Definitive hypofractionated radiotherapy for early glottic carcinoma: experience of 55Gy in 20 fractions

Introduction: A wide variety of fractionation schedules have been employed for the treatment of early glottic cancer. The aim is to report our 10-year experience of using hypofractionated radiotherapy with 55Gy in 20 fractions at 2.75Gy per fraction. Methods: Patients treated between 2004 and 2013 with definitive radiotherapy to a dose of 55Gy in 20 fractions over 4 weeks for T1/2 N0 squamous cell carcinoma of the glottis were retrospectively identified. Patients with prior therapeutic minor surgery (eg. laser stripping, cordotomy) were included. The probabilities of local control, ultimate local control (including salvage surgery), regional control, cause specific survival (CSS) and overall survival (OS) were calculated. Results: One hundred thirty-two patients were identified. Median age was 65 years (range 33–89). Median follow up was 72 months (range 7–124). 50 (38 %), 18 (14 %) and 64 (48 %) of patients had T1a, T1b and T2 disease respectively. Five year local control and ultimate local control rates were: overall - 85.6 % and 97.3 % respectively, T1a - 91.8 % and 100 %, T1b - 81.6 and 93.8 %, and T2 - 80.9 % and 95.8 %. Five year regional control, CSS and OS rates were 95.4 %, 95.7 % and 78.8 % respectively. There were no significant associations of covariates (e.g. T-stage, extent of laryngeal extension, histological grade) with local control on univariate analysis. Only increasing age and transglottic extension in T2 disease were significantly associated with overall survival (both p <0.01). Second primary cancers developed in 17 % of patients. 13 (9.8 %) of patients required enteral tube feeding support during radiotherapy; no patients required long term enteral nutrition. One patient required a tracheostomy due to a non-functioning larynx on long term follow up. Conclusions: Hypofractionated radiation therapy with a dose of 55Gy in 20 fractions for early stage glottic cancer provides high rates of local control with acceptable toxicity

Angiotensin-1 and vimentin expression and ultrastructural examination in severe preeclampsia complicated by HELLP syndrome changes in the structure of the umbilical cord

OBJECTIVE: The purpose of this study was to examine the histopathologic, ultrastructural and immunohistochemical changes in the umbilical cord in women diagnosed with HELLP syndrome. MATERIALS AND METHODS: Postpartum umbilical cords of 40 patients at the 35-38th week of pregnancy were included. 20 severe preeclamptic (HELLP) and 20 normal umbilical cords were used. After the follow-up of tissue parts of 10% formaldehyde solution for histopathology and immunohistochemistry, histopathological and angiopoietin-1 and vimentin antibodies were examined as immunohistochemical after routine paraffin follow-up. For electron microscope analysis, umbilical cord samples were taken into 2.5% glutaral aldehyde solution. RESULTS: In the statistical comparison, mean difference in increased diameter and additional anomaly on the ultrasound of preeclamptic patients was statistically different compared to control patients. In the HELLP group, hyperplasia and degenerative changes, pyknosis of the endothelial cell nuclei of the vessels and apoptotic changes in some regions were observed. Immunohistochemical analysis showed that endothelial cells, basal membrane and fibroblast cells in the HELLP group expressed high levels of vimentin. Angiotensin-1 expression was increased in amniotic epithelial cells, endothelial cells and some pericyte cells. CONCLUSIONS: As a result, it was observed that the signaling that started with trophoblastic invasion with the effect of hypoxia in severe preeclampsia and continued with dysfunction in endothelial cells was parallel to the increase in angiotensin and vimentin receptors. It is thought that the ultrastructural change in endothelial cells may cause disruption of the collagenized structure in Wharton gel, which supports this, and may cause adverse effects in fetal development and nutrition

Suppression of the second harmonic subgroup injected by an AC EAF: Design considerations and performance estimation of a shunt APF

This paper proposes a design methodology for an active power filter (APF) system to suppress the second harmonic subgroup injected by an AC electric arc furnace (EAF) to the utility grid. The APF system is composed of identical parallel units connected to the utility grid via a specially-designed coupling transformer. Each APF converter is a three-phase three-wire two-level voltage source converter (VSC). The number of parallel APF units, coupling transformer MVA rating, and turns ratio are optimized in the view of the ratings of commercially-available high voltage (HV) IGBTs. In this research work, line current waveforms sampled at 25.6-kS/s on the medium voltage (MV) side of a 65-MVA EAF transformer are then used to extract the second harmonic subgroup, 95-, 100-, and 105-Hz current components, by multiple synchronous reference frame (MSRF) analysis, which was previously proposed to decompose EAF current interharmonics and harmonics in real-time. By summing up this digital data of the second harmonic subgroup, the reference current signal for the APF system is produced in real-time. A detailed model of the APF system is then run on EMTDC/PSCAD to follow the produced reference current signal according to hysteresis band control philosophy. The simulation results show that the proposed APF system can successfully suppress the second harmonic subgroup of an AC EAF

Determining Total Phenolics, Anthocyanin Content and Ascorbic Acid Content in Some Plum Genotypes Grown in Ardahan Ecological Conditions

In this study, total phenol content, total anthocyanin content, brix, pH, titrable acidity and total ascorbic acid content in the five plum genotypes cultivated in Ardahan City are determined and sustenance of the plums are revealed. Total phenol content was determined with folin-ciocalteu’s method, total anthocyanin content was determined with pH differential method and total ascorbic acid was determined with 2,6-dichlorophenolindophenol method.It is detected that the genotype with the highest brix content (%13.9) and lowest acidity (%0.98) is cancur, the genotype with the lowest brix content (%11) and highest acidity (%2.06) is wild plum, the genotype with the highest content of total anthocyanin, total phenolic substance and ascorbic acid is the wild plum and the genotype with the least content of these is the water plum. As a result of the study, it is revealed that the plum fruit has high levels of phenolic substance, anthocyanin and ascorbic acid content, so it has a high sustenance.</p

Determining Total Phenolics, Anthocyanin Content and Ascorbic Acid Content in Some Plum Genotypes Grown in Ardahan Ecological Conditions

In this study, total phenol content, total anthocyanin content, brix, pH, titrable acidity and total ascorbic acid content in the five plum genotypes cultivated in Ardahan City are determined and sustenance of the plums are revealed. Total phenol content was determined with folin-ciocalteu’s method, total anthocyanin content was determined with pH differential method and total ascorbic acid was determined with 2,6-dichlorophenolindophenol method.It is detected that the genotype with the highest brix content (%13.9) and lowest acidity (%0.98) is cancur, the genotype with the lowest brix content (%11) and highest acidity (%2.06) is wild plum, the genotype with the highest content of total anthocyanin, total phenolic substance and ascorbic acid is the wild plum and the genotype with the least content of these is the water plum. As a result of the study, it is revealed that the plum fruit has high levels of phenolic substance, anthocyanin and ascorbic acid content, so it has a high sustenance

Comparison of initial efficacy and long-term follow-up of heparin-coated Jostent with conventional NIR stent.

The implantation of heparin-coated stents was reported to be well tolerated, but there are conflicting results about acute in-hospital complications. (sub)acute thrombosis rates, and long-term follow-up compared to uncoated stents. We compared the angiographic and clinical results after coronary placement of two stent models: the heparin-coated premounted Jostent and the uncoated premounted NIR stent. Of 710 patients revascularized, a total of 426 patients received Jostent (n = 230) or NIR stent (n = 196) implantation. The primary end points were acute or subacute thrombosis, urgent CABG, AMI or death, while the secondary end points were the comparison of the restenosis rates of the stents at the 6th month and of the functional angina classification of the stent groups at the 1st, 6th and 12th months. There were no significant differences between the Jostent and NIR stent groups regarding angiographic and procedural success. Acute thrombosis rates in the Jostent and NIR stent groups were similar while no subacute thrombosis was observed in either group. The major adverse cardiac event rates of the groups also did not differ. Angiographic restenosis occurred in 17% of the Jostent group and 16% of the NIR stent group (NS). The combined clinical and angiographic restenosis rate was also similar between the Jo and NIR groups (19% and 18%, respectively). Comparison of functional angina classes at the 1st, 6th and 12th months revealed no significant difference between the study groups. In conclusion, when compared with implantation of an uncoated premounted NIR stent, implantation of a heparin-coated premounted Jostent does not provide any more benefit with respect to initial efficacy, sub(acute) thrombosis and 6-month restenosis rates and 12-month clinical outcomes