameed Nasser, Sherien

    2013-01-01

    Objective Language is almost always affected in fragile X syndrome (FXS), and a delay in language acquisition is one of the first characteristics. The aim of this work was to study the effect of recurrent middle ear infections on the language profile in boys with FXS. Study design: Prospective case series. Setting Academic Medical Center. Subjects and Methods The present study was conducted on 30 males, ranging in age from 4–10 years. They were diagnosed as having a full mutation of DNA. The males were divided into two groups: Group A included 15 children with a history of recurrent middle ear infections more than four times per year during the first 4 years of life, and Group B did not have a history of recurrent middle ear infections during the first 4 years of life. Language assessments were done for all participants using the Standardized Arabic Language test. Results Results showed significant delays in language development in children with FXS. Relative strengths in semantics compared to syntax and pragmatics were observed in all boys. The recurrent ear infections of the boys played an important role in the language development delay. The mean of receptive, expressive, and total language age was better and higher among boys without a history of recurrent middle ear infections compared to boys with recurrent middle ear infections. Conclusion Recurrent otitis media in boys with FXS exacerbates the language problems that exist in this syndrome. PMID:24179407

  15. [Recurrent tracheoesophageal fistula in type III esophageal atresia. Diagnosis and treatment are not easy].

    PubMed

    Lepeytre, C; Roquelaure, B; de Lagausie, P; Merrot, T; Dubus, J-C

    2014-07-01

    Recurrent tracheoesophageal fistula (TEF) is possible after repair of congenital esophageal atresia. The frequency of recurrent TEF is observed in about 10% of the cases. Within a cohort of 67 children with type III esophageal atresia repaired between 1998 and 2009, we aimed to identify the number of children with recurrent TEF, the risk factors for this condition, and the treatment proposed. The sex ratio was 1.7. Surgery was performed between 4 and 36 hours of life. Five children (7.5%) had a recurrent TEF, usually during the first 3 months, revealed by respiratory symptoms related to feeding in some cases. We noted that recurrent TEF was more frequent with anastomotic leakage (P=0.09) or postsurgical pneumothorax (P<0.01). The diagnosis was made in four cases out of five by a methylene blue test performed during a tracheobronchial endoscopy. Surgical treatment was noted in four children, with three postsurgical secondary effects. One child was treated by endoscopy and an esophageal clip. With a median follow-up of 52 months, no recurrence was noted. The recurrence of TEF may be linked to postsurgical events. Diagnosis is not easy and treatment is not clearly codified. Endoscopic treatment may be an advantageous option to surgery, likely with less morbidity.

  16. Unique spectral markers discern recurrent Glioblastoma cells from heterogeneous parent population.

    PubMed

    Kaur, Ekjot; Sahu, Aditi; Hole, Arti R; Rajendra, Jacinth; Chaubal, Rohan; Gardi, Nilesh; Dutt, Amit; Moiyadi, Aliasgar; Krishna, C Murali; Dutt, Shilpee

    2016-05-25

    An inability to discern resistant cells from bulk tumour cell population contributes to poor prognosis in Glioblastoma. Here, we compared parent and recurrent cells generated from patient derived primary cultures and cell lines to identify their unique molecular hallmarks. Although morphologically similar, parent and recurrent cells from different samples showed variable biological properties like proliferation and radiation resistance. However, total RNA-sequencing revealed transcriptional landscape unique to parent and recurrent populations. These data suggest that global molecular differences but not individual biological phenotype could differentiate parent and recurrent cells. We demonstrate that Raman Spectroscopy a label-free, non-invasive technique, yields global information about biochemical milieu of recurrent and parent cells thus, classifying them into distinct clusters based on Principal-Component-Analysis and Principal-Component-Linear-Discriminant-Analysis. Additionally, higher lipid related spectral peaks were observed in recurrent population. Importantly, Raman spectroscopic analysis could further classify an independent set of naïve primary glioblastoma tumour tissues into non-responder and responder groups. Interestingly, spectral features from the non-responder patient samples show a considerable overlap with the in-vitro generated recurrent cells suggesting their similar biological behaviour. This feasibility study necessitates analysis of a larger cohort of naïve primary glioblastoma samples to fully envisage clinical utility of Raman spectroscopy in predicting therapeutic response.

  17. Unique spectral markers discern recurrent Glioblastoma cells from heterogeneous parent population

    PubMed Central

    Kaur, Ekjot; Sahu, Aditi; Hole, Arti R.; Rajendra, Jacinth; Chaubal, Rohan; Gardi, Nilesh; Dutt, Amit; Moiyadi, Aliasgar; Krishna, C. Murali; Dutt, Shilpee

    2016-01-01

    An inability to discern resistant cells from bulk tumour cell population contributes to poor prognosis in Glioblastoma. Here, we compared parent and recurrent cells generated from patient derived primary cultures and cell lines to identify their unique molecular hallmarks. Although morphologically similar, parent and recurrent cells from different samples showed variable biological properties like proliferation and radiation resistance. However, total RNA-sequencing revealed transcriptional landscape unique to parent and recurrent populations. These data suggest that global molecular differences but not individual biological phenotype could differentiate parent and recurrent cells. We demonstrate that Raman Spectroscopy a label-free, non-invasive technique, yields global information about biochemical milieu of recurrent and parent cells thus, classifying them into distinct clusters based on Principal-Component-Analysis and Principal-Component-Linear-Discriminant-Analysis. Additionally, higher lipid related spectral peaks were observed in recurrent population. Importantly, Raman spectroscopic analysis could further classify an independent set of naïve primary glioblastoma tumour tissues into non-responder and responder groups. Interestingly, spectral features from the non-responder patient samples show a considerable overlap with the in-vitro generated recurrent cells suggesting their similar biological behaviour. This feasibility study necessitates analysis of a larger cohort of naïve primary glioblastoma samples to fully envisage clinical utility of Raman spectroscopy in predicting therapeutic response. PMID:27221528

  18. Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy

    PubMed Central

    Yang, Jehn-Hsiahn; Chen, Chin-Der; Chen, Shee-Uan; Yang, Yu-Shih; Chen, Mei-Jou

    2015-01-01

    Background An endometrial polyp is a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data. Methods This case-series report included 168 premenopausal women who suffered from endometrial polyps and underwent hysteroscopic polypectomy. All of them were awaiting a future pregnancy. Office hysteroscopy was done before and after hysteroscopic polypectomy, in which preoperative hysteroscopy examined the number, type, and location of endometrial polyps, and postoperative hysteroscopy checked the polyp recurrence. Surgical indications, either infertility or the presentation of abnormal uterine bleeding, and follow-up duration were recorded. Results Seventy-three out of 168 (43%) women had polyp recurrence after hysteroscopic polypectomy. Multivariate logistic regression analysis revealed that more endometrial polyps (P = 0.015) and longer duration of follow-up (P = 0.004) were significantly associated with an increased risk of postoperative polyp recurrence. The type of endometrial polyps was not correlated with polyp recurrence potential, whereas pedunculated type endometrial polyps were closely related to the presentation of abnormal uterine bleeding (P = 0.001). Conclusions A higher number of endometrial polyps and longer follow-up duration are associated with a greater potential of polyp recurrence after hysteroscopic polypectomy. PMID:26660149

  19. Risk factors for local recurrence after en bloc endoscopic submucosal dissection for early gastric cancer

    PubMed Central

    Lee, Ju Yup; Cho, Kwang Bum; Kim, Eun Soo; Park, Kyung Sik; Lee, Yoo Jin; Lee, Yoon Suk; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

    2016-01-01

    AIM: To investigate factors related to recurrence following en bloc resection using endoscopic submucosal dissection (ESD) in patients with early gastric cancer (EGC). METHODS: A total of 1121 patients (1215 lesions) who had undergone ESD for gastric neoplasia between April 2003 and May 2010 were retrospectively reviewed. Data from 401 patients (415 lesions) were analyzed, following the exclusion of those who underwent piecemeal resection, with deep resection margin invasion or lateral margin infiltration, and diagnosed with benign lesions. RESULTS: Local recurrence after en bloc ESD was found in 36 cases (8.7%). Unclear resection margins, long procedure times, and narrow safety margins were identified as risk factors for recurrence. Lesions located in the upper third of the stomach showed a higher rate of recurrence than those located in the lower third of the stomach (OR = 2.9, P = 0.03). The probability of no recurrence for up to 24 mo was 79.9% in those with a safety resection margin ≤ 1 mm and 89.5% in those with a margin > 1 mm (log-rank test, P = 0.03). CONCLUSION: Even in cases in which en bloc ESD is performed for EGC, local recurrence still occurs. To reduce local recurrences, more careful assessment will be needed prior to the implementation of ESD in cases in which the tumor is located in the upper third of the stomach. In addition, clear identification of tumor boundaries as well as the securing of sufficient safety resection margins will be important. PMID:27076871

  20. What operation for recurrent rectal prolapse after previous Delorme’s procedure? A practical reality

    PubMed Central

    Javed, Muhammad A; Afridi, Faryal G; Artioukh, Dmitri Y

    2016-01-01

    AIM: To report our experience with perineal repair (Delorme’s procedure) of rectal prolapse with particular focus on treatment of the recurrence. METHODS: Clinical records of 40 patients who underwent Delorme’s procedure between 2003 and 2014 were reviewed to obtain the following data: Gender; duration of symptoms, length of prolapse, operation time, ASA grade, length of post-operative stay, procedure-related complications, development and treatment of recurrent prolapse. Analysis of post-operative complications, rate and time of recurrence and factors influencing the choice of the procedure for recurrent disease was conducted. Continuous variables were expressed as the median with interquartile range (IQR). Statistical analysis was carried out using the Fisher exact test. RESULTS: Median age at the time of surgery was 76 years (IQR: 71-81.5) and there were 38 females and 2 males. The median duration of symptoms was 6 mo (IQR: 3.5-12) and majority of patients presented electively whereas four patients presented in the emergency department with irreducible rectal prolapse. The median length of prolapse was 5 cm (IQR: 5-7), median operative time was 100 min (IQR: 85-120) and median post-operative stay was 4 d (IQR: 3-6). Approximately 16% of the patients suffered minor complications such as - urinary retention, delayed defaecation and infected haematoma. One patient died constituting post-operative mortality of 2.5%. Median follow-up was 6.5 mo (IQR: 2.15-16). Overall recurrence rate was 28% (n = 12). Recurrence rate for patients undergoing an urgent Delorme’s procedure who presented as an emergency was higher (75.0%) compared to those treated electively (20.5%), P value 0.034. Median time interval from surgery to the development of recurrence was 16 mo (IQR: 5-30). There were three patients who developed an early recurrence, within two weeks of the initial procedure. The management of the recurrent prolapse was as follows: No further intervention (n = 1

  1. Core reactivity estimation in space reactors using recurrent dynamic networks

    SciTech Connect

    Parlos, A.G. ); Tsai, W.K. )

    1991-01-10

    A recurrent Multi Layer Perceptron (MLP) network topology is used in the identification of nonlinear dynamic systems from only the input/output measurements. This effort is part of a research program devoted in developing real-time diagnostics and predictive control techniques for large-scale complex nonlinear dynamic systems. The identification is performed in the discrete time domain, with the learning algorithm being a modified form of the Back Propagation (BP) rule. The Recurrent Dynamic Network (RDN) developed is applied for the total core reactivity prediction of a spacecraft reactor from only neutronic power level measurements. Results indicate that the RDN can reproduce the nonlinear response of the reactor while keeping the number of nodes roughly equal to the relative order of the system. As accuracy requirements are increased, the number of required nodes also increases, however, the order of the RDN necessary to obtain such results is still in the same order of magnitude as the order of the matematical model of the system. There are a number of issues identified regarding the behavior of the RDN, which at this point are unresolved and require further research. Nevertheless, it is believed that use of the recurrent MLP structure with a variety of different learning algorithms may prove useful in utilizing artifical neural networks (ANNs) for recognition, classification and prediction of dynamic systems.

  2. Recurrence of solitary fibrous tumor of the cervical spinal cord.

    PubMed

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ito, Zenya; Ando, Kei; Ukai, Junichi; Muramoto, Akio; Shinjo, Ryuichi; Matsumoto, Tomohiro; Nakashima, Hiroaki; Matsuyama, Yukihiro; Ishiguro, Naoki

    2014-02-01

    Solitary fibrous tumor (SFT) mostly originates from the pleura because of proliferation of fibroblast cells. It is extremely rare for the tumor to originate from the spinal cord. Here, we report a rare case of SFT in the spinal cord that recurred repeatedly and progressed from intramedullary to extramedullary. A 40-year-old man underwent C4-5 intramedullary and extramedullary tumor resection in another hospital. Eighteen years later, he experienced symptoms of myelopathy because of tumor recurrence; therefore, he consulted with our hospital and underwent tumor resection again. During surgery, we found that the tumor had an intramedullary and extramedullary location. Only partial resection was possible because of intraoperative deterioration in the compound motor action potential (CMAP). After resection, the pathological diagnosis was SFT. The postoperative course was good. However, two years later, a third tumor resection was required because of dysuria and tumor growth. In this surgery, total resection of the tumor was possible without intraoperative deterioration of the CMAP. The tumor has not subsequently recurred. However, SFT recurrence is relatively common and careful follow-up is required for early detection of recurrence, even after successful removal of the tumor.

  3. Risk factors of recurrent aphthous ulceration among university students.

    PubMed

    Shi, Liuxia; Wan, Kuan; Tan, Mengmeng; Yin, Guifang; Ge, Mengkai; Rao, Xiaoqian; He, Lianping; Jin, Yuelong; Yao, Yingshui

    2015-01-01

    Recurrent aphthous ulceration (RAU) is a common oral mucosal disease. The etiological involves in genetics, vitamin deficiencies, trauma, immune dysfunction and stress. This study was to explore the related risk factors of recurrent aphthous ulceration (RAU) among college students, and provide basis for further research. We conducted a questionnaire survey among students from three colleges in Wuhu by stratified cluster sampling. The information collected includes general demographic characteristics, dietary habits and so on. The overall prevalence of RAU is 23.30% among college students (23.23% in male and 23.39% in female). There are statistical significance in prevalence of RAU between subjects with RAU and without RAU (P<0.05) the prevalence of RAU in different grade, age, adequate brushing time, good brushing habits, wear dentures or braces, other oral disease, eat barbecue, adequate exercise time is statistic difference. According to the result of multinomial logistic regression analysis, the risk of recurrent aphthous ulceration factors including grade, inadequate brushing time. Tempering was a protective factor of RAU. Some measure should be taken to control dental ulcer, which consist of promoting a correct way of living habits, paying attention to the health conscious diet, strengthen physical exercise, self-decompression and keeping good mentality. PMID:26131228

  4. Core reactivity estimation in space reactors using recurrent dynamic networks

    NASA Technical Reports Server (NTRS)

    Parlos, Alexander G.; Tsai, Wei K.

    1991-01-01

    A recurrent multilayer perceptron network topology is used in the identification of nonlinear dynamic systems from only the input/output measurements. The identification is performed in the discrete time domain, with the learning algorithm being a modified form of the back propagation (BP) rule. The recurrent dynamic network (RDN) developed is applied for the total core reactivity prediction of a spacecraft reactor from only neutronic power level measurements. Results indicate that the RDN can reproduce the nonlinear response of the reactor while keeping the number of nodes roughly equal to the relative order of the system. As accuracy requirements are increased, the number of required nodes also increases, however, the order of the RDN necessary to obtain such results is still in the same order of magnitude as the order of the mathematical model of the system. It is believed that use of the recurrent MLP structure with a variety of different learning algorithms may prove useful in utilizing artificial neural networks for recognition, classification, and prediction of dynamic systems.

  5. Recurrent Education, Policy and Development in OECD Countries: Recurrent Education in the Federal Republic of Germany.

    ERIC Educational Resources Information Center

    Rudolph, Hedwig; And Others

    This report, part of a series on the state of recurrent education in the Organization for Economic Cooperation and Development (OECD) member countries, focuses on recurrent education in West Germany. The West German thrust for continuing adult education has come from business, industry, and the 1969 Labor Promotion Act which publicly funds…

  6. Germinoma recurrence in the conus medullaris 12 years after remission of primary intracranial lesion in the pituitary.

    PubMed

    Sivasubramaniam, Vinothan; Zebian, Bassel; Thakur, Bhaskar; Saran, Frank; Chandler, Christopher

    2016-03-01

    Intracranial germinomas are rare primary central nervous system tumours that are highly sensitive to radiotherapy and chemotherapy. Recurrences are infrequent, with the majority occurring within 5 years. Although multidisciplinary treatments have resulted in good event-free survival, long-term outcomes, over decades, are relatively poorly reported. We present a rare case of a recurrence in the conus medullaris 12 years after complete remission of the primary pituitary germinoma. To the best of our knowledge, this represents the first case of a significantly delayed spinal recurrence, occurring at a very distant and uncommon site, from the primary tumour. This case highlights the importance of long-term follow-up, even after complete remission, in order to identify and limit disability from late spinal recurrences in a relatively young patient population. We consider the literature regarding identifying high risk patients, and the role of craniospinal irradiation in limiting late spinal recurrences.

  7. Genetic regulation of recurrent spontaneous abortion in humans.

    PubMed

    Vaiman, Daniel

    2015-01-01

    Recurrent pregnancy loss, defined as a pregnancy failure occurring before 24 weeks of gestation more than two or three times according to most definitions, is a fertility defect encountered in 1-5% of the patients. This defect is of course of multifactorial origin. Among the possible origins of recurrent pregnancy loss are uterine structural defaults, defective ploidy control of the embryo, defective immunological dialog between the embryo (or the fetus) and the uterus sometimes in relation with immunological disorders (such as autoimmune diseases), thrombophilia, and free radical metabolism imbalance. Numerous studies attempted to correlate variants of genes supposed to be intervening in the different facets of the early maternal-fetal or maternal-embryonic dialog, and eventually modify the outcome of fertilization, leading to success or failure of post-implantation development. The objective of the present review is to portray the major genes and gene polymorphisms studied for their putative association with recurrent pregnancy loss. Most of these genes have been studied as candidate genes for which strong biological arguments were put forward as to their putative involvement in recurrent pregnancy loss. They were mostly studied by genetic analysis, often in various populations of different ethnic origins, throughout the world. Some of these studies were available only in English as abstracts and were nevertheless used if the information was given with enough detail. With the space being too short to depict all the available literature, different major pathways relevant to the scientific question are presented without any attempt to hide the fact that discordant views often aroused for a given gene. PMID:25179715

  8. Calcaneal chondroblastoma with pathologic fracture and recurrence.

    PubMed

    Dutt, Laksha; Schade, Valerie L; Manoso, Mark W

    2015-01-01

    Chondroblastomas account for <2% of all bone tumors. The calcaneus is the fifth most common location of occurrence. Males in their second decade of life are most often affected, presenting with an insidious onset of localized pain, swelling, and tenderness. The finding of associated pathologic fracture has been rare. Imaging studies can aid in the formulation of the differential diagnosis and surgical plan. The definitive diagnosis requires histologic examination. Curettage and bone grafting is curative in >80% of cases. Local recurrence rates of ≤38% have been reported, most often because of inadequate resection, and have been associated with malignant conversion and metastasis. Adjuvant therapies can help minimize the incidence of local recurrence. Long-term follow-up examinations are recommended, given the protracted interval that can exist between recurrence and the potential for malignant conversion and metastasis. We present the case of a young, healthy, active male with a calcaneal chondroblastoma and associated pathologic fracture whose initial treatment consisted of curettage, hydrogen peroxide lavage, and allogeneic bone grafting. Recurrence developed at 15 months postoperatively and was treated with repeat curettage, high-speed burring, and reconstruction with steel Steinman pins and polymethylmethacrylate, resulting in no pain or recurrence at the 5-month follow-up point.

  9. Computational capabilities of recurrent NARX neural networks.

    PubMed

    Siegelmann, H T; Horne, B G; Giles, C L

    1997-01-01

    Recently, fully connected recurrent neural networks have been proven to be computationally rich-at least as powerful as Turing machines. This work focuses on another network which is popular in control applications and has been found to be very effective at learning a variety of problems. These networks are based upon Nonlinear AutoRegressive models with eXogenous Inputs (NARX models), and are therefore called NARX networks. As opposed to other recurrent networks, NARX networks have a limited feedback which comes only from the output neuron rather than from hidden states. They are formalized by y(t)=Psi(u(t-n(u)), ..., u(t-1), u(t), y(t-n(y)), ..., y(t-1)) where u(t) and y(t) represent input and output of the network at time t, n(u) and n(y) are the input and output order, and the function Psi is the mapping performed by a Multilayer Perceptron. We constructively prove that the NARX networks with a finite number of parameters are computationally as strong as fully connected recurrent networks and thus Turing machines. We conclude that in theory one can use the NARX models, rather than conventional recurrent networks without any computational loss even though their feedback is limited. Furthermore, these results raise the issue of what amount of feedback or recurrence is necessary for any network to be Turing equivalent and what restrictions on feedback limit computational power. PMID:18255858

  10. Calcaneal chondroblastoma with pathologic fracture and recurrence.

    PubMed

    Dutt, Laksha; Schade, Valerie L; Manoso, Mark W

    2015-01-01

    Chondroblastomas account for <2% of all bone tumors. The calcaneus is the fifth most common location of occurrence. Males in their second decade of life are most often affected, presenting with an insidious onset of localized pain, swelling, and tenderness. The finding of associated pathologic fracture has been rare. Imaging studies can aid in the formulation of the differential diagnosis and surgical plan. The definitive diagnosis requires histologic examination. Curettage and bone grafting is curative in >80% of cases. Local recurrence rates of ≤38% have been reported, most often because of inadequate resection, and have been associated with malignant conversion and metastasis. Adjuvant therapies can help minimize the incidence of local recurrence. Long-term follow-up examinations are recommended, given the protracted interval that can exist between recurrence and the potential for malignant conversion and metastasis. We present the case of a young, healthy, active male with a calcaneal chondroblastoma and associated pathologic fracture whose initial treatment consisted of curettage, hydrogen peroxide lavage, and allogeneic bone grafting. Recurrence developed at 15 months postoperatively and was treated with repeat curettage, high-speed burring, and reconstruction with steel Steinman pins and polymethylmethacrylate, resulting in no pain or recurrence at the 5-month follow-up point. PMID:25624038

  11. Network of earthquakes and recurrences therein

    NASA Astrophysics Data System (ADS)

    Krishna Mohan, T. R.; Revathi, P. G.

    2011-01-01

    We quantify the correlation between earthquakes and use the same to distinguish between relevant causally connected earthquakes. Our correlation metric is a variation on the one introduced by Baiesi and Paczuski (Phys Rev E 69:066,106, 2004). A network of earthquakes is constructed, which is time-ordered and with links between the more correlated ones. Data pertaining to the California region has been used in the study. Recurrences to earthquakes are identified employing correlation thresholds to demarcate the most meaningful ones in each cluster. The distribution of recurrence lengths and recurrence times are analyzed subsequently to extract information about the complex dynamics. We find that the unimodal feature of recurrence lengths helps to associate typical rupture lengths with different magnitude earthquakes. The out-degree of the network shows a hub structure rooted on the large magnitude earthquakes. In-degree distribution is seen to be dependent on the density of events in the neighborhood. Power laws are also obtained with recurrence time distribution agreeing with the Omori law.

  12. Photodynamic therapy of recurrent cerebral glioma

    NASA Astrophysics Data System (ADS)

    Zhu, Shu-Gan; Wu, Si-En; Chen, Zong-Qian; Sun, Wei

    1993-03-01

    Photodynamic therapy (PDT) was performed on 11 cases of recurrent cerebral glioma, including 3 cases of recurrent glioblastoma, 7 of recurrent anaplastic astrocytoma, and 1 recurrent ependymoma. Hematoporphyrin derivative (HPD) was administered intravenously at a dose of 4 - 7 mg/kg 5 - 24 hours before the operation. All patients underwent a craniotomy with a nearly radical excision of the tumor following which the tumor bed was irradiated with 630 nm laser light emitting either an argon pumped dye laser or frequency double YAG pumped dye laser for 30 to 80 minutes with a total dose of 50 J/cm2 (n equals 1), 100 J/cm2 (n equals 2), 200 J/cm2 (n equals 7), and 300 J/cm2 (n equals 1). The temperature was kept below 37 degree(s)C by irrigation. Two patients underwent postoperative radiotherapy. There was no evidence of increased cerebral edema, and no other toxicity by the therapy. All patients were discharged from the hospital within 15 days after surgery. We conclude that PDT using 4 - 7 mg/kg of HPD and 630 nm light with a dose of up to 300 J/cm2 can be used as an adjuvant therapy with no additional complications. Adjuvant PDT in the treatment of recurrent glioma is better than simple surgery.

  13. Effect of Custom-Made Footwear on Foot Ulcer Recurrence in Diabetes

    PubMed Central

    Bus, Sicco A.; Waaijman, Roelof; Arts, Mark; de Haart, Mirjam; Busch-Westbroek, Tessa; van Baal, Jeff; Nollet, Frans

    2013-01-01

    OBJECTIVE Custom-made footwear is the treatment of choice to prevent foot ulcer recurrence in diabetes. This footwear primarily aims to offload plantar regions at high ulcer risk. However, ulcer recurrence rates are high. We assessed the effect of offloading-improved custom-made footwear and the role of footwear adherence on plantar foot ulcer recurrence. RESEARCH DESIGN AND METHODS We randomly assigned 171 neuropathic diabetic patients with a recently healed plantar foot ulcer to custom-made footwear with improved and subsequently preserved offloading (∼20% peak pressure relief by modifying the footwear) or to usual care (i.e., nonimproved custom-made footwear). Primary outcome was plantar foot ulcer recurrence in 18 months. Secondary outcome was ulcer recurrence in patients with an objectively measured adherence of ≥80% of steps taken. RESULTS On the basis of intention-to-treat, 33 of 85 patients (38.8%) with improved footwear and 38 of 86 patients (44.2%) with usual care had a recurrent ulcer (relative risk −11%, odds ratio 0.80 [95% CI 0.44–1.47], P = 0.48). Ulcer-free survival curves were not significantly different between groups (P = 0.40). In the 79 patients (46% of total group) with high adherence, 9 of 35 (25.7%) with improved footwear and 21 of 44 (47.8%) with usual care had a recurrent ulcer (relative risk −46%, odds ratio 0.38 [0.15–0.99], P = 0.045). CONCLUSIONS Offloading-improved custom-made footwear does not significantly reduce the incidence of plantar foot ulcer recurrence in diabetes compared with custom-made footwear that does not undergo such improvement, unless it is worn as recommended. PMID:24130357

  14. Prevention of Recurrent Staphylococcal Skin Infections

    PubMed Central

    Creech, C. Buddy; Al-Zubeidi, Duha N.; Fritz, Stephanie A.

    2015-01-01

    Synopsis Staphylococcus aureus infections pose a significant health burden. The emergence of community-associated methicillin-resistant S. aureus has resulted in an epidemic of skin and soft tissue infections (SSTI), and many patients experience recurrent SSTI. As S. aureus colonization is associated with subsequent infection, decolonization is recommended for patients with recurrent SSTI or in settings of ongoing transmission. S. aureus infections often cluster within households and asymptomatic carriers serve as reservoirs for transmission; therefore, a household approach to decolonization is more effective than measures performed by individuals alone. Other factors, such as environmental surface contamination, may also be considered. Novel strategies for the prevention of recurrent SSTI are needed. PMID:26311356

  15. Recurrent intramedullary epidermoid cyst of conus medullaris.

    PubMed

    Fleming, Christina; Kaliaperumal, Chandrasekaran; O'Sullivan, Michael

    2011-12-13

    Spinal intramedullary epidermoid cyst is a rare condition. Recurrent epidermoid cyst in the spine cord is known to occur. The authors describe a case of recurrent conus medullaris epidermoid cyst in a 24-year-old female. She initially presented at 7 years of age with bladder disturbance in the form of diurnal enuresis and recurrent urinary tract infection. MRI lumbar spine revealed a 4 cm conus medullaris epidermoid cyst. Since the initial presentation, the cyst had recurred seven times in the same location and she underwent surgical intervention in the form of exploration and debulking. This benign condition, owing to its anatomical location, has posed a surgical and overall management challenge. This occurrence is better managed in a tertiary-care centre requiring multi-disciplinary treatment approach.

  16. Recurrence quantification analysis of global stock markets

    NASA Astrophysics Data System (ADS)

    Bastos, João A.; Caiado, Jorge

    2011-04-01

    This study investigates the presence of deterministic dependencies in international stock markets using recurrence plots and recurrence quantification analysis (RQA). The results are based on a large set of free float-adjusted market capitalization stock indices, covering a period of 15 years. The statistical tests suggest that the dynamics of stock prices in emerging markets is characterized by higher values of RQA measures when compared to their developed counterparts. The behavior of stock markets during critical financial events, such as the burst of the technology bubble, the Asian currency crisis, and the recent subprime mortgage crisis, is analyzed by performing RQA in sliding windows. It is shown that during these events stock markets exhibit a distinctive behavior that is characterized by temporary decreases in the fraction of recurrence points contained in diagonal and vertical structures.

  17. Treatment of persistent and recurrent acromegaly.

    PubMed

    Del Porto, Lana A; Liubinas, Simon V; Kaye, Andrew H

    2011-02-01

    Acromegaly is a chronic insidious disease characterised by growth hormone (GH) hypersecretion, typically from a pituitary adenoma. Effective treatment of acromegaly is vital because it is associated with a mortality rate more than twice that of the general population, an increased prevalence of colonic malignancy and many significant co-morbidities. Transsphenoidal adenoma resection is still the best first-line treatment for acromegaly but persistence (43%) or recurrence (2% to 3%) of GH hypersecretion after surgery remains a problem. Treatment options for acromegaly after failed initial therapy or recurrence include further surgery, radiotherapy, radiosurgery or medical therapies, including somatostatin analogues, dopamine agonists and growth hormone receptor antagonists. There has been a progressive lowering of the accepted GH level defining cure in acromegaly. This article reviews the efficacy and safety of the various treatment options for persistent or recurrent acromegaly and the changing definition of cure. PMID:21167718

  18. Recurrent Urinary Tract Infections and Related Conditions (For Parents)

    MedlinePlus

    ... A promising vaccine that would protect against E. coli (the most common bacterium that causes UTIs) is ... are often suggested because they may prevent E. coli from attaching to the walls of the bladder. ...

  19. [Recurrent failed ICD therapy of ventricular tachycardia].

    PubMed

    Hein, W; Ellringmann, U; Vollmann, D; Rostock, T; Schott, P

    2012-11-01

    Implantable cardioverter defibrillators (ICD) are used as standard therapy to prevent sudden cardiac death in heart failure patients. Today, physicians in emergency and intensive care medicine are often confronted with problems of ICD therapy in these patients. We report a case of a patient suffering from recurrent ventricular tachycardia (VT) requiring antiarrhythmia treatment with amiodarone. With an increasing drug loading, the VT cycle length was progressively prolonged resulting in a slow VT undetectable for the ICD. Subsequently, the patient was scheduled for VT ablation after which the patient became free of arrhythmia recurrences. PMID:23070331

  20. Recurrent pregnancy loss: evaluation and treatment.

    PubMed

    Shahine, Lora; Lathi, Ruth

    2015-03-01

    Recurrent pregnancy loss (RPL) is a multifactorial condition. Approximately half of patients with RPL will have no explanation for their miscarriages. De novo chromosome abnormalities are common in sporadic and recurrent pregnancy loss. Testing for embryonic abnormalities can provide an explanation for the miscarriage in many cases and prognostic information. Regardless of the cause of RPL, patients should be reassured that the prognosis for live birth with an evidence-based approach is excellent for most patients. The authors review current evidence for the evaluation and treatment of RPL and explore the proposed use of newer technology for patients with RPL.

  1. Recurrent aggressive fibromatosis of the chest wall.

    PubMed

    Foà, Riccardo; Rizzo, Stefania; Petrella, Francesco; De Maria, Federica; Bellomi, Massimo

    2014-01-01

    A 57-year-old woman with a previous history of aesthetic surgery for breast reduction presented with a subcutaneous mass in the right axilla. A CT scan showed a solid mass on the chest wall, and she underwent surgical resection with a diagnosis of aggressive fibromatosis. After a 10-month period of follow-up, a local recurrence occurred, and in accordance with the up-to-date approach, the recurrence has been treated with a conservative approach (medical treatments) with good control of the symptoms and downsizing of the lesion.

  2. Recurrent thyrotoxicosis after I-131 induced hypothyroidism

    SciTech Connect

    Liu, L.; Borowski, G.D.; Shtasel, P.; Rose, L.I.

    1984-01-01

    The first clinically and biochemically documented case of recurrent thyrotoxicosis after I-131 induced hypothyroidism in a patient with Graves' disease is reported. Two months after the administration of 9.2 mCi of I-131, the subject developed hypothyroidism. One month later, the patient became euthyroid. Then, nine months following ablation, the patient again developed thyrotoxicosis. A second dose of I-131 of 12.5 mCi was required to finally produce permanent hypothyroidism. This case illustrates the recurrence of hypothyroidism after what had seemed to have been adequate I-131 radiation.

  3. Cediranib Maleate and Olaparib in Treating Patients With Recurrent Ovarian, Fallopian Tube, or Peritoneal Cancer or Recurrent Triple-Negative Breast Cancer

    ClinicalTrials.gov

    2016-10-27

    Estrogen Receptor Negative; HER2/Neu Negative; Ovarian Endometrioid Adenocarcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Progesterone Receptor Negative; Recurrent Breast Carcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Triple-Negative Breast Carcinoma

  4. How Travel Demand Affects Detection of Non-Recurrent Traffic Congestion on Urban Road Networks

    NASA Astrophysics Data System (ADS)

    Anbaroglu, B.; Heydecker, B.; Cheng, T.

    2016-06-01

    Occurrence of non-recurrent traffic congestion hinders the economic activity of a city, as travellers could miss appointments or be late for work or important meetings. Similarly, for shippers, unexpected delays may disrupt just-in-time delivery and manufacturing processes, which could lose them payment. Consequently, research on non-recurrent congestion detection on urban road networks has recently gained attention. By analysing large amounts of traffic data collected on a daily basis, traffic operation centres can improve their methods to detect non-recurrent congestion rapidly and then revise their existing plans to mitigate its effects. Space-time clusters of high link journey time estimates correspond to non-recurrent congestion events. Existing research, however, has not considered the effect of travel demand on the effectiveness of non-recurrent congestion detection methods. Therefore, this paper investigates how travel demand affects detection of non-recurrent traffic congestion detection on urban road networks. Travel demand has been classified into three categories as low, normal and high. The experiments are carried out on London's urban road network, and the results demonstrate the necessity to adjust the relative importance of the component evaluation criteria depending on the travel demand level.

  5. Air leakage on the postoperative day: powerful factor of postoperative recurrence after thoracoscopic bullectomy

    PubMed Central

    Jeon, Hyun Woo; Kye, Yeo Kon; Kim, Kyung Soo

    2016-01-01

    Background Primary spontaneous pneumothorax (PSP) is a relatively common disorder in young patients. Although various surgical techniques have been introduced, recurrence after video-assisted thoracoscopic surgery (VATS) remains high. The aim of study was to identify the risk factors for postoperative recurrence after thoracoscopic bullectomy in the spontaneous pneumothorax. Methods From January 2011 through March 2013, two hundreds and thirty two patients underwent surgery because of pneumothorax. Patients with a secondary pneumothorax, as well as cases of single port surgery, an open procedure, additional pleural procedure (pleurectomy, pleural abrasion) or lack of medical records were excluded. The records of 147 patients with PSP undergoing 3-port video-assisted thoracoscopic bullectomy with staple line coverage using an absorbable polyglycolic acid (PGA) sheet were retrospectively reviewed. Results The median age was 19 years (range, 11−34 years) with male predominance (87.8%). Median postoperative hospital stay was 3 days (range, 1−10 days) without mortality. Complications were developed in five patients. A total of 24 patients showed postoperative recurrence (16.3%). Younger age less than 17 years old and immediate postoperative air leakage were risk factors for postoperative recurrence after thoracoscopic bullectomy by multivariate analysis. Conclusions Immediate postoperative air leakage was the risk factor for postoperative recurrence. However, further study will be required for the correlation of air leakage with recurrence. PMID:26904217

  6. Accumulation of allelic losses on chromosome 10 in human gliomas at recurrence

    PubMed Central

    Tokiyoshi, K; Yoshimine, T; Maruno, M; Muhammad, A K M G; Hayakawa, T

    1996-01-01

    Aims—To elucidate the implications of allelic loss on chromosome 10 in the malignant progression of human gliomas. Methods—Eight microsatellite loci (D10S249, D10S191, D10S210, D10S219, D10S246, D10S222, D10S221, and D10S212) were analysed for chromosomal deletions in histologically benign and malignant, including recurrent, gliomas. Of the 16 original tumours studied (two astrocytomas, nine anaplastic astrocytomas and five glioblastomas), the histological diagnosis at recurrence was anaplastic astrocytoma in six cases and glioblastoma in 10. Genomic DNA was extracted from formalin fixed, paraffin wax embedded sections. Samples of original and recurrent tumours were paired and amplified using PCR. Samples of histologically normal brain served as controls. Results—Of the original tumours, all five glioblastomas, five (56%) of nine anaplastic astrocytomas and none of the astrocytomas demonstrated loss of heterozygosity (LOH) on chromosome 10. Additional LOH was detected in the five cases of anaplastic astrocytoma that progressed to glioblastoma at recurrence. Additional LOH was not detected in the two cases of astrocytoma that progressed to anaplastic astrocytoma at recurrence. With the exception of one case, additional LOH was observed in the recurrent glioblastomas. Conclusion—LOH was observed at the loci of two adjacent microsatellite markers, D10S222 and D10S221 (10q23-q25), suggesting that this region on chromosome 10 is closely related to progression from anaplastic astrocytoma to glioblastoma. Images PMID:16696078

  7. A Randomized Controlled Trial of Celecoxib to Prevent Recurrence of Non-Muscle–Invasive Bladder Cancer

    PubMed Central

    Sabichi, Anita L.; Lee, J. Jack; Grossman, H. Barton; Liu, Suyu; Richmond, Ellen; Czerniak, Bogdan A.; De la Cerda, Jorge; Eagle, Craig; Viner, Jaye L.; Palmer, J. Lynn; Lerner, Seth P.

    2014-01-01

    Significant morbidity and expense result from frequent recurrences of non-muscle invasive bladder cancer (NMIBC) after standard treatment, and carcinoma in situ (Tis) is a poor prognostic factor. Predicated on observational and preclinical data strongly supporting cyclooxygenase-2 (COX-2) in the pathogenesis, and the activity of COX-2 inhibitors, in bladder cancer, we conducted a randomized, double-blind, placebo-controlled trial to determine if celecoxib could reduce the time-to-recurrence (TTR) in NMIBC patients at high risk for recurrence. 146 patients were randomized to celecoxib (200 mg) or placebo orally twice daily for at least 12 months. The average treatment duration was 1.25 years. Primary intent-to-treat analysis revealed celecoxib did not statistically significantly prolong TTR compared with placebo (P = 0.17, log-rank). With a median follow-up of 2.49 years the relative risk of recurrence in the celecoxib vs placebo arms was 0.64 (95% CI, 0.38, 1.17). The recurrence-free rate at 12 months with celecoxib was 88% (95% CI, 0.81,0.96) versus 78% (95% CI, 0.69, 0.89) with placebo. After controlling for covariates with Cox regression analysis, recurrence rates did not differ between the two study arms (HR = 0.69; 95% CI, 0.37,1.29). Celecoxib had a marginally significant effect on reducing metachronous recurrences (vs. placebo) with hazard ratio of 0.56 (95% CI, 0.3,1.06; P=0.075). Celecoxib was well tolerated, with similar adverse events and quality-of-life in both arms. Our clinical trial results do not show a clinical benefit for celecoxib in preventing NMIBC recurrence but further investigation of COX-2 inhibitors in this setting is warranted. PMID:21881030

  8. Use of recurrence plot and recurrence quantification analysis in Taiwan unemployment rate time series

    NASA Astrophysics Data System (ADS)

    Chen, Wei-Shing

    2011-04-01

    The aim of the article is to answer the question if the Taiwan unemployment rate dynamics is generated by a non-linear deterministic dynamic process. This paper applies a recurrence plot and recurrence quantification approach based on the analysis of non-stationary hidden transition patterns of the unemployment rate of Taiwan. The case study uses the time series data of the Taiwan’s unemployment rate during the period from 1978/01 to 2010/06. The results show that recurrence techniques are able to identify various phases in the evolution of unemployment transition in Taiwan.

  9. Prevention of recurrent stroke in patients with patent foramen ovale.

    PubMed

    Wessler, Benjamin S; Kent, David M

    2015-05-01

    Patent foramen ovale (PFO) is common and only rarely related to stroke. The high PFO prevalence in healthy individuals makes for difficult decision making when a PFO is found in the setting of a cryptogenic stroke, because the PFO may be an incidental finding. Recent clinical trials of device-based PFO closure have had negative overall summary results; these trials have been limited by low recurrence rates. The optimal antithrombotic strategy for these patients is also unknown. Recent work has identified a risk score that estimates PFO-attributable fractions based on individual patient characteristics, although whether this score can help direct therapy is unclear.

  10. Risk factors associated with recurrent homelessness after a first homeless episode.

    PubMed

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness. PMID:23744291

  11. Risk factors associated with recurrent homelessness after a first homeless episode.

    PubMed

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

  12. Recurrent abscess after MammoSite brachytherapy.

    PubMed

    Lopchinsky, Richard A; Giles, Kristina A

    2004-01-01

    Recently a new catheter was introduced to facilitate brachytherapy in a lumpectomy cavity. Data are limited on the side effects of high-dose brachytherapy to the lumpectomy cavity with the MammoSite catheter. We present a case of recurrent abscesses over a 7-month period in the lumpectomy cavity after MammoSite brachytherapy.

  13. Recurrent Midgut Bleeding due to Jejunal Angioleiomyoma

    PubMed Central

    Mityushin, Petr

    2016-01-01

    Angioleiomyoma being a type of true smooth muscle gastrointestinal tumors can lead to serious life-threatening gastrointestinal bleeding. We report a case of 21-year-old male patient with recurrent midgut bleeding. Contrast-enhanced CT revealed highly vascular small bowel neoplasm. The patient underwent laparotomy with bowel resection and recovered uneventfully. Histopathology revealed jejunal angioleiomyoma. PMID:27668116

  14. [Therapeutic education for recurrent depressive disorder].

    PubMed

    Carde, Soufiane; Hatif, Séverine; Samama, Diane; Charbonnel, Patricia; Jouvent, Roland

    2016-01-01

    Depression is a serious and recurrent condition which can become chronic. As a complement to other therapeutic approaches, therapeutic patient education (TPE) or psychoeducation is effective. TPE groups led by a multidisciplinary hospitalisation team in a psychiatric department are thereby integrated into the global care in order to reduce relapses and improve patients' quality of life.

  15. [Multifocus or recurrent carcinoma adenoides cysticum].

    PubMed

    Wójtowicz, P; Sujkowska, U; Kukwa, A; Sobczyk, G; Misztela, T

    1995-01-01

    Authors present the case of carcinoma adenoides cysticum, which was located in small salivary glands of palatum. After surgical treatment and radiotherapy during 3 years observation of the patient two new ca adenoides cysticum focus were noticed. It can give evidence of cancer multifocus of cancer recurrents.

  16. Recurrent Midgut Bleeding due to Jejunal Angioleiomyoma.

    PubMed

    Gachabayov, Mahir; Mityushin, Petr

    2016-01-01

    Angioleiomyoma being a type of true smooth muscle gastrointestinal tumors can lead to serious life-threatening gastrointestinal bleeding. We report a case of 21-year-old male patient with recurrent midgut bleeding. Contrast-enhanced CT revealed highly vascular small bowel neoplasm. The patient underwent laparotomy with bowel resection and recovered uneventfully. Histopathology revealed jejunal angioleiomyoma. PMID:27668116

  17. Recurrent Midgut Bleeding due to Jejunal Angioleiomyoma

    PubMed Central

    Mityushin, Petr

    2016-01-01

    Angioleiomyoma being a type of true smooth muscle gastrointestinal tumors can lead to serious life-threatening gastrointestinal bleeding. We report a case of 21-year-old male patient with recurrent midgut bleeding. Contrast-enhanced CT revealed highly vascular small bowel neoplasm. The patient underwent laparotomy with bowel resection and recovered uneventfully. Histopathology revealed jejunal angioleiomyoma.

  18. Families of Linear Recurrences for Catalan Numbers

    ERIC Educational Resources Information Center

    Gauthier, N.

    2011-01-01

    Four different families of linear recurrences are derived for Catalan numbers. The derivations rest on John Riordan's 1973 generalization of Catalan numbers to a set of polynomials. Elementary differential and integral calculus techniques are used and the results should be of interest to teachers and students of introductory courses in calculus…

  19. Recurrent Pediatric Headaches: Behavioral Concepts and Interventions

    ERIC Educational Resources Information Center

    Allen, Keith D.

    2006-01-01

    Recurrent pediatric headaches are increasingly understood to be a function of both respondent and operant processes. In particular, the environment is thought to elicit internal autonomic instability and to evoke external maladaptive pain behavior. While medical interventions often provide an appropriate first line treatment, behavioral…

  20. Psychosocial Treatment for Recurrent Genital Herpes.

    ERIC Educational Resources Information Center

    Longo, David J.; And Others

    1988-01-01

    Assigned 21 individuals with recurrent genital herpes to psychosocial intervention, social support, or waiting-list control conditions. Those receiving psychosocial intervention (herpes simplex virus information, relaxation training, stress management instructions, and an imagery technique) reported significantly greater reductions in herpes…

  1. Cutis laxa presenting as recurrent ileus

    PubMed Central

    Bharadwaj, Shishira; Shrestha, Prakash; Gohel, Tushar D.; Singh, Maninder

    2016-01-01

    Cutis laxa (CL) is a rare connective tissue disorder characterized by phenotypic appearance of loose and redundant skin. CL can be congenital or acquired. Congenital forms include autosomal dominant, autosomal recessive and X-linked recessive. Apart from cutaneous abnormalities, CL can present with visceral involvement. In this article, we report a case of CL presenting as recurrent ileus. PMID:25008264

  2. Genetic counseling of consanguineous families. Use of Smith's method to calculate recurrence risks in multifactorial inheritance in consanguineous matings.

    PubMed Central

    Bonaiti, C

    1978-01-01

    A modification of Smith's method is described for deriving recurrence risks for multifactorial conditions when parents are related. Using cleft palate as an example, the possible increased risks caused by consanguinity are discussed. PMID:641942

  3. Tanespimycin in Treating Young Patients With Recurrent or Refractory Leukemia or Solid Tumors

    ClinicalTrials.gov

    2013-06-03

    Childhood Chronic Myelogenous Leukemia; Childhood Desmoplastic Small Round Cell Tumor; Disseminated Neuroblastoma; Metastatic Childhood Soft Tissue Sarcoma; Metastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Metastatic Osteosarcoma; Previously Treated Childhood Rhabdomyosarcoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent Osteosarcoma

  4. Expression of Cold-Inducible RNA-Binding Protein (CIRP) in Pituitary Adenoma and its Relationships with Tumor Recurrence

    PubMed Central

    Wang, Mingguang; Zhang, Huan; Heng, Xueyuan; Pang, Qi; Sun, Aigang

    2015-01-01

    Background The aim of this study was to detect the expression of cold-inducible RNA-binding protein in pituitary adenoma and to determine its effects on tumor recurrence. Material/Methods We collected a total of 60 post-op samples collected from pituitary adenoma patients (including 20 cases of invasive pituitary adenoma, 20 cases of non-invasive adenoma, and 20 cases of non-invasive recurrent adenoma) admitted in our hospital. Both protein and mRNA levels of CIRP in 3 types of pituitary adenoma samples were quantified by Western blotting and real-time PCR, respectively. Results Western blotting revealed significantly elevated CIRP expression levels in invasive pituitary adenoma compared to non-invasive tumors, with statistical significance (p<0.05). Recurrent pituitary adenoma expressed significantly higher CIRP levels compared to non-recurrent tumors (p<0.05). Real-time PCR for CIRP mRNA obtained consistent results: transcript levels were significantly higher in invasive pituitary adenoma compared to non-invasive adenoma (p<0.05); recurrent adenoma also had significantly higher CIRP mRNA levels compared to non-recurrent tumors (p<0.05). Among all 3 types of pituitary adenoma, recurrent tumors had the highest levels of CIRP mRNA and protein. Conclusions The expression of CIRP in pituitary adenoma is closely related with tumor proliferation and invasion, and its significantly elevated expression level indicates post-op recurrence. PMID:25934796

  5. Analysis of Risk Factors Contributing to Recurrence of Papillary Thyroid Carcinoma in Chinese Patients Who Underwent Total Thyroidectomy

    PubMed Central

    Zhang, Wei; Jiao, De; Liu, Baoguo; Sun, Shanping

    2016-01-01

    Background Thyroid cancer is a very common endocrine malignancy, with a rate of total thyroidectomy reported to be up to 27.8%. However, studies analyzing the risk factors that contribute to recurrence of papillary thyroid carcinoma (PTC) after total thyroidectomy in China are still scarce. Material/Methods A total of 536 patients with PTC who underwent total thyroidectomy were retrospectively analyzed. Patients were divided into 2 groups: patients with no recurrent tumor were included in group 1 and patients with tumor recurrence were included in group 2. Results Of 536 patients, 65 patients (12.1%) developed a recurrence of PTC, and 471 patients (87.9%) did not have a recurrence. Univariate analysis indicated that male sex, age ≥50 years, tumor ≥1 cm, poor differentiation, lymph node metastasis, bilaterality, and multifocality may be related to PTC recurrence. Additionally, the results of the logistic regression analysis indicated that male sex, age ≥50 years, primary tumor ≥1 cm, poor dedifferentiation of the tumor, lymph node metastasis, and multifocality may be independent factors contributing to PTC recurrence. Conclusions Male sex, age more than 50 years, primary tumor larger than 1 cm, poor dedifferentiation of the primary tumor, lymph node metastasis, and multifocality were found to increase the risk of PTC recurrence in patients who underwent total thyroidectomy. Additionally, it is necessary to use strictly aggressive and extensive surgery, as well as close monitoring, after the operation. PMID:27084873

  6. RECURRENCE RATES OF OCULAR TOXOPLASMOSIS DURING PREGNANCY

    PubMed Central

    Braakenburg, Arthur M.D.; Crespi, Catherine M.; Holland, Gary N.; Wu, Sheng; Yu, Fei; Rothova, Aniki

    2014-01-01

    Purpose To investigate whether recurrence rates of ocular toxoplasmosis are higher during pregnancy among women of childbearing age. Design Retrospective longitudinal cohort study. Methods We reviewed medical records of all women seen at a university eye clinic (Utrecht, Netherlands) during episodes of active toxoplasmic retinochoroiditis that occurred while the women were of childbearing age (16–42 years). Each woman was sent a questionnaire requesting information regarding all pregnancies and episodes of ocular toxoplasmosis, whether or not episodes were observed at the eye clinic. Conditional fixed-effects Poisson regression was used to model incident rate ratios of recurrence during pregnant versus non-pregnant intervals, adjusted for potential confounders, including age at time of active toxoplasmic retinochoroiditis and interval since last episode of active disease, which are known to influence risk of recurrence. Results Questionnaires were returned by 50 (58%) of 86 women, 34 of whom had 69 pregnancies during 584 person-years of study. There were 128 episodes of ocular toxoplasmosis during the study period (6 during pregnancy). First episodes of ocular toxoplasmosis occurred between ages 9.6 and 38.5 years. Youngest age at pregnancy was 16.1 years; oldest age at childbirth was 40.9 years. Incident rate ratios for pregnant versus non-pregnant intervals were in the direction of lower recurrence rates during pregnancy, with point estimates of 0.54 and 0.75 under two different approaches, but ratios were not significantly different from the null value (p-values of 0.16 and 0.55). Conclusions Recurrence rates of ocular toxoplasmosis are likely not higher during pregnancy, in contrast to traditional beliefs. PMID:24412127

  7. The cost of breast cancer recurrences.

    PubMed Central

    Hurley, S. F.; Huggins, R. M.; Snyder, R. D.; Bishop, J. F.

    1992-01-01

    Information about the costs of recurrent breast cancer is potentially important for targeting cost containment strategies and analysing the cost-effectiveness of breast cancer control programmes. We estimated these costs by abstracting health service and consumable usage data from the medical histories of 128 patients, and valuing each of the resources used. Resource usage and costs were summarised by regarding the recurrence as a series of episodes which were categorised into five anatomical site-based groups according to the following hierarchy: visceral, central nervous system (CNS), bone, local and other. Hospital visits and investigations comprised 78% of total costs for all episodes combined, and there were significant differences between the site-based groups in the frequency of hospital visits and most investigations. Total costs were most accurately described by separate linear regression models for each group, with the natural logarithm of the cost of the episode as the dependent variable, and predictor variables including the duration of the episode, duration squared, duration cubed and a variable indicating whether the episode was fatal. Visceral and CNS episodes were associated with higher costs than the other groups and were more likely to be shorter and fatal. A fatal recurrence of duration 15.7 months (the median for our sample) was predicted to cost $10,575 (Aus + 1988; or 4,877 pounds). Reduction of the substantial costs of recurrent breast cancer is likely to be a sizable economic benefit of adjuvant systemic therapy and mammographic screening. We did not identify any major opportunities for cost containment during the management of recurrences. PMID:1558803

  8. [Recurrence of upper aerodigestive tract tumors].

    PubMed

    Martin, Laurent; Zoubir, Mustapha; Le Tourneau, Christophe

    2014-05-01

    Recurrences of tumours of the upper aerodigestive tract are frequent despite the improvement of the primary treatment and they limit the rate of survival long-term. They occur in patients with multiple co-morbidities, often associated with sequelae or side effects of earlier treatments. The salvage treatment will add a cumulative toxicity and therapeutic options are limited. The choice will go from curator to palliative treatment. The report benefit-risk must be assessed in each case depending on the terrain and prognostic factors that have been identified, such as performance status, the time between initial disease and the recurrence, the site and the stratification of the recurrence. In operable non-metastatic recurrence surgery remains the treatment of choice. Multimodal treatment involving surgery, radiation therapy and chemotherapy in this context is being evaluated. Non-operable tumors have long been considered only in a palliative context. The evaluation of detailed irradiation as bifractionnated radiotherapy combined with chemotherapy helped establish protocols allowing long-term survivals and consider these treatments as potentially curators. However, the toxicity of these treatments is important. That is why the technical innovations of the radiation and the development of new chemotherapeutic agents today offer opportunities remaining to assess. The use of irradiation targeted by intensity-modulated radiation therapy (IMRT), and stereotactic radiotherapy by decreasing the irradiated volume should decrease the toxicity. Generally better tolerated than conventional chemotherapy agents, targeted therapies also took their places associated with radiotherapy in the treatment of these patients already treated. Cetuximab was the first agent obtaining an indication. Other agents are being evaluated in metastatic recurrent tumors, including exploring the possibilities of radiopotentialisation nanoparticles and the inhibitors of apoptosis proteins.

  9. Cherry Consumption and the Risk of Recurrent Gout Attacks

    PubMed Central

    Zhang, Yuqing; Neogi, Tuhina; Chen, Clara; Chaisson, Christine; Hunter, David; Choi, Hyon K.

    2012-01-01

    Objective To study the relation between cherry intake and the risk of recurrent gout attacks among individuals with gout. Methods We conducted a case-crossover study to examine associations of a set of putative risk factors with recurrent gout attacks. Individuals with gout were prospectively recruited and followed online for one year. Participants were asked about the following information when experiencing a gout attack: the onset date of the gout attack, symptoms and signs, medications (including anti-gout medications), and potential risk factors (including daily intake of cherries and cherry extract) during the 2-day period prior to the gout attack. We assessed the same exposure information over 2-day control periods. We estimated the risk of recurrent gout attacks related to cherry intake using conditional logistic regression. Results Our study included 633 individuals with gout. Cherry intake over a 2-day period was associated with a 35% lower risk of gout attacks compared with no intake (multivariate odds ratio [OR] = 0.65, 95% CI: 0.50-0.85). Cherry extract intake showed a similar inverse association (multivariate OR=0.55, 95% CI: 0.30-0.98). The effect of cherry intake persisted across subgroups by sex, obesity status, purine intake, alcohol use, diuretic use, and use of anti-gout medications. When cherry intake was combined with allopurinol use, the risk of gout attacks was 75% lower than periods without either exposure (OR=0.25, 95% CI: 0.15-0.42). Conclusions These findings suggest that cherry intake is associated with a lower risk of gout attacks. PMID:23023818

  10. A family of Nikishin systems with periodic recurrence coefficients

    SciTech Connect

    Delvaux, Steven; Lopez, Abey; Lopez, Guillermo L

    2013-01-31

    Suppose we have a Nikishin system of p measures with the kth generating measure of the Nikishin system supported on an interval {Delta}{sub k} subset of R with {Delta}{sub k} Intersection {Delta}{sub k+1} = Empty-Set for all k. It is well known that the corresponding staircase sequence of multiple orthogonal polynomials satisfies a (p+2)-term recurrence relation whose recurrence coefficients, under appropriate assumptions on the generating measures, have periodic limits of period p. (The limit values depend only on the positions of the intervals {Delta}{sub k}.) Taking these periodic limit values as the coefficients of a new (p+2)-term recurrence relation, we construct a canonical sequence of monic polynomials {l_brace}P{sub n}{r_brace}{sub n=0}{sup {infinity}}, the so-called Chebyshev-Nikishin polynomials. We show that the polynomials P{sub n} themselves form a sequence of multiple orthogonal polynomials with respect to some Nikishin system of measures, with the kth generating measure being absolutely continuous on {Delta}{sub k}. In this way we generalize a result of the third author and Rocha [22] for the case p=2. The proof uses the connection with block Toeplitz matrices, and with a certain Riemann surface of genus zero. We also obtain strong asymptotics and an exact Widom-type formula for functions of the second kind of the Nikishin system for {l_brace}P{sub n}{r_brace}{sub n=0}{sup {infinity}}. Bibliography: 27 titles.

  11. Relapse versus reinfection: recurrent Clostridium difficile infection following treatment with fidaxomicin or vancomycin.

    PubMed

    Figueroa, Iris; Johnson, Stuart; Sambol, Susan P; Goldstein, Ellie J C; Citron, Diane M; Gerding, Dale N

    2012-08-01

    Our study sought to compare the strain types of Clostridium difficile causing initial and recurrent episodes of C. difficile infection (CDI) in adult patients with a first episode of CDI or 1 prior episode of CDI within the previous 90 days. Strains originated from patients who had been entered into two phase 3 randomized clinical trials of fidaxomicin versus vancomycin. Isolates of C. difficile from the initial and recurrent episodes within 28 (± 2) days of cure of CDI were compared using restriction endonuclease analysis (REA) typing. Paired isolates were available from 90 of 194 (46%) patients with recurrent CDI. Patients with isolates available were significantly younger (P = .008) and more likely to be from Canadian sites (P = .0001), compared with patients without isolates. In 75 of 90 subjects (83.3%), the identical REA type strain was identified at recurrence and the initial episode (putative relapse). Early recurrences (0-14 days after treatment completion) were relapses in 86.7% and a new strain (reinfection) in 13.3%. Later recurrences (15-31 days after treatment) were relapses in 76.7% and reinfections in 23.3%. Mean time (± standard deviation) to recurrence was 12.2 (± 6.4) days for relapses and 14.7 (± 6.8) days for reinfections (P = .177). The most common BI/NAP1/027 group and the previous US epidemic REA group J/NAP2/001 had a significantly higher combined rate of recurrence with the same strain (relapse), compared with the other REA groups (39 of 42 [93%] vs 36 of 48 [75%], respectively; P = .023). We found a higher than historic rate of recurrent CDI caused by the same isolate as the original episode, a finding that may be related to the relatively short observation period in this study and the high frequency of isolation of epidemic strains, such as groups BI and J, for which relapse rates may be higher than for other REA groups. Caution in generalizing these observations is required, because the patients studied were younger and more likely

  12. Dairy products, polymorphisms in the vitamin D receptor gene and colorectal adenoma recurrence.

    PubMed

    Hubner, Richard A; Muir, Kenneth R; Liu, Jo-Fen; Logan, Richard F A; Grainge, Matthew J; Houlston, Richard S

    2008-08-01

    Vitamin D receptor (VDR) activation inhibits proliferation and angiogenesis in the colorectal epithelium, and inhibits metastasis of colorectal tumors. Polymorphisms in the VDR gene alter receptor cellular levels and functioning, and may confer altered susceptibility to colorectal neoplasia. We aimed to investigate the influence of VDR polymorphisms and dietary factors impacting on vitamin D metabolism on colorectal adenoma (CRA) recurrence. Data on dietary intakes of calcium, vitamin D and dairy products were collected from 853 participants in the United Kingdom Colorectal Adenoma Prevention trial, a randomized trial of aspirin and folate for CRA recurrence prevention. The VDR Cdx2, FokI, BsmI, ApaI and TaqI polymorphisms were genotyped in 546 participants with available DNA, and gene-diet interaction analyses performed in 480. Dairy product intake was inversely related to CRA recurrence risk independent of calcium and vitamin D [relative risk (RR) = 0.64; 95% confidence intervals (CIs): 0.47-0.88, for subjects in the highest compared to lowest intake tertile, p(trend) = 0.005]. Milk accounted for 60% of dairy product intake, and on analysis of milk and nonmilk dairy products separately recurrence risk in individuals in the highest tertile of milk intake was half that of lowest tertile individuals (RR = 0.52; 95% CI: 0.38-0.72, p(trend) = 3.2 x 10(-5)), whereas nonmilk dairy products did not influence recurrence. VDR polymorphism genotypes and haplotypes did not directly alter recurrence risk, but the reduction in risk associated with high dairy product intake was confined to individuals with ApaI aA/AA genotype (p(interaction) = 0.02). These findings indicate dairy products, and in particular milk, have chemopreventive activity against CRA recurrence. PMID:18470879

  13. Intensity-Modulated Radiation Therapy in the Salvage of Locally Recurrent Nasopharyngeal Carcinoma

    SciTech Connect

    Qiu Sufang; Lin Shaojun; Tham, Ivan W.K.; Pan Jianji; Lu Jun; Lu, Jiade J.

    2012-06-01

    Purpose: Local recurrences of nasopharyngeal carcinoma (NPC) may be salvaged by reirradiation with conventional techniques, but with significant morbidity. Intensity-modulated radiation therapy (IMRT) may improve the therapeutic ratio by reducing doses to normal tissue. The aim of this study was to address the efficacy and toxicity profile of IMRT for a cohort of patients with locally recurrent NPC. Methods and Materials: Between August 2003 and June 2009, 70 patients with radiologic or pathologically proven locally recurrent NPC were treated with IMRT. The median time to recurrence was 30 months after the completion of conventional radiation to definitive dose. Fifty-seven percent of the tumors were classified asrT3-4. The minimum planned doses were 59.4 to 60 Gy in 1.8- to 2-Gy fractions per day to the gross disease with margins, with or without chemotherapy. Results: The median dose to the recurrent tumor was 70 Gy (range, 50-77.4 Gy). Sixty-five patients received the planned radiation therapy; 5 patients received between 50 and 60 Gy because of acute side effects. With a median follow-up time of 25 months, the rates of 2-year locoregional recurrence-free survival, disease-free survival, and overall survival were 65.8%, 65.8%, and 67.4%, respectively. Moderate to severe late toxicities were noted in 25 patients (35.7%). Eleven patients (15.7%) had posterior nasal space ulceration, 17 (24.3%) experienced cranial nerve palsies, 12 (17.1%) had trismus, and 12 (17.1%) experienced deafness. Extended disease-free interval (relative risk 2.049) and advanced T classification (relative risk 3.895) at presentation were adverse prognostic factors. Conclusion: Reirradiation with IMRT provides reasonable long-term control in patients with locally recurrent NPC.

  14. Recurrent Dreams and Psychosocial Adjustment in Preteenaged Children.

    PubMed

    Gauchat, Aline; Zadra, Antonio; Tremblay, Richard E; Zelazo, Philip David; Séguin, Jean R

    2009-06-01

    Research indicates that recurrent dreams in adults are associated with impoverished psychological well-being. Whether similar associations exist in children remains unknown. The authors hypothesized that children reporting recurrent dreams would show poorer psychosocial adjustment than children without recurrent dreams. One hundred sixty-eight 11-year-old children self-reported on their recurrent dreams and on measures of psychosocial adjustment. Although 35% of children reported having experienced a recurrent dream during the past year, our hypothesis was only partially supported. Multivariate analyses revealed a marginally significant interaction between gender and recurrent dream presence and a significant main effect of gender. Univariate analyses revealed that boys reporting recurrent dreams reported significantly higher scores on reactive aggression than those who did not (d = 0.58). This suggests that by age 11 years, the presence of recurrent dreams may already reflect underlying emotional difficulties in boys but not necessarily in girls. Challenges in addressing this developmental question are discussed.

  15. Ten Years of Tamoxifen Reduces Breast Cancer Recurrences, Improves Survival

    MedlinePlus

    ... Cancer Screening Research Ten Years of Tamoxifen Reduces Breast Cancer Recurrences, Improves Survival For some women with breast ... took it for 5 years. (See the table.) Breast Cancer Recurrence and Death 5 to 14 Years after ...

  16. Etiology and management of recurrent parotid pleomorphic adenoma.

    PubMed

    Witt, Robert L; Eisele, David W; Morton, Randall P; Nicolai, Piero; Poorten, Vincent Vander; Zbären, Peter

    2015-04-01

    The objective of this review study was to encompass the relevant literature and current best practice options for this challenging, sometimes incurable problem. The source of the data was Ovid MEDLINE from 1946 to 2014. Review methods consisted of articles with clinical correlates. The most important cause of recurrence is enucleation with rupture and incomplete tumor excision at operation. Incomplete pseudocapsule, extracapsular extension, pseudopods of pleomorphic adenoma tissue, and satellite pleomorphic beyond the pseudocapsule are also likely linked to recurrent pleomorphic adenoma. Most recurrent pleomorphic adenoma are multinodular. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. Treatment of recurrent pleomorphic adenoma must be individualized. Total parotidectomy, given the multicentricity of recurrent pleomorphic adenoma, is appropriate in many patients, but may be inadequate to control recurrent pleomorphic. There is accumulating evidence from retrospective series that postoperative radiation therapy results in significantly better local control.

  17. Palliative Care in Improving Quality of Life in Patients With High Risk Primary or Recurrent Gynecologic Malignancies

    ClinicalTrials.gov

    2015-10-15

    Cervical Carcinoma; Ovarian Carcinoma; Primary Peritoneal Carcinoma; Recurrent Cervical Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Vulvar Carcinoma; Uterine Corpus Cancer; Vulvar Carcinoma; Peritoneal Neoplasms

  18. Metformin Hydrochloride, Carboplatin, and Paclitaxel in Treating Patients With Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2015-05-01

    Ovarian Papillary Serous Carcinoma; Ovarian Serous Cystadenocarcinoma; Recurrent Fallopian Tube Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Primary Peritoneal Cavity Cancer

  19. Thalidomide in Treating Patients With Recurrent or Persistent Endometrial Cancer

    ClinicalTrials.gov

    2013-01-23

    Endometrial Adenoacanthoma; Endometrial Adenocarcinoma; Endometrial Adenosquamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma

  20. Copanlisib in Treating Patients With Persistent or Recurrent Endometrial Cancer

    ClinicalTrials.gov

    2016-10-25

    Endometrial Endometrioid Adenocarcinoma; Endometrial Mixed Adenocarcinoma; Endometrial Serous Adenocarcinoma; Endometrial Undifferentiated Carcinoma; Metastatic Endometrioid Adenocarcinoma; Recurrent Uterine Corpus Carcinoma

  1. Association of Family History with Cancer Recurrence and Survival Among Patients with Stage III Colon Cancer

    PubMed Central

    Chan, Jennifer A.; Meyerhardt, Jeffrey A.; Niedzwiecki, Donna; Hollis, Donna; Saltz, Leonard B.; Mayer, Robert J.; Thomas, James; Schaefer, Paul; Whittom, Renaud; Hantel, Alexander; Goldberg, Richard M.; Warren, Robert S.; Bertagnolli, Monica; Fuchs, Charles S.

    2011-01-01

    Context A family history of colorectal cancer in a first-degree relative increases the risk of developing colorectal cancer. However, the influence of family history on cancer recurrence and survival among patients with established disease remains uncertain. Objective To examine the association of family history of colorectal cancer with cancer recurrence and survival of patients with colon cancer. Design, Setting, and Participants Prospective observational study of 1,087 patients with stage III colon cancer enrolled in a randomized adjuvant chemotherapy trial (CALGB 89803) between April 1999 and May 2001. Patients provided data on family history at baseline and were followed up until March 2007 for disease recurrence and death (median follow-up 5.6 years). In a subset of patients, we assessed microsatellite instability (MSI) and expression of the mismatch repair (MMR) proteins, MLH1 and MSH2, in tumor specimens. Main Outcome Measure Disease-free survival, recurrence-free survival, and overall survival according to the presence or absence of a family history of colorectal cancer. Results Among 1,087 eligible patients, 195 (17.9%) reported a family history of colorectal cancer in a first-degree relative. Cancer recurrence or death occurred in 57/195 patients (29%; 95% confidence interval [CI], 23%-36%) with a family history of colorectal cancer and 343/892 patients (38%; 95% CI, 35%-42%) without a family history. Compared to patients without a family history, the adjusted hazard ratios (HR) among those with ≥1 affected first-degree relatives were 0.72 (95% CI, 0.54-0.96) for disease-free survival (DFS), 0.74 (95% CI, 0.55-0.99) for recurrence-free survival (RFS), and 0.75 (95% CI, 0.54-1.05) for overall survival (OS). This reduction in risk of cancer recurrence or death associated with a family history became stronger with an increasing number of affected first-degree relatives. Compared to participants without a family history of colorectal cancer, those with 1

  2. The recurrence coefficients of semi-classical Laguerre polynomials and the fourth Painlevé equation

    NASA Astrophysics Data System (ADS)

    Filipuk, Galina; Van Assche, Walter; Zhang, Lun

    2012-05-01

    We show that the coefficients of the three-term recurrence relation for orthogonal polynomials with respect to a semi-classical extension of the Laguerre weight satisfy the fourth Painlevé equation when viewed as functions of one of the parameters in the weight. We compare different approaches to derive this result, namely, the ladder operators approach, the isomonodromy deformations approach and combining the Toda system for the recurrence coefficients with a discrete equation. We also discuss a relation between the recurrence coefficients for the Freud weight and the semi-classical Laguerre weight and show how it arises from the Bäcklund transformation of the fourth Painlevé equation.

  3. Recurrent focal epithelial hyperplasia due to HPV13 in an HIV-positive patient.

    PubMed

    Moerman, M; Danielides, V G; Nousia, C S; Van Wanzeele, F; Forsyth, R; Vermeersch, H

    2001-01-01

    There are few reports on focal epithelial hyperplasia (FEH) in association with human immunodeficiency virus (HIV) infection; thus the relationship between them has not been completely clarified yet. We present a case of recurrent FEH in an HIV-positive man (the first described in Belgium), which, according to the PCR-DNA testing, was due to human papilloma virus type 13 (HPV13). To our knowledge, based on the accessible literature, this type of HPV has not been detected in any other documented study of FEH in HIV-positive patients before. Our patient experienced three recurrences of FEH in 1 year. It is therefore suggested that immunodeficiency due to HIV infection is responsible for the HPV-related FEH and the subsequent recurrences. In order to support the consideration of FEH as an oral manifestation of an HIV-related opportunistic infection, every new 'HPV-type' oral lesion in HIV-positive patients must be completely documented.

  4. Recurrent infections in partial complement factor I deficiency: evaluation of three generations of a Brazilian family

    PubMed Central

    Grumach, A S; Leitão, M F; Arruk, V G; Kirschfink, M; Condino-Neto, A

    2006-01-01

    We report here on the evaluation of a factor I-deficient Brazilian family (three generations, 39 members) with strong consanguinity. The complete factor I-deficient patients (n = 3) presented recurrent respiratory infections, skin infections and meningitis; one of them died after sepsis. They presented an impaired total haemolytic activity (CH50), low C3, low factor H and undetectable C3dg/C3d. Partial factor I deficiency was detected in 16 family members (normal low cut-off value was 25 µg/ml). Respiratory infections were the most common clinical occurrence among partial factor I-deficient relatives. Two of them were submitted to nephrectomy following recurrent urinary tract infections. An additional two heterozygous relatives presented with arthritis and rheumatic fever. Apparently, patients with partial factor I deficiency are also at higher risk for recurrent infections. Vaccination against capsulated bacteria and the eventual use of prophylactic antibiotics should be considered individually in this patient group. PMID:16412054

  5. Nasal nitric oxide in children with recurrent acute otitis media.

    PubMed

    Torretta, S; Marchisio, P; Capaccio, P; Pignataro, L

    2016-01-01

    Recently, reduced Nasal nitric oxide (nNO) nNO levels have been reported in children with adenoidal hypertrophy predisposing to chronic nasosinusal inflammation. Given the strict anatomic and physiopathologic link between the nasopharyngeal and middle ear compartments, and considering the high prevalence of otitis prone children among those affected with chronic adenoiditis, we designed a study aimed to test any possible difference in nNO levels between non-allergic children with and without recurrent acute otitis media (RAOM) associated with chronic adenoiditis. The study involved 54 children with RAOM (44.4% males; mean age= 7.5±3.5 years) and 51 children without RAOM (47.4% males; mean age= 7.0±3.8 years). nNO levels were significantly reduced in children with RAOM compared to children without RAOM (676.9±250.7 ppb vs 831.8±320.4 ppb, respectively; p= 0.02). Our results could be related to reduced NO production by the ciliated paranasal, nasopharyngeal and middle ear epithelium and the impaired sinusal ostial and Eustachian tube patency due to chronic inflammation, and seem to confirm the involvement of NO pathway in recurrent upper airway infections related to impaired ciliated respiratory mucosa.

  6. Delineating recurrent fish spawning habitats in the North Sea

    NASA Astrophysics Data System (ADS)

    Lelièvre, S.; Vaz, S.; Martin, C. S.; Loots, C.

    2014-08-01

    The functional value of spawning habitats makes them critically important for the completion of fish life cycles and spawning grounds are now considered to be “essential habitats”. Inter-annual fluctuations in spawning ground distributions of dab (Limanda Limanda), plaice (Pleuronectes platessa), cod (Gadus morhua) and whiting (Merlangius merlangus) were investigated in the southern North Sea and eastern English Channel, from 2006 to 2009. The preferential spawning habitats of these species were modelled using generalised linear models, with egg distribution being used as proxy of spawners' location. Egg spatial and temporal distributions were explored based on six environmental variables: sea surface temperature and salinity, chlorophyll a concentration, depth, bedstress and seabed sediment types. In most cases, egg density was found to be strongly related to these environmental variables. Egg densities were positively correlated with shallow to intermediate depths having low temperature and relatively high salinity. Habitat models were used to map annual, i.e. 2006 to 2009, winter spatial distributions of eggs, for each species separately. Then, annual maps were combined to explore the spatial variability of each species' spawning grounds, and define recurrent, occasional, rare and unfavourable spawning areas. The recurrent spawning grounds of all four species were located in the south-eastern part of the study area, mainly along the Dutch and German coasts. This study contributes knowledge necessary to the spatial management of fishery resources in the area, and may also be used to identify marine areas with particular habitat features that need to be preserved.

  7. Elevated Neutrophil Lymphocyte Ratio in Recurrent Optic Neuritis

    PubMed Central

    Guclu, Hande; Ozal, Sadık Altan; Pelitli Gurlu, Vuslat; Birgul, Ramazan

    2015-01-01

    Purpose. To demonstrate the relation between optic neuritis (ON) and systemic inflammation markers as neutrophil lymphocyte ratio (N/L ratio), platelet count, mean platelet volume (MPV), and red cell distribution width (RDW) and furthermore to evaluate the utilization of these markers to predict the frequency of the ON episodes. Methods. Forty-two patients with acute ON and forty healthy subjects were enrolled into the study. The medical records were reviewed for age, sex, hemoglobin (Hb), Haematocrit (Htc), RDW, platelet count, MPV, white blood cell count (WBC), neutrophil and lymphocyte count, and neutrophil lymphocyte ratio (N/L ratio). Results. The mean N/L ratio, platelet counts, and RDW were significantly higher in ON group (p = 0.000, p = 0.048, and p = 0.002). There was a significant relation between N/L ratio and number of episodes (r = 0.492, p = 0.001). There was a statistically significant difference for MPV between one episode group and recurrent ON group (p = 0.035). Conclusions. Simple and inexpensive laboratory methods could help us show systemic inflammation and monitor ON patients. Higher N/L ratio can be a useful marker for predicting recurrent attacks. PMID:26060578

  8. Primary and recurrent inverting papilloma: appearances with magnetic resonance imaging.

    PubMed

    Roobottom, C A; Jewell, F M; Kabala, J

    1995-07-01

    Inverting papilloma of the sinonasal cavity is of importance because of its association with squamous cell carcinoma and its tendency to local recurrence. Appearances of inverting papilloma have only been reported infrequently, and never in recurrent cases. We present the magnetic resonance imaging (MRI) appearances of four cases of inverting papilloma, three of which are recurrent.

  9. Serum uPAR as Biomarker in Breast Cancer Recurrence: A Mathematical Model

    PubMed Central

    Hao, Wenrui; Friedman, Avner

    2016-01-01

    There are currently over 2.5 million breast cancer survivors in the United States and, according to the American Cancer Society, 10 to 20 percent of these women will develop recurrent breast cancer. Early detection of recurrence can avoid unnecessary radical treatment. However, self-examination or mammography screening may not discover a recurring cancer if the number of surviving cancer cells is small, while biopsy is too invasive and cannot be frequently repeated. It is therefore important to identify non-invasive biomarkers that can detect early recurrence. The present paper develops a mathematical model of cancer recurrence. The model, based on a system of partial differential equations, focuses on tissue biomarkers that include the plasminogen system. Among them, only uPAR is known to have significant correlation to its concentration in serum and could therefore be a good candidate for serum biomarker. The model includes uPAR and other associated cytokines and cells. It is assumed that the residual cancer cells that survived primary cancer therapy are concentrated in the same location within a region with a very small diameter. Model simulations establish a quantitative relation between the diameter of the growing cancer and the total uPAR mass in the cancer. This relation is used to identify uPAR as a potential serum biomarker for breast cancer recurrence. PMID:27078836

  10. Serum uPAR as Biomarker in Breast Cancer Recurrence: A Mathematical Model.

    PubMed

    Hao, Wenrui; Friedman, Avner

    2016-01-01

    There are currently over 2.5 million breast cancer survivors in the United States and, according to the American Cancer Society, 10 to 20 percent of these women will develop recurrent breast cancer. Early detection of recurrence can avoid unnecessary radical treatment. However, self-examination or mammography screening may not discover a recurring cancer if the number of surviving cancer cells is small, while biopsy is too invasive and cannot be frequently repeated. It is therefore important to identify non-invasive biomarkers that can detect early recurrence. The present paper develops a mathematical model of cancer recurrence. The model, based on a system of partial differential equations, focuses on tissue biomarkers that include the plasminogen system. Among them, only uPAR is known to have significant correlation to its concentration in serum and could therefore be a good candidate for serum biomarker. The model includes uPAR and other associated cytokines and cells. It is assumed that the residual cancer cells that survived primary cancer therapy are concentrated in the same location within a region with a very small diameter. Model simulations establish a quantitative relation between the diameter of the growing cancer and the total uPAR mass in the cancer. This relation is used to identify uPAR as a potential serum biomarker for breast cancer recurrence.

  11. Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy

    PubMed Central

    Yu, Hsien-Chung; Cheng, Jin-Shiung; Lai, Kwok-Hung; Lin, Chi-Pin; Lo, Gin-Ho; Lin, Chiun-Ku; Hsu, Ping-I; Chan, Hoi-Hung; Lo, Ching-Chu; Tsai, Wei-Lun; Chen, Wen-Chi

    2005-01-01

    AIM: To evaluate the factors affecting the early tumor recurrence within one year in cirrhotic patients having a single small hepatocellular carcinoma (HCC) after complete tumor necrosis by radiofrequency ablation (RFA) therapy. METHODS: Thirty patients with a single small HCC received RFA therapy by a RFA 2000 generator with LeVeen needle. Tri-phase computerized tomogram was followed every 2 to 3 mo after RFA. The clinical effects and tumor recurrence were recorded. RESULTS: The initial complete tumor necrosis rate was 86.7%. Twenty-two patients were followed for more than one year. The local and overall recurrence rates were 13.6% and 36.4%, 33.3% and 56.2%, 46.6% and 56.2% at 12, 24 and 30 mo, respectively. No major complication or procedure-related mortality was found. The risk factors for early local tumor recurrence within one year were larger tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging. The age of patients with new tumor formation within one year was relatively younger (55.1±8.3 vs 66.7±10.8, P = 0.029). CONCLUSION: Large tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging are the risk factors for early local tumor recurrence within one year, and young age is the positive predictor for new tumor formation within one year. PMID:15770718

  12. The treatment of recurrent brain metastases with stereotactic radiosurgery

    SciTech Connect

    Loeffler, J.S.; Kooy, H.M.; Wen, P.Y.; Fine, H.A.; Cheng, C.W.; Mannarino, E.G.; Tsai, J.S.; Alexander, E. III )

    1990-04-01

    Between May 1986 and August 1989, we treated 18 patients with 21 recurrent or persistent brain metastases with stereotactic radiosurgery using a modified linear accelerator. To be eligible for radiosurgery, patients had to have a performance status of greater than or equal to 70% and have no evidence of systemic disease. All but one patient had received prior radiotherapy, and were treated with stereotactic radiosurgery at the time of recurrence. Polar lesions were treated only if the patient had undergone and failed previous complete surgical resection (10 patients). Single doses of radiation (900 to 2,500 cGy) were delivered to limited volumes (less than 27 cm3) using a modified 6MV linear accelerator. The most common histology of the metastatic lesion was carcinoma of the lung (seven patients), followed by carcinoma of the breast (four patients), and melanoma (four patients). With median follow-up of 9 months (range, 1 to 39), all tumors have been controlled in the radiosurgery field. Two patients failed in the immediate margin of the treated volume and were subsequently treated with surgery and implantation of 125I to control the disease. Radiographic response was dramatic and rapid in the patients with adenocarcinoma, while slight reduction and stabilization occurred in those patients with melanoma, renal cell carcinoma, and sarcoma. The majority of patients improved neurologically following treatment, and were able to be withdrawn from corticosteroid therapy. Complications were limited and transient in nature and no cases of symptomatic radiation necrosis occurred in any patient despite previous exposure to radiotherapy. Stereotactic radiosurgery is an effective and relatively safe treatment for recurrent solitary metastases and is an appealing technique for the initial management of deep-seated lesions as a boost to whole brain radiotherapy.

  13. Surgical and radiation therapy management of recurrent anal melanoma

    PubMed Central

    Ling, Ted C.; Slater, Jason M.; Senthil, Maheswari; Kazanjian, Kevork; Howard, Frank; Garberoglio, Carlos A.; Slater, Jerry D.

    2014-01-01

    Background Melanoma of the anorectal mucosa is a rare but highly aggressive tumor. Its presenting symptoms are frequently confused with hemorrhoids, thereby causing a delay in diagnosis. Anorectal melanoma carries with it a very poor prognosis. There is a paucity of data investigating management options for anorectal melanoma, and even fewer data reporting recurrent or refractory cases. Case presentation This case documents a 41-year-old female with a long history of hemorrhoids presenting with anorectal discharge. She was incidentally found have anorectal melanoma following surgical resection. Systemic diagnostic work-up demonstrated PET-avid lymphadenopathy in her right groin. She underwent right groin dissection. However, seven months later she recurred in her right groin and a new recurrent mass was found in her pelvis. She underwent a second groin dissection and resection of the pelvic recurrence. This was followed by a course of hypofractionated radiation therapy then systemic immunotherapy. Discussion Surgery has been the mainstay of treatment. However, the extent of surgery has been the topic of investigation. Historically, radical resections have been performed but they result in high rates of post-operative morbidity. Newer studies have compared radical resection with wide local excisions and found comparable outcomes. Anorectal melanoma is frequently a systemic disease. The ideal systemic therapy regimen has not yet been determined but numerous studies show a benefit to multi-agent treatments. Radiation therapy is typically given in the post-operative or palliative setting. Conclusions Anorectal mucosal melanoma is a very rare but aggressive disease with a poor prognosis. The overall treatment goal should strive to optimize quality of life and tumor control while minimizing treatment-related morbidities. PMID:24490051

  14. Recurrent Gram-Negative Bloodstream Infection: A 10-Year Population-Based Cohort Study

    PubMed Central

    Al-Hasan, Majdi N.; Eckel-Passow, Jeanette E.; Baddour, Larry M.

    2010-01-01

    Background Recurrent gram-negative bloodstream infection (BSI) has not been evaluated in a population-based setting; therefore, we performed a population-based retrospective cohort study to examine the incidence, recurrence, and mortality rates of gram-negative BSI. Methods We identified 944 episodes of gram-negative BSI, including 98 recurrent episodes, among Olmsted County, Minnesota, residents from 1/1/1998 to 12/31/2007. Kaplan-Meier method was used to estimate the cumulative incidence rate of recurrence and 28-day all-cause mortality rate of gram-negative BSI. Cox proportional hazard regression was used to determine risk factors for recurrence. Results The overall age- and gender-adjusted incidence rate of gram-negative BSI per 100,000 person-years was 84.5 (95% confidence interval [CI]: 79.1–90.0), including 75.7 (95% CI: 70.6–80.8) for first episodes and 8.8 (95% CI: 7.1–10.6) for recurrent episodes. Among 846 patients with first episodes of gram-negative BSI, the cumulative incidence rates of recurrence after 1, 5, and 10 years of the initial episode were 5.6%, 9.2%, and 14.6%, respectively, with death treated as a competing risk. Patients with Klebsiella species were more likely than those with Escherichia coli BSI to develop recurrent gram-negative BSI (hazard ratio: 2.33 [95% CI: 1.34–3.92], p=0.003). The 28-day all-cause mortality rates following the initial and second episodes of gram-negative BSI were 10.0% (95% CI: 8.0–12.0) and 11.3% (95% CI: 4.4–18.2), respectively. Conclusions Even though recurrent gram-negative BSI was relatively uncommon in the general population, up to 15% of patients with gram-negative BSI developed a recurrent episode within 10 years of the initial episode. PMID:20378069

  15. [Local recurrence after skin-sparing mastectomy].

    PubMed

    Brouwer, Oscar R; Donker, Mila; Woerdeman, Leonie A E; Vrancken Peeters, Marie-Jeanne T F D

    2012-01-01

    On average, 250 skin-sparing mastectomies with immediate prosthetic reconstruction are performed in the Dutch Antoni van Leeuwenhoek Hospital each year. We report on two breast cancer patients (46 and 53 years old) who each developed a local recurrence at the entry site of the core needle biopsy after skin-sparing mastectomy with immediate prosthetic reconstruction. In hindsight, the most likely cause for these recurrences was the fact that one of the entry sites for the core needle biopsies was not marked preoperatively, and thus not excised during surgery. These examples emphasise the need for accurate documentation of the locations of these entry sites, followed by their excision, in patients undergoing skin-sparing mastectomy for invasive breast cancer.

  16. The nutrition consult for recurrent stone formers.

    PubMed

    Penniston, Kristina L

    2015-07-01

    Diet is implicated in stone formation and growth. Whether alone or in concert with pharmacologics, dietary changes may be useful in reducing recurrence but only when they correct dietary stone-forming risks. Patients benefit from recommendations individualized to their food preferences as well as to lifestyle, age, food knowledge and access, preparation skills, and cultural and ethnic identities. Urologists can provide general dietary recommendations but often lack the time to provide the full complement of individualized nutrition care offered by a registered dietitian nutritionist (RDN). Urologists can partner with and refer patients to a RDN for any component of the nutrition care process: assessment of diet, diagnosis of dietary factors that contribute to stone risk factors, intervention formulation and implementation, and monitoring the effectiveness of the intervention and modifying it as needed to maintain suitably low dietary risk for stone recurrence.

  17. Immune Function and Recurrent Pregnancy Loss.

    PubMed

    Krieg, Sacha; Westphal, Lynn

    2015-07-01

    Recurrent pregnancy loss (RPL), defined as two or more consecutive miscarriages, is attributable to multiple causes. However, in 50% of cases no known cause is found. Although endometritis is a known cause of miscarriage, other inflammatory processes may play a role in idiopathic, recurrent loss. The fetoplacental unit evades rejection by the maternal immune system by poorly understood mechanisms. Despite this seemingly immune-privileged state for the fetus, human implantation requires inflammatory mediators for attachment and implantation. This review describes how the immune system must simultaneously permit and restrict trophoblastic invasion for healthy implantation and maintenance of pregnancy. Included in this review is a detailed description of the immune milieu in the decidua and abnormalities that are associated with RPL. Finally, autoimmune states associated with RPL and their treatment in an obstetrical setting are reviewed.

  18. Psychosocial factors and childhood recurrent abdominal pain.

    PubMed

    Boey, Christopher Chiong-Meng; Goh, Khean-Lee

    2002-12-01

    Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain-gut axis linking the central and enteric nervous systems are important mechanisms. PMID:12423267

  19. Recurrent Neural Network for Computing Outer Inverse.

    PubMed

    Živković, Ivan S; Stanimirović, Predrag S; Wei, Yimin

    2016-05-01

    Two linear recurrent neural networks for generating outer inverses with prescribed range and null space are defined. Each of the proposed recurrent neural networks is based on the matrix-valued differential equation, a generalization of dynamic equations proposed earlier for the nonsingular matrix inversion, the Moore-Penrose inversion, as well as the Drazin inversion, under the condition of zero initial state. The application of the first approach is conditioned by the properties of the spectrum of a certain matrix; the second approach eliminates this drawback, though at the cost of increasing the number of matrix operations. The cases corresponding to the most common generalized inverses are defined. The conditions that ensure stability of the proposed neural network are presented. Illustrative examples present the results of numerical simulations.

  20. Preventing recurrence of severe morning sickness

    PubMed Central

    Koren, Gideon; Maltepe, Caroline

    2006-01-01

    QUESTION A recent Motherisk article showed that initiating antinauseants even before symptoms start could prevent recurrence of severe morning sickness. In the study described, however, different physicians used different drugs. How can one be sure which drugs work? ANSWER The study of 26 women who had had severe morning sickness during previous pregnancies showed that using antiemetics before symptoms of morning sickness started appeared to prevent recurrence of severe morning sickness in subsequent pregnancies. Physicians in the United States used various antinauseant drugs. Physicians in Canada administered only one drug, the combination of doxylamine-pyridoxine (Diclectin®), to 12 women. Subanalysis of these 12 women revealed that pre-emptive use of doxylamine-pyridoxine significantly decreased the likelihood that severe morning sickness would recur. PMID:17279232

  1. Anesthetic Techniques and Cancer Recurrence after Surgery

    PubMed Central

    D'Arrigo, Maria G.; Triolo, Stefania; Mondello, Stefania; La Torre, Domenico

    2014-01-01

    Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients. PMID:24683330

  2. Management of Recurrent Malignant Salivary Neoplasms.

    PubMed

    Merdad, Mazin; Richmon, Jeremy D; Quon, Harry

    2016-01-01

    The management of malignant salivary gland neoplasms is based on a surgical paradigm, with intraoperative findings and pathology guiding the role of local-regional adjuvant therapy. Despite high rates of local control, local relapse can be a dominant pattern of recurrence, presenting therapeutic challenges. Although an optimal management approach has not been established, aggressive salvage surgery is favored given the morbidity associated with tumor progression at the skull base and the lack of significant response associated with other available treatment modalities. Postoperative radiotherapy has been demonstrated to be effective in the initial management of malignant salivary gland neoplasms and is generally favored for recurrent, surgically resectable tumors for the appropriate patient. PMID:27093607

  3. Stochastic variational learning in recurrent spiking networks

    PubMed Central

    Jimenez Rezende, Danilo; Gerstner, Wulfram

    2014-01-01

    The ability to learn and perform statistical inference with biologically plausible recurrent networks of spiking neurons is an important step toward understanding perception and reasoning. Here we derive and investigate a new learning rule for recurrent spiking networks with hidden neurons, combining principles from variational learning and reinforcement learning. Our network defines a generative model over spike train histories and the derived learning rule has the form of a local Spike Timing Dependent Plasticity rule modulated by global factors (neuromodulators) conveying information about “novelty” on a statistically rigorous ground. Simulations show that our model is able to learn both stationary and non-stationary patterns of spike trains. We also propose one experiment that could potentially be performed with animals in order to test the dynamics of the predicted novelty signal. PMID:24772078

  4. [How I treat...recurrent labial herpes].

    PubMed

    Nikkels, A F; Piérard, G E

    2008-11-01

    Recurrent oro-labial herpes is predominantly caused by the herpes simplex virus type 1. Following the primary infection, the virus remains in a latent stage in the trigeminal ganglion. After episodic reactivations, it is transported via the V1 or V2 axons to the lower or upper lip. Although no causal treatment exists, a series of therapeutic options are currently available. It now appears that recurrent oro-labial herpes can be treated with shorter treatment schedules with the currently available antiviral drugs. In these instances, similar clinical efficacy was obtained with increased compliance of the patient, and reduction in both the economical impact and the amount of drug intake. Newer treatment strategies are emerging including non medicated hydrocolloid dressings and combinations of a systemic antiviral drug with a topical corticosteroid. PMID:19112988

  5. Human papillomavirus types and recurrent cervical warts

    SciTech Connect

    Nuovo, G.J. ); Pedemonte, B.M. )

    1990-03-02

    The authors analyzed cervical intraepithelial neoplasias (CINs) detected after cryotherapy to determine if recurrence is associated with the same human papillomavirus (HPV) type found in the original lesion. Eight women had detectable HPV DNA in CINs that occurred after ablation of another CIN, and for each patient the HPV type in the pretreatment lesion was different from that in the CIN that appeared after cryotherapy. This compares with 12 women who had HPV detected in two or more CINs present at the same time, 11 of whom had the same HPv type noted. they concluded that although multiple, simultaneous CINs in a woman often contain the same HPV type, recurrent CINs that occur after cryotherapy contain an HPV type different from that present in the pretreatment lesion.

  6. Recurrent spontaneous compartment syndrome of the thigh.

    PubMed

    Rohman, Lebur; Chan, Sheung; Hadi, Saifullah; Maruszewski, Daniel

    2014-01-01

    Acute comparment syndrome (ACS) is a surgical emergency, in which tissue pressure becomes greater than perfusion pressure leading to tissue ischaemia. It is typically a consequence of trauma. We present a case in which a patient suffers blunt trauma to the thigh, but develops ACS 2 years after this injury and consequently endures 10-episodes of ACS (no perciptating event or cause) in the same thigh over 10 years. On the 10th presentation the patient was found to have arteriovenous malformation on MR angiography which were embolised and the fasciotomy wound closed with a split-thickness skin graft. A thorough literature search deemed this case to be the first reported recurrent spontaneous ACS of the thigh. Prompt recognition and treatment of ACS is vital. Clinicians should thoroughly investigate such patients postoperatively and involve vascular/plastic surgeons and interventianal radiologist to provide optimum care and prevent recurrence.

  7. Reirradiation of recurrent head and neck cancers

    SciTech Connect

    Emami, B.; Bignardi, M.; Spector, G.J.; Devineni, V.R.; Hederman, M.A.

    1987-01-01

    Ninety-nine patients with recurrent cancers of the head and neck region were treated with surgery, radiation therapy, or combination therapy. The follow-up period ranged from 18 months to 18 years. An initial overall complete response rate of 67% and a partial response rate of 7% (overall response rate-74%) were achieved. The eventual tumor control rate was 15%. Although equal initial response rates were achieved in recurrences at the primary site and the cervical nodes, the eventual local control was better for the former (21% vs. 10%). Patients receiving less than 5,000 rad radiotherapy had a 44% complete response and an 11% eventual tumor control. Patients receiving over 5,000 rad had an 80% complete response and a 25% eventual tumor control.

  8. Recurrent inactivating RASA2 mutations in melanoma

    PubMed Central

    Arafeh, Rand; Qutob, Nouar; Emmanuel, Rafi; Keren-Paz, Alona; Madore, Jason; Elkahloun, Abdel; Wilmott, James S.; Gartner, Jared J.; Di Pizio, Antonella; Winograd-Katz, Sabina; Sindiri, Sivasish; Rotkopf, Ron; Dutton-Regester, Ken; Johansson, Peter; Pritchard, Antonia; Waddell, Nicola; Hill, Victoria K.; Lin, Jimmy C.; Hevroni, Yael; Rosenberg, Steven A.; Khan, Javed; Ben-Dor, Shifra; Niv, Masha Y.; Ulitsky, Igor; Mann, Graham J; Scolyer, Richard A.; Hayward, Nicholas K.; Samuels, Yardena

    2016-01-01

    Analysis of 501 melanoma exomes revealed RASA2, encoding a RasGAP, as a tumor-suppressor gene mutated in 5% of melanomas. Recurrent loss-of-function mutations in RASA2 were found to increase RAS activation, melanoma cell growth and migration. RASA2 expression was lost in ≥30% of human melanomas and was associated with reduced patient survival. These findings reveal RASA2 inactivation as a melanoma driver and highlight the importance of Ras GAPs in cancer. PMID:26502337

  9. Recurrence Analysis of Eddy Covariance Fluxes

    NASA Astrophysics Data System (ADS)

    Lange, Holger; Flach, Milan; Foken, Thomas; Hauhs, Michael

    2015-04-01

    The eddy covariance (EC) method is one key method to quantify fluxes in biogeochemical cycles in general, and carbon and energy transport across the vegetation-atmosphere boundary layer in particular. EC data from the worldwide net of flux towers (Fluxnet) have also been used to validate biogeochemical models. The high resolution data are usually obtained at 20 Hz sampling rate but are affected by missing values and other restrictions. In this contribution, we investigate the nonlinear dynamics of EC fluxes using Recurrence Analysis (RA). High resolution data from the site DE-Bay (Waldstein-Weidenbrunnen) and fluxes calculated at half-hourly resolution from eight locations (part of the La Thuile dataset) provide a set of very long time series to analyze. After careful quality assessment and Fluxnet standard gapfilling pretreatment, we calculate properties and indicators of the recurrent structure based both on Recurrence Plots as well as Recurrence Networks. Time series of RA measures obtained from windows moving along the time axis are presented. Their interpretation is guided by three different questions: (1) Is RA able to discern periods where the (atmospheric) conditions are particularly suitable to obtain reliable EC fluxes? (2) Is RA capable to detect dynamical transitions (different behavior) beyond those obvious from visual inspection? (3) Does RA contribute to an understanding of the nonlinear synchronization between EC fluxes and atmospheric parameters, which is crucial for both improving carbon flux models as well for reliable interpolation of gaps? (4) Is RA able to recommend an optimal time resolution for measuring EC data and for analyzing EC fluxes? (5) Is it possible to detect non-trivial periodicities with a global RA? We will demonstrate that the answers to all five questions is affirmative, and that RA provides insights into EC dynamics not easily obtained otherwise.

  10. Recurrence of Mooren's ulcer after lamellar keratoplasty.

    PubMed

    McDonnell, P J

    1989-09-01

    A 45-year-old man with unilateral Mooren's ulcer in a quiescent state underwent annular lamellar keratoplasty after corneal rupture due to minor trauma. Postoperatively, he did well until 8 months later when a recurrence of the Mooren's ulceration occurred, involving the central island of the patient's original corneal stroma. The stroma of the lamellar graft was uninvolved. This unusual occurrence lends support to the concept that there is a specific immunologic reaction to the cornea in patients with Mooren's ulcer.

  11. Recurrent rhabdomyolysis in a child. Case presentation.

    PubMed

    Ertuğrul, Sabahattin; Yolbaş, İlyas; Aktar, Fesih; Yılmaz, Kamil; Tekin, Recep

    2016-06-01

    Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case.

  12. Scuba divers' pulmonary oedema: recurrences and fatalities.

    PubMed

    Edmonds, Carl; Lippmann, John; Lockley, Sarah; Wolfers, Darren

    2012-03-01

    Scuba divers' pulmonary oedema (SDPE) is an increasingly recognised disorder in divers. We report three fatal cases of SDPE, demonstrating its potential serious nature even in the absence of underlying cardiac disease demonstrable clinically or at autopsy. This, together with the frequency of recurrences, has implications on assessing fitness for subsequent diving, snorkelling and swimming. The differential diagnosis of this disorder is also considered, as is its possible inducement by salt water aspiration and its relationship to drowning.

  13. Stereotactic Radiotherapy for Locally Recurrent Nasopharyngeal Carcinoma

    SciTech Connect

    Leung, T.-W.; Wong, Victy Y.W.; Tung, Stewart Y.

    2009-11-01

    Purpose: To study the treatment outcome in patients with locally recurrent nasopharyngeal carcinoma (NPC) who were treated with stereotactic radiotherapy (SRT). Methods and Materials: Thirty patients with non-metastatic, locally recurrent NPC who were treated with curative intent between 1998 and 2002 were retrospectively analyzed. The International Union Against Cancer T-stage distribution at recurrence (rT) was as follows: rT1-14, rT2-7, rT3-3, and rT4-6. All patients were treated with SRT with a daily fractional dose of 2.5-4.5 Gy (median, 3 Gy) in 8-22 fractions (median, 18 fractions). Total equivalent dose (TED) was calculated by the linear-quadratic formula without a time factor correction. Results: The 5-year actuarial overall survival rate, disease-specific survival rate, and local failure-free survival (LFFS) rate for the whole group were 40%, 41.4%, and 56.8%, respectively. The 3-year LFFS rates of rT1-2 and rT3-4 diseases were 65% and 66.7%, respectively. Seven of nine patients who received a TED <55 Gy recurred locally compared with 4 of 21 patients who received >=55 Gy. Their corresponding 5-year LFFS rates were 22.2% and 75.8% (p = 0.005). The TED was the only factor significant in affecting the local control on univariate analyses. Conclusion: SRT is an effective treatment for locally recurrent NPC. TED >=55 Gy should be given to secure a higher local control rate. The late complication rates were acceptable for patients with rT1-2 disease. For patients with rT3-4 disease, more works need to be done to further decrease the late complications.

  14. Recurrent oral ulcers--an overview.

    PubMed

    Gaffar, A

    2001-01-01

    Recurrent oral ulcers (ROUs) are the most common oral mucosal disease. The etiology of ROUs is complex. The factors include mechanical trauma, genetics, stress, smoking, and viral and bacterial infections. Treatment modalities depend on the differential diagnosis of ROUs and could consist of antimicrobial agents, anti-inflammatory agents, immunomodulators, or over-the-counter medications. New therapy available in the form of a coating polymer, Colgate ORABASE Soothe.N.Seal, is clinically proven to provide rapid relief and healing of ROUs.

  15. Recurrent aphthous stomatitis and Helicobacter pylori

    PubMed Central

    Gomes, Carolina-Cavaliéri; Gomez, Ricardo-Santiago; Zina, Lívia-Guimarães

    2016-01-01

    Background Recurrent aphthous stomatitis (RAS) is a recurrent painful ulcerative disorder that commonly affects the oral mucosa. Local and systemic factors such as trauma, food sensitivity, nutritional deficiencies, systemic conditions, immunological disorders and genetic polymorphisms are associated with the development of the disease. Helicobacter pylori (H. pylori) is a gram-negative, microaerophile bacteria, that colonizes the gastric mucosa and it was previously suggested to be involved in RAS development. In the present paper we reviewed all previous studies that investigated the association between RAS and H. pylori. Material and Methods A search in Pubmed (MEDLINE) databases was made of articles published up until July 2015 using the following keywords: Helicobacter Pylori or H. pylori and RAS or Recurrent aphthous stomatitis. Results Fifteen experimental studies that addressed the relationship between infection with H. pylori and the presence of RAS and three reviews, including a systematic review and a meta-analysis were included in this review. The studies reviewed used different methods to assess this relationship, including PCR, nested PCR, culture, ELISA and urea breath test. A large variation in the number of patients included in each study, as well as inclusion criteria and laboratorial methods was observed. H. pylori can be detected in the oral mucosa or ulcerated lesion of some patients with RAS. The quality of the all studies included in this review was assessed using levels of evidence based on the University of Oxford’s Center for Evidence Based Medicine Criteria. Conclusions Although the eradication of the infection may affect the clinical course of the oral lesions by undetermined mechanisms, RAS ulcers are not associated with the presence of the bacteria in the oral cavity and there is no evidence that H. pylori infection drives RAS development. Key words:Campylobacter, elisa, h. pylori, Helicobacter Pylori, RAS, recurrent aphthous

  16. Research methodology in recurrent pregnancy loss.

    PubMed

    Christiansen, Ole B

    2014-03-01

    The aim of this article is to highlight pitfalls in research methodology that may explain why studies in recurrent pregnancy loss (RPL) often provide very divergent results. It is hoped that insight into this issue may help clinicians decide which published studies are the most valid. It may help researchers to eliminate methodological flaws in future studies, which may hopefully come to some kind of agreement about the usefulness of diagnostic tests and treatments in RPL.

  17. Recurrent sialadenoma papilliferum of the buccal mucosa.

    PubMed

    Pimentel, M T; López Amado, M; García Sarandeses, A

    1995-08-01

    Sialadenoma papilliferum is a rare, benign, exophytic tumour of the salivary glands. The prognosis is exceptionally good. Since the lesion was first described, 30 cases have been reported in the English literature, and only one of these is known to have recurred. A case of sialadenoma papilliferum occurring in the buccal mucosa with recurrence three years after local excision, is presented. The literature is briefly discussed.

  18. Recurrent ossifying epulis in a dog.

    PubMed

    Woodward, Tony M

    2002-06-01

    A seven-year-old neutered/male Siberian Husky-cross dog was referred for evaluation of a gingival mass. Two years previously, the referring veterinarian had resected an ossifying epulis from the same area between the maxillary left first and second premolars. The neoplasm recurred 4-months after the original surgery. En bloc resection provided tumor-free margins. An oral examination 12-months following surgery indicated no gross signs of recurrence.

  19. Evolution of sites of recurrence after early breast cancer over the last 20 years: implications for patient care and future research.

    PubMed

    Bouganim, N; Tsvetkova, E; Clemons, M; Amir, E

    2013-06-01

    Improvements in adjuvant therapy have led to a sustained fall in recurrences after early breast cancer. The differential reduction in local and systemic recurrences is poorly understood. This study aimed to explore changes in the distribution of loco-regional and distant recurrences in clinical trials reported over the last 20 years. We also aimed to determine the relative impact of adjuvant chemotherapy and endocrine therapy. MEDLINE search for adjuvant, phase III randomized breast cancer clinical studies between January 1990 and March 2011 was performed. Neoadjuvant, single agent biologics and studies that did not report the proportion of loco-regional and distant recurrences were excluded. The change in the frequency of recurrences was assessed as the nonparametric correlation between the number of loco-regional recurrences as a proportion of all recurrences and time. Studies were weighted by sample size. The differential effect of chemotherapy and endocrine therapy was also assessed. Fifty-three randomized clinical trials with a total of 86,598 patients were included in the analysis. Between 1990 and 2011, the proportion of loco-regional recurrences has decreased from approximately 30 to 15 % (Spearman's ρ = -0.40, p < 0.001). There was no interaction between type of surgery (mastectomy vs. lumpectomy), administration of adjuvant radiation therapy and menopausal status and the correlation of loco-regional recurrences and time. Chemotherapy regimen showed a larger negative correlation compared with endocrine therapy ( ρ = 0.49 vs. ρ = 0.24). Advances in treatment of early breast cancer have differentially reduced the proportion of loco-regional recurrences compared with distant recurrences. In recent trials, loco-regional recurrences account for less than 10-15 % of all recurrences. These falling event rates may affect patient care, especially when deciding on treatments influencing loco-regional control. This change may also impact on the design of clinical

  20. A prediction model for Clostridium difficile recurrence

    PubMed Central

    LaBarbera, Francis D.; Nikiforov, Ivan; Parvathenani, Arvin; Pramil, Varsha; Gorrepati, Subhash

    2015-01-01

    Background Clostridium difficile infection (CDI) is a growing problem in the community and hospital setting. Its incidence has been on the rise over the past two decades, and it is quickly becoming a major concern for the health care system. High rate of recurrence is one of the major hurdles in the successful treatment of C. difficile infection. There have been few studies that have looked at patterns of recurrence. The studies currently available have shown a number of risk factors associated with C. difficile recurrence (CDR); however, there is little consensus on the impact of most of the identified risk factors. Methods Our study was a retrospective chart review of 198 patients diagnosed with CDI via Polymerase Chain Reaction (PCR) from January 2009 to Jun 2013. In our study, we decided to use a machine learning algorithm called the Random Forest (RF) to analyze all of the factors proposed to be associated with CDR. This model is capable of making predictions based on a large number of variables, and has outperformed numerous other models and statistical methods. Results We came up with a model that was able to accurately predict the CDR with a sensitivity of 83.3%, specificity of 63.1%, and area under curve of 82.6%. Like other similar studies that have used the RF model, we also had very impressive results. Conclusions We hope that in the future, machine learning algorithms, such as the RF, will see a wider application. PMID:25656667

  1. Financial volatility trading using recurrent neural networks.

    PubMed

    Tino, P; Schittenkopf, C; Dorffner, G

    2001-01-01

    We simulate daily trading of straddles on financial indexes. The straddles are traded based on predictions of daily volatility differences in the indexes. The main predictive models studied are recurrent neural nets (RNN). Such applications have often been studied in isolation. However, due to the special character of daily financial time-series, it is difficult to make full use of RNN representational power. Recurrent networks either tend to overestimate noisy data, or behave like finite-memory sources with shallow memory; they hardly beat classical fixed-order Markov models. To overcome data nonstationarity, we use a special technique that combines sophisticated models fitted on a larger data set, with a fixed set of simple-minded symbolic predictors using only recent inputs. Finally, we compare our predictors with the GARCH family of econometric models designed to capture time-dependent volatility structure in financial returns. GARCH models have been used to trade volatility. Experimental results show that while GARCH models cannot generate any significantly positive profit, by careful use of recurrent networks or Markov models, the market makers can generate a statistically significant excess profit, but then there is no reason to prefer RNN over much more simple and straightforward Markov models. We argue that any report containing RNN results on financial tasks should be accompanied by results achieved by simple finite-memory sources combined with simple techniques to fight nonstationarity in the data.

  2. Recurrent hepatitis C after liver transplant

    PubMed Central

    deLemos, Andrew S; Schmeltzer, Paul A; Russo, Mark W

    2014-01-01

    End stage liver disease from hepatitis C is the most common indication for liver transplantation in many parts of the world accounting for up to 40% of liver transplants. Antiviral therapy either before or after liver transplantation is challenging due to side effects and lower efficacy in patients with cirrhosis and liver transplant recipients, as well as from drug interactions with immunosuppressants. Factors that may affect recurrent hepatitis C include donor age, immunosuppression, IL28B genotype, cytomegalovirus infection, and metabolic syndrome. Older donor age has persistently been shown to have the greatest impact on recurrent hepatitis C. After liver transplantation, distinguishing recurrent hepatitis C from acute cellular rejection may be difficult, although the development of molecular markers may help in making the correct diagnosis. The advent of interferon free regimens with direct acting antiviral agents that include NS3/4A protease inhibitors, NS5B polymerase inhibitors and NS5A inhibitors holds great promise in improving outcomes for liver transplant candidates and recipients. PMID:25152571

  3. Radiotherapy and brachytherapy for recurrent colorectal cancer

    SciTech Connect

    Nag, S. )

    1991-05-01

    Radical surgical excision of locoregional recurrence of colorectal carcinoma usually produces the best survival and should be attempted whenever possible. However, recurrences are often unresectable; hence palliative local therapy may be indicated. There are several options for the radiation therapy of local, unresectable, recurrent, or metastatic colorectal cancer. Whole pelvis irradiation of 4,000-5,000 cGy followed by a coned-down boost of 1,000-1,500 cGy generally provides good symptomatic palliation in 80-90% of patients, but long-term control or cure is rarely achieved. External beam irradiation of 2,000-3,000 cGy to the whole liver with or without concurrent chemotherapy may be used for palliation of metastatic disease to the liver. A combination of intraoperative radiation therapy applied directly to the tumor bed and external beam irradiation may improve local control and survival rates. Multiple options are available for the intraoperative use of brachytherapy which can deliver high radiation doses to the residual tumor, or tumor bed, sparing normal tissue.

  4. Incidental radiologic findings at breast cancer diagnosis and likelihood of disease recurrence.

    PubMed

    Brothers, Joel M; Kidwell, Kelley M; Brown, Richard K J; Henry, N Lynn

    2016-01-01

    Despite guidelines recommending against its routine use, perioperative imaging for distant metastases is frequently performed in newly diagnosed breast cancer patients, uncovering incidental findings of uncertain significance. We assessed the clinical significance of incidental findings by determining if their presence is associated with disease recurrence. A retrospective review of staging imaging was performed in patients with stage II or III invasive breast cancer diagnosed during 2008-2009 at a large academic medical center. Data related to perioperative imaging and disease recurrence were abstracted from the medical record. Kaplan-Meier curves and Cox proportional hazards models were used to assess the association between incidental findings and time to disease recurrence. A total of 169 of 340 patients (49.7 %) underwent staging evaluation for distant metastases (CT chest, abdomen, pelvis, bone scan, and/or PET-CT). Of these, 146 (86.4 %) had at least one suspicious or indeterminate finding. Follow-up studies were performed in 73 (43.2 %) patients. Nineteen patients were diagnosed with metastatic disease at diagnosis, 18 of whom had stage III disease. In patients without metastatic disease at diagnosis, 32 later developed recurrence. Non-calcified pulmonary nodules were associated with shorter time to disease recurrence (hazard ratio 2.51, 95 % CI 1.13-5.57, p = 0.02). Imaging for distant metastases frequently reveals indeterminate findings, most of which are not associated with disease recurrence. The association between pulmonary nodules and recurrence warrants validation in an independent cohort. Overall, these findings support current guidelines recommending against routine extent of disease evaluation in patients with newly diagnosed stage II breast cancer. PMID:26797222

  5. The impact of obesity on prostate cancer recurrence observed after exclusion of diabetics

    PubMed Central

    Agalliu, Ilir; Williams, Steve; Adler, Brandon; Androga, Lagu; Siev, Michael; Lin, Juan; Xue, Xiaonan; Huang, Gloria; Strickler, Howard D.; Ghavamian, Reza

    2016-01-01

    Purpose Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. Methods A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Results Obesity (25.6 %) and diabetes (18.7 %) were common in this cohort. There were 87 (14.3 %) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 % CI 1.17–4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. Conclusions This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence–BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity–PrCa recurrence relationship are warranted. PMID:25771797

  6. Aortic Complex Plaque Predicts the Risk of Cryptogenic Ischemic Cerebrovascular Disease Recurrence.

    PubMed

    Dong, Jing; Ma, Xin; Qie, Jingyuan; Ji, Xunming

    2016-03-01

    To evaluate the correlations between aortic complex plaque (ACP) and the recurrence of cryptogenic ischemic cerebrovascular disease (CICVD), and to investigate the clinical significance of ACP in CICVD. Methods CICVD patients (aged 17 to 84 years) admitted into the Department of Neurology, Xuanwu Hospital, from July 2011 to December 2013, were consecutively recruited, and divided into ACP and non-ACP groups according to head and neck computerized tomographic (CT) angiography. Recurrences of cerebral ischemic events (CIEs) were compared between these groups after follow-up. Results A total of 117 patients were enrolled (ACP group: 69, non-ACP group: 48) and followed up for a mean of 9.86 months (range: 3-33). The average age of the ACP group was 62.88 years, with 59.4% older than 60 years; the average age of the non-ACP group was 50.29 years, with 37.5% older than 60 years. At the 6-month follow-up, the recurrence rate of CIEs in the ACP group was significantly higher than that of the non-ACP group (17.0% [7/47] and 0% [0/36], respectively; χ2 = 4.283, P = 0.046). The cumulative recurrence risk for CIEs of the ACP group was significantly higher than for the non-ACP group (P = 0.004). Multivariate Cox survival analysis showed that ACP presence was an independent risk factor for CIE recurrence for CICVD patients (relative risk [RR] = 7.803, 95% confidence interval [CI], 1.827~33.319, P = 0.006). Conclusions ACP increased the recurrence risk of CIE in CICVD, and elderly CICVD patients should receive greater attention regarding the significance of ACP in recurrent CICVD.

  7. Aortic Complex Plaque Predicts the Risk of Cryptogenic Ischemic Cerebrovascular Disease Recurrence

    PubMed Central

    Dong, Jing; Ma, Xin; Qie, Jingyuan; Ji, Xunming

    2016-01-01

    To evaluate the correlations between aortic complex plaque (ACP) and the recurrence of cryptogenic ischemic cerebrovascular disease (CICVD), and to investigate the clinical significance of ACP in CICVD. Methods CICVD patients (aged 17 to 84 years) admitted into the Department of Neurology, Xuanwu Hospital, from July 2011 to December 2013, were consecutively recruited, and divided into ACP and non-ACP groups according to head and neck computerized tomographic (CT) angiography. Recurrences of cerebral ischemic events (CIEs) were compared between these groups after follow-up. Results A total of 117 patients were enrolled (ACP group: 69, non-ACP group: 48) and followed up for a mean of 9.86 months (range: 3-33). The average age of the ACP group was 62.88 years, with 59.4% older than 60 years; the average age of the non-ACP group was 50.29 years, with 37.5% older than 60 years. At the 6-month follow-up, the recurrence rate of CIEs in the ACP group was significantly higher than that of the non-ACP group (17.0% [7/47] and 0% [0/36], respectively; χ2 = 4.283, P = 0.046). The cumulative recurrence risk for CIEs of the ACP group was significantly higher than for the non-ACP group (P = 0.004). Multivariate Cox survival analysis showed that ACP presence was an independent risk factor for CIE recurrence for CICVD patients (relative risk [RR] = 7.803, 95% confidence interval [CI], 1.827~33.319, P = 0.006). Conclusions ACP increased the recurrence risk of CIE in CICVD, and elderly CICVD patients should receive greater attention regarding the significance of ACP in recurrent CICVD. PMID:27114844

  8. Recurrent miscarriage: a defect in nature's quality control?

    PubMed

    Quenby, Siobhan; Vince, Gill; Farquharson, Roy; Aplin, John

    2002-08-01

    Recent data on recurrent miscarriage (RM) is discussed in the framework of the selection failure hypothesis which states, 'Recurrent miscarriage is the result of failure of the prevention of 'poor quality' embryos implanting, allowing embryos that are destined to fail to implant and present clinically as recurrent miscarriage. Thus, recurrent miscarriage is a failure of nature's quality control.' The assumption that RM results from the maternal rejection of normal fetuses is challenged and evidence reviewed regarding the contribution of abnormal embryos and endometrial receptivity. Further research is needed to understand the mechanisms of maternal tract-embryo interaction and move towards improved management of recurrent pregnancy loss.

  9. Detecting Recurrence Domains of Dynamical Systems by Symbolic Dynamics

    NASA Astrophysics Data System (ADS)

    Graben, Peter beim; Hutt, Axel

    2013-04-01

    We propose an algorithm for the detection of recurrence domains of complex dynamical systems from time series. Our approach exploits the characteristic checkerboard texture of recurrence domains exhibited in recurrence plots. In phase space, recurrence plots yield intersecting balls around sampling points that could be merged into cells of a phase space partition. We construct this partition by a rewriting grammar applied to the symbolic dynamics of time indices. A maximum entropy principle defines the optimal size of intersecting balls. The final application to high-dimensional brain signals yields an optimal symbolic recurrence plot revealing functional components of the signal.

  10. Sunitinib Malate in Treating Younger Patients With Recurrent, Refractory, or Progressive Malignant Glioma or Ependymoma

    ClinicalTrials.gov

    2015-08-18

    Childhood Cerebellar Anaplastic Astrocytoma; Childhood Cerebral Anaplastic Astrocytoma; Childhood Cerebral Astrocytoma; Childhood Infratentorial Ependymoma; Childhood Mixed Glioma; Childhood Oligodendroglioma; Childhood Supratentorial Ependymoma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma

  11. Talazoparib and Temozolomide in Treating Younger Patients With Refractory or Recurrent Malignancies

    ClinicalTrials.gov

    2016-10-10

    Adult Solid Neoplasm; Childhood Solid Neoplasm; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Central Nervous System Neoplasm; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Refractory Central Nervous System Neoplasm

  12. Management and outcome of recurrent gallstone ileus: A systematic review

    PubMed Central

    Mir, Shovkat Ahmad; Hussain, Zeiad; Davey, Christine Ann; Miller, Glenn Vincent; Chintapatla, Srinivas

    2015-01-01

    AIM: To help the surgeon in decision making when treating a patient with recurrent gallstone ileus (RGSI). METHODS: A systematic review related to RGSI was performed using the databases CINAHL, EMBASE, MEDLINE via PubMed from May 1912 to April 2015. All languages were included and the grey literature was also searched. The abstracts were explored for relevance to the topic and full texts obtained as appropriate. A manual search was carried out by scrutinising the reference lists of all the full text articles and further articles were identified and obtained. Total of 903 articles were identified, 656 were excluded after abstract review, 247 full text articles were reviewed and 91 articles selected for final analysis. There were 113 cases of RGSI. RESULTS: There were 113 cases of RGSI reported in 91 articles. The majority of the recurrences, 62.6%, occurred within 6 wk of the index event. The male to female ratio was 1:7. The mean age was 69.6 years (SD 11.2) with a range of 38-95 years. The small bowel was the commonest site of impaction (92.2%). Treatment data was available for 104 patients. The two main operations performed were: (1) Enterolithotomy without repair of biliary fistula in 70.1% of all patients with a procedural mortality rate of 16.4% (12/73) and (2) a single stage surgery approach involving enterolithotomy with cholecystectomy and repair of the biliary enteric fistula in 16.3% with a procedural mortality of 11.7% (2/17). A subset analysis over last 25 years showed mortality from eneterolithotomy was 4.8% while single stage mortality was 22.2%. Enterolithotomy alone was the commonest operation performed for RGSI with four patients (5.4%) having a further recurrence of gallstone ileus. CONCLUSION: Enterolithotomy alone or followed by a delayed two-stage treatment approach is the preferred choice offering low mortality and reduced risk of recurrence. PMID:26328035

  13. Intraoperative neuropathology of glioma recurrence: cell detection and classification

    NASA Astrophysics Data System (ADS)

    Abas, Fazly S.; Gokozan, Hamza N.; Goksel, Behiye; Otero, Jose J.; Gurcan, Metin N.

    2016-03-01

    Intraoperative neuropathology of glioma recurrence represents significant visual challenges to pathologists as they carry significant clinical implications. For example, rendering a diagnosis of recurrent glioma can help the surgeon decide to perform more aggressive resection if surgically appropriate. In addition, the success of recent clinical trials for intraoperative administration of therapies, such as inoculation with oncolytic viruses, may suggest that refinement of the intraoperative diagnosis during neurosurgery is an emerging need for pathologists. Typically, these diagnoses require rapid/STAT processing lasting only 20-30 minutes after receipt from neurosurgery. In this relatively short time frame, only dyes, such as hematoxylin and eosin (H and E), can be implemented. The visual challenge lies in the fact that these patients have undergone chemotherapy and radiation, both of which induce cytological atypia in astrocytes, and pathologists are unable to implement helpful biomarkers in their diagnoses. Therefore, there is a need to help pathologists differentiate between astrocytes that are cytologically atypical due to treatment versus infiltrating, recurrent, neoplastic astrocytes. This study focuses on classification of neoplastic versus non-neoplastic astrocytes with the long term goal of providing a better neuropathological computer-aided consultation via classification of cells into reactive gliosis versus recurrent glioma. We present a method to detect cells in H and E stained digitized slides of intraoperative cytologic preparations. The method uses a combination of the `value' component of the HSV color space and `b*' component of the CIE L*a*b* color space to create an enhanced image that suppresses the background while revealing cells on an image. A composite image is formed based on the morphological closing of the hue-luminance combined image. Geometrical and textural features extracted from Discrete Wavelet Frames and combined to classify

  14. Cancer Metastases: Early Dissemination and Late Recurrences

    PubMed Central

    Friberg, Sten; Nyström, Andreas

    2015-01-01

    BACKGROUND Metastatic cells from a primary tumor can occur before the primary cancer is detected. Metastatic cells can also remain in the patient for many years after removal of the primary tumor without proliferating. These dormant malignant cells can awaken and cause recurrent disease decades after the primary treatment. The purpose of this article is to review the clinical evidence for early dissemination and late recurrences in human malignant tumors. We used the following definitions: dormancy of cells may be defined as a nonproliferating state or an arrest in the cell cycle that results in a prolonged G0 phase. If one accepts the term “late metastases” to indicate a period exceeding 10 years from the removal of the primary tumor, then the two malignancies in which this occurs most frequently are cutaneous malignant melanoma (CMM) and renal cell carcinoma (RCC). METHODS PubMed, Web of Science, and Scopus were searched with the keywords “metastases,” “early dissemination,” “late recurrences,” “inadvertently transmitted cancer,” “tumor growth rate,” “dormancy,” “circulating tumor cells,” and “transplantation of cancer.” RESULTS Several case reports of early dissemination and late recurrences of various types of malignancies were found. Analyses of the growth rates of several malignant tumors in the original host indicated that the majority of cancers had metastasized years before they were detected. CMM, RCC, and malignant glioblastoma were the three most common malignancies resulting from an organ transplantation. CMM and RCC were also the two most common malignancies that showed dormancy. In several cases of transplanted CMM and RCC, the donor did not have any known malignancy or had had the malignancy removed so long ago that the donor was regarded as cured. CONCLUSION (1) Metastases can frequently exist prior to the detection of the primary tumor. (2) Metastatic cells may reside in organs in the original host that are not

  15. Bimodal Recurrence Pattern of Tsunami in South Central Chile

    NASA Astrophysics Data System (ADS)

    Kempf, P.; Moernaut, J.; Van Daele, M. E.; Vandoorne, W.; Messens, F.; Vandenberghe, D.; Pino, M.; Urrutia, R.; De Batist, M. A. O.

    2015-12-01

    Establishing the recurrence time of large-scale tsunami is one of the main objectives of paleotsunami research, as it is fundamental for any tsunami risk assessment. Typically, the result is given in form of the mean recurrence time and a standard deviation as a range of uncertainty, assuming a normally distributed recurrence. We present a 5.5 ka long coastal lake paleotsunami record from south central Chile, which contains 17 tsunami deposits, 9 of which were previously unknown. Our record matches all 3 of the historically known tsunami, as well as all of the 5 known paleotsunami in the region without over- or underrepresentation. We used Bayesian age-depth modelling to calculate an age-depth model and extracted recurrence intervals for 16 recurrence intervals. Our findings confirm the previously published mean tsunami recurrence time on the Valdivia seismic segment of ~300 years. However, our analyses show a strongly bimodal recurrence pattern with one mode at ~115 years and the other mode at ~490 years. The least likely recurrence time between the modes is at ~300 years and coincides with the mean recurrence time. The reasons for the bimodal distribution remain speculative. They can be attributed to either spatial variability, e.g. incomplete segment rupture, splay fault rupture, up- or down-dip rupture, or to temporal variability, e.g. megathrust earthquake clustering, earthquake supercycles. Our findings highlight the importance of recognising the variability in tsunami recurrence patterns before using mean recurrence time for tsunami risk assessment.

  16. Optimal estimation of recurrence structures from time series

    NASA Astrophysics Data System (ADS)

    beim Graben, Peter; Sellers, Kristin K.; Fröhlich, Flavio; Hutt, Axel

    2016-05-01

    Recurrent temporal dynamics is a phenomenon observed frequently in high-dimensional complex systems and its detection is a challenging task. Recurrence quantification analysis utilizing recurrence plots may extract such dynamics, however it still encounters an unsolved pertinent problem: the optimal selection of distance thresholds for estimating the recurrence structure of dynamical systems. The present work proposes a stochastic Markov model for the recurrent dynamics that allows for the analytical derivation of a criterion for the optimal distance threshold. The goodness of fit is assessed by a utility function which assumes a local maximum for that threshold reflecting the optimal estimate of the system's recurrence structure. We validate our approach by means of the nonlinear Lorenz system and its linearized stochastic surrogates. The final application to neurophysiological time series obtained from anesthetized animals illustrates the method and reveals novel dynamic features of the underlying system. We propose the number of optimal recurrence domains as a statistic for classifying an animals' state of consciousness.

  17. Cholesteatoma in children, predictors and calculation of recurrence rates.

    PubMed

    Stangerup, S E; Drozdziewicz, D; Tos, M

    1999-10-01

    The aim of the study was to evaluate the long-term recurrence rate after surgery for acquired cholesteatoma in children, to search for predictors of recurrency and to analyse the impact of the applied statistical method on the outcome of the results. During a 15-year period, 114 children underwent first-time surgery for acquired cholesteatoma. The patients were re-evaluated with a median observation time of 5.8 years, range 1-16 years. Recurrence of cholesteatoma developed in 27 ears. The cumulated total recurrence rate was 24% using standard incidence rate calculation, applying Kaplan-Meier survival analysis the recurrence rate was 33%. Recurrent disease occurred significantly more frequent in children < 8 years, with negative preoperative Valsalva, ossicular resorption and with large cholesteatomas. In conclusion, young children with poor Eustachian tube function, large cholesteatoma and erosion of the ossicular chain, are at special risk of recurrence and should be observed several years after surgery. PMID:10577779

  18. Sources of magnetic fields in recurrent interplanetary streams

    NASA Technical Reports Server (NTRS)

    Burlaga, L. F.; Behannon, K. W.; Hansen, S. F.; Pneuman, G. W.; Feldman, W. C.

    1978-01-01

    The paper examines sources of magnetic fields in recurrent streams observed by the Imp 8 and Heos spacecraft at 1 AU and by Mariner 10 en route to Mercury between October 31, 1973 and February 9, 1974, during Carrington rotations 1607-1610. Although most fields and plasmas at 1 AU were related to coronal holes and the magnetic field lines were open in those holes, some of the magnetic fields and plasmas at 1 AU were related to open field line regions on the sun which were not associated with known coronal holes, indicating that open field lines may be more basic than coronal holes as sources of the solar wind. Magnetic field intensities in five equatorial coronal holes, certain photospheric magnetic fields, and the coronal footprints of the sector boundaries on the source surface are characterized.

  19. The Role of Obesity in Cancer Survival and Recurrence

    PubMed Central

    Demark-Wahnefried, Wendy; Platz, Elizabeth A.; Ligibel, Jennifer A.; Blair, Cindy K.; Courneya, Kerry S.; Meyerhardt, Jeffrey A.; Ganz, Patricia A.; Rock, Cheryl L.; Schmitz, Kathryn H.; Wadden, Thomas; Philip, Errol J.; Wolfe, Bruce; Gapstur, Susan M.; Ballard-Barbash, Rachel; McTiernan, Anne; Minasian, Lori; Nebeling, Linda; Goodwin, Pamela J.

    2012-01-01

    Obesity and components of energy imbalance, i.e., excessive energy intake and suboptimal levels of physical activity, are established risk factors for cancer incidence. Accumulating evidence suggests that these factors also may be important after the diagnosis of cancer and influence the course of disease, as well as overall health, well-being, and survival. Lifestyle and medical interventions that effectively modify these factors could potentially be harnessed as a means of cancer control. However, for such interventions to be maximally effective and sustainable, broad sweeping scientific discoveries ranging from molecular and cellular advances, to developments in delivering interventions on both individual and societal levels are needed. This review summarizes key discussion topics that were addressed in a recent Institute of Medicine Workshop entitled, “The Role of Obesity in Cancer Survival and Recurrence”; discussions included: 1) mechanisms associated with obesity and energy balance that influence cancer progression; 2) complexities of studying and interpreting energy balance in relation to cancer recurrence and survival; 3) associations between obesity and cancer risk, recurrence, and mortality; 4) interventions that promote weight loss, increased physical activity, and negative energy balance as a means of cancer control; and 5) future directions. PMID:22695735

  20. Early recurrence and ongoing parietal driving during elementary visual processing

    PubMed Central

    Plomp, Gijs; Hervais-Adelman, Alexis; Astolfi, Laura; Michel, Christoph M.

    2015-01-01

    Visual stimuli quickly activate a broad network of brain areas that often show reciprocal structural connections between them. Activity at short latencies (<100 ms) is thought to represent a feed-forward activation of widespread cortical areas, but fast activation combined with reciprocal connectivity between areas in principle allows for two-way, recurrent interactions to occur at short latencies after stimulus onset. Here we combined EEG source-imaging and Granger-causal modeling with high temporal resolution to investigate whether recurrent and top-down interactions between visual and attentional brain areas can be identified and distinguished at short latencies in humans. We investigated the directed interactions between widespread occipital, parietal and frontal areas that we localized within participants using fMRI. The connectivity results showed two-way interactions between area MT and V1 already at short latencies. In addition, the results suggested a large role for lateral parietal cortex in coordinating visual activity that may be understood as an ongoing top-down allocation of attentional resources. Our results support the notion that indirect pathways allow early, evoked driving from MT to V1 to highlight spatial locations of motion transients, while influence from parietal areas is continuously exerted around stimulus onset, presumably reflecting task-related attentional processes. PMID:26692466

  1. Hexaminolevulinate-guided fluorescence cystoscopy reduces recurrence in patients with non-muscle invasive bladder cancer

    PubMed Central

    Stenzl, Arnulf; Burger, Maximilian; Fradet, Yves; Mynderse, Lance A.; Soloway, Mark S.; Witjes, J Alfred; Kriegmair, Martin; Karl, Alexander; Shen, Yu; Grossman, H Barton

    2015-01-01

    Purpose To assess the impact that improved detection of non-muscle invasive bladder cancer with hexaminolevulinate (HAL) fluorescence cystoscopy may have on early recurrence rates. Materials and methods This prospective, randomized study enrolled 814 patients suspected of having bladder cancer at increased risk for recurrence. All patients underwent white light cystoscopy and mapping of lesions, followed by transurethral resection of the bladder (TURB) where indicated. Patients in the fluorescence group also received intravesical hexaminolevulinate solution at least one hour before cystoscopy to induce fluorescence of cancerous lesions, and underwent additional inspection with blue light before and after TURB. Adjuvant intravesical therapy was based on risk. Follow up cystoscopies at 3, 6 and 9 months were conducted with white light. Results Detection was carried out as a within-patient comparison in the fluorescence group. In this group, 286 patients were found to have at least one Ta or T1 tumor (ITT). In 47 (16%), at least one of the tumors was seen only with fluorescence (p=0.001). During the 9 month follow-up period (ITT), there were tumor recurrences in 128/271 patients (47%) in the fluorescence group and 157/280 patients (56%) in the white light group (p=0.026). The relative reduction in recurrence rate was 16%. Conclusions HAL fluorescence cystoscopy significantly improves detection of Ta and T1 lesions and significantly reduces the rate of tumor recurrence at 9 months. PMID:20850152

  2. Therapeutic resistance and cancer recurrence mechanisms: Unfolding the story of tumour coming back.

    PubMed

    Esmatabadi, Mohammad Javad Dehghan; Bakhshinejad, Babak; Motlagh, Fatemeh Movahedi; Babashah, Sadegh; Sadeghizadeh, Majid

    2016-09-01

    Cancer recurrence is believed to be one of the major reasons for the failure of cancer treatment strategies. This biological phenomenon could arise from the incomplete eradication of tumour cells after chemo- and radiotherapy. Recent developments in the design of models reflecting cancer recurrence and in vivo imaging techniques have led researchers to gain a deeper and more detailed insight into the mechanisms underlying tumour relapse. Here, we provide an overview of three important drivers of recurrence including cancer stem cells (CSCs), neosis, and phoenix rising. The survival of cancer stem cells is well recognized as one of the primary causes of therapeutic resistance in malignant cells. CSCs have a relatively latent metabolism and show resistance to therapeutic agents through a variety of routes. Neosis has proven to be as an important mechanism behind tumour self-proliferation after treatment which gives rise to the expansion of tumour cells in the injured site via production of Raju cells. Phoenix rising is a prorecurrence pathway through which apoptotic cancer cells send strong signals to the neighbouring diseased cells leading to their multiplication. The mechanisms involved in therapeutic resistance and tumour recurrence have not yet been fully understood and mostly remain unexplained. Without doubt, an improved understanding of the cellular machinery contributing to recurrence will pave the way for the development of novel, sophisticated and effective antitumour therapeutic strategies which can eradicate tumour without the threat of relapse. PMID:27581940

  3. Upregulation of APE/ref-1 in recurrence stage I, non small cell lung cancer.

    PubMed

    Kang, Min-Woong; Kang, Shin Kwang; Choi, Songyi; Lee, Choong Sik; Jeon, Byeong Hwa; Lim, Seung Pyung

    2012-02-01

    Lung cancer, the leading cause of cancer-related death, still lacks reliable biomarkers. Apurinic/apyrimidinic endonuclease 1/Ref-1 is a multifunctional protein involved in the base excision repair of DNA damaged by oxidative stress or alkylating compounds, as well as in the regulation of multiple transcription factors. To validate apurinic/apyrimidinic endonuclease 1/Ref-1 as a biomarker for prediction of lung cancer recurrence, we studied 42 patients who received curative resection and mediastinal lymph node dissection for stage I non-small-cell lung cancer. They were divided into 2 groups based on recurrence, and compared by immunohistochemistry staining of paraffin-embedded tissues and Western blot analysis. Immunohistochemical staining showed a significant difference between the cytoplasm and nucleus in patients who had a recurrence compared to those with nonrecurrent adenocarcinoma. In Western blot analysis, the recurrent adenocarcinoma group showed increased expression of apurinic/apyrimidinic endonuclease 1/Ref-1 in cytoplasm, nucleus, and in total. This indicates that apurinic/apyrimidinic endonuclease 1/Ref-1 is unregulated in recurrent stage I adenocarcinoma. For clinical application as a prognostic marker for non-small-cell lung cancer, further investigation into the role of apurinic/apyrimidinic endonuclease 1/Ref-1 in carcinogenesis is needed in an expanded prospective study.

  4. Parent of origin, mosaicism, and recurrence risk: probabilistic modeling explains the broken symmetry of transmission genetics.

    PubMed

    Campbell, Ian M; Stewart, Jonathan R; James, Regis A; Lupski, James R; Stankiewicz, Paweł; Olofsson, Peter; Shaw, Chad A

    2014-10-01

    Most new mutations are observed to arise in fathers, and increasing paternal age positively correlates with the risk of new variants. Interestingly, new mutations in X-linked recessive disease show elevated familial recurrence rates. In male offspring, these mutations must be inherited from mothers. We previously developed a simulation model to consider parental mosaicism as a source of transmitted mutations. In this paper, we extend and formalize the model to provide analytical results and flexible formulas. The results implicate parent of origin and parental mosaicism as central variables in recurrence risk. Consistent with empirical data, our model predicts that more transmitted mutations arise in fathers and that this tendency increases as fathers age. Notably, the lack of expansion later in the male germline determines relatively lower variance in the proportion of mutants, which decreases with paternal age. Subsequently, observation of a transmitted mutation has less impact on the expected risk for future offspring. Conversely, for the female germline, which arrests after clonal expansion in early development, variance in the mutant proportion is higher, and observation of a transmitted mutation dramatically increases the expected risk of recurrence in another pregnancy. Parental somatic mosaicism considerably elevates risk for both parents. These findings have important implications for genetic counseling and for understanding patterns of recurrence in transmission genetics. We provide a convenient online tool and source code implementing our analytical results. These tools permit varying the underlying parameters that influence recurrence risk and could be useful for analyzing risk in diverse family structures.

  5. Prolonged clot lysis time increases the risk of a first but not recurrent venous thrombosis.

    PubMed

    Karasu, Alev; Baglin, Trevor P; Luddington, Roger; Baglin, Caroline A; van Hylckama Vlieg, Astrid

    2016-03-01

    The role of the fibrinolytic system in the development of venous thrombosis (VT) is unclear. We studied the risk of first and recurrent VT associated with reduced fibrinolysis, as measured by clot lysis time (CLT). We also studied the relationship between CLT and thrombin generation to determine if any relationship between CLT and VT was affected by thrombin generation. Analyses were performed in the Thrombophilia Hypercoagulability Environmental risk for Venous Thromboembolism Study, a two-centre population-based case-control study, including 579 patients and 338 controls, with patients followed from the event to determine incidence of recurrent VT. Hypofibrinolysis was associated with a 1·8-fold increased risk of a first VT [95% confidence interval (CI) 1·2-2·7]. Adjustment for sex, age, study location and Endogenous Thrombin Potential (ETP) did not change the result. The risk of VT was 2·9-fold increased when the 90th percentiles of prolonged CLT and high ETP were combined, with the highest risk for unprovoked first events (Odds Ratio = 4·2, 95% CI 1·3-13·5). In the follow-up study the Hazard Ratio for a recurrent VT associated with hypofibrinolysis was 1·5 (95% CI 0·9-2·6). A weak dose response effect was observed in relation to prolongation of CLT and recurrent VT. Although hypofibrinolysis constitutes a risk factor for a first VT, an association with recurrence is, at best, weak. PMID:26773756

  6. Radiation fibrosis: differentiation from recurrent tumor by MR imaging: work in progress

    SciTech Connect

    Glazer, H.S.; Lee, J.K.T.; Levitt, R.G.; Heiken, J.P.; Ling, D.; Totty, W.G.; Balfe, D.M.; Emani, B.; Wasserman, T.H.; Murphy, W.A.

    1985-09-01

    Magnetic resonance (MR) images of 21 patients who had undergone radiation therapy were analyzed and compared with those of 15 patients who had untreated tumors. T2-weighted images were most helpful in distinguishing recurrent tumor from radiation fibrosis. Radiation fibrosis, like muscle, usually remained low in signal intensity on T2-weighted images, while tumor demonstrated higher signal intensity. In no patient was the signal intensity of tumor the same or less than muscle on the T2-weighted images. However, relatively high signal intensity on T2-weighted images is not specific for tumor recurrence and may be seen in acute radiation pneumonitis, infection, hemorrhage, and even pulmonary radiation fibrosis.

  7. Recurrent canalicular adenoma of the minor salivary glands in the upper lip.

    PubMed

    Harmse, J L; Saleh, H A; Odutoye, T; Alsanjari, N A; Mountain, R E

    1997-10-01

    Canalicular adenoma is a recently classified uncommon salivary gland neoplasm. This biologically benign growth tends to be multifocal and occurs most often in the upper lips of elderly people. Histologically and clinically it differs from the basal cell adenoma, for which it may be mistaken, in a number of ways. Its clinical importance lies in the fact that it may be confused with malignancy. Little information is available regarding the recurrence and long-term follow-up of these tumours, and where available it covers only relatively short periods. We report the recurrence of a canalicular adenoma after an 11.2 year disease-free period.

  8. "Recurrent Socialization." A New View of "Adult" and "Education" in the Life-Long Education Concept.

    ERIC Educational Resources Information Center

    Rivera, William M.

    The concept of recurrent re-socialization throughout a lifetime is discussed in relation to life-long education. The need for re-socialization, and thus renewal education through adult education, arises not only as a result of a change of physical environment but also at times of cultural shifts, critical periods, and commitment reductions. In a…

  9. Langerhans cell histiocytosis: recurrent lesions affecting mandible in a 10-year-old patient.

    PubMed

    Loducca, S V; Mantesso, A; Araújo, N S; Magalhães, M H

    2001-01-01

    Hand-Schuller-Christian disease is a multifocal variant of eosinophilic granuloma, characterised by the classical triad of bony lesions, exophthalmos and diabetes insipidus. This case relates recurrent Langerhans' cell histiocytosis lesions presented as destruction of periodontal support associated with diabetes in a 10-year-old patient. Medical history suggests that the case represents a case of Hand-Schuller Christian disease.

  10. Innate versus acquired immune response in the pathogenesis of recurrent idiopathic pericarditis.

    PubMed

    Cantarini, Luca; Luca, Cantarini; Imazio, Massimo; Massimo, Imazio; Brucato, Antonio; Antonio, Brucato; Lucherini, Orso Maria; Maria, Lucherini Orso; Galeazzi, Mauro; Mauro, Galeazzi

    2010-04-01

    The pathogenesis of recurrent pericarditis is still poorly understood and may be related either to viral infections or autoimmune and autoinflammatory disorders. The immune system plays a major role in the pathogenesis of the disease, modulating individual responses to different noxa and explaining the variable reported recurrence rate (ranging from 20% to 50% of patients) following an attack of acute or recurrent pericarditis. Increasing interest is currently being devoted to autoinflammatory disorders, a group of conditions characterized by spontaneously relapsing and remitting bouts of systemic inflammation without apparent involvement of antigen-specific T cells or significant production of auto-antibodies. Ongoing basic and clinical research is needed to provide further evidence for the understanding of this common and troublesome disease, and to develop targeted and more efficacious therapies.

  11. Recurrent malignant sino-nasal solitary fibrous tumor: Eliminate the enemy at the first instance.

    PubMed

    Roy, Soumyajit; Mallick, Supriya; Kakkar, Anchal; Jana, Manisha; Julka, Pramod Kumar

    2015-01-01

    Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that usually arise in the pleura or less commonly in relation to other serosal surfaces. Infrequent case reports of extra-pleural SFTs have been described at various sub sites within the head and neck area. We report a case of recurrent sino-nasal SFTs treated with surgery followed by re-excision and adjuvant radiation on recurrence and then salvage chemotherapy on progression. Further discussed are the challenges associated with accurate histological and immunohistochemical diagnosis, the difficulty in assessing the aggressiveness and malignant potential of these lesions and the appropriate treatment and follow-up duration that these neoplasms require. To the best of our knowledge this is the first reported case of recurrent malignant sino-nasal SFT in available scientific literature in English language.

  12. Recurrent malignant sino-nasal solitary fibrous tumor: Eliminate the enemy at the first instance.

    PubMed

    Roy, Soumyajit; Mallick, Supriya; Kakkar, Anchal; Jana, Manisha; Julka, Pramod Kumar

    2015-01-01

    Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that usually arise in the pleura or less commonly in relation to other serosal surfaces. Infrequent case reports of extra-pleural SFTs have been described at various sub sites within the head and neck area. We report a case of recurrent sino-nasal SFTs treated with surgery followed by re-excision and adjuvant radiation on recurrence and then salvage chemotherapy on progression. Further discussed are the challenges associated with accurate histological and immunohistochemical diagnosis, the difficulty in assessing the aggressiveness and malignant potential of these lesions and the appropriate treatment and follow-up duration that these neoplasms require. To the best of our knowledge this is the first reported case of recurrent malignant sino-nasal SFT in available scientific literature in English language. PMID:26458621

  13. Recurrent personality dimensions in inclusive lexical studies: indications for a big six structure.

    PubMed

    Saucier, Gerard

    2009-10-01

    Previous evidence for both the Big Five and the alternative six-factor model has been drawn from lexical studies with relatively narrow selections of attributes. This study examined factors from previous lexical studies using a wider selection of attributes in 7 languages (Chinese, English, Filipino, Greek, Hebrew, Spanish, and Turkish) and found 6 recurrent factors, each with common conceptual content across most of the studies. The previous narrow-selection-based six-factor model outperformed the Big Five in capturing the content of the 6 recurrent wideband factors. Adjective markers of the 6 recurrent wideband factors showed substantial incremental prediction of important criterion variables over and above the Big Five. Correspondence between wideband 6 and narrowband 6 factors indicate they are variants of a "Big Six" model that is more general across variable-selection procedures and may be more general across languages and populations.

  14. Safety of topotecan in the treatment of recurrent small-cell lung cancer and ovarian cancer.

    PubMed

    Garst, Jennifer

    2007-01-01

    The topoisomerase I inhibitor, topotecan, is approved for the treatment of recurrent small-cell lung cancer (SCLC) and ovarian cancer (OC). Patients with recurrent SCLC and OC typically experience multiple relapses and receive multiple rounds of chemotherapy. In these settings, disease stabilisation is considered a treatment benefit, and quality-of-life effects and cumulative toxicities of treatments should be considered. Many patients with recurrent cancer may be predisposed to treatment-related adverse events because of advanced age, renal impairment or extensive prior therapy. The standard regimen of topotecan, 1.5 mg/m(2) on days 1-5 of a 21-day cycle, has generally mild nonhaematological toxicity and a well-defined haematological toxicity profile characterised by reversible and noncumulative neutropenia. Alternative regimens may lower the incidence of haematological toxicities and maintain antitumour efficacy. Topotecan may provide physicians with a versatile therapeutic option for the treatment of patients with relapsed SCLC or OC. PMID:17181452

  15. Order and diversity in the modes of circum-Pacific earthquake recurrence

    USGS Publications Warehouse

    Thatcher, W.

    1990-01-01

    Recurrence characteristics of great circum-Pacific earthquakes and determinations of spatial distribution of seismic moment release are surveyed in order to delineate their general features and relate earthquake slip distribution to models of recurrent rupture. As noted by others, the pattern of moment release is typically very irregular, with strong concentrations in a few isolated regions of a much larger aftershock zone. Despite this complexity, rupture nucleation is notably systematic, with mainshock epicenter showing a strong tendency to locate in or immediately adjacent to identified regions of high moment release. This generalization suggests that earthquake recurrence is more likely to be controlled by maximum rather than average fault slip. Well-documented case histories from 12 plate boundary regions demonstrate that seismic strain release tends to be temporally well-ordered, while source dimensions, slip, and cumulative moment release vary considerably from cycle to cycle. -from Author

  16. Analysis of intra-operative bleeding and recurrence of juvenile nasopharyngeal angiofibromas.

    PubMed

    Liu, L; Wang, R; Huang, D; Han, D; Ferguson, E J; Shi, H; Yang, W

    2002-12-01

    The purpose of this study is to present our experience with 34 patients diagnosed with juvenile nasopharyngeal angiofibromas and treated in the Chinese PLA General Hospital between 1986 and 1999, and to examine the factors influencing intra-operative bleeding and tumour recurrence. The age of the patient, the duration of symptoms and tumour stage were related to the amount of intra-operative bleeding. The tumours were totally resected in 30 patients and recurred in five patients (16.7%), with a mean follow-up time of 77 months. The mean time to tumour recurrence after operation was 3.2 months (1-6 months). The incidence of recurrence had no correlation with the age of the patient, duration of symptoms, peri-operative treatment or surgical approaches (P > 0.05); but strongly correlated with tumour stage (P < 0.05).

  17. Growth hormone therapy and risk of recurrence/progression in intracranial tumors: a meta-analysis.

    PubMed

    Shen, Liang; Sun, Chun Ming; Li, Xue Tao; Liu, Chuan Jin; Zhou, You Xin

    2015-10-01

    Growth hormone deficiency is common in intracranial tumors, which is usually treated with surgery and radiotherapy. A number of previous studies have investigated the relationship between the growth hormone replacement therapy (GHRT) and risk of tumor recurrence/progression; however, the evidence remains controversial. We conducted a meta-analysis of published studies to estimate the potential relation between GHRT and intracranial tumors recurrence/progression. Three comprehensive databases, PUBMED, EMBASE, and Cochrane Library, were researched with no limitations, covering all published studies till the end of July, 2014. Reference lists from identified studies were also screened for additional database. The summary relative risks (RR) and 95% confidence intervals (CI) were calculated by fixed-effects models for estimation. Fifteen eligible studies, involving more than 2232 cases and 3606 controls, were included in our meta-analysis. The results indicated that intracranial tumors recurrence/progression was not associated with GHRT (RR 0.48, 95% CI 0.39-0.56), and for children, the pooled RR was 0.44 and 95% CI was 0.34-0.54. In subgroup analysis, risks of recurrence/progression were decreased for craniopharyngioma, medulloblastoma, astrocytoma, glioma, but not for pituitary adenomas, and non-functioning pituitary adenoma (NFPA), ependymoma. Results from our analysis indicate that GHRT decreases the risk of recurrence/progression in children with intracranial tumors, craniopharyngioma, medulloblastoma, astrocytoma, or glioma. However, GHRT for pituitary adenomas, NFPA, and ependymoma was not associated with the recurrence/progression of the tumors. GH replacement seems safe from the aspect of risk of tumor progression.

  18. Growth hormone therapy and risk of recurrence/progression in intracranial tumors: a meta-analysis.

    PubMed

    Shen, Liang; Sun, Chun Ming; Li, Xue Tao; Liu, Chuan Jin; Zhou, You Xin

    2015-10-01

    Growth hormone deficiency is common in intracranial tumors, which is usually treated with surgery and radiotherapy. A number of previous studies have investigated the relationship between the growth hormone replacement therapy (GHRT) and risk of tumor recurrence/progression; however, the evidence remains controversial. We conducted a meta-analysis of published studies to estimate the potential relation between GHRT and intracranial tumors recurrence/progression. Three comprehensive databases, PUBMED, EMBASE, and Cochrane Library, were researched with no limitations, covering all published studies till the end of July, 2014. Reference lists from identified studies were also screened for additional database. The summary relative risks (RR) and 95% confidence intervals (CI) were calculated by fixed-effects models for estimation. Fifteen eligible studies, involving more than 2232 cases and 3606 controls, were included in our meta-analysis. The results indicated that intracranial tumors recurrence/progression was not associated with GHRT (RR 0.48, 95% CI 0.39-0.56), and for children, the pooled RR was 0.44 and 95% CI was 0.34-0.54. In subgroup analysis, risks of recurrence/progression were decreased for craniopharyngioma, medulloblastoma, astrocytoma, glioma, but not for pituitary adenomas, and non-functioning pituitary adenoma (NFPA), ependymoma. Results from our analysis indicate that GHRT decreases the risk of recurrence/progression in children with intracranial tumors, craniopharyngioma, medulloblastoma, astrocytoma, or glioma. However, GHRT for pituitary adenomas, NFPA, and ependymoma was not associated with the recurrence/progression of the tumors. GH replacement seems safe from the aspect of risk of tumor progression. PMID:26048536

  19. Evaluation of the Prostate Bed for Local Recurrence After Radical Prostatectomy Using Endorectal Magnetic Resonance Imaging

    SciTech Connect

    Liauw, Stanley L.; Pitroda, Sean P.; Eggener, Scott E.; Stadler, Walter M.; Pelizzari, Charles A.; Vannier, Michael W.; Oto, Aytek

    2013-02-01

    Purpose: To summarize the results of a 4-year period in which endorectal magnetic resonance imaging (MRI) was considered for all men referred for salvage radiation therapy (RT) at a single academic center; to describe the incidence and location of locally recurrent disease in a contemporary cohort of men with biochemical failure after radical prostatectomy (RP), and to identify prognostic variables associated with MRI findings in order to define which patients may have the highest yield of the study. Methods and Materials: Between 2007 and 2011, 88 men without clinically palpable disease underwent eMRI for detectable prostate-specific antigen (PSA) after RP. The median interval between RP and eMRI was 32 months (interquartile range, 14-57 months), and the median PSA level was 0.30 ng/mL (interquartile range, 0.19-0.72 ng/mL). Magnetic resonance imaging scans consisting of T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging were evaluated for features consistent with local recurrence. The prostate bed was scored from 0-4, whereby 0 was definitely normal, 1 probably normal, 2 indeterminate, 3 probably abnormal, and 4 definitely abnormal. Local recurrence was defined as having a score of 3-4. Results: Local recurrence was identified in 21 men (24%). Abnormalities were best appreciated on T2-weighted axial images (90%) as focal hypointense lesions. Recurrence locations were perianastomotic (67%) or retrovesical (33%). The only risk factor associated with local recurrence was PSA; recurrence was seen in 37% of men with PSA >0.3 ng/mL vs 13% if PSA {<=}0.3 ng/mL (P<.01). The median volume of recurrence was 0.26 cm{sup 3} and was directly associated with PSA (r=0.5, P=.02). The correlation between MRI-based tumor volume and PSA was even stronger in men with positive margins (r=0.8, P<.01). Conclusions: Endorectal MRI can define areas of local recurrence after RP in a minority of men without clinical evidence of disease, with yield related to PSA

  20. Preoperative CT Predicting Recurrence of Surgically Resected Adenocarcinoma of the Lung

    PubMed Central

    Koo, Hyun Jung; Xu, Hai; Choi, Chang-Min; Song, Joon Seon; Kim, Hyeong Ryul; Lee, Jung Bok; Kim, Mi Young

    2016-01-01

    Abstract Pathologic lymphovascular invasion (LVI) has been shown to be related to tumor recurrence in lung adenocarcinoma (ADC). We investigated preoperative computed tomography (CT) findings that may be related to pathologic LVI and recurrence of surgically managed stage I–II ADC of the lung. Consecutive patients (n = 275) with ADC from January 2013 to December 2013 were retrospectively enrolled. Two independent chest radiologists analyzed the CT findings. Clinical, CT (stage, margin, pleural tag, axial location, and peritumoral interstitial thickening), and pathologic findings (stage, % lepidic growth, and LVI) were reviewed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) for patients with (n = 34) and without (n = 241) recurrence. The κ index for agreement on the CT findings between radiologists was 0.705 to 0.845. In univariate analysis, % lepidic growth (P = 0.006), LVI (P < 0.001), size (P < 0.001), and staging (P = 0.011) differentiated significantly between patients with and without recurrence. Long diameter (P < 0.001), mass type (P < 0.001), marginal lobulation (P = 0.020), central location (P < 0.001), and peritumoral interstitial thickening (P < 0.001) were significantly related to recurrence on CT. Peritumoral interstitial thickening was positively correlated with tumor size (P < 0.001), LVI (P < 0.001), N staging (P = 0.005), stage (P < 0.001), mass type (P < 0.001), and recurrence (P = 0.003). In multivariate analysis, size (HR, 1.052; 95% CI, 1.022–1.082; P < 0.001), central location (HR, 3.152; 1.387–7.166; P = 0.006), and LVI (HR, 2.153, 95% CI, 1.038–4.465; P = 0.039) were independent predictors of recurrence. Large, centrally located tumors with LVI tend to recur after surgery. Presence of peritumoral interstitial thickening on CT appears to predict pathologic LVI and recurrence. PMID:26765471

  1. Preoperative CT Predicting Recurrence of Surgically Resected Adenocarcinoma of the Lung.

    PubMed

    Koo, Hyun Jung; Xu, Hai; Choi, Chang-Min; Song, Joon Seon; Kim, Hyeong Ryul; Lee, Jung Bok; Kim, Mi Young

    2016-01-01

    Pathologic lymphovascular invasion (LVI) has been shown to be related to tumor recurrence in lung adenocarcinoma (ADC). We investigated preoperative computed tomography (CT) findings that may be related to pathologic LVI and recurrence of surgically managed stage I-II ADC of the lung.Consecutive patients (n = 275) with ADC from January 2013 to December 2013 were retrospectively enrolled. Two independent chest radiologists analyzed the CT findings. Clinical, CT (stage, margin, pleural tag, axial location, and peritumoral interstitial thickening), and pathologic findings (stage, % lepidic growth, and LVI) were reviewed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) for patients with (n = 34) and without (n = 241) recurrence.The κ index for agreement on the CT findings between radiologists was 0.705 to 0.845. In univariate analysis, % lepidic growth (P = 0.006), LVI (P < 0.001), size (P < 0.001), and staging (P = 0.011) differentiated significantly between patients with and without recurrence. Long diameter (P < 0.001), mass type (P < 0.001), marginal lobulation (P = 0.020), central location (P < 0.001), and peritumoral interstitial thickening (P < 0.001) were significantly related to recurrence on CT. Peritumoral interstitial thickening was positively correlated with tumor size (P < 0.001), LVI (P < 0.001), N staging (P = 0.005), stage (P < 0.001), mass type (P < 0.001), and recurrence (P = 0.003). In multivariate analysis, size (HR, 1.052; 95% CI, 1.022-1.082; P < 0.001), central location (HR, 3.152; 1.387-7.166; P = 0.006), and LVI (HR, 2.153, 95% CI, 1.038-4.465; P = 0.039) were independent predictors of recurrence.Large, centrally located tumors with LVI tend to recur after surgery. Presence of peritumoral interstitial thickening on CT appears to predict pathologic LVI and recurrence.

  2. Cilengitide in Treating Younger Patients With Recurrent or Progressive High-Grade Glioma That Has Not Responded to Standard Therapy

    ClinicalTrials.gov

    2014-05-05

    Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Visual Pathway and Hypothalamic Glioma

  3. Chromatin changes predict recurrence after radical prostatectomy

    PubMed Central

    Hveem, Tarjei S; Kleppe, Andreas; Vlatkovic, Ljiljana; Ersvær, Elin; Wæhre, Håkon; Nielsen, Birgitte; Kjær, Marte Avranden; Pradhan, Manohar; Syvertsen, Rolf Anders; Nesheim, John Arne; Liestøl, Knut; Albregtsen, Fritz; Danielsen, Håvard E

    2016-01-01

    Background: Pathological evaluations give the best prognostic markers for prostate cancer patients after radical prostatectomy, but the observer variance is substantial. These risk assessments should be supported and supplemented by objective methods for identifying patients at increased risk of recurrence. Markers of epigenetic aberrations have shown promising results in several cancer types and can be assessed by automatic analysis of chromatin organisation in tumour cell nuclei. Methods: A consecutive series of 317 prostate cancer patients treated with radical prostatectomy at a national hospital between 1987 and 2005 were followed for a median of 10 years (interquartile range, 7–14). On average three tumour block samples from each patient were included to account for tumour heterogeneity. We developed a novel marker, termed Nucleotyping, based on automatic assessment of disordered chromatin organisation, and validated its ability to predict recurrence after radical prostatectomy. Results: Nucleotyping predicted recurrence with a hazard ratio (HR) of 3.3 (95% confidence interval (CI), 2.1–5.1). With adjustment for clinical and pathological characteristics, the HR was 2.5 (95% CI, 1.5–4.1). An updated stratification into three risk groups significantly improved the concordance with patient outcome compared with a state-of-the-art risk-stratification tool (P<0.001). The prognostic impact was most evident for the patients who were high-risk by clinical and pathological characteristics and for patients with Gleason score 7. Conclusion: A novel assessment of epigenetic aberrations was capable of improving risk stratification after radical prostatectomy. PMID:27124335

  4. Recurrence patterns and prognostic factors in Chinese patients with squamous cell carcinoma of the vulva treated with primary surgery.

    PubMed

    Cheng, Xi; Zang, Rongyu; Wu, Xiaohua; Li, Ziting; Cai, Shumo; Zhang, Zhiyi

    2009-01-01

    The purpose of this study was to identify the prognostic factors for disease-free survival (DFS) and recurrence patterns in Chinese women with squamous cell carcinoma of the vulva treated with primary surgery. From 1980 through 2002, 100 patients with invasive squamous cell carcinoma of the vulva treated with primary surgery were included in this retrospective study. Survival analyses included the Kaplan-Meier method, log-rank test, and Cox proportional hazards model. The 5- and 10-year DFS rates were 66.5% and 45.2%, respectively. Among all the tumor-related variables age, International Federation of Gynecology and Obstetrics stage, lymphovascular space invasion, and lymph node status were found to be significant predictors of DFS for the univariate analysis. Multivariate analysis proved that age (risk ratio, 6.572; 95% confidence interval, 1.759-24.546) and lymph nodes metastasis (risk ratio, 4.178; 95% confidence interval, 1.358-12.855) were the most significant prognostic factors of DFS (P < 0.05). The overall recurrence rate was 34.0% (34/100). Among the patients with recurrences, the locations of the recurrent disease were as follows: local recurrence in 20 (58.8%), groin recurrence in 2 (5.9%), local and groin in 1 (2.9%), distant metastases in 5 (14.7%), and local recurrence and distant metastases in 5 (14.7%); data were missing for 1 (2.9%) patients. Older age and lymph nodes metastases were the independent predictors of poor prognosis for patients with invasive squamous cell carcinoma of the vulva treated with primary surgery. Local recurrence was the main recurrence pattern after primary surgery which would be improved by multidisciplinary treatment.

  5. Recurrent inactivating RASA2 mutations in melanoma.

    PubMed

    Arafeh, Rand; Qutob, Nouar; Emmanuel, Rafi; Keren-Paz, Alona; Madore, Jason; Elkahloun, Abdel; Wilmott, James S; Gartner, Jared J; Di Pizio, Antonella; Winograd-Katz, Sabina; Sindiri, Sivasish; Rotkopf, Ron; Dutton-Regester, Ken; Johansson, Peter; Pritchard, Antonia L; Waddell, Nicola; Hill, Victoria K; Lin, Jimmy C; Hevroni, Yael; Rosenberg, Steven A; Khan, Javed; Ben-Dor, Shifra; Niv, Masha Y; Ulitsky, Igor; Mann, Graham J; Scolyer, Richard A; Hayward, Nicholas K; Samuels, Yardena

    2015-12-01

    Analysis of 501 melanoma exomes identified RASA2, encoding a RasGAP, as a tumor-suppressor gene mutated in 5% of melanomas. Recurrent loss-of-function mutations in RASA2 were found to increase RAS activation, melanoma cell growth and migration. RASA2 expression was lost in ≥30% of human melanomas and was associated with reduced patient survival. These findings identify RASA2 inactivation as a melanoma driver and highlight the importance of RasGAPs in cancer. PMID:26502337

  6. Rhythmicity, Recurrence, and Recovery of Flagellar Beating

    NASA Astrophysics Data System (ADS)

    Wan, Kirsty Y.; Goldstein, Raymond E.

    2014-12-01

    The eukaryotic flagellum beats with apparently unfailing periodicity, yet responds rapidly to stimuli. Like the human heartbeat, flagellar oscillations are now known to be noisy. Using the alga C. reinhardtii, we explore three aspects of nonuniform flagellar beating. We report the existence of rhythmicity, waveform noise peaking at transitions between power and recovery strokes, and fluctuations of interbeat intervals that are correlated and even recurrent, with memory extending to hundreds of beats. These features are altered qualitatively by physiological perturbations. Further, we quantify the recovery of periodic breaststroke beating from transient hydrodynamic forcing. These results will help constrain microscopic theories on the origins and regulation of flagellar beating.

  7. Recurrent Pregnancy Loss: Etiology, Diagnosis, and Therapy

    PubMed Central

    Ford, Holly B; Schust, Danny J

    2009-01-01

    Spontaneous pregnancy loss is a surprisingly common occurrence, with approximately 15% of all clinically recognized pregnancies resulting in pregnancy failure. Recurrent pregnancy loss (RPL) has been inconsistently defined. When defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period, it affects approximately 1% to 2% of women. This review highlights the current understanding of the various etiologies implicated in RPL, including factors known to be causative, as well as those implicated as possible causative agents. The appropriate diagnostic evaluation, therapy, and prognosis are also addressed. PMID:19609401

  8. Recurrent congenital fibrosarcoma with heart metastases.

    PubMed

    Lohi, Olli; Vornanen, Martine; Kähkönen, Marketta; Vettenranta, Kim; Parto, Katriina; Arola, Mikko

    2012-07-01

    Congenital fibrosarcomas are malignant tumors that arise in soft tissues. In infants this unique tumor does not commonly metastasize, even though there may be local recurrences. We report here a boy who had congenital fibrosarcoma in his right foot, which was completely excised at the age of 3 days. Four months later, a solitary encapsulated metastasis emerged in thoracic chest wall, which was operated. During adjuvant chemotherapy he developed histologically confirmed fibrosarcoma metastases in the heart. After extended treatment with cyclophosphamide/topotecan and gemcitabine/docetaxel, the heart tumors disappeared and he has been in complete remission for 3 years.

  9. Isolated humeral recurrence in endometrial carcinoma

    PubMed Central

    Devdas, Santosh Kumar; Digumarti, Leela; Digumarti, Raghunadharao; Patro, Kunha Charan; Nutakki, Ramakoteswararao

    2016-01-01

    Isolated skeletal metastasis in endometrial carcinoma at recurrence is very rare. We report a 52-year-old woman diagnosed to have FIGO Stage 1b, Grade 1 endometrioid adenocarcinoma, presenting with isolated distal humerus metastasis, 2 years after surgery and adjuvant radiotherapy for primary disease. Imaging, bone scintigraphy, and cytology confirmed the diagnosis of poorly differentiated metastatic adenocarcinoma. She was treated with local radiotherapy followed by six cycles of paclitaxel and carboplatin chemotherapy along with zoledronic acid, monthly. She is symptom-free after the treatment and at a first follow-up visit after 3 months.

  10. Recurrent oral ulcers--an overview.

    PubMed

    Gaffar, A

    2001-01-01

    Recurrent oral ulcers (ROUs) are the most common oral mucosal disease. The etiology of ROUs is complex. The factors include mechanical trauma, genetics, stress, smoking, and viral and bacterial infections. Treatment modalities depend on the differential diagnosis of ROUs and could consist of antimicrobial agents, anti-inflammatory agents, immunomodulators, or over-the-counter medications. New therapy available in the form of a coating polymer, Colgate ORABASE Soothe.N.Seal, is clinically proven to provide rapid relief and healing of ROUs. PMID:11915640

  11. Anatomic factors in recurrent pregnancy loss.

    PubMed

    Devi Wold, Anne S; Pham, Norma; Arici, Aydin

    2006-02-01

    Anatomic uterine defects are present in 15% of women evaluated for three or more consecutive spontaneous abortions. These anatomic abnormalities can be classified as congenital or acquired. In addition to pregnancy loss, uterine malformations appear to predispose women to other reproductive difficulties including infertility, preterm labor, and abnormal presentation. These poor reproductive outcomes resulting from uterine septum, intrauterine adhesions, polyps, and fibroids are amenable to surgical correction. Therefore, it is essential to make an accurate diagnosis to offer an adequate treatment. In this article, we review the common congenital and acquired uterine anomalies associated with recurrent pregnancy losses, and discuss contemporary diagnosis and treatment options.

  12. Rhythmicity, recurrence, and recovery of flagellar beating.

    PubMed

    Wan, Kirsty Y; Goldstein, Raymond E

    2014-12-01

    The eukaryotic flagellum beats with apparently unfailing periodicity, yet responds rapidly to stimuli. Like the human heartbeat, flagellar oscillations are now known to be noisy. Using the alga C. reinhardtii, we explore three aspects of nonuniform flagellar beating. We report the existence of rhythmicity, waveform noise peaking at transitions between power and recovery strokes, and fluctuations of interbeat intervals that are correlated and even recurrent, with memory extending to hundreds of beats. These features are altered qualitatively by physiological perturbations. Further, we quantify the recovery of periodic breaststroke beating from transient hydrodynamic forcing. These results will help constrain microscopic theories on the origins and regulation of flagellar beating.

  13. Recurrent Urinary Tract Infections Management in Women

    PubMed Central

    Al-Badr, Ahmed; Al-Shaikh, Ghadeer

    2013-01-01

    Urinary tract infections (UTIs) are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50–60% of women will develop UTIs in their lifetimes. Escherichia coli is the organism that causes UTIs in most patients. Recurrent UTIs (RUTI) are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis. Although the initial treatment is antimicrobial therapy, use of different prophylactic regimens and alternative strategies are available to reduce exposure to antibiotics. PMID:23984019

  14. Isolated humeral recurrence in endometrial carcinoma.

    PubMed

    Devdas, Santosh Kumar; Digumarti, Leela; Digumarti, Raghunadharao; Patro, Kunha Charan; Nutakki, Ramakoteswararao

    2016-01-01

    Isolated skeletal metastasis in endometrial carcinoma at recurrence is very rare. We report a 52-year-old woman diagnosed to have FIGO Stage 1b, Grade 1 endometrioid adenocarcinoma, presenting with isolated distal humerus metastasis, 2 years after surgery and adjuvant radiotherapy for primary disease. Imaging, bone scintigraphy, and cytology confirmed the diagnosis of poorly differentiated metastatic adenocarcinoma. She was treated with local radiotherapy followed by six cycles of paclitaxel and carboplatin chemotherapy along with zoledronic acid, monthly. She is symptom-free after the treatment and at a first follow-up visit after 3 months. PMID:27688615

  15. Recurrent varicella in an immunocompetent woman.

    PubMed

    Dyer, Joseph; Greenfield, Melinda

    2016-01-01

    Varicella-zoster virus (VZV) infection causes 2 distinct disease processes. Primary VZV infection results in varicella (chickenpox), a common generalized eruption, and subsequent reactivation of VZV classically results in herpes zoster (shingles), which presents as a unilateral, dermatomal eruption. Although a single VZV infection typically confers protection against its reactivation, recurrent varicella rarely is reported, particularly in immunocompetent patients. We present the case of a 52-year-old black woman with an intact immune system who demonstrated 3 VZV infections. PMID:26919358

  16. Recurrent peripheral cemento-ossifying fibroma.

    PubMed

    Pereira, Treville; Shetty, Subraj; Shetty, Arvind; Pereira, Svylvy

    2015-01-01

    Peripheral cement-ossifying fibroma (PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. It frequently occurs in maxillary anterior region in teenagers and young adults. We report a case of PCOF in a 42-year-old male, which was previously surgically excised and recurred after a period of 2 years. PCOF should be considered in the differential diagnosis of reactive hyperplastic lesions originating from gingiva. Hence, early diagnosis with proper surgical excision and aggressive curettage of the adjacent tissues is essential for prevention of recurrence. PMID:26229278

  17. Isolated humeral recurrence in endometrial carcinoma

    PubMed Central

    Devdas, Santosh Kumar; Digumarti, Leela; Digumarti, Raghunadharao; Patro, Kunha Charan; Nutakki, Ramakoteswararao

    2016-01-01

    Isolated skeletal metastasis in endometrial carcinoma at recurrence is very rare. We report a 52-year-old woman diagnosed to have FIGO Stage 1b, Grade 1 endometrioid adenocarcinoma, presenting with isolated distal humerus metastasis, 2 years after surgery and adjuvant radiotherapy for primary disease. Imaging, bone scintigraphy, and cytology confirmed the diagnosis of poorly differentiated metastatic adenocarcinoma. She was treated with local radiotherapy followed by six cycles of paclitaxel and carboplatin chemotherapy along with zoledronic acid, monthly. She is symptom-free after the treatment and at a first follow-up visit after 3 months. PMID:27688615

  18. Recurrent peripheral cemento-ossifying fibroma.

    PubMed

    Pereira, Treville; Shetty, Subraj; Shetty, Arvind; Pereira, Svylvy

    2015-01-01

    Peripheral cement-ossifying fibroma (PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. It frequently occurs in maxillary anterior region in teenagers and young adults. We report a case of PCOF in a 42-year-old male, which was previously surgically excised and recurred after a period of 2 years. PCOF should be considered in the differential diagnosis of reactive hyperplastic lesions originating from gingiva. Hence, early diagnosis with proper surgical excision and aggressive curettage of the adjacent tissues is essential for prevention of recurrence.

  19. Fungal Biofilms, Drug Resistance, and Recurrent Infection

    PubMed Central

    Desai, Jigar V.; Mitchell, Aaron P.; Andes, David R.

    2014-01-01

    A biofilm is a surface-associated microbial community. Diverse fungi are capable of biofilm growth. The significance of this growth form for infection biology is that biofilm formation on implanted devices is a major cause of recurrent infection. Biofilms also have limited drug susceptibility, making device-associated infection extremely difficult to treat. Biofilm-like growth can occur during many kinds of infection, even when an implanted device is not present. Here we summarize the current understanding of fungal biofilm formation, its genetic control, and the basis for biofilm drug resistance. PMID:25274758

  20. Competing risks analyses for recurrence from primary breast cancer

    PubMed Central

    Chapman, J W; Fish, E B; Link, M A

    1999-01-01

    The effects of prognostic factors on local, regional or distant metastasis are standardly assessed separately. Competing risks analyses may be used to assess simultaneously the effects of factors on different types of first recurrence. Data for a cohort of 678 primary invasive breast cancer patients accrued between 1971 and 1990, updated to 1995, included type of first recurrence (local, regional, distant). We investigated the effects of the traditional factors of age, tumour size, nodal status, ER, PgR, adjuvant therapy (hormones, chemotherapy, radiotherapy) on type of recurrence and time to recurrence for all patients and for those aged ≥ 65. For all ages of patients, there were five factors with significant associations with type or time to first recurrence. Adjuvant radiation was the only factor which had an effect (P ≤ 0.05) on the type of first recurrence: being associated with a reduction in local recurrence. Age, nodal status, tumour size and adjuvant chemotherapy all had significant associations across all types of first recurrence, and in particular with time to recurrence for both local and distant metastasis. This indicates a potential lack of independence in these end-points. For patients ≥ 65 years of age, there were no factors which differentially affected type of recurrence, while only nodal status and tumour size had significant associations with time to recurrence. Analyses were used to assess simultaneously the effects of traditional prognostic factors and treatment options on type of first recurrence and time to first recurrence. The extension to evaluations with newer prognostic factors would expedite the determination and mode of biologic activity for such factors. © 1999 Cancer Research Campaign PMID:10188898

  1. Are reported stress and coping style associated with frequent recurrence of genital herpes?

    PubMed Central

    Cassidy, L; Meadows, J; Catalán, J; Barton, S

    1997-01-01

    OBJECTIVES: This paper reports on the cross sectional data from the longitudinal study examining the impact of genital herpes simplex virus (HSV) infection on quality of life. In particular the report sought to study the relation between recurrence of genital HSV and coping style, mood, personality, and quality of life, among other factors. SETTING AND SUBJECTS: 116 patients with a known history of genital herpes simplex infection attending the Department of Genitourinary Medicine at Chelsea and Westminster Hospital. METHODS: Psychosocial factors (stress, anxiety, depression, health locus of control, personality, social support, coping skills, and quality of life) and the reported frequency of genital herpes episodes were measured using self administered questionnaires designed to examine the relation between psychosocial status and the frequency of genital HSV episodes. RESULTS: The number of recurrences reported by patients was significantly related to the style of coping skills used. Higher recurrences were less likely to use problem focused coping skills of planning and active coping, and the emotion focused coping skills of positive reinterpretation and growth. There was a significant difference in the number of patients who believed that psychological stress was related to the number of recurrences they experienced. This belief was related to neuroticism on the Eysenck Personality Questionnaire scale, and not to any of the other measures investigated. CONCLUSION: The findings suggest that it is the way individuals cope, and their personality characteristics rather than actual levels of psychological stress, that influence their belief in a link between recurrent genital HSV and stress. HSV may become the focus of existing concerns and be viewed as the physical manifestation of stress. PMID:9389946

  2. MORAb-004 in Treating Young Patients With Recurrent or Refractory Solid Tumors or Lymphoma

    ClinicalTrials.gov

    2016-01-07

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

  3. Loss of TIMP-1 immune expression and tumor recurrence in localized prostate cancer

    PubMed Central

    dos Reis, Sabrina Thalita; Viana, Nayara Izabel; Iscaife, Alexandre; Pontes, José; Dip, Nelson; Antunes, Alberto Azoubel; Guimarães, Vanessa Ribeiro; Santana, Isaque; Nahas, William Carlos; Srougi, Miguel; Leite, Katia Ramos Moreira

    2015-01-01

    ABSTRACT Introduction and objective: Overexpression of MMPs has been related to biochemical recurrence after radical prostatectomy. TIMP1 and TIMP2 are controllers of MMPs and the aim of this study is to evaluate the expression levels of MMPs and their regulators using immunohistochemistry in tissue microarray of localized prostate cancer (PC). Materials and Methods: Immune-expression of MMP-9, MMP-2, TIMP1, TIMP-2, MMP-14 and IL8, were analyzed by immunohistochemistry in radical prostatectomy specimens of 40 patients with localized PC who underwent surgery between September 1997 and February 2000. Protein expression was considered as categorical variables, negative or positive. The results of the immune-expression were correlated to Gleason score (GS), pathological stage (TNM), pre-operatory PSA serum levels and biochemical recurrence in a mean follow up period of 92.5 months. Results: The loss of TIMP1 immune-expression was related to biochemical recurrence. When TIMP1 was negative, 56.3% patients recurred versus 22.2% of those whose TIMP1 was positive (p=0.042). MMP-9, MMP-2, IL8 and MMP-14 were positive in the majority of PC. TIMP-2 was negative in all cases. Conclusion: Negative immune-expression of TIMP1 is correlated with biochemical recurrence in patients with PC possibly by failing to control MMP-9, an important MMP related to cancer progression. PMID:26742965

  4. AZD2171 in Treating Young Patients With Recurrent, Progressive, or Refractory Primary CNS Tumors

    ClinicalTrials.gov

    2016-03-04

    Childhood Atypical Teratoid/Rhabdoid Tumor; Childhood Central Nervous System Germ Cell Tumor; Childhood Cerebral Anaplastic Astrocytoma; Childhood Cerebral Astrocytoma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood Infratentorial Ependymoma; Childhood Oligodendroglioma; Childhood Spinal Cord Neoplasm; Childhood Supratentorial Ependymoma; Recurrent Childhood Brain Neoplasm; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway Glioma

  5. Potential and limit of LiDAR data for earthquake recurrence characterization

    NASA Astrophysics Data System (ADS)

    Zielke, Olaf

    2013-04-01

    The characterization of earthquake (EQ) recurrence --assessing timing and size of past EQs along a given fault (section)-- has proven difficult, largely due the relatively short time span that is covered by instrumental seismic observations. While major EQs along a given fault are inferred to occur roughly on centennial to millennial time scales, seismographs to record them emerged little more than 100 years ago. Thus, recurrence of major EQs has essentially not yet been observed instrumentally. Stratigraphic and geomorphic evidence is used instead to describe and constrain recurrence of surface rupturing EQs. In the 1980s, analysis of such data sets culminated in the formulation of now classical EQ recurrence models. The debate about the correctness and thus applicability of these in part contradicting models is still ongoing. Over the last 10 years or so Light Detection and Ranging (LiDAR) technology became available to paleoseismic and tectono-geomorphic investigations. High spatial resolution, precision, and accuracy --the key features of LiDAR data-- revealed details in the tectono-geomorphic record that could not be resolved previously by field investigation or air photo analysis. As a result LiDAR data sets contributed and continues to contribute to improvements in the recurrence characterization of (surface rupturing) EQs. Here, I will present an overview on LiDAR data implementation in paleoseismic and tectono-geomorphic studies, including trench-based LiDAR, terrestrial LiDAR, and airborne LiDAR and I will discuss the impact of LiDAR data on constraining EQ recurrence characteristics as well as their relation to the classical EQ recurrence models. Additionally, I will discuss the intrinsic limits (that even LiDAR data cannot overcome) that arise when investigating geomorphic and stratigraphic evidence for EQ recurrence characterization. The natural complexity of the rupture process itself and its imprint on the analyzed data sets puts an unavoidable limit

  6. Intrinsic adaptation in autonomous recurrent neural networks.

    PubMed

    Marković, Dimitrije; Gros, Claudius

    2012-02-01

    A massively recurrent neural network responds on one side to input stimuli and is autonomously active, on the other side, in the absence of sensory inputs. Stimuli and information processing depend crucially on the quality of the autonomous-state dynamics of the ongoing neural activity. This default neural activity may be dynamically structured in time and space, showing regular, synchronized, bursting, or chaotic activity patterns. We study the influence of nonsynaptic plasticity on the default dynamical state of recurrent neural networks. The nonsynaptic adaption considered acts on intrinsic neural parameters, such as the threshold and the gain, and is driven by the optimization of the information entropy. We observe, in the presence of the intrinsic adaptation processes, three distinct and globally attracting dynamical regimes: a regular synchronized, an overall chaotic, and an intermittent bursting regime. The intermittent bursting regime is characterized by intervals of regular flows, which are quite insensitive to external stimuli, interceded by chaotic bursts that respond sensitively to input signals. We discuss these findings in the context of self-organized information processing and critical brain dynamics. PMID:22091667

  7. Collective stochastic coherence in recurrent neuronal networks

    NASA Astrophysics Data System (ADS)

    Sancristóbal, Belén; Rebollo, Beatriz; Boada, Pol; Sanchez-Vives, Maria V.; Garcia-Ojalvo, Jordi

    2016-09-01

    Recurrent networks of dynamic elements frequently exhibit emergent collective oscillations, which can show substantial regularity even when the individual elements are considerably noisy. How noise-induced dynamics at the local level coexists with regular oscillations at the global level is still unclear. Here we show that a combination of stochastic recurrence-based initiation with deterministic refractoriness in an excitable network can reconcile these two features, leading to maximum collective coherence for an intermediate noise level. We report this behaviour in the slow oscillation regime exhibited by a cerebral cortex network under dynamical conditions resembling slow-wave sleep and anaesthesia. Computational analysis of a biologically realistic network model reveals that an intermediate level of background noise leads to quasi-regular dynamics. We verify this prediction experimentally in cortical slices subject to varying amounts of extracellular potassium, which modulates neuronal excitability and thus synaptic noise. The model also predicts that this effectively regular state should exhibit noise-induced memory of the spatial propagation profile of the collective oscillations, which is also verified experimentally. Taken together, these results allow us to construe the high regularity observed experimentally in the brain as an instance of collective stochastic coherence.

  8. Recurrent Monostotic Fibrous Dysplasia in the Mandible.

    PubMed

    Alves, Nilton; de Oliveira, Reinaldo José; Takehana, Denise; Deana, Naira Figueiredo

    2016-01-01

    Fibrous dysplasia (FD) is a condition in which normal bone marrow is replaced by an abnormal proliferation of new fibrous connective tissue. Female patient, white, 20 years old, attended the dental clinic reporting a slow increase in volume in the right mandible region over the last 5 years. She was examined by imaging: the panoramic X-ray revealed a lesion with the appearance of ground glass while the cone-beam computed tomography showed an extensive lesion in the region of the right hemimandible. The histopathological examination was compatible with fibrous dysplasia. Bone gammagraphy was indicated, plus an endocrinological study to eliminate polyostotic forms, which produced a negative result. Monostotic fibrous dysplasia in the right hemimandible was diagnosed. Conservative surgery was carried out and after 1 year recurrence of the tumour was observed. We may conclude that conservative surgery might not be the best choice for treatment for monostotic fibrous dysplasia in the mandible and that other options must be considered, such as radical surgery or the use of bisphosphonates. In our study, we may also conclude that it is very important to explain to the patient the possibility of recurrence of the lesion and the need for monitoring with periodic imaging studies. PMID:27340572

  9. Dynamic recurrent neural networks: a dynamical analysis.

    PubMed

    Draye, J S; Pavisic, D A; Cheron, G A; Libert, G A

    1996-01-01

    In this paper, we explore the dynamical features of a neural network model which presents two types of adaptative parameters: the classical weights between the units and the time constants associated with each artificial neuron. The purpose of this study is to provide a strong theoretical basis for modeling and simulating dynamic recurrent neural networks. In order to achieve this, we study the effect of the statistical distribution of the weights and of the time constants on the network dynamics and we make a statistical analysis of the neural transformation. We examine the network power spectra (to draw some conclusions over the frequential behaviour of the network) and we compute the stability regions to explore the stability of the model. We show that the network is sensitive to the variations of the mean values of the weights and the time constants (because of the temporal aspects of the learned tasks). Nevertheless, our results highlight the improvements in the network dynamics due to the introduction of adaptative time constants and indicate that dynamic recurrent neural networks can bring new powerful features in the field of neural computing.

  10. Patient with Recurrent Polyserositis (Familial Mediterranean Fever).

    PubMed

    Agarwal, Arun; Sharma, Samiksha

    2015-08-01

    Familial Mediterranean fever (FMF) is a hereditary autosomal recessive ,systemic, auto-inflammatory disorder characterized by sporadic, unpredictable attacks of fever and serosal inflammation. FMF is caused by mutations in MEFV, a gene located on the short arm of chromosome 16 (16p13) which encodes a protein 'Pyrin'. The disorder has been given various names including familial paroxysmal polyserositis, periodic peritonitis, recurrent polyserositis, benign paroxysmal peritonitis, and periodic disease or periodic fever, As the name indicates, FMF occurs within families and is much more common in individuals of Mediterranean descent than in persons of any other ethnicity. It has been described in several ethnic groups including Sephardic Jews, Armenians, Turks, North Africans, Arabs, Greeks, and Italians. However, the disease is not restricted to these groups and sporadic cases have been reported. Diagnosis is usually clinical and it classically presents with unprovoked, recurrent attacks of fever and painful polyserositis mainly affecting the peritoneum (most common), synovium, and pleura that usually (but not always) begin in childhood. We present a atypical case of FMF with type 1 Diabetes Mellitus and FMF who had no fever, Mediterranean ancestory or family history and discuss his clinical features,diagnosis and management. PMID:27604438

  11. Gamma-ray burster recurrence timescales

    NASA Technical Reports Server (NTRS)

    Schaefer, B. E.; Cline, T. L.

    1984-01-01

    Three optical transients have been found which are associated with gamma-ray bursters (GRBs). The deduced recurrence timescale for these optical transients (tau sub opt) will depend on the minimum brightness for which a flash would be detected. A detailed analysis using all available data of tau sub opt as a function of E(gamma)/E(opt) is given. For flashes similar to those found in the Harvard archives, the best estimate of tau sub opt is 0.74 years, with a 99% confidence interval from 0.23 years to 4.7 years. It is currently unclear whether the optical transients from GRBs also give rise to gamma-ray events. One way to test this association is to measure the recurrence timescale of gamma-ray events tau sub gamma. A total of 210 gamma-ray error boxes were examined and it was found that the number of observed overlaps is not significantly different from the number expected from chance coincidence. This observation can be used to place limits on tau sub gamma for an assumed luminosity function. It was found that tau sub gamma is approx. 10 yr if bursts are monoenergetic. However, if GRBs have a power law luminosity function with a wide dynamic range, then the limit is tau sub gamma 0.5 yr. Hence, the gamma-ray data do not require tau sub gamma and tau sub opt to be different.

  12. Recurrent Monostotic Fibrous Dysplasia in the Mandible

    PubMed Central

    de Oliveira, Reinaldo José; Takehana, Denise; Deana, Naira Figueiredo

    2016-01-01

    Fibrous dysplasia (FD) is a condition in which normal bone marrow is replaced by an abnormal proliferation of new fibrous connective tissue. Female patient, white, 20 years old, attended the dental clinic reporting a slow increase in volume in the right mandible region over the last 5 years. She was examined by imaging: the panoramic X-ray revealed a lesion with the appearance of ground glass while the cone-beam computed tomography showed an extensive lesion in the region of the right hemimandible. The histopathological examination was compatible with fibrous dysplasia. Bone gammagraphy was indicated, plus an endocrinological study to eliminate polyostotic forms, which produced a negative result. Monostotic fibrous dysplasia in the right hemimandible was diagnosed. Conservative surgery was carried out and after 1 year recurrence of the tumour was observed. We may conclude that conservative surgery might not be the best choice for treatment for monostotic fibrous dysplasia in the mandible and that other options must be considered, such as radical surgery or the use of bisphosphonates. In our study, we may also conclude that it is very important to explain to the patient the possibility of recurrence of the lesion and the need for monitoring with periodic imaging studies. PMID:27340572

  13. New geological perspectives on earthquake recurrence models

    SciTech Connect

    Schwartz, D.P.

    1997-02-01

    In most areas of the world the record of historical seismicity is too short or uncertain to accurately characterize the future distribution of earthquakes of different sizes in time and space. Most faults have not ruptured once, let alone repeatedly. Ultimately, the ability to correctly forecast the magnitude, location, and probability of future earthquakes depends on how well one can quantify the past behavior of earthquake sources. Paleoseismological trenching of active faults, historical surface ruptures, liquefaction features, and shaking-induced ground deformation structures provides fundamental information on the past behavior of earthquake sources. These studies quantify (a) the timing of individual past earthquakes and fault slip rates, which lead to estimates of recurrence intervals and the development of recurrence models and (b) the amount of displacement during individual events, which allows estimates of the sizes of past earthquakes on a fault. When timing and slip per event are combined with information on fault zone geometry and structure, models that define individual rupture segments can be developed. Paleoseismicity data, in the form of timing and size of past events, provide a window into the driving mechanism of the earthquake engine--the cycle of stress build-up and release.

  14. Transsacral rectopexy for recurrent complete rectal prolapse.

    PubMed

    Araki, Y; Isomoto, H; Tsuzi, Y; Matsumoto, A; Yasunaga, M; Yamauchi, K; Hayashi, K; Kodama, T

    1999-01-01

    The aim of this study was to examine the functional outcome of transsacral rectopexy performed with Dexon mesh for recurrent complete rectal prolapse. Anorectal function was assessed by anorectal manometry and defecography, before and from 1 year after surgery in five patients who were followed up for 1-3 years. The fecal incontinence score recovered from a preoperative mean score of 3.8 to a postoperative mean score of 1.2, and constipation was improved in four patients (80%). The straining anorectal angle (S-ARA), measured by defecography, improved from a preoperative value of 120.6 degrees +/- 6.9 degrees to a postoperative value of 98.5 degrees +/- 3.5 degrees (P < 0.05), and the perineal descent (PD) improved from a preoperative value of 16.2 +/- 2.5 cm to a postoperative value of 8.1 +/- 1.3 cm (P < 0.05). The maximal resting pressure (MRP) increased from a preoperative value of 20.5 +/- 3.7 cmH2O to a postoperative value of 40.5 +/- 4.8 cmH2O (P < 0.05). These findings indicate that transsacral rectopexy with Dexon mesh can achieve good control of recurrent complete rectal prolapse. PMID:10489150

  15. [Recurrent parathyroid cyst: a clinical case].

    PubMed

    Lorenzo, J; Fernández, G; Iglesias, B; Boente, R; Sas, M

    2008-05-01

    The parathyroid cyst is a very infrequent entity, so much so that only round about 200 cases have been described up to now. It can be functional and non-functional. The studies of image don't clarify to us if procedence becomes of parathyroid or it has another origin, and the diagnosis is made with the analysis come from the liquid obtained in the puncture aspiration, where high PTH's concentrations are seen. Surgery is the treatment for functional cysts and the puncture aspiration for non- functional, the fact that they use to get solved with only one but sometimes is necessary to repeated it, even more than one time, keeping for the surgery when recurrent. We presented a clinical case of recurrent parathyroid cyst and his natural evolution, due to patient rejects surgery, being necessary repeated punctures. It hasn't become malignant after 10 years and his functional status wasn't changed, being necessary to accomplish repeated punctures aspirations each 2-3 months for local bothers.

  16. Genetic Causes of Recurrent Pregnancy Loss.

    PubMed

    Page, Jessica M; Silver, Robert M

    2016-09-01

    Pregnancy loss is one of the most common obstetric complications, affecting over 30% of conceptions. A considerable proportion of losses are due to genetic abnormalities. Indeed, over 50% of early pregnancy losses have been associated with chromosomal abnormalities. Most are due to de novo nondisjunctional events but balanced parental translocations are responsible for a small but important percentage of genetic abnormalities in couples with recurrent pregnancy loss. In the past, assessment of genetic abnormalities was limited to karyotype performed on placental or fetal tissue. However, advances in molecular genetic technology now provide rich genetic information about additional genetic causes of and risk factors for pregnancy loss. In addition, the use of preimplantation genetic testing in couples undergoing in vitro fertilization has the potential to decrease the risk of pregnancy loss from genetic abnormalities. To date, efficacy is uncertain but considerable potential remains. This chapter will review what is known about genetic causes of recurrent pregnancy loss with a focus on novel causes and potential treatments. Remaining knowledge gaps will be highlighted. PMID:27414972

  17. Concept of healing of recurrent shoulder dislocation.

    PubMed

    D'Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical-pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles.

  18. Prolonged and recurrent fevers in children.

    PubMed

    Marshall, Gary S

    2014-01-01

    Some children referred for prolonged fever are actually not having elevated temperatures; the approach here requires dissection of the history and correction of health misperceptions. Others have well-documented fevers associated with clinical, laboratory, or epidemiologic findings that should point to a specific diagnosis. "Fever-of-Unknown-Origin" (FUO) is the clinical scenario of daily fever for ≥ 14 days that defies explanation after a careful history, physical examination, and basic laboratory tests. The diagnostic approach requires a meticulous fever diary, serial clinical and laboratory evaluations, vigilance for the appearance of new signs and symptoms, and targeted investigations; the pace of the work-up is determined by the severity of the illness. Approximately half of children with FUO will have a self-limited illness and will never have a specific diagnosis made; the other half will ultimately be found to have, in order, infectious, inflammatory, or neoplastic conditions. Irregular, intermittent, recurrent fevers in the well-appearing child are likely to be sequential viral illnesses. Monogenic autoinflammatory diseases should be considered in those who do not fit the picture of recurrent infections and who do not have hallmarks of immune deficiency. Stereotypical febrile illnesses that recur with clockwork periodicity should raise the possibilities of cyclic neutropenia, if the cycle is approximately 21 days, or periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, the most common periodic fever in childhood. PMID:24120354

  19. Concept of healing of recurrent shoulder dislocation☆

    PubMed Central

    D’Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O’Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical–pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles. PMID:26229839

  20. Recurrent Obstructive Giant Inflammatory Polyposis of the Colon

    PubMed Central

    Budhraja, Vikram

    2016-01-01

    Inflammatory polyps are relatively common in patients with inflammatory bowel disease. The term giant inflammatory polyposis is used to describe inflammatory polyps greater than 1.5 cm in any dimension. Their clinical presentation can be varied, ranging from asymptomatic, with incidental detection on radiological or endoscopic testing, to symptomatic, with rectal bleeding and colonic obstruction. Although giant inflammatory polyposis is a rare finding, it is of clinical importance, since it is easily mistaken for colon cancer, with patients sometimes undergoing radical surgeries. We describe an unusual case of giant inflammatory polyposis causing recurrent symptomatic obstruction despite multiple segmental colectomies in a patient with indeterminate colitis. This is the first such reported case in English literature to the best of our knowledge.

  1. Coronal Mass Ejections and Non-recurrent Forbush Decreases

    NASA Astrophysics Data System (ADS)

    Belov, A.; Abunin, A.; Abunina, M.; Eroshenko, E.; Oleneva, V.; Yanke, V.; Papaioannou, A.; Mavromichalaki, H.; Gopalswamy, N.; Yashiro, S.

    2014-10-01

    Coronal mass ejections (CMEs) and their interplanetary counterparts (interplanetary coronal mass ejections, ICMEs) are responsible for large solar energetic particle events and severe geomagnetic storms. They can modulate the intensity of Galactic cosmic rays, resulting in non-recurrent Forbush decreases (FDs). We investigate the connection between CME manifestations and FDs. We used specially processed data from the worldwide neutron monitor network to pinpoint the characteristics of the recorded FDs together with CME-related data from the detailed online catalog based upon the Solar and Heliospheric Observatory (SOHO)/ Large Angle and Spectrometric Coronagraph (LASCO) data. We report on the correlations of the FD magnitude to the CME initial speed, the ICME transit speed, and the maximum solar wind speed. Comparisons between the features of CMEs (mass, width, velocity) and the characteristics of FDs are also discussed. FD features for halo, partial halo, and non-halo CMEs are presented and discussed.

  2. Second-order analysis of semiparametric recurrent event processes.

    PubMed

    Guan, Yongtao

    2011-09-01

    A typical recurrent event dataset consists of an often large number of recurrent event processes, each of which contains multiple event times observed from an individual during a follow-up period. Such data have become increasingly available in medical and epidemiological studies. In this article, we introduce novel procedures to conduct second-order analysis for a flexible class of semiparametric recurrent event processes. Such an analysis can provide useful information regarding the dependence structure within each recurrent event process. Specifically, we will use the proposed procedures to test whether the individual recurrent event processes are all Poisson processes and to suggest sensible alternative models for them if they are not. We apply these procedures to a well-known recurrent event dataset on chronic granulomatous disease and an epidemiological dataset on meningococcal disease cases in Merseyside, United Kingdom to illustrate their practical value.

  3. Photodynamic therapy in patients with recurrent gynecological carcinomas

    NASA Astrophysics Data System (ADS)

    Hetzel, Heinz; Mueller, Elisabeth; Kostron, Herwig

    1993-03-01

    Patients with recurrent gynecological carcinomas have a poor prognosis with a median survival time of 3 - 6 months. Four patients with recurrent vulva carcinomas, one patient with a recurrent breast cancer, and one with a recurrent cervical carcinoma underwent PDT after parenteral or topical sensitization with Photosan 3. Of those patients two women made a complete recovery with no evidence of disease 27 and 24 months after. One patient responded partially with two recurrences which were retreated twice after topical sensitization, she has survived 16 months. The remaining patients showed partial response and died 3 and 8 months after PDT. The energy delivered by an argon-dye-laser ranged between 225 and 750 J/cm2. Photosan 3 was given intravenously at a dose of 2.5 mg/kg body weight and was tolerated without any allergic reaction. A response rate of nearly 50% in recurrent gynecological malignancies encourages us to pursue PDT in gynecological diseases.

  4. Stereotactic Radiosurgery for Recurrent or Unresectable Pilocytic Astrocytoma

    SciTech Connect

    Hallemeier, Christopher L.; Pollock, Bruce E.; Schomberg, Paula J.; Link, Michael J.; Brown, Paul D.; Stafford, Scott L.

    2012-05-01

    Purpose: To report the outcomes in patients with recurrent or unresectable pilocytic astrocytoma (PA) treated with Gamma Knife stereotactic radiosurgery (SRS). Methods and Materials: Retrospective review of 18 patients (20 lesions) with biopsy-confirmed PA having SRS at our institution from 1992 through 2005. Results: The median patient age at SRS was 23 years (range, 4-56). Thirteen patients (72%) had undergone one or more previous surgical resections, and 10 (56%) had previously received external-beam radiation therapy (EBRT). The median SRS treatment volume was 9.1 cm{sup 3} (range, 0.7-26.7). The median tumor margin dose was 15 Gy (range, 12-20). The median follow-up was 8.0 years (range, 0.5-15). Overall survival at 1, 5, and 10 years after SRS was 94%, 71%, and 71%, respectively. Tumor progression (local solid progression, n = 4; local solid progression + distant, n = 1; distant, n = 2; cyst development/progression, n = 4) was noted in 11 patients (61%). Progression-free survival at 1, 5, and 10 years was 65%, 41%, and 17%, respectively. Prior EBRT was associated with inferior overall survival (5-year risk, 100% vs. 50%, p = 0.03) and progression-free survival (5-year risk, 71% vs. 20%, p = 0.008). Nine of 11 patients with tumor-related symptoms improved after SRS. Symptomatic edema after SRS occurred in 8 patients (44%), which resolved with short-term corticosteroid therapy in the majority of those without early disease progression. Conclusions: SRS has low permanent radiation-related morbidity and durable local tumor control, making it a meaningful treatment option for patients with recurrent or unresectable PA in whom surgery and/or EBRT has failed.

  5. Phase II study of PX-866 in recurrent glioblastoma

    PubMed Central

    Pitz, Marshall W.; Eisenhauer, Elizabeth A.; MacNeil, Mary V.; Thiessen, Brian; Easaw, Jacob C.; Macdonald, David R.; Eisenstat, David D.; Kakumanu, Ankineedu S.; Salim, Muhammad; Chalchal, Haji; Squire, Jeremy; Tsao, Ming Sound; Kamel-Reid, Suzanne; Banerji, Shantanu; Tu, Dongsheng; Powers, Jean; Hausman, Diana F.; Mason, Warren P.

    2015-01-01

    Background Glioblastoma (GBM) is the most aggressive malignancy of the central nervous system in adults. Increased activity of the phosphatidylinositol-3-OH kinase (PI3K) signal transduction pathway is common. We performed a phase II study using PX-866, an oral PI3K inhibitor, in participants with recurrent GBM. Methods Patients with histologically confirmed GBM at first recurrence were given oral PX-866 at a dose of 8 mg daily. An MRI and clinical exam were done every 8 weeks. Tissue was analyzed for potential predictive markers. Results Thirty-three participants (12 female) were enrolled. Median age was 56 years (range 35–78y). Eastern Cooperative Oncology Group performance status was 0–1 in 29 participants and 2 in the remainder. Median number of cycles was 1 (range 1–8). All participants have discontinued therapy: 27 for disease progression and 6 for toxicity (5 liver enzymes and 1 allergic reaction). Four participants had treatment-related serious adverse events (1 liver enzyme, 1 diarrhea, 2 venous thromboembolism). Other adverse effects included fatigue, diarrhea, nausea, vomiting, and lymphopenia. Twenty-four participants had a response of progression (73%), 1 had partial response (3%, and 8 (24%) had stable disease (median, 6.3 months; range, 3.1–16.8 months). Median 6-month progression-free survival was 17%. None of the associations between stable disease and PTEN, PIK3CA, PIK3R1, or EGFRvIII status were statistically significant. Conclusions PX-866 was relatively well tolerated. Overall response rate was low, and the study did not meet its primary endpoint; however, 21% of participants obtained durable stable disease. This study also failed to identify a statistically significant association between clinical outcome and relevant biomarkers in patients with available tissue. PMID:25605819

  6. Does Dysphagia Indicate Recurrence of Benign Esophageal Strictures?

    PubMed Central

    Borgström, Anders; Fork, Frans-Thomas; Lövdahl, Eje

    1995-01-01

    Esophageal dilatation in dysphagic patients with benign strictures is usually considered successful if the patients' dysphagia is alleviated. However, the relation between dysphagia and the diameter of a stricture is not well understood. Moreover, the dysphagia may also be caused by an underlying esophageal motor disorder. In order to compare symptoms and objective measurements of esophageal stricture, 28 patients were studied with interview and a radiologic esophagram. The latter included swallowing of a solid bolus. All patients underwent successful balloon dilatation at least one month prior to this study. Recurrence of a stricture with a diameter of less than 13 mm was diagnosed by the barium swallow in 21 patients. Recurrence of dysphagia was seen in 15 patients. Thirteen patients denied any swallowing symptoms. Chest pain was present in 9 patients. Of 15 patients with dysphagia 2 (13%) had no narrowing but severe esophageal dysmotility. Of 13 patients without dysphagia 9 (69%) had a stricture with a diameter of 13 mm or less. Of 21 patients with a stricture of 13 mm or less 14 (67%) were symptomatic while 7 (33%) were asymptomatic. Four of 11 patients with retrosternal pain had a stricture of less than 10 mm. Three patients with retrosternal pain and obstruction had severe esophageal dysmotility. Whether or not the patients have dysphagia may be more related to diet and eating habits than to the true diameter of their esophageal narrowing. We conclude that the clinical history is non-reliable for evaluating the results of esophageal stricture dilatation. In order to get an objective measurement of therapeutic outcome, barium swallow including a solid bolus is recommended. PMID:18493375

  7. Two-time recurrence of a right atrial myxoma

    PubMed Central

    Madhavan, Suresh; Akhil, P. C.; Jayaprakash, K.; George, Raju

    2015-01-01

    We report a case of a second recurrence of a right atrial myxoma in a 38-year-old woman who had surgical excision in March 2008 and excision of a recurrence in August 2012. She presented with a similar clinical picture in December 2014 and again underwent surgical excision. The case is unusual both for its location in the right atrium and its multiple recurrences in a sporadic form without any sign of the myxoma complex. PMID:26424957

  8. Endovascular management of recurrent adult coarctation of the aorta.

    PubMed

    Kpodonu, Jacques; Ramaiah, Venkatesh G; Rodriguez-Lopez, Julio A; Diethrich, Edward B

    2010-11-01

    Traditional open surgical repair has proven to be an effective treatment for the management of primary and recurrent coarctation of the thoracic aorta. Potential complications at short-term and long-term follow-up have included recurrent coarctation, hypertension, premature coronary artery disease, cerebrovascular disease, and anastomotic pseudoaneurysm. Endovascular repair of recurrent coarctation of the thoracic aorta offers a less invasive treatment approach in potential high-risk surgical patients.

  9. A reliable simultaneous representation of seismic hazard and of ground shaking recurrence

    NASA Astrophysics Data System (ADS)

    Peresan, A.; Panza, G. F.; Magrin, A.; Vaccari, F.

    2015-12-01

    Different earthquake hazard maps may be appropriate for different purposes - such as emergency management, insurance and engineering design. Accounting for the lower occurrence rate of larger sporadic earthquakes may allow to formulate cost-effective policies in some specific applications, provided that statistically sound recurrence estimates are used, which is not typically the case of PSHA (Probabilistic Seismic Hazard Assessment). We illustrate the procedure to associate the expected ground motions from Neo-deterministic Seismic Hazard Assessment (NDSHA) to an estimate of their recurrence. Neo-deterministic refers to a scenario-based approach, which allows for the construction of a broad range of earthquake scenarios via full waveforms modeling. From the synthetic seismograms the estimates of peak ground acceleration, velocity and displacement, or any other parameter relevant to seismic engineering, can be extracted. NDSHA, in its standard form, defines the hazard computed from a wide set of scenario earthquakes (including the largest deterministically or historically defined credible earthquake, MCE) and it does not supply the frequency of occurrence of the expected ground shaking. A recent enhanced variant of NDSHA that reliably accounts for recurrence has been developed and it is applied to the Italian territory. The characterization of the frequency-magnitude relation can be performed by any statistically sound method supported by data (e.g. multi-scale seismicity model), so that a recurrence estimate is associated to each of the pertinent sources. In this way a standard NDSHA map of ground shaking is obtained simultaneously with the map of the corresponding recurrences. The introduction of recurrence estimates in NDSHA naturally allows for the generation of ground shaking maps at specified return periods. This permits a straightforward comparison between NDSHA and PSHA maps.

  10. Keratocystic odontogenic tumor: A biopsy service’s experience with 104 solitary, multiple and recurrent lesions

    PubMed Central

    2016-01-01

    Background Keratocystic odontogenic tumor (KCOT) is a clinically significant cystic lesion of odontogenic origin. This study aimed to retrospectively review and describe the clinicopathologic features of KCOT and to objectively compare the clinical and histological features of solitary, multiple and recurrent KCOT in a Saudi Arabian population. Material and Methods Biopsy request forms, pathology records and archival materials (all histological slides) of 104 cases of KCOT from 75 patients were retrieved. Demographic and clinical details as well as histological evaluation were analyzed and compared between the 3 groups using chi-squared or Mann-Whitney tests of association as appropriate. Results Significant differences were noted in the age of presentation, location and association with impaction between multiple and solitary cases. Histologically, there was a difference in the mitotic count, presence of satellite cysts and proliferating odontogenic epithelium between solitary and multiple lesions. There was no difference between the KCOT that later recurred and solitary lesion which did not recur even when matched clinically for age, sex and location. There were differences when solitary KCOT that later recurred or recurrent KCOT were compared with multiple lesions. Multiple lesions still had more significant proliferative activity parameters than solitary recurrence-related KCOT. Conclusions KCOTs in Saudi Arabians are not different from those reported from other parts of the world. Clinical and histological analyses showed multiple KCOT is different from its solitary recurrent or non-recurrent counterparts and has a higher proliferative activity than both. Clinicohistologic features alone cannot wholly explain the behavior of KCOT. Key words:Descriptive study, keratocystic odontogenic tumor, odontogenic keratocyst, solitary, multiple, recurrent. PMID:27475695

  11. Trebananib in Treating Patients With Persistent or Recurrent Endometrial Cancer

    ClinicalTrials.gov

    2016-02-10

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Endometrial Serous Adenocarcinoma; Endometrioid Stromal Sarcoma; Recurrent Uterine Corpus Carcinoma

  12. An application of recurrent nets to phone probability estimation.

    PubMed

    Robinson, A J

    1994-01-01

    This paper presents an application of recurrent networks for phone probability estimation in large vocabulary speech recognition. The need for efficient exploitation of context information is discussed; a role for which the recurrent net appears suitable. An overview of early developments of recurrent nets for phone recognition is given along with the more recent improvements that include their integration with Markov models. Recognition results are presented for the DARPA TIMIT and Resource Management tasks, and it is concluded that recurrent nets are competitive with traditional means for performing phone probability estimation.

  13. Effects of Antiviral Therapy on the Recurrence of Hepatocellular Carcinoma After Curative Resection or Liver Transplantation

    PubMed Central

    Du, Yan; Su, Tong; Ding, Yibo; Cao, Guangwen

    2012-01-01

    Context Hepatocellular carcinoma (HCC) is a fatal disease. Chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection is the major cause of HCC. High viral replication rate and related hepatic/systematic inflammation are the major risk factors in HCC recurrence after hepatectomy or liver transplantation. Evidence Acquisition Some of the carcinogenesis-related HBV mutations are also associated with poor prognosis for HCC patients. Antiviral therapy is an option for improving HCC prognosis after surgery. In case of HBV-associated HCC, treatment with interferon and nucleos(t)ide analogues (NAs), especially interferon, is effective in improving the prognosis. However, long-term use of NAs increases the possibility of developing drug-resistant viral mutations such as the HBV rtA181T/sW172 mutation, which increases the risk of HCC recurrence. Results In cases of HCV-associated HCC, standard interferon with or without ribavirin therapy is effective in improving the prognosis of HCV-associated HCC; however, some HCV mutations, such as the amino acid substitution M91L, are associated with treatment failure and a poor prognosis. Therapeutic efficacy needs to be confirmed using largescale, randomized, placebo-controlled clinical trials. Conclusions Surveillance of viral mutations during antiviral treatment and a better understanding of the associations of HCC recurrence with viral load, inflammation-associated signaling, and environmental factors can aid the development of more effective strategies for the prevention of HCC recurrence after surgery. PMID:23166535

  14. Proton Therapy for Reirradiation of Progressive or Recurrent Chordoma

    SciTech Connect

    McDonald, Mark W.; Linton, Okechuckwu R.; Shah, Mitesh V.

    2013-12-01

    Purpose: To report the results in patients reirradiated with proton therapy for recurrent or progressive chordoma, with or without salvage surgery. Methods and Materials: A retrospective review of 16 consecutive patients treated from 2005 to 2012 was performed. All patients had received at least 1 prior course of radiation therapy to the same area, and all but 1 patient had at least 1 surgical resection for disease before receiving reirradiation. At the time of recurrence or progression, half of the patients underwent additional salvage surgery before receiving reirradiation. The median prior dose of radiation was 75.2 Gy (range, 40-79.2 Gy). Six patients had received prior proton therapy, and the remainder had received photon radiation. The median gross tumor volume at the time of reirradiation was 71 cm{sup 3} (range, 0-701 cm{sup 3}). Reirradiation occurred at a median interval of 37 months after prior radiation (range, 12-129 months), and the median dose of reirradiation was 75.6 Gy (relative biological effectiveness [RBE]) (range. 71.2-79.2 Gy [RBE]), given in standard daily fractionation (n=14) or hyperfractionation (n=2). Results: The median follow-up time was 23 months (range, 6-63 months); it was 26 months in patients alive at the last follow-up visit (range, 12-63 months). The 2-year estimate for local control was 85%, overall survival 80%, chordoma-specific survival 88%, and development of distant metastases 20%. Four patients have had local progression: 3 in-field and 1 marginal. Late toxicity included grade 3 bitemporal lobe radionecrosis in 1 patient that improved with hyperbaric oxygen, a grade 4 cerebrospinal fluid leak with meningitis in 1 patient, and a grade 4 ischemic brainstem stroke (out of radiation field) in 1 patient, with subsequent neurologic recovery. Conclusions: Full-dose proton reirradiation provided encouraging initial disease control and overall survival for patients with recurrent or progressive chordoma, although additional

  15. Impact of inherited thrombophilia on the risk of recurrent venous thromboembolism onset in Georgian population.

    PubMed

    Pirtskhelani, N; Kochiashvili, N; Makhaldiani, L; Pargalava, N; Gaprindashvili, E; Kartvelishvili, K

    2014-02-01

    homozygous form and double/triple heterozygous/homozygous carriage of the studied mutations as an independent risk factor of development of recurrent thrombosis in the Georgian population and prolong anticoagulation therapy in patients of similar genotype as much as possible to prevent recurrent thrombosis and related complications. PMID:24632656

  16. [The treatment of locally recurrent rectal cancer].

    PubMed

    Alberda, Wijnand J; Verhoef, Cornelis; Nuyttens, Joost J; Rothbarth, Joost; Burger, Jacobus W A

    2015-01-01

    Its incidence has decreased in recent decades due to advances in the treatment of patients with primary rectal cancer, but LRRC still occurs in 6-10% of these patients. LRRC is often accompanied by severe, progressive pain and has a major impact on quality of life. Curative treatment is possible based on surgical resection combined with chemoradiotherapy. Radical resection is the most important prognostic factor in curative treatment. Neo-adjuvant systemic therapy may further improve outcomes in LRRC patients. Many patients are not eligible for surgical treatment due to the presence of metastases or irresectability of the local recurrence. These patients should receive optimal palliative care for the disabling pain. Radiotherapy is effective against local pain in around 75% of patients but the duration of palliation is limited.

  17. Rhythmicity, recurrence, and recovery of flagellar beating

    NASA Astrophysics Data System (ADS)

    Wan, Kirsty; Goldstein, Raymond

    2015-03-01

    The eukaryotic flagellum beats with apparently unfailing periodicity, yet responds rapidly to stimuli. Like the human heartbeat, flagellar oscillations are now known to be noisy. Using the unicellular alga Chlamydomonas reinhardtii, we explore three aspects of nonuniform flagellar beating. We report the existence of rhythmicity, waveform noise peaking at transitions between power and recovery strokes, and fluctuations of interbeat intervals that are correlated and even recurrent, with memory extending to hundreds of beats. These features are altered qualitatively by physiological perturbations. Further, we quantify the recovery of periodic breaststroke beating from transient hydrodynamic forcing. These results will help constrain microscopic theories on the origins and regulation of flagellar beating. Financial support is acknowledged from the EPSRC, ERC Advanced Investigator Grant No. 247333, and a Senior Investigator Award from the Wellcome Trust.

  18. Recurrent pregnancy loss: summary and clinical recommendations.

    PubMed

    Lee, R M; Silver, R M

    2000-01-01

    Recurrent pregnancy loss (RPL) is traditionally defined as three or more consecutive pregnancy losses before 20 weeks of gestation. This problem occurs in approximately 1% of all couples and is a frustrating problem for both the patient and physician. This article provides an overview of the problem, including causes, treatments, and recommendations. Among the numerous proposed causes of RPL, only parental karyotype abnormalities, antiphospholipid syndrome, uterine malformations, and cervical incompetence are universally accepted. There are numerous treatments for RPL, but only the efficacy of heparin and low-dose aspirin in women with antiphospholipid syndrome has been established with properly controlled trials. Even after undertaking a complete evaluation, the cause of RPL remains uncertain in over 50% of cases. These patients should understand that subsequent pregnancies have up to a 70% chance of success without treatment.

  19. Anaplastic meningioma with extremely rapid recurrence.

    PubMed

    Kawahara, Yosuke; Nakada, Mitsutoshi; Hayashi, Yutaka; Watanabe, Takuya; Tamase, Akira; Hayashi, Yasuhiko; Uchiyama, Naoyuki; Nitta, Hisashi; Hamada, Jun-Ichiro

    2011-01-01

    A 62-year-old woman presented with an uncommon case of anaplastic meningioma manifesting as recent memory disturbance. Magnetic resonance imaging revealed a mass located in the right temporal lobe. She became unconscious because of uncal herniation and underwent urgent surgery. The tumor was completely resected, except for a lesion tightly attached to arteries. Histological examination indicated the presence of anaplastic meningioma with an extremely high MIB-1 labeling index (70%). After 43 days, the patient developed local recurrence and dissemination in the left temporal lobe. The exceptionally high MIB-1 labeling index corresponded with a short tumor doubling time (8.2 days). Whole-brain irradiation and linear accelerator surgery for disseminated lesions were performed, and the tumor growth halted. Although meningiomas rarely show malignant behavior, corresponding to World Health Organization grade III, it is necessary to consider malignant behavior when treating meningiomas. PMID:21613768

  20. Familial recurrent atrial myxoma: Carney's complex.

    PubMed

    Shetty Roy, A Nagesh; Radin, Michael; Sarabi, Dennis; Shaoulian, Emanuel

    2011-02-01

    We report on a family of 4 members, all of whom have had multifocal, recurrent atrial myxomas associated with skin pigmentation, melanotic schwannomas, mucocutaneous myxomas, and tumors of the ovary and pituitary, adrenal, and thyroid glands. Immunochemistry of the myxoma cells is positive for calretinin, confirming their neuroendocrine origin. Genetic studies confirmed mutations in the gene coding protein kinase A, regulatory subunit 1-α (PRKAR1α). This is Carney's complex, characterized by multiple, mucocutaneous myxomas; pigmented lesions over the lips, conjunctiva, and genitalia; adenomas of the breast and thyroid; schwannomas; and endocrinal abnormalities including Cushing syndrome and acromegaly. Members of the family require vigorous screening, including urinary free cortisol, plasma transforming growth factor-β(1) and thyrotropin-releasing hormone, testicular ultrasound, routine echocardiographic screening, searches for cardiac and mucocutaneous myxomas in multiple locations, and genetic studies for the PRKAR1α gene sequence. PMID:21298650

  1. Decision Making in Recurrent Neuronal Circuits

    PubMed Central

    Wang, Xiao-Jing

    2009-01-01

    Decision making has recently emerged as a central theme in neurophysiological studies of cognition, and experimental and computational work has led to the proposal of a cortical circuit mechanism of elemental decision computations. This mechanism depends on slow recurrent synaptic excitation balanced by fast feedback inhibition, which not only instantiates attractor states for forming categorical choices but also long transients for gradually accumulating evidence in favor of or against alternative options. Such a circuit endowed with reward-dependent synaptic plasticity is able to produce adaptive choice behavior. While decision threshold is a core concept for reaction time tasks, it can be dissociated from a general decision rule. Moreover, perceptual decisions and value-based economic choices are described within a unified framework in which probabilistic choices result from irregular neuronal activity as well as iterative interactions of a decision maker with an uncertain environment or other unpredictable decision makers in a social group. PMID:18957215

  2. Mesenchymal phosphaturic tumour: early detection of recurrence

    PubMed Central

    Allevi, Fabiana; Rabbiosi, Dimitri; Mandalà, Marco; Colletti, Giacomo

    2014-01-01

    The case of a recurrent phosphaturic mesenchymal tumour of the maxillary sinus 10 years after the first surgical excision is reported. The neoplasm first presented with paraneoplastic osteomalacia causing a pathological femur fracture. A right maxillary sinus tumour was identified and treated thereafter. The patient had no local symptoms and serum electrolytes returned to normal after surgical removal of the tumour. However, 10 years later, the patient's urine Ca and P levels increased and an octreoscan detected a new tumour in the right maxillary sinus. Early diagnosis prevented the effects of the paraneoplastic activity of the neoplasm. This case emphasises the importance of specific, close follow-up, because the neoplasm rarely produces local signs indicating its position. To our knowledge, this is the first reported case of a late relapse presenting without relevant symptoms (local pain or swelling or pathological fractures). PMID:24827649

  3. Recurrent implantation failure: a comprehensive review.

    PubMed

    Zohni, Khaled M; Gat, Itai; Librach, Clifford

    2016-12-01

    Successful pregnancy involves a synchronized, coordinated cross-talk between an embryo capable of implanting, and an endometrium enabling implantation. Recurrent implantation failure (RIF) refers to unsuccessful implantation after repeated transfers of morphologically good quality embryos into a normal uterus. The etiology for RIF can be attributed to the embryo itself, the mother or, in some cases, both. Despite extensive research on underlying causes for RIF, our understanding of this condition is still limited. With the evolving molecular technologies, efforts are focused on studying the implantation process itself, including the molecular aspects of endometrial-embryonic interactions, normal human embryonic development, and preimplantation genetic evaluation. This knowledge will pave the way toward new diagnostic and therapeutic strategies for RIF. In this article, we present a comprehensive review of our current knowledge on this topic. PMID:26982235

  4. The treatment of recurrent malignant pleural effusion.

    PubMed

    Austin, E H; Flye, M W

    1979-08-01

    Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancer patient. At least a dozen different techniques have been advocated for controlling this common complication of malignant disease. The present review collects and examines the clinical results of all techniques designed to treat this problem. The pathophysiology and diagnostic evaluation of the effusion are also discussed. On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend intrapleurally administered tetracycline with thoracostomy drainage as the technique of choice. Instillation of a talc suspension with thoracostomy drainage is also a safe and effective technique and should be employed when tetracycline fails or is contraindicated. PMID:383031

  5. Recurrent coarctation: interventional techniques and results.

    PubMed

    Saxena, Anita

    2015-04-01

    Coarctation of the aorta (CoA) accounts for 5% to 8% of all congenital heart defects. With all forms of interventions for native CoA, repeat intervention may be required due to restenosis and/or aneurysm formation. Restenosis rates vary from 5% to 24% and are higher in infants and children and in those with arch hypoplasia. Although repeat surgery can be done for recurrent CoA, guidelines from a number of professional societies have recommended balloon angioplasty with or without stenting as the preferred intervention for patients with isolated recoarctation. For infants and young children with recurrent coarctation, balloon angioplasty has been shown to be safe and effective with low incidence of complications. However, the rates of restenosis and reinterventions are high with balloon angioplasty alone. Endovascular stent placement is indicated, either electively in adults or as a bailout procedure in those who develop a complication such as dissection or intimal tear after balloon angioplasty. Conventionally bare metal stents are used; these can be dilated later if required. Covered stents, introduced more recently, are best reserved for those who have aneurysm at the site of previous repair or who develop a complication such as aortic wall perforation or tear. Stents produce complete abolition of gradients across the coarct segment in a majority of cases with good opening of the lumen on angiography. The long-term results are better than that of balloon angioplasty alone, with very low rates of restenosis. However, endovascular stenting is a technically demanding procedure and can be associated with serious complications rarely.

  6. Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy

    PubMed Central

    Liu, Shaohui; Sun, Lisa L.; Kavanaugh, A. Scott; Langford, Marlyn P.; Liang, Chanping

    2013-01-01

    We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative day 11, but had a normal fundus exam and intraocular pressure (IOP). Flat chamber persisted despite treatment with cycloplegics, steroids, and a Healon injection into the anterior chamber. A transverse B-scan of the peripheral fundus revealed a shallow annular peripheral choroidal detachment. The suprachoroidal fluid was drained. The patient presented 3 days later with a recurrent flat chamber and an annular peripheral choroidal effusion. The fluid was removed and reinforcement of the scleral flap was performed with the resolution of the flat anterior chamber. A large corneal epithelial defect developed after the second drainage. The oral prednisone was tapered quickly and the topical steroid was decreased. One week later, his vision decreased to count fingers with severe corneal stromal edema and Descemet's membrane folds that improved to 20/50 within 24 h of resumption of the oral steroid and frequent topical steroid. The patient's visual acuity improved to 20/20 following a slow withdrawal of the oral and topical steroid. Eight months after surgery, the IOP was 15 mm Hg without glaucoma medication. The detection of a shallow anterior choroidal detachment by transverse B-scan is critical to making the correct diagnosis. Severe cornea edema can occur if the steroid is withdrawn too quickly. Thus, steroids should be tapered cautiously in steroid-dependent patients. PMID:24348402

  7. Topological pattern selection in recurrent networks.

    PubMed

    Bahraini, Alireza; Abbassian, Abdolhossein

    2012-07-01

    The impact of adding correlation to a population of neurons on the information and the activity of the population is one of the fundamental questions in recent system neuroscience. In this paper, we would like to introduce topology-based correlation at the level of storing patterns in a recurrent network. We then study the effects of topological patterns on the activity and memory capacity of the network. The general aim of the present work is to show how the repertoire of possible stored patterns is determined by the underlying network topology. Two topological probability rules for pattern selection in recurrent network are introduced. The first one selects patterns according to a Gibbs-type distribution. We start with a Hopfield-type dynamics on a ring model and then a Langevin model on a general random graph is treated. The phenomenon of phase transition in pattern selection motivated us to introduce an alternative topological rule for pattern selection. In a network of N neurons on a random d-regular graph, two asymptotic cases, d/N→0 and d/N→1, have been discussed for the new rule, and it is shown that capacity of the network grows considerably as d/N→1. By introducing the notions of asymptotic eigenvector, we will be able to study the behaviour of the discrete model in the limit d/N→0. It will be proved that for degree d less than a critical value there is a positive role for noise, in which case increasing the number of patterns will improve the storage capacity.

  8. Variable carbon losses from recurrent fires in drained tropical peatlands.

    PubMed

    Konecny, Kristina; Ballhorn, Uwe; Navratil, Peter; Jubanski, Juilson; Page, Susan E; Tansey, Kevin; Hooijer, Aljosja; Vernimmen, Ronald; Siegert, Florian

    2016-04-01

    Tropical peatland fires play a significant role in the context of global warming through emissions of substantial amounts of greenhouse gases. However, the state of knowledge on carbon loss from these fires is still poorly developed with few studies reporting the associated mass of peat consumed. Furthermore, spatial and temporal variations in burn depth have not been previously quantified. This study presents the first spatially explicit investigation of fire-driven tropical peat loss and its variability. An extensive airborne Light Detection and Ranging data set was used to develop a prefire peat surface modelling methodology, enabling the spatially differentiated quantification of burned area depth over the entire burned area. We observe a strong interdependence between burned area depth, fire frequency and distance to drainage canals. For the first time, we show that relative burned area depth decreases over the first four fire events and is constant thereafter. Based on our results, we revise existing peat and carbon loss estimates for recurrent fires in drained tropical peatlands. We suggest values for the dry mass of peat fuel consumed that are 206 t ha(-1) for initial fires, reducing to 115 t ha(-1) for second, 69 t ha(-1) for third and 23 t ha(-1) for successive fires, which are 58-7% of the current IPCC Tier 1 default value for all fires. In our study area, this results in carbon losses of 114, 64, 38 and 13 t C ha(-1) for first to fourth fires, respectively. Furthermore, we show that with increasing proximity to drainage canals both burned area depth and the probability of recurrent fires increase and present equations explaining burned area depth as a function of distance to drainage canal. This improved knowledge enables a more accurate approach to emissions accounting and will support IPCC Tier 2 reporting of fire emissions.

  9. A phase II trial of oral gimatecan for recurrent glioblastoma.

    PubMed

    Hu, Jethro; Wen, Patrick Y; Abrey, Lauren E; Fadul, Camilo E; Drappatz, Jan; Salem, Nadia; Supko, Jeffrey G; Hochberg, Fred

    2013-02-01

    Gimatecan is a lipophilic oral camptothecin analogue with preclinical activity in glioma models. We conducted a multicenter phase II trial to evaluate the efficacy of gimatecan in adults with recurrent glioblastoma. Eligibility criteria included ≤1 prior treatment for recurrent disease, age ≥18, Eastern Cooperative Oncology Group performance status 0-1, and normal organ function. Patients taking enzyme-inducing anti-seizure medications were excluded. Gimatecan 1.22 mg/m(2) was given orally once daily for 5 consecutive days during each 28-day cycle. The primary endpoint was progression-free survival at 6 months. A Simon 2-stage optimal design was used in which 19 patients were evaluated in the 1st stage, with an additional 36 patients accrued if >4 patients in stage 1 achieved PFS at 6 months. 29 patients were enrolled in the study, with median age of 58 years (range, 25-77 years); 58.6 % female. All patients received prior surgery, radiation therapy, and at least one chemotherapy regimen. The daily dose was reduced to 1.0 mg/m(2) after four of the first 10 patients experienced grade 4 hematologic toxicity. Treatment-related grade 3/4 toxicities included thrombocytopenia (17.2 %), leukopenia (17.2 %) and neutropenia (10.3 %). None of the 19 patients treated at 1.0 mg/m(2)/day experienced grade 4 hematologic toxicity. One patient had a partial radiographic response by modified Macdonald criteria. Only 3 patients (12 %) were progression-free at 6 months. Median time to progression was 12.0 weeks (7.0, 17.0).Treatment with gimatecan 1.0 mg/m(2)/day for 5 days, repeated every 28-days showed minimal efficacy.

  10. Variable carbon losses from recurrent fires in drained tropical peatlands.

    PubMed

    Konecny, Kristina; Ballhorn, Uwe; Navratil, Peter; Jubanski, Juilson; Page, Susan E; Tansey, Kevin; Hooijer, Aljosja; Vernimmen, Ronald; Siegert, Florian

    2016-04-01

    Tropical peatland fires play a significant role in the context of global warming through emissions of substantial amounts of greenhouse gases. However, the state of knowledge on carbon loss from these fires is still poorly developed with few studies reporting the associated mass of peat consumed. Furthermore, spatial and temporal variations in burn depth have not been previously quantified. This study presents the first spatially explicit investigation of fire-driven tropical peat loss and its variability. An extensive airborne Light Detection and Ranging data set was used to develop a prefire peat surface modelling methodology, enabling the spatially differentiated quantification of burned area depth over the entire burned area. We observe a strong interdependence between burned area depth, fire frequency and distance to drainage canals. For the first time, we show that relative burned area depth decreases over the first four fire events and is constant thereafter. Based on our results, we revise existing peat and carbon loss estimates for recurrent fires in drained tropical peatlands. We suggest values for the dry mass of peat fuel consumed that are 206 t ha(-1) for initial fires, reducing to 115 t ha(-1) for second, 69 t ha(-1) for third and 23 t ha(-1) for successive fires, which are 58-7% of the current IPCC Tier 1 default value for all fires. In our study area, this results in carbon losses of 114, 64, 38 and 13 t C ha(-1) for first to fourth fires, respectively. Furthermore, we show that with increasing proximity to drainage canals both burned area depth and the probability of recurrent fires increase and present equations explaining burned area depth as a function of distance to drainage canal. This improved knowledge enables a more accurate approach to emissions accounting and will support IPCC Tier 2 reporting of fire emissions. PMID:26661597

  11. Autofluorescence imaging in recurrent oral squamous cell carcinoma.

    PubMed

    Scheer, Martin; Fuss, Juliana; Derman, Mehmet Ali; Kreppel, Matthias; Neugebauer, Jörg; Rothamel, Daniel; Drebber, Uta; Zoeller, Joachim E

    2016-03-01

    The survival of patients with oral cancer is decreased by locoregional recurrence after an initial multimodal treatment. In order to identify lesions in the oral cavity for a possible recurrence, clinical evaluation as well as MRI or CT scanning is advised. The evaluation of mucosa lesions is hampered by changes related to radio- and chemotherapy as well as reconstruction with tissue flaps. Several techniques for easier identification of tissue abnormalities in the oral cavity have been advocated as adjuncts in order to facilitate identification. Especially methods using altered tissue fluorescence have gained much interest during the last decade. The aim of our prospective study was to evaluate fluorescence properties of undiagnosed mucosa lesions with the VELscope device in patients with multimodal treated oral cancer prior to histological confirmation. In total, 41 patients with a history of oral squamous cell carcinomas (OSCC) (19 females and 22 males) with undiagnosed mucosa lesions where included in the study. After clinical evaluation, examination and documentation using the VELscope® device were performed. Then, an incisional biopsy was performed. An autofluorescence loss indicating a malignant or dysplastic mucosa condition could be detected in six patients (14.6 %); however, only one OSCC and one SIN revealed a complete autofluorescence loss. In four patients, OSCC was present in lesions with retained autofluorescence. Sensitivity and specificity for the VELscope® examination to identify malignant oral lesions by autofluorescence were 33.3 and 88.6 %, respectively. The positive and negative predictive values were 33.3 and 88.6 %, respectively. No statistical correlation between gender and lesion appearance versus autofluorescence loss could be detected. In contrast to mucosa lesions in patients with no prior treatment, the autofluorescence evaluation with the VELscope reveals no additional information in our analysis. Accordingly, invasive biopsies

  12. A Prospective Multi-center Trial of Escherichia coli Extract for the Prophylactic Treatment of Patients with Chronically Recurrent Cystitis

    PubMed Central

    Kim, Kun Suk; Kim, Ji-Yoon; Jeong, In Gab; Paick, Jae-Seung; Son, Hwancheol; Lim, Dae Jung; Shim, Hong Bang; Park, Won Hee; Jung, Hee Chang

    2010-01-01

    We have assessed the efficacy and safety of Escherichia coli extract (ECE; Uro-Vaxom®) which contains active immunostimulating fractions, in the prophylactic treatment of chronically recurrent cystitis. Forty-two patients with more than 2 episodes of cystitis in the proceeding 6 months were treated for 3 months with one capsule daily of ECE and observed for a further 6 months. The primary efficacy criterion was the number of episodes of recurrent cystitis during the 6 months after treatment compared to those during the 6 months before treatment. At the end of the 9-month trial, 34 patients (all women) were eligible for statistical analysis. Their mean age was 56.4 yr (range, 34-75 yr), and they had experienced recurrent urinary tract infections for 7.2±5.2 yr. The number of recurrences was significantly lower during the 6-month follow-up period than during the 6 months preceding the trial (0.35 vs. 4.26, P<0.001). During the follow-up, 28 (82.4%) patients had no recurrences and 4 (11.8%) had 1 each. In patients who relapsed, ECE alleviated cystitis symptoms, including painful voiding, frequency and urgency. There were no serious adverse events related to the study drug. Our study demonstrates the efficacy and safety of ECE in the prophylactic treatment of chronically recurrent cystitis. PMID:20191044

  13. Low recurrence rate after mini surgery outside the tendon combined with short rehabilitation in patients with midportion Achilles tendinopathy

    PubMed Central

    Alfredson, Håkan

    2016-01-01

    Background There is a general opinion that a structured and specific rehabilitation is needed after treatment of midportion Achilles tendinopathy to minimize recurrence of the condition. There is sparse knowledge about the recurrence rates in large patient materials after specific treatments for midportion Achilles tendinopathy. Aim This study aimed to investigate the recurrence rates in a large number of patients with chronic painful midportion Achilles tendinopathy that had been surgically treated with the ultrasound (US) and Doppler (DP)-guided mini-surgical scraping technique. Postoperatively, a relatively simple rehabilitation protocol, including a range of movement exercises and gradually increased walking and biking before allowing free activity, was used. Materials and methods From a database, information about the recurrence rates after US + DP-guided mini-surgical scraping, performed by a single surgeon on 519 tendons with US + DP-verified chronic painful midportion Achilles tendinopathy, was obtained. Results Recurrence of painful midportion Achilles tendinopathy was found in 26 of 519 (5%) operated tendons, 13 from women and 13 from men. In 13 tendons, a close by located plantaris tendon was extirpated during the reoperation. Conclusion In this large material on patients treated with US + DP-guided mini-surgical scraping for midportion Achilles tendinopathy, there were few recurrences, although only a simple and nonspecific rehabilitation protocol was used. PMID:27274323

  14. Allopathic versus Homeopathic Strategies and the Recurrence of Prescriptions: Results from a Pharmacoeconomic Study in Italy.

    PubMed

    Basili, Andrea; Lagona, Francesco; Roberti di Sarsina, Paolo; Basili, Corallina; Valeria Paterna, Teresa

    2011-01-01

    This is a pharmaeconomic study to assess the impact of different, cost-specific pharmacological strategies on the recurrence rate of prescriptions in the treatment of cold symptoms. Data were obtained from a prospective cohort study reporting individual prescriptions histories of subjects experiencing cold symptoms, obtained by a stratified random sample of 316 subjects, clustered into 139 Italian families, followed up for 40 months. Costs of homeopathic and allopathic treatments were recorded within each prescription. A Cox proportional hazards model with random effects was exploited to regress time elapsed between subsequent prescriptions over the relative difference between homeopathic- and allopathic-related costs, adjusting for age and gender and accounting for unobserved individual heterogeneity. Relative risks of event (prescription) re-occurrence have been estimated. The recurrence rate of prescriptions raise when allopathic strategies are preferred to homeopathic alternatives. No significant differences were observed between gender groups, while age was marginally significant. Inter-subjects heterogeneity was not significant.

  15. Gene-Expression Signature Predicts Postoperative Recurrence in Stage I Non-Small Cell Lung Cancer Patients

    PubMed Central

    Lu, Yan; Wang, Liang; Liu, Pengyuan; Yang, Ping; You, Ming

    2012-01-01

    About 30% stage I non-small cell lung cancer (NSCLC) patients undergoing resection will recur. Robust prognostic markers are required to better manage therapy options. The purpose of this study is to develop and validate a novel gene-expression signature that can predict tumor recurrence of stage I NSCLC patients. Cox proportional hazards regression analysis was performed to identify recurrence-related genes and a partial Cox regression model was used to generate a gene signature of recurrence in the training dataset −142 stage I lung adenocarcinomas without adjunctive therapy from the Director's Challenge Consortium. Four independent validation datasets, including GSE5843, GSE8894, and two other datasets provided by Mayo Clinic and Washington University, were used to assess the prediction accuracy by calculating the correlation between risk score estimated from gene expression and real recurrence-free survival time and AUC of time-dependent ROC analysis. Pathway-based survival analyses were also performed. 104 probesets correlated with recurrence in the training dataset. They are enriched in cell adhesion, apoptosis and regulation of cell proliferation. A 51-gene expression signature was identified to distinguish patients likely to develop tumor recurrence (Dxy = −0.83, P<1e-16) and this signature was validated in four independent datasets with AUC >85%. Multiple pathways including leukocyte transendothelial migration and cell adhesion were highly correlated with recurrence-free survival. The gene signature is highly predictive of recurrence in stage I NSCLC patients, which has important prognostic and therapeutic implications for the future management of these patients. PMID:22292069

  16. Plasminogen activator inhibitor-1 4G/5G polymorphism, factor V Leiden, prothrombin mutations and the risk of VTE recurrence.

    PubMed

    Sundquist, Kristina; Wang, Xiao; Svensson, Peter J; Sundquist, Jan; Hedelius, Anna; Larsson Lönn, Sara; Zöller, Bengt; Memon, Ashfaque A

    2015-11-25

    Plasminogen-activator inhibitor (PAI)-1 is an important inhibitor of the plasminogen/plasmin system. PAI-1 levels are influenced by the 4G/5G polymorphism in the PAI-1 promoter. We investigated the relationship between the PAI-1 polymorphism and VTE recurrence, and its possible modification by factor V Leiden (FVL) and prothrombin (PTM) mutations. Patients (n=1,069) from the Malmö Thrombophilia Study were followed from discontinuation of anticoagulant treatment until diagnosis of VTE recurrence or the end of the study (maximum follow-up 9.8 years). One hundred twenty-seven patients (11.9 %) had VTE recurrence. PAI-1 was genotyped by TaqMan PCR. Cox regression analysis adjusted for age, sex and acquired risk factors of VTE showed no evidence of an association between PAI-1 genotype and risk of VTE recurrence in the study population as a whole. However, by including an interaction term in the analysis we showed that FVL but not PTM modified the effect of PAI-1 genotype: patients with the 4G allele plus FVL had a higher risk of VTE recurrence [hazard ratio (HR) =2.3, 95 % confidence interval (CI) =1.5-3.3] compared to patients with the 4G allele but no FVL (reference group) or FVL irrespective of PAI-1 genotype (HR=1.8, 95 % CI=1.3-2.5). Compared to reference group, 5G allele irrespective of FVL was associated with lower risk of VTE recurrence only when compared with 4G allele together with FVL. In conclusion, FVL has a modifying effect on PAI-1 polymorphism in relation to risk of VTE recurrence. The role of PAI-1 polymorphism as a risk factor of recurrent VTE may be FVL dependent.

  17. Recurrence rates in bipolar disorder: Systematic comparison of long-term prospective, naturalistic studies versus randomized controlled trials.

    PubMed

    Vázquez, Gustavo H; Holtzman, Jessica N; Lolich, María; Ketter, Terence A; Baldessarini, Ross J

    2015-10-01

    Bipolar disorder (BD) is a recurrent, lifelong illness with high risks of disability and excess mortality. Despite many treatment options with demonstrated short-term efficacy, evidence concerning long-term treatment effectiveness in BD remains limited and the relative value of naturalistic studies versus randomized, controlled trials (RCTs) in its assessment, uncertain. Systematic computer-searching yielded 10 naturalistic studies and 15 RCTs suitable for analysis of recurrence rates and their association with treatments and selected clinical factors. In naturalistic studies (3904 BD subjects, 53.3% women, 85.8% BD-I, mean onset age 29.1, followed up to 2.1 years), the pooled recurrence rate was 55.2% (26.3%/year). In RCTs (4828 subjects, 50.9% women, 96.0% BD-I, mean onset age 23.1, followed up to 1.9 years), the pooled recurrence rate was 39.3% (21.9%/year) with mood-stabilizing drug-treatment versus 60.6% (31.3%/year) with placebo; drug-versus-placebo outcomes favored antipsychotics over lithium, and disfavor an approved anticonvulsant. Depressive episode-polarity increased from 27.7% at intake to 52.0% at first-recurrence (p<0.0001). Recurrence rate (%/year) did not differ by study-type, was greater with younger onset and rapid-cycling, and paradoxically declined with longer observation. In short, recurrences of major affective episodes up to two years during putative mood-stabilizing treatment of BD patients in prospective, naturalistic studies and RCTs were substantial and similar (26.3 vs. 21.9%/year). Episode-polarity shifted strongly toward depressive first-recurrences. These findings support the value of naturalistic studies to complement long-term RCTs, and add to indications that control of depression in BD remains particularly unsatisfactory. PMID:26238969

  18. Recurrence rates in bipolar disorder: Systematic comparison of long-term prospective, naturalistic studies versus randomized controlled trials.

    PubMed

    Vázquez, Gustavo H; Holtzman, Jessica N; Lolich, María; Ketter, Terence A; Baldessarini, Ross J

    2015-10-01

    Bipolar disorder (BD) is a recurrent, lifelong illness with high risks of disability and excess mortality. Despite many treatment options with demonstrated short-term efficacy, evidence concerning long-term treatment effectiveness in BD remains limited and the relative value of naturalistic studies versus randomized, controlled trials (RCTs) in its assessment, uncertain. Systematic computer-searching yielded 10 naturalistic studies and 15 RCTs suitable for analysis of recurrence rates and their association with treatments and selected clinical factors. In naturalistic studies (3904 BD subjects, 53.3% women, 85.8% BD-I, mean onset age 29.1, followed up to 2.1 years), the pooled recurrence rate was 55.2% (26.3%/year). In RCTs (4828 subjects, 50.9% women, 96.0% BD-I, mean onset age 23.1, followed up to 1.9 years), the pooled recurrence rate was 39.3% (21.9%/year) with mood-stabilizing drug-treatment versus 60.6% (31.3%/year) with placebo; drug-versus-placebo outcomes favored antipsychotics over lithium, and disfavor an approved anticonvulsant. Depressive episode-polarity increased from 27.7% at intake to 52.0% at first-recurrence (p<0.0001). Recurrence rate (%/year) did not differ by study-type, was greater with younger onset and rapid-cycling, and paradoxically declined with longer observation. In short, recurrences of major affective episodes up to two years during putative mood-stabilizing treatment of BD patients in prospective, naturalistic studies and RCTs were substantial and similar (26.3 vs. 21.9%/year). Episode-polarity shifted strongly toward depressive first-recurrences. These findings support the value of naturalistic studies to complement long-term RCTs, and add to indications that control of depression in BD remains particularly unsatisfactory.

  19. Temozolomide and O6-Benzylguanine in Treating Children With Recurrent Brain Tumors

    ClinicalTrials.gov

    2013-09-27

    Childhood Central Nervous System Germ Cell Tumor; Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Ependymoblastoma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Infratentorial Ependymoma; Childhood Low-grade Cerebellar Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Medulloepithelioma; Childhood Mixed Glioma; Childhood Oligodendroglioma; Childhood Supratentorial Ependymoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway and Hypothalamic Glioma

  20. FR901228 in Treating Children With Refractory or Recurrent Solid Tumors or Leukemia

    ClinicalTrials.gov

    2013-01-15

    Blastic Phase Chronic Myelogenous Leukemia; Childhood Central Nervous System Germ Cell Tumor; Childhood Choroid Plexus Tumor; Childhood Chronic Myelogenous Leukemia; Childhood Craniopharyngioma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood High-grade Cerebral Astrocytoma; Childhood Infratentorial Ependymoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Spinal Cord Neoplasm; Childhood Supratentorial Ependymoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Refractory Chronic Lymphocytic Leukemia; Relapsing Chronic Myelogenous Leukemia; Unspecified Childhood Solid Tumor, Protocol Specific