Does preoperative neutrophil lymphocyte ratio predict risk of recurrence and occult central nodal metastasis in papillary thyroid carcinoma?

Background Preoperative neutrophil to lymphocyte ratio (NLR) might be prognostic in papillary thyroid carcinoma (PTC). Given the controversy of prophylactic central neck dissection (pCND) in clinically nodal-negative (cN0) PTC, our study evaluated whether preoperative NLR predicted disease-free survival (DFS) and occult central nodal metastasis (CNM) in cN0 PTC. Methods A total of 191 patients who underwent pCND were analyzed. Complete blood counts with differential counts were taken before operation. NLR was calculated by dividing preoperative neutrophil count with lymphocyte count. Patients were categorized into NLR tertiles: first (NLR 2.79; n = 64). Four other patient types, namely, benign nodular goiter, clinically nodal-positive (cN1) PTC, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma (ATC), were used as references. Results Age at operation (p < 0.001) and tumor size (p = 0.037) significantly increased with higher NLR. First tertile had significantly more TNM stage I tumors (p = 0.01) and lowest MACIS score (p = 0.002). Tumor size [hazard ratio (HR) 1.422, 95% confidence interval (CI) 1.119-1.809, p = 0.004] and multicentricity (HR = 2.545, 95% CI 1.073-6.024, p = 0.034) independently predicted DFS, whereas old age [odds ratio (OR) 1.026, 95% CI 1.006-1.046, p = 0.009), male (OR 2.882, 95% CI 1.348-6.172, p = 0.006), and large tumor (OR 1.567, 95% CI 1.209-2.032, p = 0.001) independently predicted occult CNM. NLR was not significantly associated with DFS or occult CNM. ATC had significantly higher NLR than cN1 PTC (7.28 vs. 2.74, p < 0.001). Conclusions Although a higher NLR may imply a poorer tumor profile, it was not significantly associated with a worse DFS or higher risk of occult CNM in cN0 PTC. Perhaps, future research should focus on the prognostic value in other thyroid cancer types with a poorer prognosis. © 2014 Société Internationale de Chirurgie.postprin

Evaluating the Morbidity and Efficacy of Reoperative Surgery in the Central Compartment for Persistent/Recurrent Papillary Thyroid Carcinoma

postprin

The transition from English to mother-tongue Chinese as medium of instruction; issues and problems as seen by Hong Kong teachers

In this article we consider the article and problems as seen by Hong Kong teachers during the transitional period from English to mother-tongue Chinese as medium of instruction (MOI). It is vital to examine teachers' perceptions for they reflect the real situation at the school level and are likely to affect the successful implementation of MOI policy. Our data show that while teachers generally adopted a positive attitude towards the change, they experienced difficulties, such as lack of confidence using Modern Standard Written Chinese (MSWC) as a teaching language, lack of quality Chinese teaching resources, pressure resulting from parents' resistance and anxiety on account of the uncertainty of government language policy for the senior secondary level. © 2001 Kluwer Academic Publishers.link_to_subscribed_fulltex

Does preoperative neutrophil lymphocyte ratio predict risk of recurrence and occult central nodal metastasis in clinically nodal negative papillary thyroid carcinoma?

Oral presentatio

ADVANCED HIGH PERFORMANCE SOLID WALL BLANKET CONCEPTS

OAK A271 ADVANCED HIGH PERFORMANCE SOLID WALL BLANKET CONCEPTS. First wall and blanket (FW/blanket) design is a crucial element in the performance and acceptance of a fusion power plant. High temperature structural and breeding materials are needed for high thermal performance. A suitable combination of structural design with the selected materials is necessary for D-T fuel sufficiency. Whenever possible, low afterheat, low chemical reactivity and low activation materials are desired to achieve passive safety and minimize the amount of high-level waste. Of course the selected fusion FW/blanket design will have to match the operational scenarios of high performance plasma. The key characteristics of eight advanced high performance FW/blanket concepts are presented in this paper. Design configurations, performance characteristics, unique advantages and issues are summarized. All reviewed designs can satisfy most of the necessary design goals. For further development, in concert with the advancement in plasma control and scrape off layer physics, additional emphasis will be needed in the areas of first wall coating material selection, design of plasma stabilization coils, consideration of reactor startup and transient events. To validate the projected performance of the advanced FW/blanket concepts the critical element is the need for 14 MeV neutron irradiation facilities for the generation of necessary engineering design data and the prediction of FW/blanket components lifetime and availability